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Twelve-year clinical trajectories of multimorbidity in a population of older adults

Author

Listed:
  • Davide L. Vetrano

    (Karolinska Institutet and Stockholm University
    Fondazione Policlinico Universitario “A. Gemelli” IRCCS, and Università Cattolica del Sacro Cuore)

  • Albert Roso-Llorach

    (Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol)
    Universitat Autònoma de Barcelona)

  • Sergio Fernández

    (Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol)
    Universitat Autònoma de Barcelona)

  • Marina Guisado-Clavero

    (Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol)
    Universitat Autònoma de Barcelona)

  • Concepción Violán

    (Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol)
    Universitat Autònoma de Barcelona)

  • Graziano Onder

    (Istituto Superiore di Sanità, Via Giano della Bella 34)

  • Laura Fratiglioni

    (Karolinska Institutet and Stockholm University
    Stockholm Gerontology Research Center)

  • Amaia Calderón-Larrañaga

    (Karolinska Institutet and Stockholm University)

  • Alessandra Marengoni

    (Karolinska Institutet and Stockholm University
    University of Brescia)

Abstract

Multimorbidity—the co-occurrence of multiple diseases—is associated to poor prognosis, but the scarce knowledge of its development over time hampers the effectiveness of clinical interventions. Here we identify multimorbidity clusters, trace their evolution in older adults, and detect the clinical trajectories and mortality of single individuals as they move among clusters over 12 years. By means of a fuzzy c-means cluster algorithm, we group 2931 people ≥60 years in five clinically meaningful multimorbidity clusters (52%). The remaining 48% are part of an unspecific cluster (i.e. none of the diseases are overrepresented), which greatly fuels other clusters at follow-ups. Clusters contribute differentially to the longitudinal development of other clusters and to mortality. We report that multimorbidity clusters and their trajectories may help identifying homogeneous groups of people with similar needs and prognosis, and assisting clinicians and health care systems in the personalization of clinical interventions and preventive strategies.

Suggested Citation

  • Davide L. Vetrano & Albert Roso-Llorach & Sergio Fernández & Marina Guisado-Clavero & Concepción Violán & Graziano Onder & Laura Fratiglioni & Amaia Calderón-Larrañaga & Alessandra Marengoni, 2020. "Twelve-year clinical trajectories of multimorbidity in a population of older adults," Nature Communications, Nature, vol. 11(1), pages 1-9, December.
    • Handle: RePEc:nat:natcom:v:11:y:2020:i:1:d:10.1038_s41467-020-16780-x
    DOI: 10.1038/s41467-020-16780-x
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    Cited by:

    1. Javier Alvarez-Galvez & Esther Ortega-Martin & Begoña Ramos-Fiol & Victor Suarez-Lledo & Jesus Carretero-Bravo, 2023. "Epidemiology, mortality, and health service use of local-level multimorbidity patterns in South Spain," Nature Communications, Nature, vol. 14(1), pages 1-16, December.

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