Pathogenesis of multimorbidity—what is known?

BACKGROUND: Multimorbidity is gaining increasing attention due to its substantial medical, healthcare political and social challenges. So far, however, there have been only few studies attempting to characterize the underlying pathogenesis. METHOD: A selective literature search was carried out in PubMed. RESULTS: There is no generally accepted definition of multimorbidity. In the studies published so far, attempts have mostly been made to identify frequent clusters of diseases. In order to prevent multimorbidity, however, it is necessary to characterize the underlying mechanisms of development in more detail. For this purpose, a concept is presented based on the previously published data, in particular from longitudinal studies showing the importance of known risk factors. Possible pathogenetic processes involving multimorbidity are briefly discussed. CONCLUSION: For most pathogenetic processes leading to multimorbidity there is no suitable pharmacological treatment available; however, behavior such as lack of exercise, dietary habits, smoking and high alcohol consumption are of considerable importance for the development of multimorbidity and can in principle be influenced by treatment.