A visual representation of interconnected diseases leading to mortality.

Decoding Multimorbidity: How Disease Combinations Impact Longevity After 80

Theo Raines in Health & Wellness December 2025 • 4 min read.

"Unlocking the secrets of disease clusters in octogenarians to predict and potentially extend lifespan."

As populations worldwide age, multimorbidity—the coexistence of multiple chronic conditions—is becoming a leading healthcare challenge, particularly among the elderly. While healthcare systems often focus on individual diseases, the reality for many seniors is a complex web of interconnected health issues. This approach can lead to redundant, impractical, and even harmful care strategies.

Recognizing the limitations of a single-disease approach, researchers are increasingly exploring how specific combinations of chronic conditions affect health outcomes. This shift is crucial because certain disease clusters may accelerate functional decline, disability, and mortality more than the sum of their individual parts. Understanding these patterns could pave the way for more effective and personalized interventions.

This article delves into the findings of a prospective community-based cohort study, the Octabaix study, which investigated the impact of multimorbidity patterns on mortality in adults aged 85 and older. By analyzing specific disease combinations and their association with survival rates, the study offers valuable insights into how healthcare can better address the needs of our aging population.

The Octabaix Study: Unveiling Deadly Duos and Trios

A visual representation of interconnected diseases leading to mortality.

The Octabaix study, conducted between 2009 and 2014, followed 328 community-dwelling individuals aged 85 years. Researchers collected data on various factors, including sociodemographics, sensory status, cardiovascular risk factors, and geriatric assessments. Multimorbidity patterns were defined as the co-occurrence of two or three specific chronic conditions from a list of 16.

The study revealed that the median number of chronic conditions per participant was four, highlighting the high prevalence of multimorbidity in this age group. Several individual morbidities were significantly associated with an increased risk of death:

At 3-year follow-up: Chronic obstructive pulmonary disease (COPD), atrial fibrillation (AF), and malignancy (cancer).
At 5-year follow-up: Dementia, malignancy, and COPD.

However, the most striking findings emerged when examining specific disease combinations. After adjusting for functional status using the Barthel Index, certain multimorbidity patterns were far more predictive of mortality than individual conditions. For example, at the 3-year mark, the combination of atrial fibrillation, chronic kidney disease (CKD), and visual impairment was particularly deadly. By 5 years, a combination of hypertension, CKD, and malignancy was also strongly associated with mortality.

Rethinking Healthcare for the Oldest Old: A Call for Targeted Multimorbidity Approaches

The Octabaix study underscores the importance of moving beyond a single-disease approach to healthcare for the elderly. Multimorbidity, particularly in specific combinations, exerts a significant influence on mortality, often exceeding the risks associated with individual conditions.

The study's identification of high-risk disease clusters, such as atrial fibrillation, CKD, and visual impairment, highlights the need for targeted interventions. Healthcare providers should prioritize identifying and managing these combinations to improve outcomes for octogenarians.

By recognizing the synergistic effects of multimorbidity, healthcare systems can develop more effective strategies to promote longevity and improve the quality of life for the oldest members of our society. Future research should focus on further elucidating these patterns and developing tailored interventions to address the unique challenges they present.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/cia.s123173, Alternate LINK

Title: Multimorbidity As Specific Disease Combinations, An Important Predictor Factor For Mortality In Octogenarians: The Octabaix Study

Subject: Geriatrics and Gerontology

Journal: Clinical Interventions in Aging

Publisher: Informa UK Limited

Authors: Assumpta Ferrer, Francesc Formiga, Héctor Sanz, Jesús Almeda, Glòria Padrós

Published: 2017-01-01

Everything You Need To Know

What was the Octabaix study and what did it aim to discover?

The Octabaix study, conducted from 2009 to 2014, was a prospective community-based cohort study that followed 328 individuals aged 85 years and older. It collected data on various factors like sociodemographics, sensory status, cardiovascular risk factors, and geriatric assessments. The goal was to understand how specific combinations of chronic diseases, known as multimorbidity patterns, impact mortality in this age group. By analyzing the co-occurrence of two or three chronic conditions from a list of 16, researchers aimed to identify which disease combinations were most predictive of mortality.

According to the Octabaix study, which individual chronic conditions were linked to a higher risk of death in older adults?

The Octabaix study found that several individual chronic conditions were significantly associated with an increased risk of death in adults aged 85 years and older. At the 3-year follow-up, Chronic Obstructive Pulmonary Disease (COPD), Atrial Fibrillation (AF), and malignancy (cancer) were key indicators. By the 5-year follow-up, dementia joined malignancy and COPD as significant predictors of mortality.

What specific combinations of diseases were identified as particularly deadly in the Octabaix study?

The Octabaix study revealed that specific combinations of diseases were more predictive of mortality than individual diseases alone. For instance, at the 3-year mark, the combination of Atrial Fibrillation, Chronic Kidney Disease (CKD), and visual impairment was particularly deadly. By 5 years, a combination of hypertension, CKD, and malignancy was also strongly associated with mortality.

What is multimorbidity, and why is it important to consider when addressing the health of older adults according to the information?

Multimorbidity is the coexistence of multiple chronic conditions in an individual. It is particularly relevant in the elderly where healthcare systems often focus on individual diseases. This approach may not be sufficient, as certain disease clusters can accelerate functional decline, disability, and mortality more than the sum of their individual parts. The Octabaix study highlights the significance of addressing multimorbidity to improve healthcare for the aging population.

What are the implications of the Octabaix study for healthcare approaches for the elderly?

The Octabaix study suggests that healthcare for the elderly should move beyond a single-disease approach and adopt targeted multimorbidity strategies. By identifying specific disease combinations that significantly impact mortality, healthcare providers can develop more effective and personalized interventions. This approach could lead to improved outcomes and extended lifespan for the aging population by proactively managing these high-risk combinations.