Multiple Chronic Conditions Can Hasten Cognitive Decline

Living with multiple chronic conditions (i.e., multimorbidity) can hasten cognitive decline. This cognitive decline includes faster declines in global cognition, immediate recall, and working memory.

These findings were reported in “Multimorbidity and Cognitive Decline Over 14 Years in Older Americans” by Melissa Y. Wei, M.D., MPH, MS; Deborah A. Levine, M.D., MPH; Laura B. Zahodne, Ph.D.; Mohammed U. Kabeto, MS; and Kenneth M. Langa, M.D., Ph.D. Researchers Dr. Wei and Kenneth Mukamal, M.D., developed the Multimorbidity-Weighted Index (MWI), which measures a person’s cumulative chronic conditions and the impact of these conditions on quality of life, and predicts many other important health outcomes including physical, mental, social, and cognitive health.

The goal was to determine the effect of chronic conditions on cognitive abilities, including episodic and working memory, and the rate of cognitive decline. To accomplish this, the researchers calculated the MWI score of 14,265 participants from the National Institute on Aging’s (NIA’s) Health and Retirement Study, with a mean age of 67 years. The researchers then followed the participants over a period of 14 years; MWI observations totaled 73,700 for these participants, which were used to compute their MWI score.

Based on nationally-representative Health and Retirement participants, the researchers found that participants with high MWI scores were also more likely to have worse cognitive health overall, and in specific domains. Each point increase in MWI was associated with declines in global cognition, immediate recall, delayed recall, and working memory. Although multimorbidity was associated with faster declines in global cognition, immediate recall, and working memory, it was not associated with delayed recall.

Health care professionals can access an abbreviated version of the Multimorbidity-Weighted Index tool to calculate multimorbidity and predict future physical functioning and risk of death by entering anonymous data. The tool is available at (accessed July 29, 2019).

The full text of “Multimorbidity and Cognitive Decline Over 14 Years in Older Americans” was published June 6, 2019, by Journals of Gerontology, Series A. An abstract is available online at (accessed July 29, 2019).

For more information, contact: Kara Gavin, Manager, Research and Policy Media Relations, University of Michigan Institute for Healthcare Policy and Innovation, 2800 Plymouth Road, Building 16, 4th Floor, Ann Arbor, Michigan 48109; 734-764-2220; Fax: 734-615-2169; Email:; Website:


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