{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:03:03Z","timestamp":1785420183561,"version":"3.56.0"},"posted":{"date-parts":[[2026,6,22]]},"group-title":"Epidemiology","reference-count":51,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"name":"National Institute on Ageing and National Cancer Institute at the National Institutes of Health","award":["U01AG029824"],"award-info":[{"award-number":["U01AG029824"]}]},{"name":"National Institute on Ageing and National Cancer Institute at the National Institutes of Health","award":["U19AG062682"],"award-info":[{"award-number":["U19AG062682"]}]},{"name":"National Health and Medical Research Council of Australia","award":["1127060"],"award-info":[{"award-number":["1127060"]}]},{"name":"National Health and Medical Research Council of Australia","award":["2016438"],"award-info":[{"award-number":["2016438"]}]},{"id":[{"id":"https:\/\/ror.org\/02bfwt286","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Australian Government Research Training Program Scholarship"},{"name":"Monash International Tuition Scholarship"},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"crossref","award":["110205-2025_PDF"],"award-info":[{"award-number":["110205-2025_PDF"]}],"id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,6,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Multimorbidity is common in older adults, but sex differences in chronic condition clustering remain unclear. This study explored multimorbidity clusters and their associations with all-cause mortality among community-dwelling adults aged 70 years and over.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a secondary analysis of data from 16,095 Australian ASPREE participants aged \u226570 years without prior dementia or cardiovascular disease. Fifteen baseline chronic conditions were grouped using latent class analysis (LCA). Observed-to-expected (O\/E) ratios characterised conditions over-represented within clusters, and Cox proportional hazards models assessed associations with all-cause mortality.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 16,095 participants (mean age 74 years), 88.3% had multimorbidity at baseline; 4,217 deaths occurred over a median follow-up of 10.85 years. Five clusters were identified overall: hypertension &amp; dyslipidemia (52.1%), gout &amp; metabolic (14.4%), depressive symptoms, osteoporosis &amp; frailty (10.0%), anaemia &amp; kidney disease (10.2%), and hypotension, thyroid disorder &amp; past cancer (13.3%). Sex-stratified analyses revealed three clusters in males and four in females. The frailty, depressive symptoms &amp; osteoporosis cluster was associated with higher mortality in both sexes (aHR 1.56 [95% CI 1.40\u20131.73] in males; 1.68 [1.49\u20131.89] in females). Higher mortality was also observed for the metabolic, gout &amp; kidney disease cluster in males (aHR 1.63 [1.47\u20131.81]) and the gout, anaemia &amp; kidney disease cluster in females (aHR 1.96 [1.74\u20132.21]).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Distinct multimorbidity clusters differed by sex and were associated with increased all-cause mortality. These findings may support risk stratification, targeted screening, and more person-centred management of older adults with multimorbidity.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.06.18.26355909","type":"posted-content","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T16:25:39Z","timestamp":1782145539000},"source":"Crossref","is-referenced-by-count":0,"title":["Sex-specific multimorbidity clusters and all-cause mortality in relatively healthy older adults: findings from the ASPREE cohort"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3750-5666","authenticated-orcid":false,"given":"Rong","family":"Du","sequence":"first","affiliation":[{"name":"1School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 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