What is the impact of physical activity and physical function on the development of Multimorbidity in older adults over time? A population based cohort study.

Ryan A¹, Murphy C^2,3, Boland F¹, Galvin R⁴, Smith SM¹.

Abstract

BACKGROUND:

Multimorbidity is recognised internationally as having a serious impact on health outcomes. It is associated with reduced quality of life, increased healthcare utilisation and future functional decline. Physical activity is associated with good health and psychological well-being. The aim of this study was to identify the impact of physical activity and physical function on the development and worsening of multimorbidity over time.

METHODS:

Using The Irish Longitudinal Study on Ageing (TILDA), we analysed 4,823 participants >50 years with and without multimorbidity. Multimorbidity was defined as the presence of ≥2 chronic conditions. Development of multimorbidity was measured as the accrual of additional conditions over a two year period. Physical activity and physical function were measured using the International Physical ActivityQuestionnaire (IPAQ), gait speed (m/sec) and grip strength (kg).

RESULTS:

Sixteen groups of chronic conditions were included in analyses. 53.7% of included participants had multimorbidity at baseline and 71.7% at follow up. 638/2092 (30.4%) participants without multimorbidity and 1005/2415 (41.6%) with existing multimorbidity developed new condition/s. Gait speed (RR=0.67, CI:0.49-0.90), grip strength (RR=0.98, CI:0.97-0.99) and age (compared to 50-59 years, 60-69: RR=1.30, CI:1.11-1.52; ≥70: RR=1.35, CI:1.03 – 1.77) were significantly associated with development of multimorbidity and accrual of additional conditions.

CONCLUSION:

These results show that physical function is associated with the development and worsening of multimorbidity over time. They support the recent National Institute for Health & Care Excellence (NICE) Guidance on multimorbidity that suggests that patients with multimorbidity and reduced gait speed should be identified and targeted for interventions to improve health outcomes.