Taining Golden Lake Comprehensive Chronic Disease Management Initiative

China is undergoing rapid population aging, with chronic non-communicable diseases (NCDs) becoming the leading cause of death and disability. Taining County, located in a mountainous area of Fujian Province, faces a higher-than-average aging population and a growing burden of hypertension, diabetes, dyslipidemia, and cardiovascular diseases. Early detection and standardized management remain insufficient, and healthcare resources are limited. This study will establish a prospective cohort covering ≥20,000 residents, integrating demographic, lifestyle, clinical, laboratory, and imaging data. Active follow-up will be conducted annually, complemented by passive follow-up through local healthcare and death registry systems. The study will (1) identify epidemiological features and risk factors of common chronic diseases, (2) explore multimorbidity and aging trajectories, and (3) develop a replicable "Taining Model" for chronic disease prevention and management at the county level. The results will provide an evidence base for public health decision-making and chronic disease control strategies in similar rural and mountainous regions.

Inclusion criteria

• Age ≥18 years, male or female.
• Resident of Taining County for ≥6 months and expected to remain in the county for at least the next 3 years.
• Full civil capacity and able to understand study procedures.
• Willing to voluntarily participate and provide written informed consent.
• Able to complete baseline survey and follow-up visits.

Exclusion criteria

• Refusal to sign informed consent.
• Severe psychiatric disorders or cognitive impairment preventing participation.
• End-stage disease with expected survival <1 year.
• Long-term migrants (≥6 months per year outside the county), unable to guarantee follow-up.
• Participation in other clinical studies that may interfere with this research.