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Background <p>Different multimorbidity patterns can affect health trajectories and influence survival.</p> Aims <p>We investigated their association with mortality in two population-based cohorts of older adults.</p> Methods <p>Two Italian cohorts of randomly selected individuals (60–79 years old) from general population: CUORE (baseline 2008–2012) and Moli-sani (baseline 2005–2010). Latent Class Analysis used to identify homogeneous groups of multimorbid individuals (≥ 2 diseases) with similar underlying disease patterns. Cox regression models used to assess the association of multimorbidity patterns and all-cause mortality (end of follow-up 12/31/2019). Results pooled in a random-effects meta-analysis.</p> Results <p>Total samples of 3,695 individuals in CUORE (48% male, mean age 68.8 years [SD 5.6]) and 7,801 in Moli-sani (51% male, mean age 68.2 years [SD 5.4]). In both cohorts, six multimorbidity patterns were identified and named after their overexpressed diseases: <i>hypercholesterolemia; metabolic</i>,<i> depression and cancer; cardiometabolic and respiratory; gastrointestinal</i>,<i> genitourinary and depression; respiratory; unspecific</i> (i.e., no diseases overexpressed). Overall mortality rates were 1.66 per 100 person/years in CUORE and 1.85 per 100 person/years in Moli-sani. Compared to the multimorbidity-free group (&lt; 2 diseases), individuals displaying a <i>cardiometabolic and respiratory</i> pattern showed the highest mortality (pooled HR 2.62, 95% CI 2.15–3.10), followed by <i>unspecific</i> (pooled HR 1.45, 95% CI 1.21–1.68), <i>respiratory</i> (pooled HR 1.33, 95% CI 1.01–1.64) and <i>gastrointestinal</i>,<i> genitourinary and depression</i> (pooled HR 1.33, 95% CI 1.06–1.60).</p> Discussion <p>Multimorbidity patterns in older adults are differentially associated to shorter survival.</p> Conclusions <p>Their identification may help optimize clinical management by improving risk stratification, allowing for more targeted prevention and intervention strategies.</p>

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Multimorbidity patterns and mortality in older adults: a two-cohort pooled analysis

  • 期刊论文

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  • 发表日期：

    2025年8月20日

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  • Cecilia Damiano,
  • Simona Costanzo,
  • Benedetta Marcozzi,
  • Teresa Panzera,
  • Chiara Donfrancesco,
  • Augusto Di Castelnuovo,
  • Cinzia Lo Noce,
  • Sara Magnacca,
  • Federico Triolo,
  • Maria Beatrice Zazzara,
  • Luigi Palmieri,
  • Licia Iacoviello,
  • Graziano Onder,
  • Davide Liborio Vetrano

摘要

Background

Different multimorbidity patterns can affect health trajectories and influence survival.

Aims

We investigated their association with mortality in two population-based cohorts of older adults.

Methods

Two Italian cohorts of randomly selected individuals (60–79 years old) from general population: CUORE (baseline 2008–2012) and Moli-sani (baseline 2005–2010). Latent Class Analysis used to identify homogeneous groups of multimorbid individuals (≥ 2 diseases) with similar underlying disease patterns. Cox regression models used to assess the association of multimorbidity patterns and all-cause mortality (end of follow-up 12/31/2019). Results pooled in a random-effects meta-analysis.

Results

Total samples of 3,695 individuals in CUORE (48% male, mean age 68.8 years [SD 5.6]) and 7,801 in Moli-sani (51% male, mean age 68.2 years [SD 5.4]). In both cohorts, six multimorbidity patterns were identified and named after their overexpressed diseases: hypercholesterolemia; metabolic, depression and cancer; cardiometabolic and respiratory; gastrointestinal, genitourinary and depression; respiratory; unspecific (i.e., no diseases overexpressed). Overall mortality rates were 1.66 per 100 person/years in CUORE and 1.85 per 100 person/years in Moli-sani. Compared to the multimorbidity-free group (< 2 diseases), individuals displaying a cardiometabolic and respiratory pattern showed the highest mortality (pooled HR 2.62, 95% CI 2.15–3.10), followed by unspecific (pooled HR 1.45, 95% CI 1.21–1.68), respiratory (pooled HR 1.33, 95% CI 1.01–1.64) and gastrointestinal, genitourinary and depression (pooled HR 1.33, 95% CI 1.06–1.60).

Discussion

Multimorbidity patterns in older adults are differentially associated to shorter survival.

Conclusions

Their identification may help optimize clinical management by improving risk stratification, allowing for more targeted prevention and intervention strategies.