Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries
Abstract Background Sedentary behavior (SB) is, irrespective of a person’s physical activity levels, associated with a wide range of deleterious outcomes such as diabetes, stroke and associated premature mortality. There are no nationally representative, multi-national, population-based studies inve...
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doaj-eeb8ae419fe64b2a9a6b31d873c920bb2020-11-24T23:44:03ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682017-10-0114111310.1186/s12966-017-0602-zPhysical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countriesDavy Vancampfort0Brendon Stubbs1Ai Koyanagi2KU Leuven Department of Rehabilitation SciencesPhysiotherapy Department, South London and Maudsley NHS Foundation TrustResearch and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de DéuAbstract Background Sedentary behavior (SB) is, irrespective of a person’s physical activity levels, associated with a wide range of deleterious outcomes such as diabetes, stroke and associated premature mortality. There are no nationally representative, multi-national, population-based studies investigating the relationship between SB, chronic conditions, and physical multimorbidity (i.e., two or more chronic physical conditions). Thus, this cross-sectional study aimed to assess the association between chronic conditions, physical multimorbidity and SB among community-dwelling adults in six low- and middle-income countries (LMICs). We also explored the influential factors of these relationships. Method The Study on Global Ageing and Adult Health (SAGE) survey included 34,129 adults aged ≥50 years. SB was self-reported and expressed as a categorical variable [<8 or ≥8 h per day (high SB)]. Eleven chronic physical conditions (angina, arthritis, asthma, chronic back pain, chronic lung disease, diabetes, edentulism, hearing problems, hypertension, stroke, visual impairment) were assessed. Multivariable logistic regression and mediation analyses were conducted. Results The prevalence of physical multimorbidity and high SB (≥8 h/day) were 45.5% (43.7%–47.4%) and 10.8% (9.7%–12.1%), respectively. The prevalence of high SB increased in a linear fashion from 7.1% in people with no chronic condition to 24.1% in those with ≥4 chronic conditions. In the multivariable analysis, visual impairment (OR = 2.62), stroke (OR = 2.02), chronic back pain (OR = 1.70) hearing problems (OR = 1.58), chronic lung disease (OR = 1.48), asthma (OR = 1.39), arthritis (OR = 1.22) and multimorbidity (OR = 1.41) were significantly associated with high SB. Disability explained more than 50% of the association for all chronic conditions with particularly high percentages (>80%) for arthritis, asthma, and multimorbdity. Mobility problems explained 88.1% and 85.1% of the association of SB with arthritis and physical multimorbidiy, respectively. Pain was highly influential in the SB-arthritis relationship (85.6%). Sleep/energy problems explained between 9.3% (stroke) to 49.1% (arthritis) of the association, and cognitive problems from 21.5% (stroke) to 33.4% (hearing problems). Findings for anxiety and depression were mixed. Conclusion In LMICs, those with chronic conditions and physical multimorbidity are significantly more sedentary. Targeted messages to reduce time spent sedentary among individuals with chronic conditions may ameliorate associated disability, mobility difficulties and pain that are themselves the most important risk factors for SB.http://link.springer.com/article/10.1186/s12966-017-0602-zMultimorbidityPainMobility limitationSittingSedentary time |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Davy Vancampfort Brendon Stubbs Ai Koyanagi |
spellingShingle |
Davy Vancampfort Brendon Stubbs Ai Koyanagi Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries International Journal of Behavioral Nutrition and Physical Activity Multimorbidity Pain Mobility limitation Sitting Sedentary time |
author_facet |
Davy Vancampfort Brendon Stubbs Ai Koyanagi |
author_sort |
Davy Vancampfort |
title |
Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries |
title_short |
Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries |
title_full |
Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries |
title_fullStr |
Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries |
title_full_unstemmed |
Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries |
title_sort |
physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries |
publisher |
BMC |
series |
International Journal of Behavioral Nutrition and Physical Activity |
issn |
1479-5868 |
publishDate |
2017-10-01 |
description |
Abstract Background Sedentary behavior (SB) is, irrespective of a person’s physical activity levels, associated with a wide range of deleterious outcomes such as diabetes, stroke and associated premature mortality. There are no nationally representative, multi-national, population-based studies investigating the relationship between SB, chronic conditions, and physical multimorbidity (i.e., two or more chronic physical conditions). Thus, this cross-sectional study aimed to assess the association between chronic conditions, physical multimorbidity and SB among community-dwelling adults in six low- and middle-income countries (LMICs). We also explored the influential factors of these relationships. Method The Study on Global Ageing and Adult Health (SAGE) survey included 34,129 adults aged ≥50 years. SB was self-reported and expressed as a categorical variable [<8 or ≥8 h per day (high SB)]. Eleven chronic physical conditions (angina, arthritis, asthma, chronic back pain, chronic lung disease, diabetes, edentulism, hearing problems, hypertension, stroke, visual impairment) were assessed. Multivariable logistic regression and mediation analyses were conducted. Results The prevalence of physical multimorbidity and high SB (≥8 h/day) were 45.5% (43.7%–47.4%) and 10.8% (9.7%–12.1%), respectively. The prevalence of high SB increased in a linear fashion from 7.1% in people with no chronic condition to 24.1% in those with ≥4 chronic conditions. In the multivariable analysis, visual impairment (OR = 2.62), stroke (OR = 2.02), chronic back pain (OR = 1.70) hearing problems (OR = 1.58), chronic lung disease (OR = 1.48), asthma (OR = 1.39), arthritis (OR = 1.22) and multimorbidity (OR = 1.41) were significantly associated with high SB. Disability explained more than 50% of the association for all chronic conditions with particularly high percentages (>80%) for arthritis, asthma, and multimorbdity. Mobility problems explained 88.1% and 85.1% of the association of SB with arthritis and physical multimorbidiy, respectively. Pain was highly influential in the SB-arthritis relationship (85.6%). Sleep/energy problems explained between 9.3% (stroke) to 49.1% (arthritis) of the association, and cognitive problems from 21.5% (stroke) to 33.4% (hearing problems). Findings for anxiety and depression were mixed. Conclusion In LMICs, those with chronic conditions and physical multimorbidity are significantly more sedentary. Targeted messages to reduce time spent sedentary among individuals with chronic conditions may ameliorate associated disability, mobility difficulties and pain that are themselves the most important risk factors for SB. |
topic |
Multimorbidity Pain Mobility limitation Sitting Sedentary time |
url |
http://link.springer.com/article/10.1186/s12966-017-0602-z |
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