Long-term high-altitude residence is associated with a progressively elevated risk of self-reported…

Cohort studyInternational journal of environmental health research· Jul 2026

Long-term high-altitude residence is associated with a progressively elevated risk of self-reported multimorbidity: evidence from the CHARLS.

Yizhan Wu, Jiangwei Liu

Multimorbidity & PolypharmacyCohort studyPrognosisQ2IF 2.6

High-altitude residence linked to 53.8% higher risk of new multimorbidity

Long-term high-altitude residence is associated with a progressively elevated risk of self-reported multimorbidity: evidence from the CHARLS.

Yizhan Wu, Jiangwei Liu

International journal of environmental health research · Jul 2026 · Q2 in General Medicine

Background

High-altitude residence affects approximately 503 million people worldwide, yet its longitudinal impact on multimorbidity (coexistence of two or more self-reported, physician-diagnosed chronic conditions) remains poorly understood.

Methods

Using four waves (2011-2018) of the China Health and Retirement Longitudinal Study (China Health and Retirement Longitudinal Study), we examined 8,121 adults aged ≥45 years from prefectures classified as high altitude (≥1,500 m) or low altitude (<1,500 m).

n = 8,121 adults

Results

high-altitude living raises the odds of developing multiple chronic conditions

HR 1.54 (95% CI 1.34 to 1.76)

CI excludes the null - significant

More results

Generalized estimating equations (generalized estimating equations) revealed a significant altitude-by-time interaction (odds ratio [OR]=1.033, 95% confidence interval [CI]: 1.006-1.060, P = 0.014), indicating a progressively faster rise in multimorbidity prevalence at high altitude over follow-up.

More results

The association was consistent across all eight subgroups and multiple sensitivity analyses (HR range: 1.432-1.523).

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Conclusion

High altitude should be incorporated into chronic-disease risk assessment, and prevention policies in high-altitude regions should prioritize multimorbidity, emphasizing sustained monitoring of long-term residents.

Long-term high-altitude residence is associated with a progressively elevated risk of self-reported multimorbidity: evidence from the CHARLS.

Long-term high-altitude residence is associated with a progressively elevated risk of self-reported multimorbidity: evidence from the CHARLS.

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