Lifestyle factors and multimorbidity: a cross sectional study

Abstract

BackgroundLifestyle factors have been associated mostly with individual chronic diseases. We investigated the relationship between lifestyle factors (individual and combined) and the co-occurrence of multiple chronic diseases.MethodsCross-sectional analysis of results from the Program of Research on the Evolution of a Cohort Investigating Health System Effects (PRECISE) in Quebec, Canada. Subjects aged 45 years and older. A randomly-selected cohort in the general population recruited by telephone. Multimorbidity (3 or more chronic diseases) was measured by a simple count of self-reported chronic diseases from a list of 14. Five lifestyle factors (LFs) were evaluated: 1) smoking habit, 2) alcohol consumption, 3) fruit and vegetable consumption, 4) physical activity, and 5) body mass index (BMI). Each LF was given a score of 1 (unhealthy) if recommended behavioural targets were not achieved and 0 otherwise. The combined effect of unhealthy LFs (ULFs) was evaluated using the total sum of scores.ResultsA total of 1,196 subjects were analyzed. Mean number of ULFs was 2.6 ± 1.1 SD. When ULFs were considered separately, there was an increased likelihood of multimorbidity with low or high BMI [Odd ratio (95% Confidence Interval): men, 1.96 (1.11-3.46); women, 2.57 (1.65-4.00)], and present or past smoker [men, 3.16 (1.74-5.73)]. When combined, in men, 4-5 ULFs increased the likelihood of multimorbidity [5.23 (1.70-16.1)]; in women, starting from a threshold of 2 ULFs [1.95 (1.05-3.62)], accumulating more ULFs progressively increased the likelihood of multimorbidity.ConclusionsThe present study provides support to the association of lifestyle factors and multimorbidity.

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

“…A secondary cross-sectional analysis of the PRECISE cohort from Canada did not find a significant association between high risk drinking and multimorbidity (odds ratio (OR) 0.94, 95% CI 0.43-2.03 for men and OR 0.83, 95% CI 0.31-2.23 for women), which is in line with our findings. 9 We found a 32% increase in the multimorbidity hazard in association with physical inactivity. This is consistent with the results of the previous prospective Finnish study which found a 34% increase in the risk of multimorbidity in men and 62% in women with physical inactivity who were initially disease-free.…”

“…9,10,12 We only included data from the three most recent ELSA waves for this analysis in order to capture all five lifestyle factors; we still had a large number of people in the study with over 100,000 person-months of follow-up, however when assessing different triads and tetrads of unhealthy lifestyle factors the number of people with specific combinations of unhealthy lifestyle factors was quite low as depicted by the small number of people in some triads and tetrads (Supplementary Table 1) and wide confidence intervals of the estimates. Consequently, it is difficult to distinguish true negative findings from the negative findings associated with low statistical power; therefore the findings should be interpreted with caution.…”

Clinical and lifestyle-related risk factors for incident multimorbidity: 10-year follow-up of Finnish population-based cohorts 1982–2012

“…Only a few studies have evaluated the association of modifiable risk factors with multimorbidity, and especially the longitudinal studies are scarce [5][6][7][8][9]. Biological and lifestyle factors such as hypercholesterolemia, hypertension, obesity, smoking, physical inactivity and unhealthy diet are common risk factors for many chronic diseases [1].…”

Determinants of Multimorbidity among The Elderly Population in Indonesia

“…19 Recent study found the association of lifestyle factors and multimorbidity. 20 The burden of multimorbidity has typically been studied in high income countries, very few of these studies conducted in low and middle income countries. 4,13 As such, the prevalence and determinants of multimorbidity in Indonesia is relatively unknown.…”