Older adults living with multiple chronic conditions, known as multimorbidity, may respond differently to lifestyle interventions depending on the specific combination of diseases they have. A new study published in Nature Aging, led by researchers from Karolinska Institutet and Università Cattolica del Sacro Cuore in Rome, suggests that understanding these disease patterns could help make disability prevention more personalised.

Maintaining mobility and independent movement is essential for a healthy and independent life in older age. Researchers examined whether a lifestyle intervention produced different effects among older adults with varying combinations of chronic diseases.

The study analysed data from 1,199 adults over the age of 70 across 11 European countries. All participants had physical frailty, reduced muscle mass, and at least two chronic conditions. Participants were randomly assigned to either a programme combining physical activity, dietary guidance, and technical support, or a control programme providing information about healthy ageing.

Researchers identified four main disease patterns: non-specific multimorbidity, psychiatric multimorbidity, cardiovascular and metabolic multimorbidity, and respiratory multimorbidity.

Overall, the lifestyle intervention reduced the risk of mobility impairment or death by 22% compared with the control group. However, the benefits varied between disease patterns. The strongest effect was seen among participants with a psychiatric disease pattern, where the risk was reduced by 35%. Participants with non-specific multimorbidity also benefited, while little to no benefit was observed among those with cardiovascular-metabolic or respiratory multimorbidity.

Davide Liborio Vetrano, associate professor of Geriatric Research at Karolinska Institutet and first author of the study, noted that the number of health conditions alone may not determine how well someone responds to an intervention. Instead, the combination of conditions may also play an important role.

The findings suggest that future prevention programmes could consider an individual's overall disease profile rather than focusing on individual conditions alone. Such an approach may help develop more targeted strategies to maintain mobility and prevent disability in older adults.

However, the researchers emphasise that this was a post-hoc analysis of a clinical trial, and the findings need to be confirmed through further studies and broader populations.

The study was conducted as part of the European SPRINTT project, involving researchers from universities and research institutions across 11 European countries. Funding included support from the Innovative Medicines Initiative (IMI), Swedish Research Council, and Karolinska Institutet.

Source: https://news.ki.se/disease-patterns-may-guide-lifestyle-interventions-in-older-adults