Prevalence of behavioural risk factors and their combinations among older adults: cross-sectional results of the nationwide study Gesundheit 65+

Background Behavioural risk factors (BRFs) negatively impact health and well-being across life course, including older age. Data on their prevalence among older adults in Germany are scarce. This study examines prevalence of single BRFs — alcohol use, smoking, insufficient vegetable and fruit consumption, physical inactivity, and obesity — and identifies BRF combinations with a focus on sociodemographic disparities in adults aged 65 years and older. Methods The nationwide Gesundheit 65 + study (06/2021–04/2022) used a two-stage, stratified random sample from residents’ registration offices, and a design tailored to older adults. Data from 3,139 participants with complete information on all BRFs were analysed. Weighted prevalence estimates and 95% confidence intervals (CI) for BRFs, their total number, and combinations were stratified by age, sex, and education. Non-overlapping CIs indicated statistical significance. Results Prevalence estimates were 78.4% for physical inactivity, 71.8% for insufficient vegetable and fruit consumption, 56.3% for alcohol use, 21.0% for obesity, and 9.9% for smoking. Men reported more often than women alcohol use (69.8% vs. 45.2%) and inadequate diet (77.9% vs. 66.7%). Except for inadequate diet, prevalence varied by age and education. Participants averaged 2.4 BRFs; 83.1% reported multiple BRFs. The most frequent combinations were alcohol use + inadequate diet + physical inactivity (21.8%), inadequate diet + physical inactivity (16.0%), and physical inactivity alone (8.3%). Conclusions Multiple BRFs are highly prevalent among older adults in Germany, highlighting the need for comprehensive strategies combining policy measures (e.g. bans on alcohol advertising), community-level interventions (e.g. improved walkability), and targeted individual interventions to promote balanced diet, physical activity, and reduced alcohol use.