Clinical Epidemiology and Global Health · Oct 28, 2026
Connected patterns among non-communicable chronic disease comorbidities in community-dwelling older people in the state of Alagoas, Brazil
By Santos JRL, Bádue GS, Ribeiro-Andrade M et al.
Objective To explore the connected patterns among non-communicable chronic diseases (NCDs) in community-dwelling older people. Methods Cross-sectional study conducted using an analytical subsample derived from the 1st Alagoas Survey on Health, Nutrition, and Quality of Life of Older People, a population-based parent study that employed a multistage probability sampling strategy. Participants aged ≥ 60 years, residing in Alagoas were included, regardless of whether they had a previous NCD diagnosis. To assess disease interconnectivity, statistical significance (p < 0.05) and co-occurrence [observed-to-expected ratio (OER) > 1.00] were applied. Results Of the 905 participants, 66.5% were women (n = 602), and 20.3% (n = 184) were long-lived, with 32.0% (n = 234) reporting a monthly income of up to one minimum wage and 26.1% (n = 227) polypharmacy. The prevalence of comorbidities was 62.9% (n = 569). Among NCDs, hypertension (n = 623; 68.8%) and bone diseases (n = 345; 38.1%) were most frequent. Twelve disease pairs met the complex network criterion. Cardiovascular and bone diseases had five direct connections, with the strongest associations observed for renal disease (OER = 2.28) and pulmonary disease (OER = 1.63). The network comprised a cohesive, highly connected community with several closed triples. Conclusion The findings corroborate the cardiovascular and metabolic risk among older people in Alagoas and underscore the need to reorganize health care and services, prioritizing the patterns observed in the community.