Stomach disease as a terminal node in comorbidity networks among middle-aged and older adults: An integrated analysis of network topology and risk factors

Abstract

Background: Stomach disease is highly prevalent among middle-aged and older adults and often coexists with other chronic conditions, yet its comorbidity patterns remain unclear. This cross-sectional study aimed to construct a comorbidity network for stomach disease and identify its key associated factors using data from the China Health and Retirement Longitudinal Study (CHARLS, 2008-2020). Methods: A total of 19,541 participants were included. Data on 18 demographic variables and 14 chronic diseases were collected. Disease network analysis, extended Bayesian information criterion graphical least absolute shrinkage and selection operator (LASSO), the LASSO regression, and logistic regression were employed to examine network topology and factors associated with stomach disease. Results: A total of 19,541 unique participants were included. Among them, 26.17% (5,114/19,541) had stomach disease. Disease network analysis and regression analysis revealed significant, stable relationships among the included diseases. Nine diseases, including arthritis, dyslipidemia, and heart disease, were identified as independent factors associated with stomach disease. Among demographic characteristics, nine indicators, such as age, male sex, and current alcohol consumption, were independently associated with stomach disease (p < 0.05). Conclusion: Our study reveals that stomach disease in middle-aged and older adults primarily functions as a “terminal” phenomenon. It is statistically associated with core diseases within the network. Stomach disease is independently associated with multiple chronic conditions, such as arthritis, heart disease, and liver diseases, as well as factors like rural residence. These associations should be interpreted as statistical correlations rather than causal relationships, given the cross-sectional design. Relevance for patients: Stomach disease in older adults often reflects broader chronic disease burdens, warranting holistic rather than symptom-only management.

Keywords

Stomach disease / Middle-aged and older adults / CHARLS / Disease network analysis

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