Clinical and environmental factors, functional status, and multimorbidity—stratifying progression and prognosis of multimorbidity, frailty, and disability: the Age-It Research Program

Objectives: This paper describes the methodology and activities of the third thematic challenge (Spoke 3) of the Age-It program. Spoke 3 aims to address the clinical complexity and heterogeneity of older subjects’ phenotypes through an interdisciplinary biomedical approach. Methods: Spoke 3 will investigate biomarkers related to multimorbidity and frailty, develop prognostic algorithms using novel methodological approaches, including artificial intelligence (AI) techniques to combine biological and clinical data, and identify management strategies for complex older subjects with multimorbidity and frailty. These activities will be realized by launching new prospective longitudinal studies and through new analyses of existing longitudinal cohorts. Results: Spoke 3 is expected to generate original evidence concerning older subjects with multimorbidity and/or frailty, to support a more precise diagnostic evaluation, to improve the ability to predict the functional and cognitive trajectories, with the final aim of better managing this complex population. Spoke 3 also aims to evaluate the impact of climate change and pollution on the health status of older subjects by combining health and environmental data. Discussion: Overcoming the traditional medical approach, focused on the diagnosis and treatment of single diseases, Spoke 3 should provide important original evidence to improve the management of older subjects with multimorbidity and frailty.