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Title: Association Between Lifestyle Factors and the Incidence of Multimorbidity in an Older English Population
Authors: Dhalwani, Nafeesa N.
Zaccardi, Francesco
O'Donovan, Gary
Carter, Patrice
Hamer, Mark
Yates, Thomas
Davies, Melanie
Khunti, Kamlesh
First Published: 28-Jul-2016
Publisher: Oxford University Press (OUP) for Gerontological Society of America
Citation: Journals of Gerontology, Series A, 2016, doi: 10.1093/gerona/glw146
Abstract: 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.
DOI Link: 10.1093/gerona/glw146
ISSN: 1079-5006
eISSN: 1758-535X
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2016. This version of the article is distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License ( ), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Appears in Collections:Published Articles, Dept. of Health Sciences

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