Abstract

BackgroundPreventing chronic disease is important in health policy in countries with significantly ageing populations. This study aims to examine the prevalence of chronic disease multimorbidity and its association with physical activity and sleep duration; and to understand whether physical activity modifies associations between sleep duration and multimorbidity.MethodsWe utilized longitudinal data of a nationally-representative sample from the China Health and Retirement Longitudinal Study (in year 2011 and 2015; N = 5321; 54.7% female; age ≥ 45 years old). Fourteen chronic diseases were used to measure multimorbidity (ten self-reported, and four by blood test). Participants were grouped into high, moderate, and low level based on self-reported frequencies and durations of physical activity with different intensities for at least 10 min at a time in a usual week. Poor and good sleepers were categorized according to average hours of actual sleep at each night during the past month. Panel data method of random-effects logistic regression model was applied to estimate the association of physical activity and sleep with multimorbidity, adjusting for social-demographic and behavioural confounders.ResultsFrom 2011 to 2015, the prevalence of multimorbidity increased from 52.2 to 62.8%. In 2015, the proportion of participants engaging in high, moderate, and low level of physical activity was 30.3, 24.4 and 45.3%, respectively, and 63.6% of adults had good sleep. For both genders, compared with good sleep, poor sleep was associated with higher odds of multimorbidity (OR = 1.527, 95% CI: 1.277, 1.825). Compared to the high-level group, participants with a low level of physical activity were significantly more likely to have multimorbidity (OR = 1.457, 95% CI: 1.277, 1.825), but associations were stronger among women. The relative excess risk due to interaction between poor sleep and moderate or low physical activity was positive but non-significant on multimorbidity.ConclusionsThe burden of multimorbidity was high in China. Low physical activity and poor sleep was independently and significantly associated with a higher likelihood of multimorbidity in women and both genders, separately. Physical activity could modify the association between sleep and multimorbidity.

Highlights

  • Preventing chronic disease is important in health policy in countries with significantly ageing populations

  • The present study extended these observations in a larger sample of Chinese adults and verified that sleep duration was important for preventing multimorbidity

  • The burden of multimorbidity is high in China, among the older population

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Summary

Introduction

Preventing chronic disease is important in health policy in countries with significantly ageing populations. Whether and to what extent the benefits of physical activity and sleep duration on preventing or predicting the multimorbidity are relatively unknown in China. Despite the inconsistency in measurement, the literature shows that multimorbidity is highly prevalent among middle-aged and older adults, ranging from 30 to 95% across age groups and countries [4]. In China, multimorbidity is common among middle-aged and older adults, with a prevalence of nearly 50% [5, 6]. Preventing the rising prevalence of multimorbidity has become an important clinical and public health challenge in China as well as other countries

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