疾患パターンが高齢者の生活習慣介入を導く可能性(Disease patterns may guide lifestyle interventions in older adults)

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2026-08-31 カロリンスカ研究所(KI)

スウェーデンのカロリンスカ研究所などの研究チームは、70歳超で身体的フレイル、筋肉量低下、複数の慢性疾患を抱える1,199人を対象に、疾患の組み合わせによって生活習慣介入の効果が異なることを明らかにした。11か国のデータを用い、参加者を疾患パターンに基づき「非特異型」「精神疾患型」「心血管・代謝型」「呼吸器型」の4群に分類。運動、食事指導、技術支援を組み合わせた介入では、全体として移動能力障害または死亡のリスクが22%低下したが、精神疾患型では35%低下する一方、心血管・代謝型と呼吸器型では明確な効果が認められなかった。この結果は、慢性疾患の「数」だけでなく「組み合わせ」を考慮することで、高齢者の障害予防を個別化できる可能性を示す。ただし、今回の解析は臨床試験の事後解析であり、さらなる検証が必要とされている。

<関連情報>

SPRINTT試験から得られた、複数の疾患が併存するパターンが虚弱な高齢者の移動障害予防に及ぼす影響 Multimorbidity patterns influence mobility disability prevention in frail older adults from the SPRINTT trial

Davide Liborio Vetrano,Caterina Gregorio,Federico Triolo,Luca Soraci,Antonio Cherubini,Matteo Tosato,Stephan von Haehling,Emanuele Marzetti,Francesco Landi & Riccardo Calvani
Nature Aging  Published:31 August 2026
DOI:https://doi.org/10.1038/s43587-026-01188-x

疾患パターンが高齢者の生活習慣介入を導く可能性(Disease patterns may guide lifestyle interventions in older adults)

Abstract

Preserving independence in older adults is a public health priority. Lifestyle interventions can prevent physical disability, but whether their efficacy is influenced by multimorbidity profiles is unclear. In this post hoc analysis of the SPRINTT randomized trial (NCT02582138), we investigated whether the efficacy of a multicomponent intervention (physical activity with technological support and nutritional counseling) differed across multimorbidity patterns. We included 1,199 community-dwelling adults aged ≥70 years with frailty, sarcopenia and two or more chronic conditions. Latent class analysis identified four multimorbidity patterns: unspecific (55%), psychiatric (24%), cardiometabolic (13%) and respiratory (7%). The intervention reduced the overall risk of mobility disability or death (hazard ratio (HR) 0.78, 95% confidence interval (CI) 0.66–0.92). In subgroup analyses, a significant benefit was observed in participants with a psychiatric multimorbidity pattern (HR 0.65, 95% CI 0.47–0.92). Bayesian partial pooling analyses also supported a beneficial effect in the unspecific pattern (HR 0.80, 95% credible interval 0.69–0.93), while estimates for the cardiometabolic and respiratory patterns were imprecise and not statistically significant. The intervention increased the event-free probability at 24 and 36 months and extended the time free from mobility disability or death by 2.09 months overall. Gains were 3.09 months in the psychiatric pattern and 1.99 months in the unspecific pattern, with no meaningful differences observed in the cardiometabolic and respiratory patterns. These findings suggest that the composition of multimorbidity may influence responsiveness to lifestyle interventions and that stratification based on disease patterns could improve the targeting and effectiveness of preventive strategies in older adults.

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