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Multimorbidity Indices in Adults: A Systematic Review of Data Frameworks, Weighting Methods, and Applications
Claire Hui-Yu Tsai1, Shu-Sen Chang2, Toby Kai- Bo Shen3
1Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
Archives of Gerontology and Geriatrics
|April 18, 2026
Summary
Multimorbidity indices vary widely, impacting clinical care and policy. This review synthesizes evidence on their development and predictive performance, highlighting a need for standardized, inclusive approaches.
Area of Science:
- Health Services Research
- Epidemiology
- Gerontology
Background:
- Understanding multimorbidity burden is crucial for clinical care and policy.
- Numerous multimorbidity indices exist, but with varied designs and applications.
- This review synthesizes evidence on multimorbidity index development and predictive utility.
Purpose of the Study:
- To systematically review the development and use of multimorbidity indices.
- To evaluate the predictive performance of these indices for clinical outcomes and health service use.
Main Methods:
- Systematic search of PubMed, Web of Science, and Scopus (2000-2025).
- Included studies on adults with ≥2 chronic conditions using index-based prediction.
- Extracted data on study design, population, index variables, methods, and validation.
Main Results:
- 63 studies identified, primarily from the US, UK, and Canada.
- Indices commonly predict health status, mortality, and healthcare use.
- Charlson Comorbidity Index (CCI), Multimorbidity-Weighted Index (MWI), and CIRS were frequent; few included mental health.
- Validation metrics (C-statistics) ranged from 0.66 to 0.931; 43% validated existing indices.
Conclusions:
- Multimorbidity indices show gaps in scope and consistency, particularly regarding mental health.
- Standardized reporting is lacking, hindering broader adoption.
- Indices are valuable for system planning and risk stratification but require refinement.
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