


A detailed description of the sampling procedures and data collection methods has been previously published ( 10). The study was designed to identify factors contributing to mobility decline and disability in older persons. The present analysis used data from the Invecchiare in Chianti (Aging in the Chianti Area, InCHIANTI) study, a longitudinal population-based study of older people living in the Chianti area, Tuscany, Italy. This study aims to investigate the relationship of levels of inflammatory markers and anabolic hormones with multimorbidity in the participants of the InCHIANTI study to identify cross-sectional correlates and predictors of future development of multimorbidity over a 9-year follow-up. Yet, this hypothesis has not been formally tested. Thus, it is reasonable to hypothesize that individuals with chronic inflammation and/or hormonal dysregulation are more likely to be affected by or to develop multimorbidity. Both conditions are risk factors for chronic diseases and predict a variety of adverse health outcomes, including frailty, disability, and mortality. Epidemiological and clinical studies have found that older persons often show a “low-grade chronic proinflammatory state” ( 8) and a “multiple hormonal dysregulation” ( 9) characterized by high levels of serum cytokines and low levels of anabolic hormones, respectively. Understanding the nature of such risk factors may shed light on the mechanisms by which some individuals tend to develop multiple and apparently unrelated chronic diseases as they age ( 7). However, little is known about risk factors for multimorbidity beyond age. Moreover, it is well-established that multimorbidity increases with age and, independent of age, it is strongly associated with frailty, disability, hospitalization, and mortality ( 6). Because aging is the strongest risk factor for many chronic diseases, including cardiovascular diseases, type 2 diabetes, cancer, and dementia, multimorbidity is considered an important landmark of poor health status in older people, resulting recently increasing interest among gerontology and clinical geriatric researchers in this topic ( 5). The coexistence of multiple diseases in the same person is usually referred to as multi morbidity if one condition is the focus, then the term comorbidity is more often used ( 4). T he number of older persons affected by multiple chronic diseases is progressively increasing and caring for them poses a number of scientific and organizational challenges for health care systems around the world ( 1–3). Multimorbidity, Inflammation, Interleukin-6, Aging, Chronic diseases.
