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Association Between Lifestyle Factors and the Incidence of Multimorbidity in an Older English Population

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journal contribution
posted on 11.10.2016, 13:35 by Nafeesa N. Dhalwani, Francesco Zaccardi, Gary O'Donovan, Patrice Carter, Mark Hamer, Thomas Yates, Melanie Davies, Kamlesh Khunti
Background: Evidence on the role of lifestyle factors in relation to multimorbidity, especially in elderly populations, is scarce. We assessed the association between five lifestyle factors and incident multimorbidity (presence of ≥2 chronic conditions) in an English cohort aged ≥50 years. Methods: We used data from waves 4, 5, and 6 of the English Longitudinal Study of Ageing. Data on smoking, alcohol consumption, physical activity, fruit and vegetable consumption, and body mass index were extracted and combined to generate a sum of unhealthy lifestyle factors for each individual. We examined whether these lifestyle factors individually or in combination predicted multimorbidity during the subsequent wave. We used marginal structural Cox proportional hazard models, adjusted for both time-constant and time-varying factors. Results: A total of 5,476 participants contributed 232,749 person-months of follow-up during which 1,156 cases of incident multimorbidity were recorded. Physical inactivity increased the risk of multimorbidity by 33% (adjusted hazard ratio [aHR]: 1.33, 95% confidence interval [CI]: 1.03–1.73). The risk was about two to three times higher when inactivity was combined with obesity (aHR: 2.87, 95% CI: 1.55–5.31) or smoking (aHR: 2.35, 95% CI: 1.36–4.08) and about four times when combined with both (aHR: 3.98, 95% CI: 1.02–17.00). Any combination of 2, 3, and 4 or more unhealthy lifestyle factors significantly increased the multimorbidity hazard, compared with none, from 42% to 116%. Conclusion: This study provides evidence of a temporal association between combinations of different unhealthy lifestyle factors with multimorbidity. Population level interventions should include reinforcing positive lifestyle changes in the population to reduce the risk of developing multimorbidity.

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Citation

Journals of Gerontology, Series A, 2016, doi: 10.1093/gerona/glw146

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine

Version

AM (Accepted Manuscript)

Published in

Journals of Gerontology

Publisher

Oxford University Press (OUP) for Gerontological Society of America

issn

1079-5006

eissn

1758-535X

Acceptance date

09/07/2016

Copyright date

2016

Available date

28/07/2017

Publisher version

http://biomedgerontology.oxfordjournals.org/content/early/2016/07/28/gerona.glw146

Language

en

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