Synergistic Interactions of Midlife Multimorbidity on Dementia： A Stratified Analysis by Neuropsychiatric Subtypes
Abstract
Abstract Background This study examined whether individual chronic conditions, disease combinations, and disease-disease interactions were associated with suspected dementia and its neuropsychiatric symptom profiles. Methods This cross-section study included adults aged 60 years or older from three districts in Nantong, China. Suspected dementia was identified using the Revised Hasegawa Dementia Scale. Six somatic comorbidities were assessed from reported medical history, and neuropsychiatric symptoms were evaluated using the Neuropsychiatric Inventory Questionnaire. Multiple imputation was used for missing covariate data. Logistic regression and Firth penalized logistic regression were used to estimate associations for single diseases, two- and three disease combinations, and interaction terms. Latent class analysis was performed among participants with suspected dementia and complete neuropsychiatric symptom data. Results Among 2,597 participants, 591 were classified as having suspected dementia. After full adjustment, multimorbidity patterns showed stronger associations than individual diseases. The leading two-disease combinations were diabetes with oral disease (aOR = 4.28), osteoporosis with ear disease (aOR = 3.13), ear disease with oral disease (aOR = 2.88), and diabetes with osteoporosis (aOR = 2.50). The strongest three-disease patterns were diabetes with eye disease and oral disease (aOR = 4.22), diabetes with ear disease and oral disease (aOR = 3.51), and…
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