Fessler Layan, Maltagliati Silvio, Sieber Stefan, Cullati Stéphane, Tessitore Elena, Craviari Cecilia, Luthy Christophe, Hanna Eliana, Meyer Philippe, Orsholits Dan, Sarrazin Philippe, Cheval Boris
Univ. Grenoble-Alpes, SENS, F-38000 Grenoble, France.
LIVES Centre, Swiss Centre of Expertise in Life Course Research, University of Lausanne, Switzerland.
Prev Med Rep. 2023 Jun 2;34:102265. doi: 10.1016/j.pmedr.2023.102265. eCollection 2023 Aug.
Multimorbidity, defined as the presence of two or more chronic conditions, is increasingly prevalent and is a major contributor to ill health in old age. Physical activity (PA) is a key protective factor for health and individuals with multimorbidity could particularly benefit from engaging in PA. However, direct evidence that PA has greater health benefits in people with multimorbidity is lacking. The objective of the present study was to investigate whether the associations between PA and health were more pronounced in individuals with (vs. without) multimorbidity. We used data from 121,875 adults aged 50 to 96 years (mean age = 67 ± 10 years, 55% women) enrolled in the Survey of Health, Ageing and Retirement in Europe (SHARE). Multimorbidity and PA were self-reported. Health indicators were assessed using tests and validated scales. Variables were measured up to seven times over a 15-year period. Confounder-adjusted linear mixed-effects models were used to investigate the moderating role of multimorbidity on the associations of PA with the levels and trajectories of health indicators across aging. Results showed that multimorbidity was associated with declines in physical, cognitive, and mental health, as well as poorer general health. Conversely, PA was positively associated with these health indicators. We found a significant interaction between multimorbidity and PA, revealing that positive associations between PA and health indicators were strengthened in people with multimorbidity - although this stronger association became less pronounced in advanced age. These findings suggest that the protective role of PA for multiple health indicators is enhanced in individuals with multimorbidity.
多重疾病（定义为存在两种或更多种慢性病）日益普遍，是导致老年人健康不佳的主要因素。身体活动（PA）是健康的关键保护因素，患有多重疾病的个体尤其能从参与身体活动中受益。然而，缺乏直接证据表明身体活动对患有多重疾病的人有更大的健康益处。本研究的目的是调查在患有（与未患有）多重疾病的个体中，身体活动与健康之间的关联是否更为显著。我们使用了来自欧洲健康、老龄化和退休调查（SHARE）的121,875名年龄在50至96岁之间的成年人（平均年龄 = 67 ± 10岁，55%为女性）的数据。多重疾病和身体活动情况均为自我报告。健康指标通过测试和经过验证的量表进行评估。在15年的时间里对变量进行了多达7次的测量。使用经过混杂因素调整的线性混合效应模型来研究多重疾病对身体活动与衰老过程中健康指标水平和轨迹之间关联的调节作用。结果表明，多重疾病与身体、认知和心理健康的下降以及总体健康状况较差有关。相反，身体活动与这些健康指标呈正相关。我们发现多重疾病和身体活动之间存在显著的交互作用，这表明在患有多重疾病的人群中，身体活动与健康指标之间的正相关关系得到了加强——尽管这种更强的关联在高龄时变得不那么明显。这些发现表明，身体活动对患有多重疾病的个体在多种健康指标方面的保护作用得到了增强。
