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Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Association between physical activity, multimorbidity, self-rated health and functional limitation in the Spanish population

Authors: Cristina Cimarras-Otal, Amaia Calderón-Larrañaga, Beatriz Poblador-Plou, Francisca González-Rubio, Luis A Gimeno-Feliu, José L Arjol-Serrano, Alexandra Prados-Torres

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

Physical activity (PA) has been shown to improve the general health of patients with chronic diseases and to prevent the onset of such conditions. However, the association between multimorbidity and PA has not been investigated in detail, and recent studies of this topic yield dissenting results. The objective of this study was to examine whether PA levels were associated with multimorbidity, self-rated health and functional limitation.

Methods

This was a cross-sectional study based on data from the 2009 European Health Interview Survey for Spain. The sample population included 22,190 adults over 15 years of age. The independent variables were multimorbidity (measured as the number of chronic diseases), activity limitations, and self-rated health status. The dependent variable was PA level, measured as a) a continuous variable in metabolic equivalents (METs) and b) a dichotomous variable based on international recommendations (</≥500 MET-minutes per week). The associations between the dependent and independent variables were evaluated across sex and age groups (16–24, 25–44, 45–64, 65–74, >74 years), using multivariate linear and logistic regression models that were adjusted for age, educational level and employment status.

Results

An inverse association was found between PA and multimorbidity among older males and young females between 16–24 years. This negative association was also observed among males aged 25–44 years when analysing PA as a dichotomous variable. Self-rated health status was directly related to the achievement of minimum PA levels among middle-aged and older individuals, but the opposite happened among the youngest group of females. Significant associations between the existence of activity limitations and the performance of lower volumes of PA were consistently observed among subjects over 44 years.

Conclusions

There is an inverse association between multimorbidity and PA in the youngest and oldest age groups. In addition, both low self-rated health status and the presence of functional limitations were related to lower PA in most of the examined population groups. These features should be considered in the design and implementation of community-based approaches to promoting PA, if further corroborated in longitudinal studies.
Literature
1.
go back to reference US Department of Health and Human Services: Physical activity guidelines advisory committee report, 2008: to the secretary of health and human services, part A: executive summary. Nutr Rev. 2009, 67: 114-120.CrossRef US Department of Health and Human Services: Physical activity guidelines advisory committee report, 2008: to the secretary of health and human services, part A: executive summary. Nutr Rev. 2009, 67: 114-120.CrossRef
2.
3.
go back to reference Woodcock J, Franco OH, Orsini N, Roberts I: Non-vigorous physical activity and all-cause mortality: systematic review and meta-analysis of cohort studies. Int J Epidemiol. 2011, 40: 121-138. 10.1093/ije/dyq104.CrossRefPubMed Woodcock J, Franco OH, Orsini N, Roberts I: Non-vigorous physical activity and all-cause mortality: systematic review and meta-analysis of cohort studies. Int J Epidemiol. 2011, 40: 121-138. 10.1093/ije/dyq104.CrossRefPubMed
5.
go back to reference Katzmarzyk PT, Janssen I: The economic costs associated with physical inactivity and obesity in Canada: an update. Can J Appl Physiol. 2004, 29: 90-115. 10.1139/h04-008.CrossRefPubMed Katzmarzyk PT, Janssen I: The economic costs associated with physical inactivity and obesity in Canada: an update. Can J Appl Physiol. 2004, 29: 90-115. 10.1139/h04-008.CrossRefPubMed
6.
go back to reference Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP: American College of Sports Medicine position stand: quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011, 43: 1334-1359. 10.1249/MSS.0b013e318213fefb.CrossRefPubMed Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP: American College of Sports Medicine position stand: quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011, 43: 1334-1359. 10.1249/MSS.0b013e318213fefb.CrossRefPubMed
7.
go back to reference Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CD, Heath GW, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007, 39: 1423-1434. 10.1249/mss.0b013e3180616b27.CrossRefPubMed Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CD, Heath GW, Thompson PD, Bauman A: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007, 39: 1423-1434. 10.1249/mss.0b013e3180616b27.CrossRefPubMed
8.
go back to reference Van den Akker M, Buntinx F, Metsemakers JF, Roos S, Knottnerus JA: Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol. 1998, 51: 367-375. 10.1016/S0895-4356(97)00306-5.CrossRefPubMed Van den Akker M, Buntinx F, Metsemakers JF, Roos S, Knottnerus JA: Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol. 1998, 51: 367-375. 10.1016/S0895-4356(97)00306-5.CrossRefPubMed
9.
go back to reference Formiga F, Ferrer A, Sanz H, Marengoni A, Alburquerque J, Pujol R: Patterns of comorbidity and multimorbidity in the oldest old: the Octabaix study. Eur J Intern Med. 2013, 24: 40-44. 10.1016/j.ejim.2012.11.003.CrossRefPubMed Formiga F, Ferrer A, Sanz H, Marengoni A, Alburquerque J, Pujol R: Patterns of comorbidity and multimorbidity in the oldest old: the Octabaix study. Eur J Intern Med. 2013, 24: 40-44. 10.1016/j.ejim.2012.11.003.CrossRefPubMed
10.
go back to reference Autenrieth CS, Kirchberger I, Heier M, Zimmermann AK, Peters A, Doring A, Thonard B: Physical activity is inversely associated with multimorbidity in elderly men: results from the KORA-Age Augsburg Study. Prev Med. 2013, 57: 17-19. 10.1016/j.ypmed.2013.02.014.CrossRefPubMed Autenrieth CS, Kirchberger I, Heier M, Zimmermann AK, Peters A, Doring A, Thonard B: Physical activity is inversely associated with multimorbidity in elderly men: results from the KORA-Age Augsburg Study. Prev Med. 2013, 57: 17-19. 10.1016/j.ypmed.2013.02.014.CrossRefPubMed
11.
go back to reference Hudon C, Soubhi H, Fortin M: Relationship between multimorbidity and physical activity: secondary analysis from the Quebec health survey. BMC Public Health. 2008, 8: 304-10.1186/1471-2458-8-304.CrossRefPubMedPubMedCentral Hudon C, Soubhi H, Fortin M: Relationship between multimorbidity and physical activity: secondary analysis from the Quebec health survey. BMC Public Health. 2008, 8: 304-10.1186/1471-2458-8-304.CrossRefPubMedPubMedCentral
12.
go back to reference Han MA, Kim KS, Park J, Kang MG, Ryu SY: Association between levels of physical activity and poor self-rated health in Korean adults: the Third Korea National Health and Nutrition Examination Survey (KNHANES), 2005. Public Health. 2009, 123: 665-669. 10.1016/j.puhe.2009.08.005.CrossRefPubMed Han MA, Kim KS, Park J, Kang MG, Ryu SY: Association between levels of physical activity and poor self-rated health in Korean adults: the Third Korea National Health and Nutrition Examination Survey (KNHANES), 2005. Public Health. 2009, 123: 665-669. 10.1016/j.puhe.2009.08.005.CrossRefPubMed
13.
go back to reference Brown HE, Ryde GC, Gilson ND, Burton NW, Brown WJ: Objectively measured sedentary behavior and physical activity in office employees: relationships with presenteeism. J Occup Environ Med. 2013, 55: 945-953. 10.1097/JOM.0b013e31829178bf.CrossRefPubMed Brown HE, Ryde GC, Gilson ND, Burton NW, Brown WJ: Objectively measured sedentary behavior and physical activity in office employees: relationships with presenteeism. J Occup Environ Med. 2013, 55: 945-953. 10.1097/JOM.0b013e31829178bf.CrossRefPubMed
14.
go back to reference Kaplan MS, Newsom JT, McFarland BH, Lu L: Demographic and psychosocial correlates of physical activity in late life. Am J Prev Med. 2001, 21: 306-312. 10.1016/S0749-3797(01)00364-6.CrossRefPubMed Kaplan MS, Newsom JT, McFarland BH, Lu L: Demographic and psychosocial correlates of physical activity in late life. Am J Prev Med. 2001, 21: 306-312. 10.1016/S0749-3797(01)00364-6.CrossRefPubMed
15.
go back to reference Bize R, Johnson JA, Plotnikoff RC: Physical activity level and health-related quality of life in the general adult population: a systematic review. Prev Med. 2007, 45: 401-415. 10.1016/j.ypmed.2007.07.017.CrossRefPubMed Bize R, Johnson JA, Plotnikoff RC: Physical activity level and health-related quality of life in the general adult population: a systematic review. Prev Med. 2007, 45: 401-415. 10.1016/j.ypmed.2007.07.017.CrossRefPubMed
17.
go back to reference Harrison C, Britt H, Miller G, Henderson J: Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice. BMJ Open. 2014, 4: e004694-10.1136/bmjopen-2013-004694.CrossRefPubMedPubMedCentral Harrison C, Britt H, Miller G, Henderson J: Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice. BMJ Open. 2014, 4: e004694-10.1136/bmjopen-2013-004694.CrossRefPubMedPubMedCentral
18.
go back to reference Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngue A, Salis JP, Oja P: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003, 35: 1381-1395. 10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMed Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngue A, Salis JP, Oja P: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003, 35: 1381-1395. 10.1249/01.MSS.0000078924.61453.FB.CrossRefPubMed
19.
go back to reference Washburn RA, Smith KW, Jette AM, Janney CA: The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993, 46: 153-162. 10.1016/0895-4356(93)90053-4.CrossRefPubMed Washburn RA, Smith KW, Jette AM, Janney CA: The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993, 46: 153-162. 10.1016/0895-4356(93)90053-4.CrossRefPubMed
20.
go back to reference Hull EE, Rofey DL, Robertson RJ, Nagle EF, Otto AD, Aaron DJ: Influence of marriage and parenthood on physical activity: a 2-year prospective analysis. J Phys Act Health. 2010, 7: 577-583.PubMedPubMedCentral Hull EE, Rofey DL, Robertson RJ, Nagle EF, Otto AD, Aaron DJ: Influence of marriage and parenthood on physical activity: a 2-year prospective analysis. J Phys Act Health. 2010, 7: 577-583.PubMedPubMedCentral
21.
go back to reference Florencio GL, Goncalves AK, Canario AC, Silva MJ: Aging: a reflection about physical activity and oxidative stress in women. Acta Med Port. 2011, 24 (Suppl 4): 983-988.PubMed Florencio GL, Goncalves AK, Canario AC, Silva MJ: Aging: a reflection about physical activity and oxidative stress in women. Acta Med Port. 2011, 24 (Suppl 4): 983-988.PubMed
22.
go back to reference Colman G, Dave D: Exercise, physical activity, and exertion over the business cycle. Soc Sci Med. 2013, 93: 11-20.CrossRefPubMed Colman G, Dave D: Exercise, physical activity, and exertion over the business cycle. Soc Sci Med. 2013, 93: 11-20.CrossRefPubMed
23.
go back to reference Kirk MA, Rhodes RE: Occupation correlates of adults' participation in leisure-time physical activity: a systematic review. Am J Prev Med. 2011, 40: 476-485. 10.1016/j.amepre.2010.12.015.CrossRefPubMed Kirk MA, Rhodes RE: Occupation correlates of adults' participation in leisure-time physical activity: a systematic review. Am J Prev Med. 2011, 40: 476-485. 10.1016/j.amepre.2010.12.015.CrossRefPubMed
24.
go back to reference Moschny A, Platen P, Klaassen-Mielke R, Trampisch U, Hinrichs T: Barriers to physical activity in older adults in Germany: a cross-sectional study. Int J Behav Nutr Phys Act. 2011, 8: 121-10.1186/1479-5868-8-121.CrossRefPubMedPubMedCentral Moschny A, Platen P, Klaassen-Mielke R, Trampisch U, Hinrichs T: Barriers to physical activity in older adults in Germany: a cross-sectional study. Int J Behav Nutr Phys Act. 2011, 8: 121-10.1186/1479-5868-8-121.CrossRefPubMedPubMedCentral
25.
go back to reference Bock C, Jarczok MN, Litaker D: Community-based efforts to promote physical activity: a systematic review of interventions considering mode of delivery, study quality and population subgroups. J Sci Med Sport. 2013, 17: 276-282.CrossRefPubMed Bock C, Jarczok MN, Litaker D: Community-based efforts to promote physical activity: a systematic review of interventions considering mode of delivery, study quality and population subgroups. J Sci Med Sport. 2013, 17: 276-282.CrossRefPubMed
26.
go back to reference Peterson JA: Get moving! Physical activity counseling in primary care. J Am Acad Nurse Pract. 2007, 19: 349-357. 10.1111/j.1745-7599.2007.00239.x.CrossRefPubMed Peterson JA: Get moving! Physical activity counseling in primary care. J Am Acad Nurse Pract. 2007, 19: 349-357. 10.1111/j.1745-7599.2007.00239.x.CrossRefPubMed
27.
go back to reference Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM: Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002, 137: 208-215. 10.7326/0003-4819-137-3-200208060-00015.CrossRefPubMed Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM: Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002, 137: 208-215. 10.7326/0003-4819-137-3-200208060-00015.CrossRefPubMed
28.
go back to reference Task Force on Community Preventive Services: Recommendations to increase physical activity in communities. Am J Prev Med. 2002, 22: 67-72.CrossRef Task Force on Community Preventive Services: Recommendations to increase physical activity in communities. Am J Prev Med. 2002, 22: 67-72.CrossRef
29.
go back to reference Liggett L, Gray A, Parnell W, McGee R, McKenzie Y: Validation and reliability of the New Lifestyles NL-1000 accelerometer in New Zealand preschoolers. J Phys Act Health. 2012, 9: 295-299.PubMed Liggett L, Gray A, Parnell W, McGee R, McKenzie Y: Validation and reliability of the New Lifestyles NL-1000 accelerometer in New Zealand preschoolers. J Phys Act Health. 2012, 9: 295-299.PubMed
30.
go back to reference Boyd LJ, Ball K, Aughey RJ: The reliability of MinimaxX accelerometers for measuring physical activity in Australian football. Int J Sports Physiol Perform. 2011, 6: 311-321.PubMed Boyd LJ, Ball K, Aughey RJ: The reliability of MinimaxX accelerometers for measuring physical activity in Australian football. Int J Sports Physiol Perform. 2011, 6: 311-321.PubMed
31.
go back to reference Aughey RJ: Applications of GPS technologies to field sports. Int J Sports Physiol Perform. 2011, 6: 295-310.PubMed Aughey RJ: Applications of GPS technologies to field sports. Int J Sports Physiol Perform. 2011, 6: 295-310.PubMed
32.
go back to reference Harrison CL, Thompson RG, Teede HJ, Lombard CB: Measuring physical activity during pregnancy. Int J Behav Nutr Phys Act. 2011, 8: 19-10.1186/1479-5868-8-19.CrossRefPubMedPubMedCentral Harrison CL, Thompson RG, Teede HJ, Lombard CB: Measuring physical activity during pregnancy. Int J Behav Nutr Phys Act. 2011, 8: 19-10.1186/1479-5868-8-19.CrossRefPubMedPubMedCentral
33.
go back to reference Roman VB, Ribas BL, Ngo J, Serra ML: Validity of the international physical activity questionnaire in the Catalan population (Spain). Gac Sanit. 2013, 27: 254-257. 10.1016/j.gaceta.2012.05.013.CrossRef Roman VB, Ribas BL, Ngo J, Serra ML: Validity of the international physical activity questionnaire in the Catalan population (Spain). Gac Sanit. 2013, 27: 254-257. 10.1016/j.gaceta.2012.05.013.CrossRef
34.
go back to reference Rutten A, Abu-Omar K: Prevalence of physical activity in the European Union. Soz Praventivmed. 2004, 49: 281-289.PubMed Rutten A, Abu-Omar K: Prevalence of physical activity in the European Union. Soz Praventivmed. 2004, 49: 281-289.PubMed
Metadata
Title
Association between physical activity, multimorbidity, self-rated health and functional limitation in the Spanish population
Authors
Cristina Cimarras-Otal
Amaia Calderón-Larrañaga
Beatriz Poblador-Plou
Francisca González-Rubio
Luis A Gimeno-Feliu
José L Arjol-Serrano
Alexandra Prados-Torres
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-1170

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