Management of multimorbidity in the midst of cognitive decline through clinical decision‐support software
Mark C. Zelek, John Q. Walker, Marwan N. SabbaghAbstract
INTRODUCTION
Multimorbidity – the coexistence of multiple chronic conditions – is common among older adults with cognitive impairment but is rarely addressed in an integrated manner.
METHODS
We analyzed 17,915 adults aged 55 to 84 years (8997 receiving uMETHOD clinical decision‐support care plans and 8918 from the National Health and Nutrition Examination Survey). The mean age was 69.0 years (SD 7.65; 95% CI: 68.86 to 69.1). Multimorbidity was quantified from diagnoses, labs, medications, vitals, and platform‐inferred conditions. Associations with cognitive impairment were modeled using age‐ and sex‐adjusted logistic regression.
RESULTS
Cognitive impairment was reported in 25.91% of participants (97.5% with ≥2 conditions); each additional condition was associated with higher odds (odds ratio: 1.069; 95% CI: 1.061 to 1.077; p < 0.0001). Prominent clusters included vascular‐metabolic disorders and micronutrient deficiencies.
DISCUSSION
Cognitive vulnerability rises stepwise with disease burden. Precision, multimorbidity‐aware decision support that integrates multidomain data can align cognitive and systemic care in real‐world practice.