Physical activity is inversely associated with multimorbidity in elderly men: Results from the KORA-Age Augsburg Study

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Abstract

Objective

Physical activity is suggested to play a key role in the prevention of several chronic diseases. However, data on the association between physical activity and multimorbidity are lacking.

Methods

Using data from 1007 men and women aged 65–94 years who participated in the population-based KORA (Cooperative Health Research in the Region of Augsburg)-Age project conducted in Augsburg/Germany and two adjacent counties in 2008/09, 13 chronic conditions were identified, and physical activity scores were calculated based on the self-reported physical activity scale for the elderly (PASE). Multivariable sex-specific logistic regression was applied to determine the association of the continuous physical activity score with multimorbidity (≥ 2 out of 13 diseases).

Results

Physical activity (mean PASE score ± SD) was higher in men (125.1 ± 59.2) than in women (112.2 ± 49.2). Among men, the odds ratio (OR) for multimorbidity was 0.73 (95% CI: 0.60–0.90) for a 1 standard deviation increase of the PASE score. No significant results could be observed for women (OR: 1.05; 95% CI: 0.83–1.33).

Conclusion

We demonstrated an inverse association between physical activity and multimorbidity among men. Further prospective studies have to confirm the temporality of effects.

Highlights

► Total physical activity was associated with multimorbidity in men, but not in women. ► This association was observed in the highest versus the lowest activity quartile. ► Total and household activities were related with the CMD cluster among men.

Introduction

Chronic medical conditions such as cardiovascular disease have been identified as the leading cause of morbidity and mortality worldwide (World Health Organization, 2011). With rising life expectancies, multimorbidity, commonly defined as the co-occurrence of two or more chronic diseases in one individual, has reached alarmingly high numbers in the aged population (Marengoni et al., 2011). In a recent study among 123,224 German insurance policy holders aged ≥ 65 years, prevalence estimates of multimorbidity were 73% (van den Bussche et al., 2011). In the KORA (Cooperative Health Research in the Region of Augsburg)-Age Study, multimorbidity was prevalent in 58.6% of the 4127 persons aged 65–94 years (Kirchberger et al., 2012).

Engaging in an active lifestyle has proven to be protective against chronic diseases, such as coronary heart disease (Hakim et al., 1999) or type 2 diabetes (Hu et al., 2003), as reviewed by Bassuk and Manson (2005). However, epidemiological studies addressing the relationship between physical activity and multimorbidity are lacking and the very few studies investigating this research topic reported conflicting results (Hudon et al., 2008, Kaplan et al., 2001).

The aim of the present study was to investigate whether physical activity assessed as a continuous variable is inversely associated with multimorbidity among a large population-based sample of elderly men and women aged 65–94 years.

Section snippets

Methods

The present data are derived from the KORA-Age Study conducted in 2008/2009, which is a follow-up of all participants aged 65–94 years on December 31st, 2008 (n = 9197), who took part in at least one of the four cross-sectional MONICA (Multinational monitoring of trends and determinants in cardiovascular diseases)/KORA surveys conducted between 1984 and 2001 in the city of Augsburg and the two adjacent counties. 1079 eligible individuals (response rate: 53.8%) undertook an extensive examination (

Results

Table 1 shows that the mean PASE Score in any physical activity domain was higher among men than in women. Almost two-thirds of the study population (62.3% of men, 68.5% of women) were multimorbid.

Hypertension (62.3%) was the most frequently reported individual condition, followed by eye disease (45.3%), heart disease (30.6%) and joint disease (18.2%). The most common disease pairs were hypertension and eye disease (30.2%), and 6.3% of the study participants indicated that they exclusively

Discussion

In this cross-sectional analysis of 1007 elderly participants, our data suggest an inverse association between physical activity and multimorbidity in men, but not in women.

To date, very few population-based studies have been devoted to the topic of multimorbidity and physical activity. In a Canadian study among 12,611 individuals aged 65 years and older (Kaplan et al., 2001), the absence of 13 chronic conditions was related to frequent physical activity. However, results from another study

Conflict of interest statement

None of the authors declare any actual or potential conflict of interest.

Funding

The KORA research platform (KORA, Cooperative Health Research in the Region of Augsburg) was initiated and financed by the Helmholtz Zentrum München — German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research and by the State of Bavaria. The KORA-Age project was financed by the German Federal Ministry of Education and Research (BMBF FKZ 01ET0713, 01ET1003A) as part of the “Health in old age” program.

Acknowledgments

The authors thank the participants of the KORA-Age Study and the staff at the Augsburg Study center for their important contributions.

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