Stockholm, Sweden — A new, multi-country analysis identifies a small set of blood biomarkers that could forecast the risk of multimorbidity in older adults. The study followed more than 2,200 residents over 60 living in Stockholm, tracking their health over a 15-year period.
What the study did
Table of Contents
- 1. What the study did
- 2. Seven biomarkers that stood out
- 3. Independent replication
- 4. What the results suggest
- 5. Next steps and broader context
- 6. Biomarker snapshot
- 7. Bottom line for readers
- 8. About the research
- 9. Key implications for health policy
- 10. What this means for you
- 11. Share your thoughts
- 12. 【4】.Serum creatinine & eGFRRenal functionDeclining eGFR ( 3.5) link to atherosclerotic disease and neurodegeneration【7】.Vitamin D (25‑OH‑D)Bone health & immunityDeficiency (300 ng/mL) reflects chronic inflammation and predicts metabolic syndrome progression【9】.Composite Biomarker Scores
- 13. Key Blood Biomarkers Linked to multimorbidity
- 14. How Biomarker Panels Improve Risk Prediction
- 15. Practical Tips for Clinicians
- 16. Benefits of Early Biomarker Screening
- 17. Real‑World Example: Biomarker‑Driven Care in a Community Clinic
- 18. Emerging Research Directions
Researchers evaluated 54 blood-based biomarkers that reflect metabolism, inflammation, vascular health, and neurodegeneration. They then examined how these markers related to three measures of multimorbidity: the total number of diseases, five common disease patterns, and the speed at which new diseases appeared over time.
Seven biomarkers that stood out
Seven markers emerged as especially informative. Five were consistently linked with all multimorbidity measures: GDF-15, HbA1c, cystatin C, leptin, and insulin.Two others—gamma-glutamyl transferase (GGT) and albumin—were specifically associated with the pace of disease progression.
Independent replication
The team verified these findings in a separate group of 522 participants in the United States, reinforcing the potential relevance of the identified biomarkers across populations.
What the results suggest
Lead researchers say the data point to metabolism, stress responses, and energy regulation as key drivers of multimorbidity in older adults. The researchers emphasize that these biomarkers could, in the future, enable simple blood tests to flag high‑risk individuals for earlier intervention.
“Alterations in metabolism and related stress responses appear to be central to how multiple chronic diseases accumulate,” saeid one of the study’s senior investigators. “This opens the door to proactive strategies that could slow the onset of multimorbidity.”
Next steps and broader context
Going forward, scientists plan to monitor how these biomarkers change over time and to test whether lifestyle changes or medications can influence the disease process. The work was conducted in collaboration with researchers from the Royal Institute of Technology and SciLifeLab in Sweden, the University of Brescia and the University of Milano‑Bicocca in Italy, and the US National Institute on Aging.
Biomarker snapshot
| Biomarker | Biological domain | Association with multimorbidity |
|---|---|---|
| GDF-15 | Metabolism / Stress signaling | Linked with all measures of multimorbidity |
| HbA1c | Blood sugar control | Linked with all measures of multimorbidity |
| Cystatin C | Kidney function | Linked with all measures of multimorbidity |
| Leptin | Energy regulation / metabolism | Linked with all measures of multimorbidity |
| Insulin | metabolic signaling | Linked with all measures of multimorbidity |
| GGT | Liver enzyme / metabolic health | Specifically tied to rate of disease progression over time |
| Albumin | Nutritional status | Specifically tied to rate of disease progression over time |
Bottom line for readers
The findings point toward a future where a standard blood test could help identify people at higher risk of accumulating chronic illnesses. Early detection would pave the way for preventive interventions, lifestyle adjustments, and timely treatment adjustments to slow multimorbidity’s advance.
About the research
The study was conducted in collaboration with leading Swedish institutions and international partners, and its conclusions were reinforced by a US cohort. The investigative team stresses that ongoing follow-up will illuminate how biomarker trajectories respond to lifestyle and medical interventions.
Key implications for health policy
As populations age, integrating biomarker screening into routine care could help allocate preventive resources more effectively, prioritizing those at greatest risk for multimorbidity. This approach aligns with a broader shift toward precision geriatric medicine, where interventions are tailored to an individual’s biology as well as their clinical history.
What this means for you
Even as science advances, maintaining healthy lifestyle habits remains essential. Regular physical activity, a balanced diet, and routine medical check-ups support metabolic and vascular health, potentially delaying the onset of multiple chronic conditions.
Disclaimer: This article is for informational purposes and does not constitute medical advice. Consult a healthcare professional for personalized guidance.
What biomarker would you want doctors to monitor most closely, and how could lifestyle changes influence its trajectory? Tell us in the comments below or join the discussion on social media.
Readers are invited to explore related research and expert analyses linked to this topic for deeper context and updated findings as new data become available.
【4】.
Serum creatinine & eGFR
Renal function
Declining eGFR (<60 mL/min/1.73 m) signals early kidney impairment and is associated with higher burden of cardiovascular and musculoskeletal disorders【5】.
N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP)
Cardiac stress
Moderate elevations predict future heart failure, atrial fibrillation, and even all‑cause mortality in older cohorts【6】.
Lipid profile (LDL‑C,HDL‑C,triglycerides)
Dyslipidemia
Unfavorable ratios (LDL‑C/HDL‑C > 3.5) link to atherosclerotic disease and neurodegeneration【7】.
Vitamin D (25‑OH‑D)
Bone health & immunity
Deficiency (<20 ng/mL) associates with osteoporosis, falls, and increased inflammatory markers【8】.
Ferritin
Iron storage & acute‑phase reactant
High ferritin (>300 ng/mL) reflects chronic inflammation and predicts metabolic syndrome progression【9】.
Composite Biomarker Scores
produce.Understanding Multimorbidity in Older Adults
- Multimorbidity = the coexistence of ≥ 2 chronic conditions (e.g., diabetes, cardiovascular disease, dementia).
- Prevalence rises sharply after age 65, reaching ≈ 65 % in community‑dwelling seniors.
- Early identification of individuals at high risk allows targeted prevention, medication optimization, and reduced healthcare costs.
Why Blood Biomarkers matter
- Blood samples are minimally invasive, inexpensive, and can be integrated into routine check‑ups.
- Biomarkers reflect underlying pathophysiology (inflammation, metabolic dysregulation, endothelial dysfunction) that drives the accumulation of chronic diseases.
- A panel of biomarkers provides a composite risk score that outperforms age‑alone models (AUROC 0.81 vs 0.68)【1】.
Key Blood Biomarkers Linked to multimorbidity
| biomarker | Primary Pathway | Evidence for Multimorbidity Prediction |
|---|---|---|
| C‑reactive protein (CRP) | Systemic inflammation | Elevated CRP (>3 mg/L) predicts incident hypertension, type 2 diabetes, and frailty within 5 years【2】. |
| Interleukin‑6 (IL‑6) | Cytokine‑mediated inflammation | High IL‑6 levels correlate with combined risk of cardiovascular disease and cognitive decline【3】. |
| Glycated hemoglobin (HbA1c) | Chronic hyperglycemia | HbA1c ≥ 5.7 % identifies pre‑diabetic status,which doubles odds of developing kidney disease and peripheral arterial disease【4】. |
| Serum creatinine & eGFR | Renal function | Declining eGFR (<60 mL/min/1.73 m²) signals early kidney impairment and is associated with higher burden of cardiovascular and musculoskeletal disorders【5】. |
| N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP) | Cardiac stress | Moderate elevations predict future heart failure, atrial fibrillation, and even all‑cause mortality in older cohorts【6】. |
| Lipid profile (LDL‑C, HDL‑C, triglycerides) | Dyslipidemia | Unfavorable ratios (LDL‑C/HDL‑C > 3.5) link to atherosclerotic disease and neurodegeneration【7】. |
| Vitamin D (25‑OH‑D) | Bone health & immunity | Deficiency (<20 ng/mL) associates with osteoporosis, falls, and increased inflammatory markers【8】. |
| Ferritin | Iron storage & acute‑phase reactant | High ferritin (>300 ng/mL) reflects chronic inflammation and predicts metabolic syndrome progression【9】. |
Composite Biomarker Scores
- Multimorbidity Risk Index (MRI‑B) combines CRP,IL‑6,HbA1c,eGFR,and NT‑proBNP.
- In the Ageing‑Biomarker Cohort (n = 12,300, 2024‑2025), MRI‑B identified high‑risk individuals with a 3‑fold increase in 3‑year multimorbidity incidence compared with low‑risk scores【10】.
How Biomarker Panels Improve Risk Prediction
- Additive Predictive Power – Each marker captures a distinct pathophysiological domain; together they explain > 50 % of variance in multimorbidity trajectories.
- Dynamic Monitoring – serial measurements reveal trend patterns (e.g., rising IL‑6) that prompt early lifestyle or pharmacologic interventions.
- Personalized Care Pathways – Biomarker‑driven stratification guides intensity of screening (e.g., more frequent echocardiograms for elevated NT‑proBNP).
Practical Tips for Clinicians
- Integrate a Standard Panel: Order CRP,IL‑6,HbA1c,eGFR,and NT‑proBNP annually for patients ≥ 65 y; add lipid profile and vitamin D if not already done.
- Use Electronic Health Record (EHR) Alerts: Set thresholds (CRP > 3 mg/L, IL‑6 > 5 pg/mL) to trigger automated care pathways.
- Interpret in Context: Adjust for acute infections (temporary CRP spikes) and medication effects (e.g., statins lowering LDL‑C).
- Educate Patients: Explain that biomarkers are “early warning lights” and that lifestyle changes (diet, physical activity) can modify levels.
Benefits of Early Biomarker Screening
- Reduced Hospitalizations – Early detection of cardiac stress (NT‑proBNP) lowered heart‑failure admissions by 22 % in a Medicare‑linked pilot (2025)【11】.
- Cost‑Effectiveness – A health‑economic model estimated a net saving of $1,340 per screened senior over 5 years due to avoided complications【12】.
- Improved quality of Life – Patients receiving biomarker‑guided interventions reported higher physical function scores (SF‑36) after 12 months【13】.
Real‑World Example: Biomarker‑Driven Care in a Community Clinic
Setting: Oakridge primary Care, suburban Chicago, serving ≈ 3,200 patients ≥ 65 y.
implementation Steps
- Integrated a 5‑marker panel (CRP, IL‑6, HbA1c, eGFR, NT‑proBNP) into the annual wellness visit order set.
- Trained nursing staff to draw blood during vitals collection, reducing extra appointments.
- Developed a risk‑scoring dashboard within the EHR, automatically flagging high‑risk scores.
Outcomes (2024‑2025)
- High‑risk identification: 18 % (≈ 580) of seniors classified as high risk.
- Intervention uptake: 84 % of flagged patients received targeted counseling (dietary changes, physical therapy) and medication review.
- Multimorbidity progression: 12‑month incidence of ≥ 2 new chronic conditions dropped from 27 % (pre‑implementation) to 15 % (post‑implementation).
Emerging Research Directions
- Proteomics & Metabolomics: High‑throughput platforms are discovering novel markers (e.g., kynurenine, fibroblast growth factor‑21) that may refine risk models.
- Machine‑Learning Algorithms: Integrating biomarker data with genetics and lifestyle factors improves predictive accuracy (> 0.90 AUROC) in pilot studies【14】.
- Intervention trials: Ongoing RCTs (e.g., BIOMARK‑Multimorbidity 2026) test whether biomarker‑guided anti‑inflammatory therapy reduces disease accumulation.
Key Takeaway for Practitioners
Incorporating a concise, evidence‑based blood biomarker panel into routine geriatric assessments offers a powerful, cost‑effective strategy to predict and curb multimorbidity risk, ultimately enhancing patient outcomes and reducing the burden on health systems.