Multimorbidity and frailty in older adults – Davide Liborio Vetrano group

The goal of our research is to identify promising and personalized targets of prevention and intervention to prolong older adults’ health span and to improve risk stratification and prognostication of persons living with burdensome geriatric syndromes, such as multimorbidity, frailty and dementia.

Research news

Our research

By recognizing the aging process as a complex and heterogeneous phenomenon, our primary goal is to identify clinically relevant health phenotypes in the older population. By decomposing and combining meaningful health domains – including disease, physical and cognitive functioning – we look for robust models to group people in homogeneous classes. Multimorbidity, frailty, disability and dementia are some of the geriatric syndromes we exploit to this end. These phenotypes can simultaneously serve as targets for personalized prevention and intervention, as well as function as metrics for risk stratification. Led by Davide Liborio Vetrano , much of our research is devoted to the understanding of the biological, clinical and psychosocial determinants of geriatric syndromes, as well as their impact on one’s future health trajectory.

Research areas

More specifically, our research group – in collaboration with several Swedish and international researchers – focuses on the following research areas:

Multimorbidity development and progression

Multimorbidity is defined as the co-occurrence of multiple diseases in the same individual, and is often the trigger of complex clinical profiles, including frailty and dementia. In our group, great emphasis is given to the understanding of systematic clustering of diseases in the same individuals. Specific aspects investigated by us are:

  1. The definition of rigorous models to classify older people – both cross-sectionally and longitudinally – in clinically relevant multimorbidity patterns
  2. How milder multimorbidity patterns evolve toward more complex phenotypes and frailty
  3. What is the prognosis of different multimorbidity patterns across diverse outcomes and clinical settings or patient groups

Frailty assessment and population stratification

Frailty is a clinical syndrome characterized by an increased susceptibility to minor stressors, highly associated to reduced survival and poor functioning. By applying novel analytical strategies, our group is strongly focused on the following aspects:

  1. Validation of robust models to measure frailty in older people across different settings, with huge emphasis on primary care
  2. Investigation of frailty secular trends on large populations
  3. Understanding of the determinants of accelerated frailty progression

Geriatric syndromes’ biological signature

Multimorbidity, frailty, sarcopenia, disability and dementia are among the most burdensome and prevalent syndromes affecting the older population. By exploiting a selected large panel of blood-based biomarkers, analyzed alone or in combination, we aim to:

  1. Clarify the main biological pathways involved in the development and progression of the above mentioned geriatric syndromes
  2. Shed light on the biological underpinnings of the intricate relation between somatic and mental health
  3. Build stratification tools to identify individuals at higher risk of experiencing negative health-relate outcomes

Impact of acute events on health trajectories

Health trajectories of older adults can be shaped, among the others, by the occurrence of acute events that include infections, cardiovascular accidents and traumatic injuries. Our group is interested in untangling the following specific aspects:

  1. The impact of acute events on clinical and functional trajectories, as for example on cognitive decline or frailty
  2. The impact of acute events on healthcare utilization patterns
  3. The interplay of acute events and pre-existing geriatric syndromes in the further development of negative outcomes

Risk profiles of intense and avoidable healthcare utilization

Older adults living with complex combinations of clinical and functional impairments are frequent users of healthcare services. While maintaining the main focus on the different combination of clinical and functional phenotypes, our aims include the identification of risk profiles for:

  1. The occurrence of frequent and multiple transitions of older individuals across diverse living and healthcare settings
  2. The incidence of avoidable and unplanned episodes of care, with a main focus on hospitalizations

Several data sources have been used and are currently used by our group, including population-based studies (SNAC-K, NEAR), Nordic Countries National Patient Registers, and InterRAI  data from several European, North American and Asian countries. 


All publications from group members

Staff and contact

Group leader

All members of the group

Visiting address

Aging Research Center, Department of Neurobiology, Care Sciences and Society, Tomtebodavägen 18 A, Solna, SE-171 65 Solna, Sweden

Postal address

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

Past members and visiting researchers

  • Xin Xia, PhD Student at Karolinska Institutet (2021-2023)
  • Elena Baldasso, Master’s student at Milano Bicocca University (2022-2023)
  • Giuliana Locatelli, Master’s student at Milano Bicocca University (2022-2023)
  • Merle Hendel, Master’s student at Maastricht University (2020-2021)
  • Roselyne Akugizibwe, Master’s student at KI (2020-2021)
  • Hao Luo, Assistant professor at Hong Kong University (2021)
  • Riccardo Calvani, postdoc at KI (50%, 2020)
  • Anna Picca, postdoc at KI (50%, 2020)

Current and previous projects

Davide Liborio Vetrano group's current research is fully funded through research grants obtained in national and international competitions.


Pursuing new frontiers for a healthier aging: simulation-based manipulation of biological pathways involved in multimorbidity, frailty and dementia development

  • Funder: The Strategic Research Area in Epidemiology and Biostatistics (SFOepi), KI – consolidator grant
  • PI: Davide Liborio Vetrano
  • Duration: 2023-2026

Biomarker signatures of progressing multimorbidity: in pursuit of personalized approaches to clinically complex older individuals

  • Funder: Swedish Research Council
  • PI: Davide Liborio Vetrano
  • Duration: 2021-2025

Trajectories of care needs and care transitions after age 60: the interplay between individuals’ frailty, their environment, and personal perspectives

  • Funder: Swedish Research Council for Health, Working Life and Welfare (FORTE)
  • PI: Davide Liborio Vetrano
  • Duration: 2021-2025

Atrial Fibrillation integrated approach in FraIl, multimoRbid and polyMedicated Older people (AFFIRMO)

  • Funder: European Commission
  • Local PI, WP leader: Davide Liborio Vetrano
  • Duration: 2020-2025

Individualized CARE for OLDer persons with complex chronic conditions in-home care and nursing homes (I-CARE4OLD)

  • Funder: European Commission
  • Local PI, WP leader: Davide Liborio Vetrano
  • Duration: 2020-2025


Impact of lower respiratory tract infections on older individuals’ global health status and healthcare utilization: results from a longitudinal population-based study

  • Funder: Partnership Karolinska Institutet and MSD
  • PI: Davide Liborio Vetrano
  • Duration: 2022-2023

Biomarker signatures of the multimorbidity-frailty continuum: in pursuit of personalized medicine for older adults

  • Funder: The Strategic Research Area in Epidemiology and Biostatistics (SFOepi), KI – starting grant
  • PI: Davide Liborio Vetrano
  • Duration: 2021-2023

Immunization, frailty and healthy aging

  • Funder: Partnership Karolinska Institutet and MSD
  • PI: Davide Liborio Vetrano
  • Duration: 2019