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Twelve-year clinical trajectories of multimorbidity in a population of older adults
Multimorbidity—the co-occurrence of multiple diseases—is associated to poor prognosis, but the scarce knowledge of its development over time hampers the effectiveness of clinical interventions. Here we identify multimorbidity clusters, trace their evolution in older adults, and detect the clinical t...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320143/ https://www.ncbi.nlm.nih.gov/pubmed/32591506 http://dx.doi.org/10.1038/s41467-020-16780-x |
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author | Vetrano, Davide L. Roso-Llorach, Albert Fernández, Sergio Guisado-Clavero, Marina Violán, Concepción Onder, Graziano Fratiglioni, Laura Calderón-Larrañaga, Amaia Marengoni, Alessandra |
author_facet | Vetrano, Davide L. Roso-Llorach, Albert Fernández, Sergio Guisado-Clavero, Marina Violán, Concepción Onder, Graziano Fratiglioni, Laura Calderón-Larrañaga, Amaia Marengoni, Alessandra |
author_sort | Vetrano, Davide L. |
collection | PubMed |
description | Multimorbidity—the co-occurrence of multiple diseases—is associated to poor prognosis, but the scarce knowledge of its development over time hampers the effectiveness of clinical interventions. Here we identify multimorbidity clusters, trace their evolution in older adults, and detect the clinical trajectories and mortality of single individuals as they move among clusters over 12 years. By means of a fuzzy c-means cluster algorithm, we group 2931 people ≥60 years in five clinically meaningful multimorbidity clusters (52%). The remaining 48% are part of an unspecific cluster (i.e. none of the diseases are overrepresented), which greatly fuels other clusters at follow-ups. Clusters contribute differentially to the longitudinal development of other clusters and to mortality. We report that multimorbidity clusters and their trajectories may help identifying homogeneous groups of people with similar needs and prognosis, and assisting clinicians and health care systems in the personalization of clinical interventions and preventive strategies. |
format | Online Article Text |
id | pubmed-7320143 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-73201432020-06-30 Twelve-year clinical trajectories of multimorbidity in a population of older adults Vetrano, Davide L. Roso-Llorach, Albert Fernández, Sergio Guisado-Clavero, Marina Violán, Concepción Onder, Graziano Fratiglioni, Laura Calderón-Larrañaga, Amaia Marengoni, Alessandra Nat Commun Article Multimorbidity—the co-occurrence of multiple diseases—is associated to poor prognosis, but the scarce knowledge of its development over time hampers the effectiveness of clinical interventions. Here we identify multimorbidity clusters, trace their evolution in older adults, and detect the clinical trajectories and mortality of single individuals as they move among clusters over 12 years. By means of a fuzzy c-means cluster algorithm, we group 2931 people ≥60 years in five clinically meaningful multimorbidity clusters (52%). The remaining 48% are part of an unspecific cluster (i.e. none of the diseases are overrepresented), which greatly fuels other clusters at follow-ups. Clusters contribute differentially to the longitudinal development of other clusters and to mortality. We report that multimorbidity clusters and their trajectories may help identifying homogeneous groups of people with similar needs and prognosis, and assisting clinicians and health care systems in the personalization of clinical interventions and preventive strategies. Nature Publishing Group UK 2020-06-26 /pmc/articles/PMC7320143/ /pubmed/32591506 http://dx.doi.org/10.1038/s41467-020-16780-x Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Vetrano, Davide L. Roso-Llorach, Albert Fernández, Sergio Guisado-Clavero, Marina Violán, Concepción Onder, Graziano Fratiglioni, Laura Calderón-Larrañaga, Amaia Marengoni, Alessandra Twelve-year clinical trajectories of multimorbidity in a population of older adults |
title | Twelve-year clinical trajectories of multimorbidity in a population of older adults |
title_full | Twelve-year clinical trajectories of multimorbidity in a population of older adults |
title_fullStr | Twelve-year clinical trajectories of multimorbidity in a population of older adults |
title_full_unstemmed | Twelve-year clinical trajectories of multimorbidity in a population of older adults |
title_short | Twelve-year clinical trajectories of multimorbidity in a population of older adults |
title_sort | twelve-year clinical trajectories of multimorbidity in a population of older adults |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320143/ https://www.ncbi.nlm.nih.gov/pubmed/32591506 http://dx.doi.org/10.1038/s41467-020-16780-x |
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