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Increased burden of respiratory symptoms may increase the risk of mortality. We assessed the association between respiratory symptom clusters and mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Participants were derived from two population-based Swedish adult cohorts (<jats:italic>N<\/jats:italic>\u2009=\u200963,060). Cluster analysis was performed with Locality Sensitive Hashing (LSH)-<jats:italic>k-<\/jats:italic>prototypes in subjects with\u2009\u2265\u20091 self-reported respiratory symptom. Linked mortality register data (up to 21\u00a0years of follow-up,\u2009&gt;\u2009600,000 person-years) were used. Associations between clusters and all-cause\/cause-specific mortality were assessed using asymptomatic subjects as reference.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Over 60% reported \u2265\u20091 respiratory symptom and ~\u200930% reported \u2265\u20095 respiratory symptoms. Five clusters were identified, partly overlapping with established respiratory disease phenotypes but many individuals were undiagnosed: (1) \"low-symptomatic\" (30.3%); (2) \"allergic nasal symptoms\" (10.7%); (3) \"allergic nasal symptoms, wheezing, and dyspnea attacks\" (4.7%); (4) \"wheezing and dyspnea attacks\" (6.6%); (5) \"recurrent productive cough and wheezing\" (4.1%). All but Cluster 2 were associated with all-cause mortality, highest risk for Cluster 3 (hazard ratio 1.4, 95% confidence interval 1.13\u20131.73) and Cluster 5 (1.4, 1.22\u20131.61). Comparable associations were seen for cardiovascular mortality. For respiratory mortality, Cluster 4 (2.02, 1.18\u20133.46) and Cluster 5 (1.89, 1.1\u20133.25) were most strongly associated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Respiratory symptoms are common in the general adult population, with identifiable clusters. These clusters have clinical relevancy as they are differentially associated with mortality and relatively weakly correlated with diagnosed respiratory disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12931-025-03224-7","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T14:55:51Z","timestamp":1744815351000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["All-cause and cause-specific mortality in respiratory symptom clusters: a population-based multicohort study"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0220-5961","authenticated-orcid":false,"given":"Daniil","family":"Lisik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0553-8067","authenticated-orcid":false,"given":"Helena","family":"Backman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5258-0906","authenticated-orcid":false,"given":"Hannu","family":"Kankaanranta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7510-8460","authenticated-orcid":false,"given":"Rani","family":"Basna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1630-3167","authenticated-orcid":false,"given":"Linnea","family":"Hedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-0041","authenticated-orcid":false,"given":"Linda","family":"Ekerljung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0892-5668","authenticated-orcid":false,"given":"Fredrik","family":"Nyberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3292-7471","authenticated-orcid":false,"given":"Anne","family":"Lindberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7010-7191","authenticated-orcid":false,"given":"G\u00f6ran","family":"Wennergren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2358-8754","authenticated-orcid":false,"given":"Eva","family":"R\u00f6nmark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2876-6089","authenticated-orcid":false,"given":"Bright","family":"Nwaru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4387-4096","authenticated-orcid":false,"given":"Lowie","family":"Vanfleteren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,16]]},"reference":[{"issue":"6","key":"3224_CR1","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1016\/j.aprim.2014.07.006","volume":"47","author":"MJ Bruscas Alijarde","year":"2015","unstructured":"Bruscas Alijarde MJ, Naberan To\u00f1a K, Lamb\u00e1n S\u00e1nchez MT, Bello Dronda S. 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Informed written consent was obtained from all participating individuals.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Helena Backman reports personal fees from AstraZeneca, Boehringer-Ingelheim, and GSK, outside the current work. Hannu Kankaanranta reports personal fees for lectures and consulting from AstraZeneca, Boehringer-Ingelheim, Chiesi Pharma, GSK, MSD, Novartis, Orion Pharma, and Sanofi Genzyme outside the current work. Fredrik Nyberg holds some AstraZeneca shares. Anne Lindberg reports personal fees for advisory board work for AstraZeneca, GlaxoSmithKline, Novartis and Boehringer Ingelheim, as well as personal fees for scientific lectures for Boehringer Ingelheim and Novartis, both outside the submitted work. The other authors declare no conflict of interest in relation to this work. Lowie Vanfleteren reports personal fees for lectures, advisory board or consulting for AstraZeneca, GSK, Chiesi, Novartis, Boehringer and Pulmonx. Daniil Lisik, Rani Basna, Linnea Hedman, Linda Ekerljung, G\u00f6ran Wennergren, Eva R\u00f6nmark, and Bright Nwaru have no conflicts to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"150"}}