Physical-psychological-cognitive multimorbidity: a narrative review

Area of Science:

• Gerontology
• Public Health
• Clinical Medicine

Background:

• Physical-psychological-cognitive multimorbidity (PPC-MM) is a distinct phenotype in older adults.
• PPC-MM involves the coexistence of chronic physical conditions, psychological disorders, and cognitive impairment.
• The combined impact of these three domains may be greater than individual conditions.

Purpose of the Study:

• To delineate operational definitions of PPC-MM across major cohort studies.
• To summarize global epidemiological characteristics of PPC-MM.
• To synthesize evidence on multi-level risk factors associated with PPC-MM.

Main Methods:

• Review of major cohort studies to define PPC-MM operationally.
• Analysis of epidemiological data to determine global prevalence.
• Synthesis of research on risk factors, including socioeconomic status and adverse childhood experiences.

Main Results:

• PPC-MM prevalence varies globally, with higher rates in Chinese older adults (5.8%–17.2%) compared to European/American populations (1.2%–4.3%).
• Key risk factors include low socioeconomic status, adverse childhood experiences, and circadian syndrome.
• Potential mechanisms involve HPA axis dysregulation, inflammaging, and loneliness.

Conclusions:

• PPC-MM is a complex condition influenced by social, psychological, behavioral, and biological factors.
• Integrated care, utilizing comprehensive geriatric assessment, is a potential management strategy.
• This approach may help delay functional decline and enhance the quality of life for affected older adults.