{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:59:35Z","timestamp":1792511975551,"version":"4.5.0"},"reference-count":87,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Population aging has led to a rising prevalence of multimorbidity among older adults, posing a significant global public health challenge. This study aims to comprehensively integrate the evidence regarding the prevalence of multimorbidity among the older adults and the influencing factors through a systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research question was structured using the PICOS framework:\n                      <jats:bold>P<\/jats:bold>\n                      opulation: adults aged \u226560 or \u226565;\n                      <jats:bold>I<\/jats:bold>\n                      ntervention\/Phenomenon of Interest: multimorbidity (\u22652 chronic conditions);\n                      <jats:bold>C<\/jats:bold>\n                      omparator: not applicable (prevalence synthesis) or various demographic groups (risk factor analysis);\n                      <jats:bold>O<\/jats:bold>\n                      utcomes: prevalence of multimorbidity and pooled odds ratios (OR) of risk factors;\n                      <jats:bold>S<\/jats:bold>\n                      tudy design: cross-sectional studies. We conducted a comprehensive search of multiple databases up to July 2025 to identify cross-sectional studies that reported the prevalence and\/or risk factors of multimorbidity (defined as \u22652 chronic conditions) in adults aged \u226560 or \u226565. The pooled prevalence was estimated using a random-effects model, and heterogeneity was explored through subgroup analysis and meta-regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-nine studies involving 729,043 older adults were included. The global pooled prevalence of multimorbidity was 46.0% (95% CI: 38.0%\u221255.0%), with substantial heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 99.98%). Meta-regression identified survey location as a key source of heterogeneity. Subgroup analyses revealed a higher prevalence in females (48%) than males (41%) and a lower prevalence in studies from China (40%) compared to other countries (53%). Significant risk factors included age \u2265 70 years (OR = 1.43), female sex (OR = 1.59), BMI \u2265 28 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (OR = 1.97), low education (OR = 1.44), single status (OR = 1.32), and low income (OR = 1.46).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multimorbidity is highly prevalent among the global older adults, with significant geographical and demographic variations. Modifiable risk factors such as obesity, low education, and low income are crucial targets for intervention to alleviate the burden of multimorbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1680745","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T05:19:34Z","timestamp":1765430374000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":34,"title":["About half of older adults have two or more chronic conditions at the same time: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Xianshang","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengrui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zong","family":"Ning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2253","DOI":"10.18502\/ijph.v51i10.10983","article-title":"Effects of 24-form Tai Chi on cardio-pulmonary functions, exercise performances, and cognitive functions of the aged","volume":"51","author":"Guo","year":"2022","journal-title":"Iran J Public Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.1016\/S0140-6736(15)00516-4","article-title":"The world report on ageing and health: a policy framework for healthy ageing","volume":"387","author":"Beard","year":"2016","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1186\/s12889-019-6465-2","article-title":"Spatiotemporal evolution of global population ageing from 1960 to 2017","volume":"19","author":"Li","year":"2019","journal-title":"BMC Public Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"14653","DOI":"10.1038\/s41598-021-94318-x","article-title":"Association of self-rated health with chronic disease, mental health symptom and social relationship in older people","volume":"11","author":"Yang","year":"2021","journal-title":"Sci Rep."},{"key":"B5","unstructured":"?2008\n          The World Health Report 2008: Primary Health Care now More Than Ever"},{"key":"B6","doi-asserted-by":"publisher","first-page":"409","DOI":"10.2147\/RMHP.S239074","article-title":"Strengthening primary health-care services to help prevent and control long-term (chronic) non-communicable diseases in low- and middle-income countries","volume":"13","author":"Haque","year":"2020","journal-title":"Risk Manag Health Policy."},{"key":"B7","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.maturitas.2020.04.016","article-title":"Multimorbidity in a cohort of middle-aged women: risk factors and disease clustering","volume":"137","author":"Bl\u00fcmel","year":"2020","journal-title":"Maturitas."},{"key":"B8","doi-asserted-by":"publisher","first-page":"760792","DOI":"10.3389\/fpubh.2021.760792","article-title":"Multimorbidity in hospitalized patients admitted to general practice departments and its implications for the general practice healthcare system: a four-year longitudinal study in China","volume":"9","author":"Zhou","year":"2021","journal-title":"Front Public Health."},{"key":"B9","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1186\/s12877-024-04956-9","article-title":"Factors associated with the level of self-management in elderly patients with chronic diseases: a pathway analysis","volume":"24","author":"Cong","year":"2024","journal-title":"BMC Geriatr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e057017","DOI":"10.1136\/bmjopen-2021-057017","article-title":"Variation in the estimated prevalence of multimorbidity: systematic review and meta-analysis of 193 international studies","volume":"12","author":"Ho","year":"2022","journal-title":"BMJ Open."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e287","DOI":"10.1016\/S2666-7568(24)00007-2","article-title":"Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review","volume":"5","author":"Nicholson","year":"2024","journal-title":"Lancet Healthy Longev."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e048676","DOI":"10.1136\/bmjopen-2021-048676","article-title":"Pillay-van Wyk V. 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