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. 2019 Jun 12;17(1):108.
doi: 10.1186/s12916-019-1339-0.

Physical activity, multimorbidity, and life expectancy: a UK Biobank longitudinal study

Yogini V Chudasama  1   2 , Kamlesh K Khunti  3   4 , Francesco Zaccardi  3 , Alex V Rowlands  3   5   6 , Thomas Yates  3   5 , Clare L Gillies  3 , Melanie J Davies  3   5 , Nafeesa N Dhalwani  3   4   7
Affiliations

Physical activity, multimorbidity, and life expectancy: a UK Biobank longitudinal study

Yogini V Chudasama et al. BMC Med. .

Abstract

Background: Multimorbidity is an emerging public health priority. Physical activity (PA) is recommended as one of the main lifestyle behaviours, yet the benefits of PA for people with multimorbidity are unclear. We assessed the benefits of PA on mortality and life expectancy in people with and without multimorbidity.

Methods: Using the UK Biobank dataset, we extracted data on 36 chronic conditions and defined multimorbidity as (a) 2 or more conditions, (b) 2 or more conditions combined with self-reported overall health, and (c) 2 or more top-10 most common comorbidities. Leisure-time PA (LTPA) and total PA (TPA) were measured by questionnaire and categorised as low (< 600 metabolic equivalent (MET)-min/week), moderate (600 to < 3000 MET-min/week), and high (≥ 3000 MET-min/week), while objectively assessed PA was assessed by wrist-worn accelerometer and categorised as low (4 min/day), moderate (10 min/day), and high (22 min/day) walking at brisk pace. Survival models were applied to calculate adjusted hazard ratios (HRs) and predict life expectancy differences.

Results: 491,939 individuals (96,622 with 2 or more conditions) had a median follow-up of 7.0 (IQR 6.3-7.6) years. Compared to low LTPA, for participants with multimorbidity, HR for mortality was 0.75 (95% CI 0.70-0.80) and 0.65 (0.56-0.75) in moderate and high LTPA groups, respectively. This finding was consistent when using TPA measures. Using objective PA, HRs were 0.49 (0.29-0.80) and 0.29 (0.13-0.61) in the moderate and high PA groups, respectively. These findings were similar for participants without multimorbidity. In participants with multimorbidity, at the age of 45 years, moderate and high LTPA were associated with an average of 3.12 (95% CI 2.53, 3.71) and 3.55 (2.34, 4.77) additional life years, respectively, compared to low LTPA; in participants without multimorbidity, corresponding figures were 1.95 (1.59, 2.31) and 1.85 (1.19, 2.50). Similar results were found with TPA. For objective PA, moderate and high levels were associated with 3.60 (- 0.60, 7.79) and 5.32 (- 0.47, 11.11) life years gained compared to low PA for those with multimorbidity and 3.88 (1.79, 6.00) and 4.51 (2.15, 6.88) life years gained in those without. Results were consistent when using other definitions of multimorbidity.

Conclusions: There was an inverse dose-response association between PA and mortality. A moderate exercise is associated with a longer life expectancy, also in individuals with multimorbidity.

Keywords: Co-morbidity; Life expectancy; Mortality; Multimorbidity; Physical activity; UK Biobank.

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Conflict of interest statement

ND is currently a full-time employee of Evidera Inc. which is a contract research organisation providing research and consultancy support for pharmaceutical companies in using real-world data. FZ is a Clinical Research Fellow funded with an unrestricted Educational Grant from Sanofi-Aventis and an unrestricted educational grant from the NIHR CLAHRC East Midlands to the University of Leicester; the funding sources had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. KK has acted as a consultant and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Servier, and Merck Sharp & Dohme. He has received grants in support of investigator and investigator-initiated trials from Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Boehringer Ingelheim, and Merck Sharp & Dohme. KK has received funds for research and honoraria for speaking at meetings and has served on advisory boards for Lilly, Sanofi-Aventis, Merck Sharp & Dohme, and Novo Nordisk. MJD has acted as consultant, advisory board member, and speaker for Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, AstraZeneca, and Janssen and as a speaker for Mitsubishi Tanabe Pharma Corporation. She has received grants in support of investigator and investigator-initiated trials from Novo Nordisk, Sanofi-Aventis, and Lilly. All other authors declare there is no duality of interest in connection with their involvement in this study. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Comorbidity patterns of the included 36 chronic conditions (%) (n = 491,939)
Fig. 2
Fig. 2
Association between moderate and high physical activity (PA) and mortality when compared to the low PA group for participants with and without multimorbidity (2 or more conditions)
Fig. 3
Fig. 3
Modelling years of life lost by multimorbidity (2 or more conditions)
Fig. 4
Fig. 4
Life year gains associated with moderate and high physical activity (PA) when compared to the low PA group for participants with and without multimorbidity (2 or more conditions)
See this image and copyright information in PMC

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