Abstract
Introduction: While multimorbidity (having ≥2 chronic conditions) is associated with inadequate higher intensity exercise, less is known about how multimorbidity relates to total movement accumulated throughout the day. We tested the hypothesis that multimorbidity is associated with lower 24-hr movement in a population-based study. Methods: We analyzed data from 2011-2014 National Health and Nutrition Examination Survey. A wrist-worn device (ActiGraph GT3X) captured movement over 24 hours in Monitor-Independent Movement Summary units (MIMS-units). Multimorbidity was quantified using 13 chronic conditions included in the CDC recommendations via self-report or clinical thresholds. We conducted multivariable linear regressions analyses to examine the association of each chronic condition and number of conditions with total daily MIMS-units. Models were adjusted for age, sex, race/ethnicity, education, and smoking, as well as the other chronic conditions in the model by condition type, per convention. Results: The sample included 7013 US adults aged 30+ (mean (± SE) age 53.2 ± 0.3 years, 53% female, 30% non-White). On average, participants had 2.4 (range 0-11) chronic conditions with 62% having ≥2. Those with ≥2 conditions had -1183.6 (95% CI: -1401.0, -966.2) lower daily MIMS-units. On a continuous scale, for each additional condition, movement was lower by -504.2 (95% CI: -580.4, -427.9) MIMS-units. Compared to those with 0 conditions, there was a dose-response reduction in movement with multimorbidity ( Figure ). Presence (vs absence) of obesity, diabetes, stroke, chronic kidney disease, cancer, depression, and memory problems were each associated with lower 24-hr movement activity. Conclusions: Multimorbidity is highly prevalent in US adults and associated with lower 24-hr movement. Intervention strategies focused on promotion of daily lifestyle movement may attenuate population-level multimorbidity burden. Future research should examine which co-occurring conditions contribute to low movement.
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