Top

Published in:

01-12-2020 | Original Investigation

Lifestyle factors and multimorbidity among older adults (ELSI-Brazil)

Authors: Marina Gabriela Nascimento de Almeida, Mary Anne Nascimento-Souza, Maria Fernanda Lima-Costa, Sérgio Viana Peixoto

Published in: European Journal of Ageing | Issue 4/2020

Abstract

The objective of the study was to evaluate the association between unhealthy lifestyle factors (individual and combined) and multimorbidity stratified by sex, in a national sample representative of Brazilians aged 50 years or older. Data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline, conducted in 2015–2016, were used. Multimorbidity was defined by the existence of two or more of the 19 chronic diseases. Four unhealthy lifestyle factors were considered: (1) at-risk alcohol consumption, (2) current or past smoking, (3) insufficient physical activity and (4) below-recommended consumption of fruits and vegetables. The association between unhealthy lifestyle factors, individual and combined, was assessed by logistic regression. Among the 7918 study participants, the prevalence of multimorbidity was 75.8% (95% CI 73.7–77.7) among women and 58.7% (95% CI 56.0–61.3) among men. Among women, none of the analyzed behaviors presented an independent and statistically significant association (p < 0.05) with multimorbidity. Among men, at-risk alcohol consumption was associated with lower odds of multimorbidity. On the other hand, current or past smoking and insufficient physical activity were associated with greater odds of this condition. In addition, the presence of three or four unhealthy lifestyle factors was associated with greater odds of multimorbidity among men. The results reinforce the need for interventions to promote healthy behaviors among older men with two or more chronic diseases. In addition, it is evident that the health services need to act in an attempt to modify unhealthy behaviors after medical diagnosis of chronic diseases to reduce the risk of future complications.

Autenrieth CS, Kirchberger I, Heier M, Zimmermann AK, Peters A, Doring A, Thorand B (2013) Physical activity is inversely associated with multimorbidity in elderly men: results from the KORA-Age Augsburg study. Prev Med 57(1):17–19. https://doi.org/10.1016/j.ypmed.2013.02.014CrossRef

Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, Baugh V, Bekedam H, Billo N, Casswell S et al (2011) Priority actions for the non-communicable disease crisis. Lancet 377(9775):1438–1447. https://doi.org/10.1016/S0140-6736(11)60393-0CrossRef

Bloom DE, Chatterji S, Kowal P, Lloyd-Sherlock P, McKee M, Rechel B, Rosenberg L, Smith JP (2015) Macroeconomic implications of population ageing and selected policy responses. Lancet 385(9968):649–657. https://doi.org/10.1016/S0140-6736(14)61464-1CrossRef

Boeing H, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A, Leschik-Bonnet E, Müller MJ, Oberritter H, Schulze M, Stehle P, Watzl B (2012) Critical review: vegetables and fruit in the prevention of chronic diseases. Eur J Nutr 51(6):637–663. https://doi.org/10.1007/s00394-012-0380-yCrossRef

Brasil (2015) Fiocruz - Fundação Oswaldo Cruz Manual de Entrevista Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil). http://elsi.cpqrr.fiocruz.br. Accessed 01 June 2019

Cimarras-Otal C, Calderón-Larrañaga A, Poblador-Plou B, González-Rubio F, Gimeno-Feliu LA, Arjol-Serrano JL, Prados-Torres A (2014) Association between physical activity, multimorbidity, self-rated health and functional limitation in the Spanish population. BMC Public Health 14:1170. https://doi.org/10.1186/1471-2458-14-1170CrossRef

Dhalwani NN, O’Donovan G, Zaccardi F, Hamer M, Yates T, Davies M, Khunti K (2016) Long terms trends of multimorbidity and association with physical activity in older English population. Int J Behav Nutr Phys Act 13:8. https://doi.org/10.1186/s12966-016-0330-9CrossRef

Dhalwani NN, Zaccardi F, O’Donovan G, Carter P, Hamer M, Yates T, Davies M, Khunti K (2017) Association between lifestyle factors and the incidence of multimorbidity in an older English population. J Gerontol A Biol Sci Med Sci 72(4):528–534. https://doi.org/10.1093/gerona/glw146CrossRef

Erhardt L (2009) Cigarette smoking: an undertreated risk factor for cardiovascular disease. Atherosclerosis 205(1):23–32. https://doi.org/10.1016/j.atherosclerosis.2009.01.007CrossRef

Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H (2012) A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med 10(2):142–151. https://doi.org/10.1370/afm.1337CrossRef

Fortin M, Haggerty J, Almirall J, Bouhali T, Sasseville M, Lemieux M (2014) Lifestyle factors and multimorbidity: a cross sectional study. BMC Public Health 14:686. https://doi.org/10.1186/1471-2458-14-686CrossRef

Gulliford MC (2001) Low rates of detection and treatment of hypertension among current cigarette smokers. J Hum Hypertens 15(11):771–773CrossRef

Harrison C, Britt H, Miller G, Henderson J (2014) Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice. BMJ Open 4(7):e004694. https://doi.org/10.1136/bmjopen-2013-004694CrossRef

Kolb H, Martin S (2017) Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes. BMC Med 15(1):131. https://doi.org/10.1186/s12916-017-0901-xCrossRef

Lima-Costa MF, de Andrade FB, de Souza PRB Jr, Neri AL, Duarte YAO, Castro-Costa E, de Oliveira C (2018) The Brazilian longitudinal study of aging (ELSI-Brazil): objectives and design. Am J Epidemiol 187(7):1345–1353. https://doi.org/10.1093/aje/kwx387CrossRef

Macinko J, Mullachery P, Silver D, Jimenez G, Neto OLM (2015) Patterns of alcohol consumption and related behaviors in Brazil: evidence from the 2013 National Health Survey (PNS 2013). PLoS ONE 10(7):e0134153. https://doi.org/10.1371/journal.pone.0134153CrossRef

Malta DC, Neto OLM, Junior JBS (2011) Presentation of the strategic action plan for coping with chronic diseases in Brazil from 2011 to 2022. Epidemiol Serv Saúde 20(4):425–438. https://doi.org/10.5123/s1679-49742011000400002CrossRef

Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, Meinow B, Fratiglioni L (2011) Aging with multimorbidity: a systematic review of the literature. Ageing Res Ver 10(4):430–439. https://doi.org/10.1016/j.arr.2011.03.003CrossRef

Matheson EM, King DE, Everett CJ (2012) Healthy lifestyle habits and mortality in overweight and obese individuals. J Am Board Fam Med 25(1):9–15. https://doi.org/10.3122/jabfm.2012.01.110164CrossRef

Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, Braggion G (2001) International physical activity questionnaire (IPAQ): study of validity and reliability in Brazil. Rev Bras Ativ Fis Saude 6(2):5–18. https://doi.org/10.12820/rbafs.v.6n2p5-18CrossRef

Mendoza-Sassi R, Béria JU (2001) Health services utilization: a systematic review of related factors. Cad Saude Publica 17(4):819–832. https://doi.org/10.1590/S0102-311X2001000400016CrossRef

Molander RC, Yonker JA, Krahn DD (2010) Age-related changes in drinking patterns from mid- to older age: results from the Wisconsin longitudinal study. Alcohol Clin Exp Res 34(7):1182–1192. https://doi.org/10.1111/j.1530-0277.2010.01195.xCrossRef

National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2010) Rethinking drinking: alcohol and your health. National Institutes of Health. http://pubs.niaaa.nih.gov/publications/RethinkingDrinking/Rethinking_Drinking.pdf. Accessed 05 June 2019

Noronha BP, Nascimento-Souza MA, Costa MF, Peixoto SV (2019) Alcohol consumption patterns and associated factors among elderly Brazilians: National Health Survey (2013). Cien Saude Colet 24(11):4171–4180. https://doi.org/10.1590/1413-812320182411.32652017CrossRef

Nunes BP, Batista SRR, Andrade FB, Souza PRB, Lima-Costa MF, Facchini LA (2018) Multimorbidade em indivíduos com 50 anos ou mais de idade: ELSI-Brasil. Saúde Pública 52(2):10S. https://doi.org/10.11606/s1518-8787.2018052000637CrossRef

Patel K, Schlundt D, Larson C, Wang H, Brown A, Hargreaves M (2009) Chronic illness and smoking cessation. Nicotine Tob Res 11(8):933–939. https://doi.org/10.1093/ntr/ntp088CrossRef

Peixoto SV, Firmo JOA, Lima-Costa MF (2006) Health conditions and smoking among older adults in two communities in Brazil (The Bambuí and Belo Horizonte Health Surveys). Cad Saúde Pública 22(9):1925–1934. https://doi.org/10.1590/S0102-311X2006000900024CrossRef

Peixoto SV, Mambrini JVM, Firmo JOA, Loyola Filho AI, Souza Junior PRB, Andrade FB, Lima-Costa MF (2018) Physical activity practice among older adults: results of the ELSI-Brazil. Rev Saude Publica 52(2):5s. https://doi.org/10.11606/S1518-8787.2018052000605CrossRef

Portes LH, Machado CV, Turci SRB, Figueiredo VC, Cavalcante TM, Silva VLDCE (2018) Tobacco control policies in Brazil: a 30-year assessment. Cien Saude Colet 23(6):1837–1848. https://doi.org/10.1590/1413-81232018236.05202018CrossRef

Prince MJ, Wu F, Guo Y, Gutierrez Robledo LM, O’Donnell M, Sullivan R, Yusuf S (2015) The burden of disease in older people and implications for health policy and practice. Lancet 385(9967):549–562. https://doi.org/10.1016/S0140-6736(14)61347-7CrossRef

Ruel G, Shi Z, Zhen S, Zuo H, Kroger E, Sirois C, Levesque JF, Taylor AW (2013) Association between nutrition and the evolution of multimorbidity: the importance of fruits and vegetables and whole grain products. Clin Nutr 33(3):513–520. https://doi.org/10.1016/j.clnu.2013.07.009CrossRef

Salomon JA, Wang H, Freeman MK, Vos T, Flaxman AD, Lopez AD, Murray CJ (2012) Healthy life expectancy for 187 countries 1990–2010: a systematic analysis for the Global Burden Disease Study 2010. Lancet 380(9859):2144–2162. https://doi.org/10.1016/S0140-6736(12)61690-0CrossRef

Sasazuki S, Inoue M, Iwasaki M, Sawada N, Shimazu T, Yamaji T, Tsugane S (2012) Combined impact of five lifestyle factors and subsequent risk of cancer: the Japan Public Health Center Study. Prev Med 54(2):112–116. https://doi.org/10.1016/j.ypmed.2011.11.003CrossRef

Shield KD, Parry C, Rehm J (2013) Chronic diseases and conditions related to alcohol use. Alcohol Res 35(2):155–173

Silsbury Z, Goldsmith R, Rushton A (2015) Systematic review of the measurement properties of self-report physical activity questionnaires in healthy adult populations. BMJ Open 5(9):e008430. https://doi.org/10.1136/bmjopen-2015-008430CrossRef

Silva LES, Claro RM (2019) Time trends in the consumption of fruits and vegetables among adults in Brazilian state capitals and the Federal District 2008–2016. Cad Saúde Pública 35(5):00023618. https://doi.org/10.1590/0102-311x00023618CrossRef

Violan C, Foguet-Boreu Q, Flores-Mateo G, Salisbury C, Blom J, Freitag M, Glynn L, Muth C, Valderas JM (2014) Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies. PLoS ONE 9(7):e102149. https://doi.org/10.1371/journal.pone.0102149.eCollectionCrossRef

Wolle CC, Sanches M, Zilberman ML, Caetano R, Zaleski M, Laranjeira RR et al (2011) Differences in drinking patterns between men and women in Brazil. Rev Bras Psiquiatr 33(4):367–373. https://doi.org/10.1590/S1516-44462011000400010CrossRef

World Health Organization (1995) Physical status: the use and interpretation of anthropometry. In: Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization 1995. https://www.who.int/childgrowth/publications/physical_status/en/. Accessed 20 June 2019

World Health Organization (2002) Reducing risks, promoting healthy. The world health report. https://apps.who.int/iris/bitstream/handle/10665/42510/WHR_2002.pdf?sequence=1. Accessed 28 June 2019

World Health Organization (2003) Diet, nutrition and the prevention of chronic diseases. In: Report of the joint WHO/FAO expert consultation WHO Technical Report Series, No. 916. https://apps.who.int/iris/bitstream/handle/10665/42665/WHO_TRS_916.pdf;jsessionid=4FCC71377A160E6E42B9F1996AA92FD7?sequence=1.Accessed 23 June 2019

World Health Organization (2010a) Global recommendations on physical activity for health.Switzerland: World Health Organization. https://www.who.int/dietphysicalactivity/global-PA-recs-2010.pdf. Accessed 23 June 2019

World Health Organization (2010b) Global status report on noncommunicable diseases. http://apps.who.int/nmh/publications/ncd_report_full_en.pdf. Accessed 23 June 2019

World Health Organization (‎2016)‎ Multimorbidity. World Health. Organization. http://www.who.int/iris/handle/10665/252275. Accessed 23 June 2019

Wu F, Guo Y, Chatterji S, Zheng Y, Naidoo N, Jiang Y, Biritwum R, Yawson A, Minicuci N, Salinas-Rodriguez A (2015) Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global ageing and adult health (SAGE) wave 1. BMC Public Health 15:88. https://doi.org/10.1186/s12889-015-1407-0CrossRef

Title: Lifestyle factors and multimorbidity among older adults (ELSI-Brazil)
Authors: Marina Gabriela Nascimento de Almeida
Mary Anne Nascimento-Souza
Maria Fernanda Lima-Costa
Sérgio Viana Peixoto
Publication date: 01-12-2020
Publisher: Springer Netherlands
Published in: European Journal of Ageing / Issue 4/2020
Print ISSN: 1613-9372
Electronic ISSN: 1613-9380
DOI: https://doi.org/10.1007/s10433-020-00560-z

At a glance: The STEP trials

Springer Medicine

Lifestyle factors and multimorbidity among older adults (ELSI-Brazil)

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2020

The gender health gap in Europe’s ageing societies: universal findings across countries and age groups?

Physical activity and subjective age across adulthood in four samples

Publisher Correction to: An exploration of subjective age, actual age, age awareness, and engagement in everyday

Views on ageing: a lifespan perspective

Changes in views on aging in later adulthood: the role of cardiovascular events

Current directions in views on ageing