What Is the Impact of Physical Activity and Physical Function on the Development of Multimorbidity in Older Adults Over Time? A Population-Based Cohort Study

Abstract

BackgroundMultimorbidity is recognized internationally as having a serious impact on health outcomes. It is associated with reduced quality of life, increased health care utilization, and future functional decline. Physical activity is associated with good health and psychological well-being. The aim of this study was to identify the impact of physical activity and physical function on the development and worsening of multimorbidity over time.MethodsUsing The Irish Longitudinal Study on Ageing (TILDA), we analyzed 4,823 participants ≥50 years with and without multimorbidity. Multimorbidity was defined as the presence of ≥2 chronic conditions. Development of multimorbidity was measured as the accrual of additional conditions over a 2-year period. Physical activity and physical function were measured using the International Physical Activity Questionnaire (IPAQ), gait speed (m/sec), and grip strength (kg).ResultsSixteen groups of chronic conditions were included in analyses. 53.7% of included participants had multimorbidity at baseline and 71.7% at follow-up. Six hundred and thirty-eight of 2,092 (30.4%) participants without multimorbidity and 1,005 of 2,415 (41.6%) with existing multimorbidity developed new condition/s. Gait speed (relative risk [RR] = 0.67, confidence interval [CI]: 0.49–0.90), grip strength (RR = 0.98, CI: 0.97–0.99), and age (compared to 50–59 years, 60–69: RR = 1.30, CI: 1.11–1.52; ≥70: RR = 1.35, CI: 1.03–1.77) were significantly associated with the development of multimorbidity and accrual of additional conditions.ConclusionThese results show that physical function is associated with the development and worsening of multimorbidity over time. They support the recent National Institute for Health & Care Excellence (NICE) Guidance on multimorbidity that suggests that patients with multimorbidity and reduced gait speed should be identified and targeted for interventions to improve health outcomes.

Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population

“…It is also possible that other factors, e.g., greater disease burden, depressive symptoms, and financial constraints may contribute to both lower HRQoL and lower physical functioning in this population [52], however, we did not examine them in the current study. While the cross-sectional nature of the study prevents us from drawing causal inferences, tackling physical inactivity and obesity among these patients does hold some promise in preventing accrual of other conditions and further worsening of multimorbidity over time [53]. There is evidence to suggest that even small improvements in physical activity can result in clinically relevant reduction in the overall risk of chronic conditions like cardiovascular diseases as well as in all-cause mortality [54,55].…”

Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population

“…This meant that 29% of the participants did not achieve the recommended criteria of at least 150 minutes per week of physical activity; this group corresponds to those with low activity in our study. The Irish Longitudinal Study on Ageing assessed 8,175 community-dwelling residents aged 50 years and older using the IPAQ and categorized them as low, moderate and high activity based on the same criteria as the current study [55]. The prevalence of low activity among those with multimorbidity in the Irish study was 30% which was lower than that found in the current study.…”

Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population

“…week of physical activity; this group corresponds to those with low activity in our study. The Irish Longitudinal Study on Ageing assessed 8,175 community-dwelling residents aged 50 years and older using the IPAQ and categorized them as low, moderate and high activity based on the same criteria as the current study [55]. The prevalence of low activity among those with multimorbidity in the Irish study was 30% which was lower than that found in the current study.…”

“…Other studies have found that physical inactivity was associated with both obesity and multimorbidity [56,57], and being overweight or obese was an independent risk factor for multimorbidity [58,59]. While the cross-sectional nature of the study prevents us from drawing causal inferences, tackling physical inactivity and obesity among these patients does hold some promise in preventing accrual of other conditions and further worsening of multimorbidity over time [55]. There is evidence to suggest that even small improvements in physical activity can result in clinically relevant reduction in the overall risk of chronic conditions like cardiovascular diseases as well as in all-cause mortality [60,61].…”