Abstract
BackgroundModifiable health risk factors (MHRFs) significantly affect morbidity and mortality rates and frequently occur in specific combinations or risk clusters. Using five MHRFs (smoking, high-risk alcohol consumption, physical inactivity, low intake of fruits and vegetables, and obesity) this study investigates the extent to which risk clusters are observed in a representative sample of women aged 65 and older in Germany. Additionally, the structural composition of the clusters is systematically compared with data and findings from other countries.MethodsA pooled data set of Germany’s representative cross-sectional surveys GEDA09 and GEDA10 was used. The cohort comprised 4,617 women aged 65 and older. Specific risk clusters based on five MHRFs are identified, using hierarchical cluster analysis. The MHRFs were defined as current smoking (daily or occasionally), risk alcohol consumption (according to the Alcohol Use Disorders Identification Test, a sum score of 4 or more points), physical inactivity (less active than 5 days per week for at least 30 min and lack of sports-related activity in the last three months), low intake of fruits and vegetables (less than one serving of fruits and one of vegetables per day), and obesity (a body mass index equal to or greater than 30). A total of 4,292 cases with full information on these factors are included in the cluster analysis. Extended analyses were also performed to include the number of chronic diseases by age and socioeconomic status of group members.ResultsA total of seven risk clusters were identified. In a comparison with data from international studies, the seven risk clusters were found to be stable with a high degree of structural equivalency.ConclusionEvidence of the stability of risk clusters across various study populations provides a useful starting point for long-term targeted health interventions. The structural clusters provide information through which various MHRFs can be evaluated simultaneously.
Highlights
Modifiable health risk factors (MHRFs) significantly affect morbidity and mortality rates and frequently occur in specific combinations or risk clusters
With the identification of seven distinct clusters of risk patterns based on the five MHRFs: Smoking, Alcohol, Inactivity, Diet, and Obesity in older women in Germany, our study shows that MHRFs tend to be associated in clusters
Despite the varying methods used to operationalize MHRFs and the varying age ranges that appear in the studies used in for comparison, six clusters of large structural consensus can be identified in the study populations
Summary
Modifiable health risk factors (MHRFs) significantly affect morbidity and mortality rates and frequently occur in specific combinations or risk clusters. While emerging data suggest a narrowing of the gender age gap in some countries [3], the longer life expectancy of women in most parts of the world [4, 5] highlights changing sex ratios associated with the process of aging. This imbalance increases with age and has been called the “feminization of age” [6, 7]. Women have a higher prevalence of chronic diseases and disorders (e.g. osteoporosis, back pain, depression) and are affected more frequently by disability and impairment [11, 12]
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