Open Access Open Badges Research article

Age and gender differences in the prevalence and patterns of multimorbidity in the older population

José María Abad-Díez123*, Amaia Calderón-Larrañaga2345, Antonio Poncel-Falcó36, Beatriz Poblador-Plou345, José Manuel Calderón-Meza5, Antoni Sicras-Mainar7, Mercedes Clerencia-Sierra38 and Alexandra Prados-Torres2345

Author Affiliations

1 Department of Health Wellbeing and Family, Government of Aragón, Zaragoza, Spain

2 Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain

3 EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Via Universitas 36, 50017 Zaragoza, Spain

4 Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Zaragoza, Spain

5 Teaching Unit of Preventive Medicine and Public Health, Aragón Health Sciences Institute (IACS), IIS Aragón, Zaragoza, Spain

6 Zaragoza Sector III Primary Care Directorate, Aragon Health Service (SALUD), Zaragoza, Spain

7 Planning Management, Badalona Serveis Assistencials S.A., Badalona, Spain

8 Socio-Sanitary Assessment Unit, Miguel Servet University Hospital, Zaragoza, Spain

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BMC Geriatrics 2014, 14:75  doi:10.1186/1471-2318-14-75

Published: 17 June 2014



The coexistence of several chronic diseases in one same individual, known as multimorbidity, is an important challenge facing health care systems in developed countries. Recent studies have revealed the existence of multimorbidity patterns clustering systematically associated distinct clinical entities. We sought to describe age and gender differences in the prevalence and patterns of multimorbidity in men and women over 65 years.


Observational retrospective multicentre study based on diagnostic information gathered from electronic medical records of 19 primary care centres in Aragon and Catalonia. Multimorbidity patterns were identified through exploratory factor analysis. We performed a descriptive analysis of previously obtained patterns (i.e. cardiometabolic (CM), mechanical (MEC) and psychogeriatric (PG)) and the diseases included in the patterns stratifying by sex and age group.


67.5% of the aged population suffered two or more chronic diseases. 32.2% of men and 45.3% of women were assigned to at least one specific pattern of multimorbidity, and 4.6% of men and 8% of women presented more than one pattern simultaneously. Among women over 65 years the most frequent pattern was the MEC pattern (33.3%), whereas among men it was the CM pattern (21.2%). While the prevalence of the CM and MEC patterns decreased with age, the PG pattern showed a higher prevalence in the older age groups.


Significant gender differences were observed in the prevalence of multimorbidity patterns, women showing a higher prevalence of the MEC and PG patterns, as well as a higher degree of pattern overlapping, probably due to a higher life expectancy and/or worse health. Future studies on multimorbidity patterns should take into account these differences and, therefore, the study of multimorbidity and its impact should be stratified by age and sex.

Multimorbidity; Comorbidity; Chronic disease; Primary health care; Prevalence; Frail elderly