What does this research mean for the field?

Accumulating multiple unhealthy lifestyle factors, particularly smoking and abnormal BMI, significantly increases the likelihood of multimorbidity in adults aged 45 and older, with women showing increased risk at a lower threshold of combined factors than men. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 4, 2014BMC Public Health279 citationsOpen Access

Lifestyle factors and multimorbidity: a cross sectional study

MFMartin FortinUniversité de Sherbrooke JHJeannie HaggertyMcGill University JAJosé AlmirallUniversité de Sherbrooke

Structured PICO

Do unhealthy lifestyle factors increase the likelihood of multimorbidity in adults aged 45 years and older?

Population

1,196 subjects aged 45 years and older from a randomly-selected cohort in the general population in Quebec, Canada.

Intervention

Presence of unhealthy lifestyle factors (smoking, alcohol consumption, low fruit and vegetable consumption, low physical activity, and abnormal body mass index).

Comparator

Absence of unhealthy lifestyle factors (achieving recommended behavioural targets).

Outcome

Multimorbidity (defined as 3 or more self-reported chronic diseases from a list of 14).patient reported

The accumulation of unhealthy lifestyle factors is associated with a progressively increased likelihood of multimorbidity, with a lower threshold of harm observed in women compared to men.

Abstract

BACKGROUND: Lifestyle factors have been associated mostly with individual chronic diseases. We investigated the relationship between lifestyle factors (individual and combined) and the co-occurrence of multiple chronic diseases. METHODS: Cross-sectional analysis of results from the Program of Research on the Evolution of a Cohort Investigating Health System Effects (PRECISE) in Quebec, Canada. Subjects aged 45 years and older. A randomly-selected cohort in the general population recruited by telephone. Multimorbidity (3 or more chronic diseases) was measured by a simple count of self-reported chronic diseases from a list of 14. Five lifestyle factors (LFs) were evaluated: 1) smoking habit, 2) alcohol consumption, 3) fruit and vegetable consumption, 4) physical activity, and 5) body mass index (BMI). Each LF was given a score of 1 (unhealthy) if recommended behavioural targets were not achieved and 0 otherwise. The combined effect of unhealthy LFs (ULFs) was evaluated using the total sum of scores. RESULTS: A total of 1,196 subjects were analyzed. Mean number of ULFs was 2.6 ± 1.1 SD. When ULFs were considered separately, there was an increased likelihood of multimorbidity with low or high BMI Odd ratio (95% Confidence Interval): men, 1.96 (1.11-3.46); women, 2.57 (1.65-4.00), and present or past smoker men, 3.16 (1.74-5.73). When combined, in men, 4-5 ULFs increased the likelihood of multimorbidity 5.23 (1.70-16.1); in women, starting from a threshold of 2 ULFs 1.95 (1.05-3.62), accumulating more ULFs progressively increased the likelihood of multimorbidity. CONCLUSIONS: The present study provides support to the association of lifestyle factors and multimorbidity.

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