Healthcare 2023, 11, 1906. https://doi.org/10.3390/healthcare11131906 www.mdpi.com/journal/healthcare Article The Multimorbidity and Lifestyle Correlates in Chinese Population Residing in Macau: Findings from a Community-Based Needs Assessment Study Qingling Yang 1 , Quanzhi Zhang 1,2 , Fei Wan Ngai 1 , Shaoling Wang 1 , Dexing Zhang 3 , Yang Gao 4 , Chun Hao 5 , Harry Haoxiang Wang 5,6 , Oi Ching Bernice Lam Nogueira 7 , Ming Liu 7 , Alex Molasiotis 8 , Alice Loke 1 and Yaojie Xie 1, * 1 School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China 2 School of Nursing, Harbin Medical University, Harbin 150088, China 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China 4 Department of Sport, Physical Education, and Health, Hong Kong Baptist University, Hong Kong SAR, China 5 School of Public Health, Sun Yat-sen University, Guangzhou 510080, China 6 College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh EH8 9AG, UK 7 School of Health Sciences and Sports, Macao Polytechnic Institute, Macao 999078, China 8 Health and Social Care Research Centre, University of Derby, Derby DE22 1GB, UK * Correspondence: grace.yj.xie@polyu.edu.hk; Tel.: +852-63135399 Abstract: Multimorbidity has become one of the most pressing public health concerns worldwide. The objectives of this study were to understand the prevalence of multimorbidity and its relation- ship with lifestyle factors among Chinese adults in Macau, and to investigate the combined contri- bution of common lifestyle factors in predicting multimorbidity. Data were collected through face- to-face interviews using a self-reported questionnaire on common chronic diseases, lifestyle factors and sociodemographics. BMI, physical activity, drinking status, smoking status and sleep quality were assessed, and a composite lifestyle score (0 to 9 points) was calculated, and the higher the score, the healthier the lifestyle. A total of 1443 participants were included in the analysis, of whom 55.2% were female, 51.8% were middle aged or elderly and 30.5% completed tertiary education or higher. The prevalence of multimorbidity was 10.3%. The combination of hypertension and hyper- lipidaemia was the most common (22.2%) multimorbidity among the participants with multimor- bidity. After the adjustment of the covariates, it was found that the participants who were over- weight (OR: 1.95, 95% CI: 1.18–3.20, p = 0.009) or obese (OR: 3.76, 95% CI: 2.38–5.96, p < 0.001), former drinkers (OR: 2.43, 95% CI: 1.26–4.69, p = 0.008), and those who reported poor sleep quality (OR: 2.25, 95% CI: 1.49–3.40, p < 0.001) had a high risk of developing multimorbidity. A one-unit increase in the lifestyle score was associated with a 0.33-times reduction in the risk of developing multimor- bidity (OR: 0.67; 95% CI: 0.59–0.77, p < 0.001). A combination of lifestyle factors can infuence a va- riety of multimorbidity among the Chinese adults in Macau. Thus, comprehensively assessing the combined contribution of several lifestyle factors in predicting multimorbidity is important. Keywords: multimorbidity; lifestyle; drinking; BMI; sleeping 1. Introduction Multimorbidity is defned as the coexistence of two or more chronic diseases in a single individual [1]. The prevalence of multimorbidity has grown worldwide in recent years, which has led to heavy disease burdens and high health costs globally [2]. In the United States, the prevalence of multimorbidity among the young population (aged 18– 44 years) ranges from 37.9% in the District of Columbia to 64.4% in West Virginia [3]. A Citation: Yang, Q.; Zhang, Q.; Ngai, F.W.; Wang, S.; Zhang, D.; Gao, Y.; Hao, C.; Wang, H.H.; Nogueira, O.C.B.L.; Liu, M.; et al. The Multimorbidity and Lifestyle Correlates in Chinese Population Residing in Macau: Findings from a Community-Based Needs Assessment Study. Healthcare 2023, 11, 1906. htps://doi.org/10.3390/ healthcare11131906 Academic Editor: João Paulo Brito Received: 15 May 2023 Revised: 19 June 2023 Accepted: 29 June 2023 Published: 30 June 2023 Copyright: © 2023 by the authors. Li- censee MDPI, Basel, Switerland. This article is an open access article distributed under the terms and con- ditions of the Creative Commons At- tribution (CC BY) license (htps://cre- ativecommons.org/licenses/by/4.0/).