Multimorbidity patterns and risk of frailty in older community-dwelling adults: a population-based cohort study

Abstract

Background the aim of this study was to examine the cross-sectional and longitudinal associations of different multimorbidity patterns with physical frailty in older adults. Methods we used data from the Swedish National study on Aging and Care in Kungsholmen to generate a physical frailty measure, and clusters of participants with similar multimorbidity patterns were identified through fuzzy c-means cluster analyses. The cross-sectional association (n = 2,534) between multimorbidity clusters and physical frailty was measured through logistic regression analyses. Six- (n = 2,122) and 12-year (n = 2,140) longitudinal associations were determined through multinomial logistic regression analyses. Results six multimorbidity patterns were identified at baseline: psychiatric diseases; cardiovascular diseases, anaemia and dementia; sensory impairments and cancer; metabolic and sleep disorders; musculoskeletal, respiratory and gastrointestinal diseases; and an unspecific pattern lacking any overrepresented diseases. Cross-sectionally, each pattern was associated with physical frailty compared with the unspecific pattern. Over 6 years, the psychiatric diseases (relative risk ratio [RRR]: 3.04; 95% confidence intervals [CI]: 1.59–5.79); cardiovascular diseases, anaemia and dementia (RRR 2.25; 95% CI: 1.13–4.49) and metabolic and sleep disorders (RRR 1.99; 95% CI: 1.25–3.16) patterns were associated with incident physical frailty. The cardiovascular diseases, anaemia and dementia (RRR: 4.81; 95% CI: 1.59–14.60); psychiatric diseases (RRR 2.62; 95% CI: 1.45–4.72) and sensory impairments and cancer (RRR 1.87; 95% CI: 1.05–3.35) patterns were more associated with physical frailty, compared with the unspecific pattern, over 12 years. Conclusions we found that older adults with multimorbidity characterised by cardiovascular and neuropsychiatric disease patterns are most susceptible to developing physical frailty.

Body mass trajectories and multimorbidity in old age: 12-year results from a population-based study

“…Interestingly, it has been observed that unintentional weight loss involves mostly subcutaneous fat, leaving the abdominal fat, which is metabolically active in increasing inflammation and cardiovascular risk, more intact [43]. Older people affected by multimorbidity patterns conformed by neuropsychiatric diseases have an increased risk of incident frailty, mainly due to their detrimental impact on their nutritional status, fatigue, engagement in physical activity, and muscle fitness [44]. Previous research from our group has also shown that cardiovascular and, even more prominently, neuropsychiatric multimorbidity have a clear impact on functional decline and disability [21].…”

Frailty, multimorbidity patterns and mortality in institutionalized older adults in Italy

“…Different multimorbidity patterns, characterized by the combination of cardiovascular, pulmonary, and neuropsychiatric diseases, have been defined [4]. These patterns are differentially associated with health outcomes, confirming that the effects of multimorbidity are strictly dependent on the underlying diseases combinations [5,6].…”

Social inequalities in multimorbidity patterns in Europe: A multilevel latent class analysis using the European Social Survey (ESS)

“…Classification is associated with unobserved groups of individuals called latent classes. This technique has often been used to identify multimorbidity patterns and their association with social determinants ( Jacob et al, 2020 ; Tazzeo et al, 2021 ; Zhu et al, 2020 ).…”