Blood Test Reveals Multimorbidity Risk in Older Adults

Predicting who will develop clusters of chronic diseases, and how quickly these conditions accumulate, has remained a major clinical challenge. A long-term population study now shows that a small set of routinely measurable blood biomarkers can predict both the risk and pace of multimorbidity development in ageing adults.

In the study led by researchers at Karolinska Institutet (Stockholm, Sweden), the team analyzed blood samples from more than 2,200 adults aged over 60 from the general population of Stockholm, focusing on biomarkers linked to inflammation, metabolism, vascular health, and neurodegeneration. Using baseline blood samples, the researchers measured 54 biomarkers and followed participants for up to 15 years. They assessed how these markers related to three multimorbidity outcomes: the total number of chronic diseases, five common disease patterns, and the speed at which new diseases accumulated over time.

Seven biomarkers emerged as particularly significant predictors. Five markers—GDF-15, HbA1c, cystatin C, leptin, and insulin—were consistently associated with all multimorbidity measures, while gamma-glutamyl transferase and albumin were specifically linked to faster disease accumulation. The findings were validated in an independent U.S. cohort of 522 individuals. The study, published in Nature Medicine, showed that participants with adverse metabolic biomarker profiles were more likely to develop specific clusters of chronic conditions and to accumulate diseases more rapidly.

The results suggest that disruptions in metabolism, stress response, and energy regulation are key biological drivers of multimorbidity in older adults. Simple blood tests could therefore be used to identify individuals at high-risk years before multiple chronic conditions develop, opening the door to earlier preventive interventions. The researchers plan to examine how these biomarkers change over time and whether lifestyle modifications or medical treatments can alter disease trajectories. Future studies will explore how biomarker-guided strategies could be integrated into routine geriatric care.

“Our study suggests that disturbances in metabolism, stress responses, and energy regulation are among the main drivers of multimorbidity in older people,” said Davide Liborio Vetrano, principal investigator. “This opens up the possibility of using simple blood tests to identify high-risk individuals, enabling earlier intervention in the future.”

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Karolinska Institutet