Association Between Chronic Conditions, Physical Multi-morbidity, and Sedentary Behaviour

Introduction

A recent study investigated the relationship between chronic conditions, physical multi-morbidity, and sedentary behaviour among adults residing in six countries. Sedentary behaviour has been linked to various adverse health outcomes, including diabetes, stroke, and premature mortality, regardless of an individual’s physical activity levels. To date, there have been no nationally representative, multi-national, or population-based studies focusing on this relationship.

Study Overview

This cross-sectional study aimed to explore the connection between chronic conditions, physical multi-morbidity, and sedentary behaviour in community-dwelling adults across six low- and middle-income countries. The Study on Global Ageing and Adult Health (SAGE) survey included a sample of 34,129 adults aged over 50 from China, South Africa, Ghana, India, Mexico, and Russia. Participants reported their sedentary behaviour as either high (more than eight hours a day) or low (less than eight hours a day). Researchers evaluated eleven chronic physical conditions, including angina, arthritis, asthma, chronic back pain, chronic lung disease, diabetes, edentulism, hearing issues, hypertension, stroke, and visual impairment.

Study Results

The findings were published in the International Journal of Behavioral Nutrition and Physical Activity in 2017. The study revealed a linear increase in the prevalence of high sedentary behaviour, rising from 7.1% among individuals with no chronic conditions to 24.1% among those with more than four chronic conditions.

In the multivariable analysis, significant associations were observed between high sedentary behaviour and conditions such as visual impairment, stroke, chronic back pain, hearing problems, chronic lung disease, asthma, arthritis, and multi-morbidity. Disability accounted for over 50% of the association across all chronic conditions, with particularly high percentages for arthritis, asthma, and multi-morbidity (over 80%). Mobility issues explained 88% and 85% of the link between sedentary behaviour and arthritis and physical multi-morbidity, respectively. Pain was a major factor, accounting for over 86% of the relationship between sedentary behaviour and arthritis.

Additionally, sleep and energy problems contributed between 9.3% (for stroke) and 49.1% (for arthritis) to this association, while cognitive issues accounted for 21.5% (for stroke) to 33.4% (for hearing problems). The findings regarding anxiety and depression presented mixed results.

Implications for Clinicians and Future Research

In low- and middle-income countries, individuals with chronic conditions and physical multi-morbidity exhibit significantly higher levels of sedentary behaviour. Clinicians should not only consider pain, mobility issues, and disability as barriers to physical activity for patients with chronic conditions but also take into account psychological factors such as sleep quality and cognitive function.

Future research in these regions should aim to assess the effectiveness of interventions designed to reduce sedentary behaviour as a means of managing chronic health conditions.

About the Author

This article was written by Dr. Swapna Aleti, a Scientific Writer and Associate Professor.

References

1. Fortin M, Stewart M, Poitras M-E, Almirall J, Maddocks H. A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. The Ann Fam Med. 2012;10:142–51.
2. Picco L, Achilla E, Abdin E, Chong SA, Vaingankar JA, McCrone P, Chua HC, Heng D, Magadi H, Ng LL. Economic burden of multimorbidity among older adults: impact on healthcare and societal costs. BMC Health Serv Res. 2016;16:173.
3. Vancampfort D, Stubb B, Koyanagi A. Physical chronic conditions, multimorbidity and sedentary behaviors amongst middle-aged and older adults in six low- and middle-income countries. International Journal of Behavioral Nutrition and Physical Activity. 2017.

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