Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries.
Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries.
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DOI：
10.1186/s12966-017-0602-z
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发表时间：
2017-10-27
期刊：
影响因子：
--
通讯作者：
Koyanagi A
中科院分区：
文献类型：
--
作者：
Vancampfort D;Stubbs B;Koyanagi A
无论一个人的体力活动水平如何，久坐行为 (SB) 都与多种有害结果相关，例如糖尿病、中风和相关的过早死亡。目前还没有具有全国代表性、跨国性、以人群为基础的研究来调查 SB、慢性病和身体多重病（即两种或多种慢性身体疾病）之间的关系。因此，这项横断面研究旨在评估六个低收入和中等收入国家 (LMIC) 社区居住成年人的慢性病、身体多重疾病和 SB 之间的关联。我们还探讨了这些关系的影响因素。全球老龄化与成人健康研究 (SAGE) 调查涵盖了 34,129 名 50 岁以上的成年人。 SB 由自我报告并表示为分类变量 [每天<8 或 ≥8 小时（高 SB）]。评估了十一种慢性身体状况（心绞痛、关节炎、哮喘、慢性背痛、慢性肺病、糖尿病、无牙颌、听力问题、高血压、中风、视力障碍）。进行了多变量逻辑回归和中介分析。身体多种疾病和高 SB（≥8 小时/天）的患病率分别为 45.5% (43.7%–47.4%) 和 10.8% (9.7%–12.1%)。高 SB 患病率以线性方式增加，从没有慢性病的人群中的 7.1% 增加到患有 ≥ 4 种慢性病的人群中的 24.1%。在多变量分析中，视力障碍（OR = 2.62）、中风（OR = 2.02）、慢性背痛（OR = 1.70）、听力问题（OR = 1.58）、慢性肺病（OR = 1.48）、哮喘（OR = 1.39）、关节炎（OR = 1.22）和多种疾病（OR = 1.41）与高发病率显着相关。 SB。残疾解释了所有慢性病的 50% 以上的相关性，其中关节炎、哮喘和多种疾病的比例特别高 (>80%)。行动问题分别解释了 SB 与关节炎和躯体多病相关的 88.1% 和 85.1%。疼痛对 SB 与关节炎的关系影响很大 (85.6%)。睡眠/能量问题解释了相关性的 9.3%（中风）至 49.1%（关节炎），认知问题解释了 21.5%（中风）至 33.4%（听力问题）。焦虑和抑郁的结果好坏参半。在中低收入国家中，患有慢性病和身体多种疾病的人明显更久坐。减少慢性病患者久坐时间的有针对性的信息可能会改善相关的残疾、行动困难和疼痛，而这些本身就是久坐最重要的风险因素。本文的在线版本 (10.1186/s12966-017-0602-z) 包含补充材料，可供授权用户使用。
Sedentary behavior (SB) is, irrespective of a person’s physical activity levels, associated with a wide range of deleterious outcomes such as diabetes, stroke and associated premature mortality. There are no nationally representative, multi-national, population-based studies investigating the relationship between SB, chronic conditions, and physical multimorbidity (i.e., two or more chronic physical conditions). Thus, this cross-sectional study aimed to assess the association between chronic conditions, physical multimorbidity and SB among community-dwelling adults in six low- and middle-income countries (LMICs). We also explored the influential factors of these relationships. The Study on Global Ageing and Adult Health (SAGE) survey included 34,129 adults aged ≥50 years. SB was self-reported and expressed as a categorical variable [<8 or ≥8 h per day (high SB)]. Eleven chronic physical conditions (angina, arthritis, asthma, chronic back pain, chronic lung disease, diabetes, edentulism, hearing problems, hypertension, stroke, visual impairment) were assessed. Multivariable logistic regression and mediation analyses were conducted. The prevalence of physical multimorbidity and high SB (≥8 h/day) were 45.5% (43.7%–47.4%) and 10.8% (9.7%–12.1%), respectively. The prevalence of high SB increased in a linear fashion from 7.1% in people with no chronic condition to 24.1% in those with ≥4 chronic conditions. In the multivariable analysis, visual impairment (OR = 2.62), stroke (OR = 2.02), chronic back pain (OR = 1.70) hearing problems (OR = 1.58), chronic lung disease (OR = 1.48), asthma (OR = 1.39), arthritis (OR = 1.22) and multimorbidity (OR = 1.41) were significantly associated with high SB. Disability explained more than 50% of the association for all chronic conditions with particularly high percentages (>80%) for arthritis, asthma, and multimorbdity. Mobility problems explained 88.1% and 85.1% of the association of SB with arthritis and physical multimorbidiy, respectively. Pain was highly influential in the SB-arthritis relationship (85.6%). Sleep/energy problems explained between 9.3% (stroke) to 49.1% (arthritis) of the association, and cognitive problems from 21.5% (stroke) to 33.4% (hearing problems). Findings for anxiety and depression were mixed. In LMICs, those with chronic conditions and physical multimorbidity are significantly more sedentary. Targeted messages to reduce time spent sedentary among individuals with chronic conditions may ameliorate associated disability, mobility difficulties and pain that are themselves the most important risk factors for SB. The online version of this article (10.1186/s12966-017-0602-z) contains supplementary material, which is available to authorized users.
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