ArticleScientific reports2020
Five-year trajectories of multimorbidity patterns in an elderly Mediterranean population using Hidden Markov Models.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Patterns of multimorbidity, their outcomes and analytical methods for their determination: a systematic review.BMC public health · 2026Pooled it
- A systematic review and meta-analysis of disease clusters in multimorbidity.Nature communications · 2025Pooled it
- Trial
- Association of multimorbidity and its patterns with risk of mortality among the elderly in Shenzhen, China.BMC geriatrics · 2026Article
- Paths to multimorbidity: a longitudinal perspective on disease accumulation in Catalonia, Spain.European journal of public health · 2026Article
- Frailty progression: The role of multimorbidity configurations in frailty transitions and predicting mortality risk among older adults.BMC medicine · 2026Article
- Development of a risk assessment model for multimorbidity of diabetes, hypertension, and coronary heart disease with XGBoost in primary care in Shanghai, China: a retrospective study.BMC cardiovascular disorders · 2026Article
- Multimorbidity trends in Catalonia, 2010-21: a population-based cohort study.International journal of epidemiology · 2026Article
- Dynamics of multimorbidity patterns in older population across socioeconomic areas.Communications medicine · 2025Article
- Comorbidity and medication patterns in atrial fibrillation patients: association with adverse clinical outcomes.Internal and emergency medicine · 2025Article
- Using electronic health records to understand multimorbidity in older people: a scoping review.European geriatric medicine · 2025Article
- Charting the Pathways of Cardiometabolic Multimorbidity: A Systematic Review of Clinical Trajectories.Journal of clinical medicine · 2025Review
- Hidden Markov models reveal behavioral state dynamics in depth-related locomotion in mice.PloS one · 2025Article
- Clinical subtypes of older adults starting long-term care in Japan and their association with prognoses: a data-driven cluster analysis.Scientific reports · 2024Article
- Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populations.BMC medicine · 2024Article
- Unraveling cradle-to-grave disease trajectories from multilayer comorbidity networks.NPJ digital medicine · 2024Article
- Characterisation, symptom pattern and symptom clusters from a retrospective cohort of Long COVID patients in primary care in Catalonia.BMC infectious diseases · 2024Article
- Multimorbidity patterns and trajectories in young and middle-aged adults: a large-scale population-based cohort study.Frontiers in public health · 2024Article
- Navigating Sex-Specific Disease Dynamics in Incident Dementia.Proceedings. IEEE International Conference on Bioinformatics and Biomedicine · 2023Article
- Contribution of Frailty to Multimorbidity Patterns and Trajectories: Longitudinal Dynamic Cohort Study of Aging People.JMIR public health and surveillance · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study aimed to analyse the trajectories and mortality of multimorbidity patterns in patients aged 65 to 99 years in Catalonia (Spain). Five year (2012-2016) data of 916,619 participants from a primary care, population-based electronic health record database (Information System for Research in Primary Care, SIDIAP) were included in this retrospective cohort study. Individual longitudinal trajectories were modelled with a Hidden Markov Model across multimorbidity patterns. We computed the mortality hazard using Cox regression models to estimate survival in multimorbidity patterns. Ten multimorbidity patterns were originally identified and two more states (death and drop-outs) were subsequently added. At baseline, the most frequent cluster was the Non-Specific Pattern (42%), and the least frequent the Multisystem Pattern (1.6%). Most participants stayed in the same cluster over the 5 year follow-up period, from 92.1% in the Nervous, Musculoskeletal pattern to 59.2% in the Cardio-Circulatory and Renal pattern. The highest mortality rates were observed for patterns that included cardio-circulatory diseases: Cardio-Circulatory and Renal (37.1%); Nervous, Digestive and Circulatory (31.8%); and Cardio-Circulatory, Mental, Respiratory and Genitourinary (28.8%). This study demonstrates the feasibility of characterizing multimorbidity patterns along time. Multimorbidity trajectories were generally stable, although changes in specific multimorbidity patterns were observed. The Hidden Markov Model is useful for modelling transitions across multimorbidity patterns and mortality risk. Our findings suggest that health interventions targeting specific multimorbidity patterns may reduce mortality in patients with multimorbidity.
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