Older adults living with several chronic diseases, a condition known as multimorbidity, may respond differently to interventions aimed at preventing disability, depending on the combination of diseases they have. A new study, published in Nature Aging and led by researchers at Karolinska Institutet and Università Cattolica del Sacro Cuore in Rome, suggests that looking at patterns of multimorbidity, rather than individual diseases alone, could help make prevention more personalised.
Being able to walk and move around independently is a key prerequisite for an independent life in old age. Researchers have now investigated whether the effect of a lifestyle intervention differs between different groups of older people living with several chronic conditions at the same time.
The study is based on data from 1,199 people aged over 70 from 11 European countries. All participants had physical frailty, reduced muscle mass and at least two chronic conditions. The participants were randomly assigned either to a programme involving physical activity, dietary advice and technical support, or to a programme providing information on healthy ageing.
The researchers identified four different disease patterns amongst the participants: a non-specific pattern with no dominant disease group; a psychiatric pattern; a cardiovascular and metabolic pattern; and a respiratory pattern.
Across the entire study group, the lifestyle intervention reduced the risk of developing mobility impairment or dying by 22 per cent compared with the control group. However, the results varied between the different disease groups. The clearest effect was seen among people with a psychiatric disease pattern, where the risk fell by 35 per cent. People with non-specific multimorbidity – corresponding to a milder disease burden – also benefited from the intervention, while essentially no benefit was observed among participants with cardiometabolic or respiratory multimorbidity patterns.
Photo: Maria Yohuang
“Our results show that it is not just the number of conditions that matters. The combination of conditions can also influence how well a preventive lifestyle intervention works,” says Davide Liborio Vetrano , associate professor of Geriatric Research at the Aging Research Center , Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and first author of the study.
According to the researchers, the results may help ensure that preventive programmes in the future are better tailored to the individual’s disease profile.
“The study suggests that a more personalised strategy could make it easier to target the right intervention to the right person and thereby prevent disability in older people,” says Davide Liborio Vetrano.
At the same time, the researchers emphasise that the study is a post-hoc analysis of a clinical trial and that the results need to be confirmed in other studies and in broader groups of older people.
The study was carried out as part of the European SPRINTT project, involving researchers from several universities and research institutes in 11 European countries. The research was funded, amongst other sources, by the Innovative Medicines Initiative (IMI) and with support from the Swedish Research Council and Karolinska Institutet. The researchers state that they have no conflicts of interest.
Publication
Multimorbidity patterns influence mobility disability prevention in frail older adults from the SPRINTT trial . Vetrano DL, Gregorio C, Triolo F, Soraci L, Cherubini A, Tosato M, von Haehling S, Marzetti E, Landi F, Calvani R., Nature Aging. 2026. DOI: 10.1038/s43587-026-01188-x.
