Multidimensional health in old age – Amaia Calderón-Larrañaga group

Our research focuses on studying health in older age shifting from the traditional focus on single diseases towards multidimensional and longitudinal health trajectories. More specifically, we study the clinical, psychosocial and behavioral determinants of multimorbidity and frailty, as well as the interaction of these syndromes with older people’s use and needs for medical and social care services.

Part of the Department of Neurobiology, Care Sciences and Society

Research news

Upcoming activities

Research focus

Our aim is to improve our understanding of health in old age from a person-centered perspective by considering its complexity and between- and within- individual heterogeneity. Our final goal is to provide the evidence needed by healthcare managers to deliver better care at a more appropriate time and place.

Most of the research that we do is based on data from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K).

Ongoing projects

Research support

  • Swedish Research Council (VR)
  • The Swedish Research Council for Health, Working Life, and Welfare (Forte)
  • Karolinska Institutet Faculty Board (Senior Researcher position)
  • Karolinska Institutet Strategic Research Area in Epidemiology – SfoEpi

Publications

Concordance and Discrepancies Among 5 Creatinine-Based Equations for Assessing Estimated Glomerular Filtration Rate in Older Adults.
Beridze G, Vetrano DL, Marengoni A, Dai L, Carrero JJ, Calderón-Larrañaga A
JAMA Netw Open 2023 Mar;6(3):e234211

Effectiveness of interventions designed to mitigate the negative health outcomes of informal caregiving to older adults: an umbrella review of systematic reviews and meta-analyses.
Kirvalidze M, Abbadi A, Dahlberg L, Sacco LB, Morin L, Calderón-Larrañaga A
BMJ Open 2023 Apr;13(4):e068646

Social network and severe lower respiratory tract infections in older adults: findings from a Swedish longitudinal population-based study.
Murphy GL, Beridze G, Vetrano DL, Calderón-Larrañaga A
Int J Infect Dis 2023 Mar;128():176-183

Body mass trajectories and multimorbidity in old age: 12-year results from a population-based study.
Calderón-Larrañaga A, Hu X, Guo J, Ferrucci L, Xu W, Vetrano DL
Clin Nutr 2021 Dec;40(12):5764-5770

Multimorbidity burden and dementia risk in older adults: The role of inflammation and genetics.
Grande G, Marengoni A, Vetrano DL, Roso-Llorach A, Rizzuto D, Zucchelli A, Qiu C, Fratiglioni L, Calderón-Larrañaga A
Alzheimers Dement 2021 May;17(5):768-776

Twelve-year clinical trajectories of multimorbidity in a population of older adults.
Vetrano DL, Roso-Llorach A, Fernández S, Guisado-Clavero M, Violán C, Onder G, Fratiglioni L, Calderón-Larrañaga A, Marengoni A
Nat Commun 2020 Jun;11(1):3223

Sleep disturbances and the speed of multimorbidity development in old age: results from a longitudinal population-based study.
Sindi S, Pérez LM, Vetrano DL, Triolo F, Kåreholt I, Sjöberg L, Darin-Mattsson A, Kivipelto M, Inzitari M, Calderón-Larrañaga A
BMC Med 2020 Dec;18(1):382

Multimorbidity and functional impairment-bidirectional interplay, synergistic effects and common pathways.
Calderón-Larrañaga A, Vetrano DL, Ferrucci L, Mercer SW, Marengoni A, Onder G, Eriksdotter M, Fratiglioni L
J Intern Med 2019 Mar;285(3):255-271

Rapidly developing multimorbidity and disability in older adults: does social background matter?
Calderón-Larrañaga A, Santoni G, Wang HX, Welmer AK, Rizzuto D, Vetrano DL, Marengoni A, Fratiglioni L
J Intern Med 2018 May;283(5):489-499

Assessing and Measuring Chronic Multimorbidity in the Older Population: A Proposal for Its Operationalization.
Calderón-Larrañaga A, Vetrano DL, Onder G, Gimeno-Feliu LA, Coscollar-Santaliestra C, Carfí A, Pisciotta MS, Angleman S, Melis RJF, Santoni G, Mangialasche F, Rizzuto D, Welmer AK, Bernabei R, Prados-Torres A, Marengoni A, Fratiglioni L
J Gerontol A Biol Sci Med Sci 2017 Oct;72(10):1417-1423

Members and contact

Group leader

All members of the group

Other people connected to the group

  • Kokoroskos, Emmanouil

Contact and visit us

Postal address

Aging Research Center, Department of Neurobiology, Care Sciences and Society
Karolinska Institutet
SE-171 77 Stockholm

Visiting address

Tomtebodavägen 18 A, Widerström Building, floors 9 and 10
SE-171 65 Solna

Map to Widerström building, Tomtebodavägen 18a, Solna

Ongoing projects

Most of the research that we do is based on data from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K).

Monitoring older adults’ health for preventive and early interventions: use of the Health Assessment Tool (HAT) in the Swedish primary care setting

The Health Assessment Tool (HAT), developed and tested in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), is a comprehensive index of biological age that could facilitate the early identification of those with health and functional disabilities and higher risk of rapid deterioration. HAT may also allow predicting medical and social care needs in older people at individual and community levels. Thus, HAT seems of particular interest in the primary care setting. However, exploring its external validity and possible use with real life data is essential before its widespread use in primary care. This project aims to assess the external validity and feasibility of HAT in the Swedish primary care setting by: 1) measuring its capacity to predict quality of life, unplanned hospitalizations, institutionalization, use of home care and death over one year, and 2) assessing the personal experience of the primary care staff in using HAT, as well as opportunities and threats for a successful implementation.

In collaboration with

  • Emmanouil Kokoroskos, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Aging Research Center
  • Christina Olsson, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy
  • Davide Liborio Vetrano, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Aging Research Center
  • Caroline Wachtler, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care
  • Cecilia Fagerström, Linnaeus University, Region Kalmar
  • Anders Wimo, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics

Related links

Article with Eva Gustafson and Maria Johansson, belonging to the data collection group in Färjestaden hälsocentral (Barometern.se)
Presentation of our work related to the implementation of HAT in primary care at Liberala Seniorers riksnätver, 2 June 2023 (Facebook post)

Older adults’ contribution to informal caregiving: temporal trends, profiles and adverse health consequences

The project aims to provide evidence on the magnitude of older people’s contribution to informal caregiving and to gain knowledge of their particular health needs, through three research lines. The first research line will analyze temporal trends in informal and formal care reception and provision during the last three decades, with a focus on older people as informal care providers. The second will explore the association between caregiving in old age and negative health outcomes and potential underlying factors. The third will identify older caregivers most susceptible to being negatively affected by caregiving, and the stage when such consequences tend to occur. In the context of this project, an ad-hoc nationwide survey has been sent out to 31,000 Swedes older than 55 years, which will map, integrate and track the characteristics of caregivers, care recipients, and care contexts. This will be essential to adapt supportive services to the actual needs of older caregivers and prevent their health from being negatively impacted.

In collaboration with

  • Lena Dahlberg, Dalarna Univeristy, School of Health and Welfare and Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Aging Research Center
  • Elizabeth Hanson, Linnaeus Univerisity, Department of Health and Caring Sciences, Nationellt kompetenscentrum anhöriga (Nka)
  • Mariam Kirvalidze, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Aging Research Center
  • Lennart Magnusson, Linnaeus Univerisity, Department of Health and Caring Sciences, Nationellt kompetenscentrum anhöriga (Nka)
  • Lucas Morin, Karolinska Institutet, Department of Medical Epidemiology and Biostatistics
  • Anders Wimo, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics

Related links

"Vi behöver veta mer om anhörigas vardag", Senioren, 13 October 2023
"Monica vårdar sin man i hemmet - 11 år efter stroken", Vetenskapsradion, Sveriges Radio, 7 June 2023
Viktig och stor undersökning om anhörigas stöd till äldre, Nationellt Kompetenscentrum anhöriga NKA's website, 17 May 2023

Multimorbidity and kidney function in old age: longitudinal trajectories and synergistic effects

The overall aim of this project is to investigate the longitudinal trajectories and synergistic effects between multimorbidity and kidney function in old age. The final goal is to better understand the complex and dynamic evolution of people with multimorbidity and, hence, optimize their management and care. The specific objectives of this project are: 1) to quantify the concordance and explore sources of discrepancies between commonly used eGFR equations; 2) to characterize multimorbidity patterns in a community-dwelling population of older adults with a wide spectrum of kidney function, and to explore the associations between these patterns and future kidney function trajectories; 3) to study the association between eGFR and the evolution of multimorbidity, and to explore the moderating role of inflammation biomarkers on such associations; and 4) to study the synergistic interplay between chronic kidney disease severity and multimorbidity in predicting negative health outcomes linked to survival and avoidable or unplanned care use.

In collaboration with

  • Giorgi Beridze, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Aging Research Center
  • Juan-Jesús Carrero, Karolinska Institutet, Department of Medical Epidemiology and Biostatistics
  • Lu Dai, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Aging Research Center
  • Davide Liborio Vetrano, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Aging Research Center

Dietary determinants of multimorbidity and frailty

The present project aims to increase our knowledge concerning the dietary determinants of geriatric syndromes, such as multimorbidity and frailty, which are one of the major contributors to ill health among older adults. Contrary to what is the case for most pharmacological interventions, key health-related behaviours, such as maintaining adequate nutrition, could potentially exert powerful influences on these conditions and reduce the risk of death. Nevertheless, the dietary determinants of geriatric syndromes have seldom been researched in depth, which precludes the design of interventions to palliate the expected increase in age-associated health and social needs in the coming decades. Taking advantage of the well-characterized population-based Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), we aim to fill some of these knowledge gaps putting geriatric syndromes and the biological mechanisms of aging at the centre, and studying them through the lens of dietary patterns, foods and nutrients.

In collaboration with

  • Adrián Carballo-Casla, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Aging Research Center
  • Fernando Rodríguez-Artalejo, Universidad Autónoma de Madrid, Department of Preventive Medicine, Public Health, and Microbiology, Spain

Collaborations

Projects

Researchers

  • Isabel del Cura, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud.
    • Multimorbidity in the Spanish National Health Service: characterization, impact and trajectories in older people (MM-SNS Project)
  • Joao Forjaz and Carmen Rodríguez, Escuela Nacional de Sanidad del Instituto de Salud Carlos III.
    • Caregiving and Aging in Spain and Sweden (CASS): trends, profiles and determinants of health and quality of life.
  • Christiane Muth, Department of General Practice and Family Medicine, Medical Faculty OWL, University of Bielefeld, Marjan van den Akker, Institute for General Practice, Johann Wolfgang Goethe University, José María Valderas, Department of Family Medicine, National University of Singapore.
    • Conditions and circumstances associated with irreversible declines in health among people with multimorbidity.
  • René Melis, Department of Geriatrics of Radboud University, Anna Marseglia, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society
    • Trajectories of social and cognitive health among healthy older adults (SHARED EU Consortium).
  • Marco Inzitari and Joan Ars, Parc Sanitari Pere Virgili, Vall Hebron Institut de Recerca.
    • Patterns of sedentary behavior and physical activity in older adults using accelerometer data.
  • Amaia Bacigalupe and Unai Martín, Department de Sociología y Trabajo Social, Universidad del País Vasco.
    • Gender inequalities in mental health among older adults.

Outreach activities

Symposium on person-centred and integrated cre for older people, held at KI Campus Solna on 21 March 2023

Recordings from the symposium
News article on ki.se
Report published in the journal Äldre i Centrum (in Swedish)

"Multimorbidity research at the cross-roads", symposium held at KI Campus Solna in May 2018

Recordings from the symposium "Multimorbidity research at the cross-roads"
Output of the symposium in three review articles published in JIM

Umbrella review on the effectiveness of interventions designed to mitigate the negative health outcomes of informal caregiving to older adults

Publication in the journal Äldre i Centrum (in Swedish)
Article on Nationellt Kompetenscentrum anhöriga (Nka)'s website (in Swedish)