Dataset Information

Multimorbidity is associated with lower total 24-hour movement activity among US adults.

ABSTRACT:

Objective

Having chronic conditions may result in reduced physical and cognitive function but less is known about multimorbidity with daily movement. We examined the association of multimorbidity and device-measured total daily movement in a nationally representative sample of US adults aged ≥ 30 years from the 2011-2014 National Health and Nutrition Examination Surveys.

Methods

Any multimorbidity (≥2 conditions) and complex multimorbidity (≥3 conditions across ≥ 3 body systems) were quantified using 16 chronic conditions via self-report and/or clinical thresholds. Total movement over 24-hours (Monitor-Independent Movement Summary units [MIMS-units]) was measured using a wrist-worn device (ActiGraph GT3X). Multivariable linear regression examined the association of 1) each chronic condition, 2) number of conditions, 3) any multimorbidity, and 4) complex multimorbidity with total movement. Covariates included age, gender, race/ethnicity, educational attainment, and smoking status.

Results

Among US adults (N = 7304, mean age: 53.2 ± 0.34 years, 53.2% female, 69.4% Non-Hispanic White), 62.2% had any multimorbidity with 34.2% having complex multimorbidity. After adjustment, a higher number of chronic conditions was associated with incrementally lower total movement (β MIMS-units [95% CI] compared to those with no chronic conditions; one: -419 [-772, -66], two: -605 [-933, -278], three: -1201 [-1506, -895], four: -1908 [-2351, -1465], 5+: -2972 [-3384, -2560]). Complex multimorbidity presence was associated with -1709 (95% CI: -2062, -1357) and -1269 (-1620, -918) lower total movement compared to those without multimorbidity and multimorbidity but not complex, respectively.

Conclusions

Multimorbidity was associated with lower 24-h movement among US adults and may be helpful for identifying adults at risk for low movement.

SUBMITTER: Dooley EE

PROVIDER: S-EPMC10632122 | biostudies-literature | 2023 Dec

REPOSITORIES: biostudies-literature

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Publications

Multimorbidity is associated with lower total 24-hour movement activity among US adults.

Dooley Erin E EE Chen Ligong L Ghazi Lama L Hornikel Bjoern B Martinez-Amezcua Pablo P Palta Priya P Bowling C Barrett CB Muntner Paul P Lewis Cora E CE Pettee Gabriel Kelley K

Preventive medicine reports 20231021

<h4>Objective</h4>Having chronic conditions may result in reduced physical and cognitive function but less is known about multimorbidity with daily movement. We examined the association of multimorbidity and device-measured total daily movement in a nationally representative sample of US adults aged ≥ 30 years from the 2011-2014 National Health and Nutrition Examination Surveys.<h4>Methods</h4>Any multimorbidity (≥2 conditions) and complex multimorbidity (≥3 conditions across ≥ 3 body systems) w ...[more]

PMID: 37954962

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Project description:BackgroundThe relationship between 24-hour (24-h) movement guidelines and frailty remains unclear. We aimed to investigate the associations between meeting 24-h movement guidelines and frailty and to conduct secondary analyses by age, gender, and ethnicity.MethodsIn this study, we extracted data from the National Health and Nutrition Examination Survey (2007-2018) database. A total of 5,726 participants (50.25 ± 0.31 years) were included in this analysis, representing 38,240,356 noninstitutionalized U.S.IndividualsThree 24-h movement behaviors, namely, physical activity, sedentary behavior (SB), and sleep, were self-reported using the standardized questionnaires. The 49-item frailty index was used to measure frailty. Multivariable logistic regression models and trend tests were used to examine the associations between meeting 24-h movement guidelines and frailty. Sensitivity analyses were also conducted to ensure the robustness of our results.ResultsThe total age-adjusted prevalence of frailty was 30.5%. In the fully adjusted model, compared with not meeting any of the 24-h movement guidelines, the adjusted odds ratios (AORs) of frailty were 0.786 (95% CI: 0.545, 1.133), 1.161 (95% CI: 0.787, 1.711), and 0.915 (95% CI: 0.616, 1.358) for participants meeting only moderate to vigorous physical activity (MVPA), only SB, and only sleep guidelines, respectively, but no statistically significant differences were observed (all P values > 0.05). Participants who met the SB + sleep guidelines (AOR = 0.613, 95% CI: 0.423, 0.887), MVPA + sleep guidelines (AOR = 0.389, 95% CI: 0.255, 0.593), and MVPA + SB guidelines (AOR = 0.555, 95% CI: 0.383, 0.806) presented a significantly lower risk of frailty by 39%, 61%, and 45%, respectively. Meeting all 3 guidelines (AOR = 0.377, 95% CI: 0.264, 0.539) and meeting 2 guidelines (AOR = 0.527, 95% CI: 0.377, 0.736) were associated with a lower risk of frailty (P value < 0.001), showing a linear trend (P for trend < 0.001). The strength of these associations varied somewhat by age, gender, and ethnicity.ConclusionsSignificant associations between the 24-h movement guidelines and frailty were observed among U.S. adults. Future studies are warranted to examine the causality and trajectory of these associations.

Project description:ImportanceLower physical activity (PA) levels have been proposed as a mechanism to explain the association between hearing loss and various adverse outcomes of aging. But whether hearing loss is associated with lower PA is poorly understood.ObjectiveTo evaluate whether hearing loss is associated with lower levels of PA.Design, setting, and participantsThis cross-sectional analysis was conducted in a representative sample of US adults (aged 30-69 years) who participated in the 2011-2012 cycle of the National Health and Nutrition Examination Survey (NHANES). Data analysis was conducted from July to September 2021.ExposuresHearing was assessed, in dB, by pure-tone audiometry and summarized as the better hearing ear's pure-tone average (BPTA) of 4 speech frequencies (500, 1000, 2000, and 4000 kHz); a higher BTPA indicates worse hearing. Hearing was also categorized into normal (BPTA ≤25 dB), mild hearing impairment (>25 to 40 dB), and moderate or greater hearing impairment (>40 dB).Main outcomes and measuresTotal 24-hour movement activity was measured using wrist accelerometers worn at all times for 7 consecutive days and summarized in monitor-independent movement summary units (MIMS) units (higher MIMS units indicate more movement). The association between BPTA and MIMS units was evaluated using a multivariable-adjusted (demographic characteristics and chronic conditions) piecewise spline regression (knot at 15 dB). Mean differences in MIMS units across hearing categories compared with normal hearing were estimated.ResultsThe study included 2490 participants (mean [SE] age, 48.9 [0.3] years; 900 [weighted percentage, 69.3%] White individuals, 1248 [weighted percentage, 50.8%] female participants). Before the knot at 15 dB, we found that each 10-dB higher BPTA was associated with 860.4 (95% CI, 444.8-1276.1) higher MIMS units. Conversely, after the knot, each 10-dB higher BPTA was associated with 458.6 (95% CI, 27.7-889.4) lower MIMS units. The difference in MIMS units across hearing categories was not statistically significant.Conclusions and relevanceIn this cross-sectional study, in the range of hearing sensitivity of BPTA of 15 dB or greater, worse hearing was associated with lower MIMS units. Lower PA may be a mechanism contributing to the association between hearing impairment and adverse health.

Project description:PurposeThis study aimed to assess the association of a wrist-worn, device-based metric of 24-h movement with cognitive function and subjective cognitive complaints among older adults, 60 yr and older.MethodsThis is a cross-sectional analysis of the 2011-2012 and 2013-2014 National Health and Nutrition Examination Survey (NHANES) cycles. A wrist-worn ActiGraph GT3X+ accelerometer captured total 24-h movement activity, analyzed as Monitor-Independent Movement Summary units (MIMS-units), and quantified into placement based on an age- and sex-standardized percentile. Cognitive tests in the domains of memory, language/verbal fluency, and executive performance were administered. Test-specific cognitive z -scores were generated. Subjective cognitive complaints included perceived difficulty remembering and confusion/memory loss.ResultsThe analytical sample included 2708 U.S. older adults (69.5 ± 0.2 yr, 55% female, 20.9% non-White). Multivariable linear regressions revealed those in quartiles 3 (50th-74th percentile) and 4 (≥75th percentile) for their age and sex had higher cognitive function z -scores across all domains compared with those in quartile 1. Logistic regressions demonstrated those in quartiles 3 and 4 also had lower odds of reporting difficulty remembering (adjusted odds ratio [AOR] = 0.52, 95% confidence interval [CI] = 0.31-0.89; AOR = 0.57, 95% CI = 0.37-0.88) and confusion/memory loss (AOR = 0.49, 95% CI = 0.27-0.91; AOR = 0.49, 95% CI = 0.27-0.98), respectively, compared with those in quartile 1.ConclusionsIn a representative sample of U.S. older adults, higher cognitive functioning occurs among those that perform total 24-h movement activity at or above the 50th percentile for their age and sex. Future studies should consider movement behaviors across a 24-h period on cognitive health outcomes in older adults. More research exploring prospective associations of MIMS-units and time-use behaviors across midlife and older adulthood that may affect cognitive functioning across diverse populations is needed.

Project description:BackgroundSleep, sedentary behaviour, and physical activity are essential components within the 24-hour time frame. Existing questionnaires used to measure these behaviours have insufficient measurement properties and are unsuitable for assessing compliance with the WHO Physical Activity and 24-hour Movement Guidelines. To describe the development process of the 24-hour Movement Questionnaire (QMov24h) and its testing. The QMov24h was developed to gather detailed information on sleep, sedentary behaviour, and physical activity.MethodsThe sample comprised 117 participants (58% women), aged 30.95 ± 13.56 years. The development process of the QMov24h followed the COSMIN guidelines: (i) Construction of items; (ii) Face validity with end-users; (iii) Content validity with experts; (iv) Criterion validity against accelerometry and convergent validity against diary assessments; and (v) 7-day test-retest reliability.ResultsThe QMov24h presented adequate content and face validity. The QMov24h showed moderate criterion validity for sleep (rho=0.343;p<0.001), light physical activity (rho=0.31;p=0.002) and total aerobic physical activity (rho=0.343;p<0.001), as well as strong criterion validity for sedentary behaviour (rho=0.428;p<0.001) and aerobic moderate-to-vigorous physical activity (rho=0.534;p<0.001). Reliability varied from poor to excellent (ICC from 0.38 to 0.962;p<0.001) for all questionnaire variables. Regarding compliance of the 24-hour movement guidelines, the questionnaire also showed a strong to almost perfect percentage of agreement with accelerometry (from 69% to 94.3%), and minimal to strong reliability (k from 0.38 to 0.87) between the first and second administrations of the QMov24h.ConclusionsThe QMov24h questionnaire is a valid and reliable tool for assessing levels of movement behaviours and compliance with guidelines in adults. Its measurement properties are comparable to, or even better than, those of existing questionnaires, while posing a similar burden to participants. The QMov24h is useful for research, clinical practice, and public health surveillance. The QMov24h has strong psychometric properties, making it suitable for translation, cultural adaptation, and testing in diverse populations for broader international use.

Project description:BackgroundTime spent in physical activity (PA), sedentary behaviour (SB), and sleep always takes up the whole day. New public health guidelines combining recommendations for PA, SB, and sleep have been issued in several countries. Thailand was the first country to release the 24-h guidelines for adults. Currently, there is no evidence on the population prevalence of meeting 24-h movement guidelines in Thailand. This study, therefore, aimed to determine 15-year trends and associations of meeting 24-h movement guidelines among Thai adults.MethodWe analysed cross-sectional data from 2001, 2004, 2009, and 2015 Thai Time-Use Surveys, coded using the International Classification of Activities for Time-Use Statistics (ICATUS). All ICATUS-based activities were categorised into moderate-to-vigorous PA (MVPA), light PA (LPA), SB, and sleep based on a previously developed classification system. A total of 167,577 adult participants were included. The participants were classified according to the Thai 24-h movement guidelines into meeting or not meeting the following criteria: 1) ≥150 min/week of MVPA; 2) interrupting SB every 2 h; 3) sleeping 7-9 h per day; and 4) adhering to all three guidelines.ResultsIn 2015, the prevalence of adults who met the MVPA, SB, sleep, and overall recommendations was 81.7, 44.6, 56.4, and 21.3%, respectively. A significant linear increase was found for the prevalence of meeting the SB recommendation, while the prevalence meeting the MVPA, sleep, and overall recommendations was lowest in 2001, peaked in 2004 or 2009, and declined in 2015. The lowest odds for meeting the 24-h guidelines were found among males, those living in urban areas, inhabitants of Bangkok and South Thailand, unemployed, and those with low education level.ConclusionsDespite promising trends in the prevalence of meeting PA, SB, and sleep recommendations, a majority of Thai adults still do not meet the overall 24-h movement guidelines. Further actions are needed to promote more MVPA, less SB, and adequate sleep in Thai adults, particularly among males, those living in urban areas, inhabitants of Bangkok and South Thailand, unemployed, and those with low education level.

Project description:BackgroundThe increasing annual global deaths are attributable to noncommunicable chronic diseases (NCDs). Adhering to healthy lifestyle behaviors is associated with lower NCD risk, particularly among individuals with ample movement, enough sleep, and reduced sedentariness. Nevertheless, there are only few prospective assessments on the association of interactions between daily activities with NCD prevention, while the associations between adhering to Canadian 24-Hour Movement Guidelines (24HGs) for adults and NCD risks are still unknown. Compared to the general population, obese and overweight populations are at a higher risk of developing NCDs. Currently, it is unclear whether the health benefits of adhering to 24HGs differ between the general population and the obese population.ObjectiveThis study explores prospective associations between adherence to 24HGs and NCD risks by weight status among overweight and obese adults in China.MethodsThis decadal study consists of 9227 adults aged 35 years and older without any major NCDs at enrolment in the China Health and Nutrition Survey (2004-2011) and followed up until 2015. The exposure of interest was the overall score of compliance with 24HGs measured by participants' self-report, wherein 1 point was assigned for compliance to each component, resulting in an aggregated score ranging from 0 to 3. The primary outcome was the first occurrence of major NCDs (high blood pressure, stroke, diabetes, cancer, and acute myocardial infarction). Log-binomial regression models were used to evaluate the associations.Results: Overall, 4315 males and 4912 females, with 25,175 person-years of follow-up, were included in our analyses. The average baseline age was 50.21 (SD 11.04) years. Among the overweight and obese groups, those adhering to 1 (risk ratio [RR] 0.37, 95% CI 0.19-0.74; P=.004), 2 (RR 0.37, 95% CI 0.19-0.72; P=.003), and 3 (RR 0.32, 95% CI 0.14-0.73; P=.006) recommendations of 24HGs had a significantly lower NCD risk than those not adhering to any of the activity guidelines. Among the normal or underweight groups, those adhering to 1 (RR 0.49, 95% CI 0.27-0.96; P=.03) and 3 (RR 0.40, 95% CI 0.17-0.94; P=.03) components had a significantly lower NCD risk than those not adhering to any of the activity guidelines.ConclusionsIn this prospective study, we found that active adherence to recommendations of 24HGs was associated with lower risks of NCDs, especially among overweight and obese participants. Additionally, overweight and obese individuals who met at least 1 component of 24HGs were at a significantly lower risk for NCDs, but this protective effect was not found among individuals in the normal and underweight groups. Individuals with excess body weight who tend to be more susceptible to health risks may gain greater health benefits than the general population by adhering to the recommendations of 24HGs.

Dataset Information

Multimorbidity is associated with lower total 24-hour movement activity among US adults.

Objective

Methods

Results

Conclusions

Publications

Multimorbidity is associated with lower total 24-hour movement activity among US adults.

Similar Datasets

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