Multimorbidity patterns and 15-year trajectories of physical performance: a population-based study

Area of Science:

• Gerontology
• Epidemiology
• Public Health

Background:

• Chronic diseases significantly impact physical function in older adults.
• Understanding how specific disease combinations affect physical performance trajectories is crucial.
• This study investigates multimorbidity patterns and their association with 15-year physical performance changes.

Purpose of the Study:

• To explore the association between distinct multimorbidity patterns and long-term physical performance changes.
• To identify if different combinations of chronic diseases predict varying rates of physical decline.
• To inform targeted strategies for preserving physical function in aging populations.

Main Methods:

• Longitudinal analysis of 3112 dementia-free older adults (aged 60+) over 15 years.
• Physical performance assessed via walking speed and chair-stand tests, combined into an overall measure.
• Latent class analysis identified multimorbidity patterns; linear mixed models assessed performance changes over time.

Main Results:

• Four distinct multimorbidity patterns were identified: psychiatric/respiratory/musculoskeletal, anemia/sensory impairment, cardiometabolic/inflammatory, and unspecific.
• All identified multimorbidity patterns were associated with faster annual declines in physical performance compared to no/single disease.
• The cardiometabolic & inflammatory pattern exhibited the steepest decline (β*time = -0.066), followed by anemia & sensory impairment (β*time = -0.043).

Conclusions:

• Multimorbidity patterns are differentially linked to the rate of physical performance decline in older adults.
• The cardiometabolic & inflammatory pattern is most strongly associated with a rapid decrease in physical function.
• Identifying specific multimorbidity patterns can guide personalized interventions to maintain physical function in aging individuals.