Evaluating services for older adults with multimorbidity across health and social care

This research explored the combined impact of multimorbidity (having two or more long-term conditions) and frailty in older adults, using data-driven approaches to inform integrated models of care. While multimorbidity and frailty often co-occur, they are frequently managed in isolation in healthcare settings. This project aimed to determine how these conditions intersect and how their combined presence affects health outcomes, healthcare use, and service needs.

Findings show that managing multimorbidity without considering frailty may be insufficient and can lead to poorer health outcomes, avoidable admissions, and increased service use. This research highlights the importance of incorporating frailty assessments into the routine care of people with multiple conditions and encourages a shift towards more holistic, personalised approaches to care planning in later life.

Multimorbidity interventions vary in effectiveness, but incorporating frailty assessments improves outcomes; analysis of 1,500 patients aged 70+ from the Delirium and Population Health Informatics Cohort and linked data from Barking and Dagenham residents showed that impaired mobility strongly affects quality of life, and that acute hospital admissions in older adults with multiple conditions drive long-term increases in health and social care service use and costs.Multimorbidity and frailty frequently co-occur in older adults, and their combination leads to significantly poorer outcomes than either condition alone.

Managing multimorbidity without assessing frailty can result in missed opportunities for prevention and early intervention.

Frailty status modified the impact of multimorbidity on outcomes such as emergency admissions and functional decline.

Interventions focused solely on managing multiple conditions without addressing frailty are likely to be less effective.

Comprehensive assessments by multidisciplinary teams are associated with improved management of complex patients and better functional outcomes.

Impaired mobility emerged as a strong predictor of adverse outcomes in people with frailty and multimorbidity, highlighting it as a critical intervention target.

To date, this project has informed existing evidence through a number of publications. See links below.

Medical Research Council (MRC)

Wellcome Trust

Rosetrees Trust

NIHR UCLH Biomedical Research Centre (BRC)

Camden Clinical Commissioning Group