{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:15:43Z","timestamp":1760058943785,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001321","name":"Subcommittee C of the Research Committee, Stellenbosch University","doi-asserted-by":"publisher","award":["129853","115461"],"award-info":[{"award-number":["129853","115461"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Research Foundation of South Africa","award":["129853","115461"],"award-info":[{"award-number":["129853","115461"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Multimorbidity poses significant challenges for resource-constrained healthcare systems, particularly in low and middle income countries where specific combinations of chronic conditions may differentially impact function. This cross-sectional study examined multimorbidity patterns and associations with functioning among 165 adults attending semi-rural primary healthcare facilities in South Africa. Participants completed performance-based measures (handgrip strength, five-times sit-to-stand test, step test and exercise prescription tool [STEP] maximum oxygen consumption) and self-reported function (12-item WHODAS 2.0). Exploratory factor analysis identified three multimorbidity patterns: HIV-hypercholesterolaemia-obesity (Pattern 1), hypertension-anaemia-lung disease (Pattern 2), and stroke-heart disease-hypercholesterolaemia (Pattern 3). Pattern 1 was associated with reduced aerobic capacity (\u03b2 = \u22126.41, 95% CI: \u22129.45, \u22123.36) and grip strength (\u03b2 = \u22120.11, 95% CI: \u22120.14, \u22120.07). Pattern 2 showed associations with mild (\u03b2 = 1.12, 95% CI: 0.28, 1.97) and moderate (\u03b2 = 1.48, 95% CI: 0.53, 2.43) self-reported functional problems and reduced grip strength (\u03b2 = \u22120.05, 95% CI: \u22120.09, \u22120.003). Pattern 3 was associated with all self-reported impairment levels, with the strongest association for severe impairment (\u03b2 = 2.16, 95% CI: 0.32, 4.01). These findings highlight the convergence of infectious and non-communicable diseases in this setting. Simple clinical measures like grip strength and self-reported function may hold potential as screening or monitoring tools in the presence of disease patterns, warranting further research.<\/jats:p>","DOI":"10.3390\/ijerph22050780","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T10:27:41Z","timestamp":1747218461000},"page":"780","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Multimorbidity Patterns and Functioning Associations Among Adults in a Local South African Setting: A Cross-Sectional Study"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2255-371X","authenticated-orcid":false,"given":"Karina","family":"Berner","sequence":"first","affiliation":[{"name":"Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0171-588X","authenticated-orcid":false,"given":"Diribsa Tsegaye","family":"Bedada","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, University of Waterloo, P.O. Box 200, University Avenue West, Waterloo, ON N2L 3G1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3726-9153","authenticated-orcid":false,"given":"Hans","family":"Strijdom","sequence":"additional","affiliation":[{"name":"Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid","family":"Webster","sequence":"additional","affiliation":[{"name":"Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0238-0943","authenticated-orcid":false,"given":"Quinette","family":"Louw","sequence":"additional","affiliation":[{"name":"Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.arr.2017.05.003","article-title":"Evidence on multimorbidity from definition to intervention: An overview of systematic reviews","volume":"37","author":"Xu","year":"2017","journal-title":"Ageing Res. 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