The prevalence of multimorbidity and its association with physical activity and sleep duration in middle aged and elderly adults: a longitudinal analysis from China

Abstract

Background Preventing chronic disease is important in health policy in countries with significantly ageing populations. This study aims to examine the prevalence of chronic disease multimorbidity and its association with physical activity and sleep duration; and to understand whether physical activity modifies associations between sleep duration and multimorbidity. Methods We utilized longitudinal data of a nationally-representative sample from the China Health and Retirement Longitudinal Study (in year 2011 and 2015; N = 5321; 54.7% female; age ≥ 45 years old). Fourteen chronic diseases were used to measure multimorbidity (ten self-reported, and four by blood test). Participants were grouped into high, moderate, and low level based on self-reported frequencies and durations of physical activity with different intensities for at least 10 min at a time in a usual week. Poor and good sleepers were categorized according to average hours of actual sleep at each night during the past month. Panel data method of random-effects logistic regression model was applied to estimate the association of physical activity and sleep with multimorbidity, adjusting for social-demographic and behavioural confounders. Results From 2011 to 2015, the prevalence of multimorbidity increased from 52.2 to 62.8%. In 2015, the proportion of participants engaging in high, moderate, and low level of physical activity was 30.3, 24.4 and 45.3%, respectively, and 63.6% of adults had good sleep. For both genders, compared with good sleep, poor sleep was associated with higher odds of multimorbidity (OR = 1.527, 95% CI: 1.277, 1.825). Compared to the high-level group, participants with a low level of physical activity were significantly more likely to have multimorbidity (OR = 1.457, 95% CI: 1.277, 1.825), but associations were stronger among women. The relative excess risk due to interaction between poor sleep and moderate or low physical activity was positive but non-significant on multimorbidity. Conclusions The burden of multimorbidity was high in China. Low physical activity and poor sleep was independently and significantly associated with a higher likelihood of multimorbidity in women and both genders, separately. Physical activity could modify the association between sleep and multimorbidity.

Quality of Sleep in the Cypriot Population and Its Association With Multimorbidity: A Cross-Sectional Study

“…Moreover, our result agrees with the finding of a longitudinal study in Canada which reported that chronic diseases may be influenced by disrupted sleep (46). Finally, a recent study in China (47) reported that multimorbidity and poor sleep are associated overall in both genders and also among women separately (47). However, it is not yet clear if the poor quality of sleep is a consequence of the presence of several chronic diseases in an individual or whether it leads to an increase in the number of chronic diseases in an individual.…”

Validation of the geriatric sleep questionnaire

“…Likewise, sleep disorders become more frequent in older people [5,6,14]. Risk factors for sleep disorders in old age include gender, being more common in women [7,[15][16][17]; older age [18,19]; lower education [20,21]; loneliness, institutionalization, social isolation [10,16,22,23]; less functionality [23,24]; chronic diseases [25][26][27]; and medication use [5,7,10].…”

“…Suboptimal sleep, in turn, is responsible for health problems in later life, including physical problems [17,[26][27][28], mental difficulties [7,10,14,22,[28][29][30][31], affectivity imbalance [32], and cognitive impairment [7,10,33,34]. Moreover, poor sleep quality increases the risk of mortality [6,10].…”

The Interaction Between Self-Reported Sleep Duration and Physical Activity on Peripheral Artery Disease in Chinese Adults: A Cross-Sectional Analysis in the Tianning Cohort Study

“… 55 Another longitudinal Chinese study revealed participants with poor sleep (sleeping <7 h or >9h) and low physical activity had the highest multimorbidity of chronic diseases compared to other combinations. 56 …”