FOCUS – Counting Illnesses Isn’t Enough to Assess Risk in Older Adults

Diabetes, cardiovascular disease, respiratory disorders, depression, arthritis, osteoporosis and other chronic conditions are common in advanced age, writes salute.eu.

Having two or more chronic conditions in the same person, known as multimorbidity, is one of the main challenges of modern geriatrics.

But according to a study published in the international journal Nature Aging by researchers at the Faculty of Medicine and Surgery of the Catholic University of the Sacred Heart, the number of diseases isn’t enough to determine the clinical risk of a frail older adult.

Equally important is how these conditions combine and interact with one another.

Researchers identified four multimorbidity patterns: the unspecific, respiratory, psychiatric and cardiometabolic patterns.

The analysis showed the benefit of preventive interventions was particularly pronounced in people with psychiatric and unspecific profiles.

The study included about 1,200 people aged 70 and older who were physically frail, had sarcopenia and at least two chronic conditions.

The data came from the Sprintt Project, one of the major European clinical studies on physical frailty and sarcopenia in older people.

The project, launched in 2016, aimed to evaluate the effectiveness of a combined intervention that included physical activity, technological support and nutritional counseling, with the goal of reducing the risk of motor disability.

According to researcher Emanuele Marzetti, the results show that preventing disability in frail older people must become increasingly personalized.

Two people with the same number of chronic conditions can have different clinical needs and different responses to treatment, depending on the type of conditions and how they interact with one another.

For this reason, classifying older people by multimorbidity profiles could help guide preventive and rehabilitative strategies more accurately.

Prevention

According to Francesco Landi, professor of Internal Medicine at the Catholic University of the Sacred Heart and director of the Department of Aging, Orthopedics and Rheumatology at Fondazione Policlinico Universitario Agostino Gemelli IRCCS, longevity should not turn into a waiting period for physical frailty.

He stresses the importance of prevention from younger ages, protecting older people’s mobility and physical function.

The study’s key message, the researchers say, is that counting chronic illnesses isn’t enough. To prevent disability, physical function must also be assessed, the ability to move preserved, and action taken before frailty progresses into disability.