Physical activity in the elderly could reduce multimorbidity risk

Research published recently in International Journal of Behavioral Nutrition and Physical Activity looked at the link between lower levels of physical activity and multimorbidity. Here, co-author Nafeesa Dhalwani answers our questions.

Why did you decide to use multimorbidity as a primary outcome, rather than looking at major chronic diseases individually?

Whilst it is important to study the association with individual chronic disease, multimorbidity (defined as two or more chronic conditions) has now become the norm in primary care. This is because most older adults present with multiple chronic conditions, which makes the care and management more complex than a single condition.

This can lead to poorer health outcomes, higher health utilization and poor quality of life. To address this global health issue a better understanding of multimorbidity is required, which is currently lacking in scientific literature.

How does your research build on what has previously been found in the literature?

As mentioned above, there are major research gaps in the area of multimorbidity and to date only one study from the Netherlands has looked at the long term trends of multimorbidity. However, these data are now over a decade old.

Healthcare environments, diagnosis and management pathways have changed a lot in the past ten years and therefore contemporaneous estimates are required in order to plan health care interventions effectively.

Our study, based on a national sample of ageing population from England found a steady increase in multimorbidity over the ten year period with further evidence that the higher your levels of physical activity, the lower your odds are to have multimorbidity.

Also the association between physical activity and multimorbidity has been studied in the past in different populations but results remain inconclusive.

Our study, based on a national sample of ageing population from England found a steady increase in multimorbidity over the ten year period with further evidence that the higher your levels of physical activity, the lower your odds are to have multimorbidity.

There is clearly more work required to look at causation and mechanisms by which physical activity may prevent multimorbidity but our work suggests that physical activity may have a great potential as a preventive strategy in multimorbidity.

Would it be interesting to further look into the effect of the genetic background and baseline BMI?

Yes it will definitely be interesting to look at whether these association hold for different ethnic groups as we already know the risk of diabetes and cardiovascular diseases vary greatly by ethnicity.

Another interesting aspect is the role of other lifestyle factors in the development of multimorbidity (such as smoking, obesity, and so on). We are currently exploring these in a larger, well-phenotyped dataset and will have the results ready soon.

Additionally, another important question is whether the trajectories of the development of multimorbidity and progression to mortality is different between both sexes, by ethnicity or any other factors.

Genetics is another potential aspect which hasn’t really been explored much in the field of multimorbidity.

How would you interpret your findings?

The World Health Organisation recommends that older adults should do at least 150 min of moderate-intensity physical activity during the week or at least 75 min of vigorous-intensity physical activity during the week or an equivalent combination of both.

So based on our findings, we would encourage older people to engage in physical activity. However, considering the myriad of health and mobility issues in this population, they may need more supervision or tailored physical activity plans to optimize the effects of physical activity.

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