title: Aging with multimorbidity: a systematic review of the literature.
abstract: A literature search was carried out to summarize the existing scientific evidence concerning occurrence, causes, and consequences of multimorbidity (the coexistence of multiple chronic diseases) in the elderly as well as models and quality of care of persons with multimorbidity. According to pre-established inclusion criteria, and using different search strategies, 41 articles were included (four of these were methodological papers only). Prevalence of multimorbidity in older persons ranges from 55 to 98%. In cross-sectional studies, older age, female gender, and low socioeconomic status are factors associated with multimorbidity, confirmed by longitudinal studies as well. Major consequences of multimorbidity are disability and functional decline, poor quality of life, and high health care costs. Controversial results were found on multimorbidity and mortality risk. Methodological issues in evaluating multimorbidity are discussed as well as future research needs, especially concerning etiological factors, combinations and clustering of chronic diseases, and care models for persons affected by multiple disorders. New insights in this field can lead to the identification of preventive strategies and better treatment of multimorbid patients.
authors.affiliation: Aging Research Center, NVS Department, Karolinska Institutet and Stockholm University, Sweden. marengon@med.unibs.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marengoni
authors.forename: Sara
authors.initials: S
authors.lastname: Angleman
authors.forename: René
authors.initials: R
authors.lastname: Melis
authors.forename: Francesca
authors.initials: F
authors.lastname: Mangialasche
authors.forename: Anita
authors.initials: A
authors.lastname: Karp
authors.forename: Annika
authors.initials: A
authors.lastname: Garmen
authors.forename: Bettina
authors.initials: B
authors.lastname: Meinow
authors.forename: Laura
authors.initials: L
authors.lastname: Fratiglioni
mesh_terms: D000375:Aging / Q000473:pathology* / Q000502:physiology / Q000523:psychology*; D000818:Animals; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D006801:Humans; D011787:Quality of Health Care / Q000592:standards; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors