Objective To examine the joint association of a composite lifestyle score and the number of chronic musculoskeletal pain sites with all-cause mortality.Methods This prospective study included 36 106 participants from the third survey of the Trøndelag Health Survey Study (2006–2008) in Norway, with up to 14 years of follow-up. We estimated HRs with 95% CIs for all-cause mortality associated with the number of chronic pain sites and a composite lifestyle score based on body mass index, smoking status, leisure-time physical activity, alcohol consumption and intake of fruit and vegetables. Each factor was scored from 0 to 2, yielding a total score ranging from 0 to 10, with higher scores indicating a healthier lifestyle.Results During an average follow-up of 12.5 years, 4436 (12%) participants died. Compared with individuals without chronic musculoskeletal pain and with the healthiest lifestyle (score 8–10 points), individuals with the poorest lifestyle (score 0–3 points) had an HR for all-cause mortality of 1.78 (95% CI 1.50 to 2.11) if they had no chronic pain and an HR of 1.86 (95% CI 1.48 to 2.33) if they had ≥5 chronic pain sites. In comparison, individuals with the healthiest lifestyle and ≥5 chronic pain sites had an HR of 0.92 (95% CI 0.70 to 1.22).Conclusions Individuals with multiple unhealthy lifestyle factors have nearly twice the risk of death from all causes compared with those with the healthiest lifestyle. We found no synergistic effect between multisite pain and the composite lifestyle score on mortality.
Nilsen et al. (Sun,) studied this question.