Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study
Autoři:
Yogini V. Chudasama aff001; Kamlesh Khunti aff001; Clare L. Gillies aff001; Nafeesa N. Dhalwani aff001; Melanie J. Davies aff001; Thomas Yates aff001; Francesco Zaccardi aff001
Působiště autorů:
Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom
aff001; National Institute for Health Research (NIHR) Applied Research Collaboration—East Midlands (ARC-EM) Leicester Diabetes Centre, Leicester, United Kingdom
aff002; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester Diabetes Centre, Leicester, United Kingdom
aff003
Vyšlo v časopise:
Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study. PLoS Med 17(9): e32767. doi:10.1371/journal.pmed.1003332
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pmed.1003332
Souhrn
Background
Whether a healthy lifestyle impacts longevity in the presence of multimorbidity is unclear. We investigated the associations between healthy lifestyle and life expectancy in people with and without multimorbidity.
Methods and findings
A total of 480,940 middle-aged adults (median age of 58 years [range 38–73], 46% male, 95% white) were analysed in the UK Biobank; this longitudinal study collected data between 2006 and 2010, and participants were followed up until 2016. We extracted 36 chronic conditions and defined multimorbidity as 2 or more conditions. Four lifestyle factors, based on national guidelines, were used: leisure-time physical activity, smoking, diet, and alcohol consumption. A combined weighted score was developed and grouped participants into 4 categories: very unhealthy, unhealthy, healthy, and very healthy. Survival models were applied to predict life expectancy, adjusting for ethnicity, working status, deprivation, body mass index, and sedentary time. A total of 93,746 (19.5%) participants had multimorbidity. During a mean follow-up of 7 (range 2–9) years, 11,006 deaths occurred. At 45 years, in men with multimorbidity an unhealthy score was associated with a gain of 1.5 (95% confidence interval [CI] −0.3 to 3.3; P = 0.102) additional life years compared to very unhealthy score, though the association was not significant, whilst a healthy score was significantly associated with a gain of 4.5 (3.3 to 5.7; P < 0.001) life years and a very healthy score with 6.3 (5.0 to 7.7; P < 0.001) years. Corresponding estimates in women were 3.5 (95% CI 0.7 to 6.3; P = 0.016), 6.4 (4.8 to 7.9; P < 0.001), and 7.6 (6.0 to 9.2; P < 0.001) years. Results were consistent in those without multimorbidity and in several sensitivity analyses. For individual lifestyle factors, no current smoking was associated with the largest survival benefit. The main limitations were that we could not explore the consistency of our results using a more restrictive definition of multimorbidity including only cardiometabolic conditions, and participants were not representative of the UK as a whole.
Conclusions
In this analysis of data from the UK Biobank, we found that regardless of the presence of multimorbidity, engaging in a healthier lifestyle was associated with up to 6.3 years longer life for men and 7.6 years for women; however, not all lifestyle risk factors equally correlated with life expectancy, with smoking being significantly worse than others.
Klíčová slova:
Alcohol consumption – Body Mass Index – Diet – Life expectancy – Medical risk factors – Physical activity – Public and occupational health – Sedentary behavior
Zdroje
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