Risk factors for multimorbidity in adulthood: A systematic review

Tazzeo C, Zucchelli A, Vetrano DL, Demurtas J, Smith L, Schöne D, Sanchez-Rodriguez D, Onder G, Balci C, Bonetti S, Grande G, Torbahn G, Veronese N, Marengoni A (2023)

Publication Type: Journal article, Review article

Publication year: 2023


Book Volume: 91

Article Number: 102039

DOI: 10.1016/j.arr.2023.102039


Background: Multimorbidity, the coexistence of multiple chronic diseases in an individual, is highly prevalent and challenging for healthcare systems. However, its risk factors remain poorly understood. Objective: To systematically review studies reporting multimorbidity risk factors. Methods: A PRISMA-compliant systematic review was conducted, searching electronic databases (MEDLINE, EMBASE, Web of Science, Scopus). Inclusion criteria were studies addressing multimorbidity transitions, trajectories, continuous disease counts, and specific patterns. Non-human studies and participants under 18 were excluded. Associations between risk factors and multimorbidity onset were reported. Results: Of 20,806 identified studies, 68 were included, with participants aged 18–105 from 23 countries. Nine risk factor categories were identified, including demographic, socioeconomic, and behavioral factors. Older age, low education, obesity, hypertension, depression, low pysical function were generally positively associated with multimorbidity. Results for factors like smoking, alcohol consumption, and dietary patterns were inconsistent. Study quality was moderate, with 16.2% having low risk of bias. Conclusions: Several risk factors seem to be consistently associated with an increased risk of accumulating chronic diseases over time. However, heterogeneity in settings, exposure and outcome, and baseline health of participants hampers robust conclusions.

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Tazzeo, C., Zucchelli, A., Vetrano, D.L., Demurtas, J., Smith, L., Schöne, D.,... Marengoni, A. (2023). Risk factors for multimorbidity in adulthood: A systematic review. Ageing Research Reviews, 91. https://doi.org/10.1016/j.arr.2023.102039


Tazzeo, Clare, et al. "Risk factors for multimorbidity in adulthood: A systematic review." Ageing Research Reviews 91 (2023).

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