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Patterns of chronic multimorbidity in the elderly population
Marengoni A, Rizzuto D, Wang HX, Winblad B, Fratiglioni L.. Journal of the American Geriatrics Society, 2009-02-01
Topic: Risk, prevention and care in population studies
Objectives To describe patterns of comorbidity and multimorbidity in elderly people. Design A community-based survey. Setting Data were gathered from the Kungsholmen Project, a urban, community-based prospective cohort in Sweden. Participants Adults aged 77 and older living in the community and in institutions of the geographically defined Kungsholmen area of Stockholm (N=1,099). Measurements Diagnoses based on physicians' examinations and supported by hospital records, drug use, and blood samples. Patterns of comorbidity and multimorbidity were evaluated using four analytical approaches: prevalence figures, conditional count, logistic regression models, and cluster analysis. Results Visual impairments and heart failure were the diseases with the highest comorbidity (mean 2.9 and 2.6 co-occurring conditions, respectively), whereas dementia had the lowest (mean 1.4 comorbidities). Heart failure occurred rarely without any comorbidity (0.4%). The observed prevalence of comorbid pairs of conditions exceeded the expected prevalence for several circulatory diseases and for dementia and depression. Logistic regression analyses detected similar comorbid pairs. The cluster analysis revealed five clusters. Two clusters included vascular conditions (circulatory and cardiopulmonary clusters), and another included mental diseases along with musculoskeletal disorders. The last two clusters included only one major disease each (diabetes mellitus and malignancy) together with their most common consequences (visual impairment and anemia, respectively). Conclusion In persons with multimorbidity, there exists co-occurrence of diseases beyond chance, which clinicians need to take into account in their daily practice. Some pathological mechanisms behind the identified clusters are well known; others need further clarification to identify possible preventative strategies.
Key findings
- Results Visual impairments and heart failure were the diseases with the highest comorbidity (mean 2.9 and 2.6 co-occurring conditions, respectively), whereas dementia had the lowest (mean 1.4 comorbidities).
- The cluster analysis revealed five clusters.
Why it matters
This community-based survey of people aged 77 and older found that dementia had the lowest number of co-occurring conditions (a mean of 1.4 comorbidities). It reports patterns of comorbidity and multimorbidity and does not test any treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Study designprospective cohort
- Participants1,099
- Effect size0.4%
- Evidence strengthModerate
How this study scored 64/100
Published in a peer-reviewed journal, and it is a prospective cohort study, followed forward from enrollment. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A prospective cohort study, followed forward from enrollment |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,099 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 425 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 22.4 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 4 / 6 | Cited 16.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 3 / 4 | Cited 64 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Laura Fratiglioni: h-index 133 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Karolinska Institutet: institution h-index 1,477 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19207138) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 64 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Marengoni, A., Rizzuto, D., Wang, H. X., Winblad, B., & Fratiglioni, L. (2009). Patterns of chronic multimorbidity in the elderly population. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2008.02109.x
Vancouver
Marengoni A, Rizzuto D, Wang HX, Winblad B, Fratiglioni L. Patterns of chronic multimorbidity in the elderly population. Journal of the American Geriatrics Society. 2009. doi:10.1111/j.1532-5415.2008.02109.x. PMID: 19207138.
BibTeX
@article{marengoni2009-19207138,
author = {Marengoni, A. and Rizzuto, D. and Wang, H. X. and Winblad, B. and Fratiglioni, L.},
title = {{Patterns of chronic multimorbidity in the elderly population}},
journal = {Journal of the American Geriatrics Society},
year = {2009},
doi = {10.1111/j.1532-5415.2008.02109.x},
pmid = {19207138},
url = {https://doi.org/10.1111/j.1532-5415.2008.02109.x}
}
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