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Prevalence of Activity Limitations and Association with Multimorbidity Among US Adults 50 to 64 Years Old.

ABSTRACT: BACKGROUND:Functional limitations may be more common in middle-aged adults than previously recognized. However, there are few published data on the prevalence of activity limitations, and their association with multimorbidity, among adults 50 to 64 years old. OBJECTIVE:To describe the prevalence of activity limitations and the association with multimorbidity in middle-aged adults. DESIGN:Cross-sectional analysis of US population-based National Health and Nutrition Examination Survey (NHANES) 2011-2016. PARTICIPANTS:The total number of community-dwelling NHANES participants aged 50-64 years old is 4217. MAIN MEASURES:Chronic conditions included hypertension, high cholesterol, diabetes mellitus, obesity, chronic kidney disease, cancer, stroke, coronary heart disease, heart failure, chronic obstructive pulmonary disease/asthma, arthritis, and depression. Activity limitations were defined as any difficulty within each of four International Classification of Functioning (ICF) domains: functional limitations (kneeling, carrying, standing, sitting, reaching, grasping, pulling), mobility (walking ¼ mile, climbing 10 steps), basic activities of daily living (BADLs; walking, transferring, eating, dressing), and instrumental activities of daily living (IADLs; finances, chores, cooking). We calculated prevalence ratios for activity limitations using generalized estimating equations. KEY RESULTS:The prevalence of functional limitations, mobility limitations, BADL difficulty, and IADL difficulty was 34%, 11%, 15%, and 17%, respectively. Seventy-two percent of participants had two or more chronic conditions; 23% had two, 18% had three, 15% had four, and 16% had five or more. Multivariable adjusted prevalence ratios (95% CI) for functional limitations among those with 2, 3, 4, and 5 or more chronic conditions, compared with 0-1 conditions, were 1.94 (1.43-2.63), 2.50 (1.93-3.23), 3.26 (2.48-4.27), and 4.54 (3.48-5.93), respectively (p trend?

SUBMITTER: Bowling CB

PROVIDER: S-EPMC6848639 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Prevalence of Activity Limitations and Association with Multimorbidity Among US Adults 50 to 64 Years Old.

Bowling C Barrett CB Deng Luqin L Sakhuja Swati S Morey Miriam C MC Jaeger Byron C BC Muntner Paul P

Journal of general internal medicine 20190821 11

<h4>Background</h4>Functional limitations may be more common in middle-aged adults than previously recognized. However, there are few published data on the prevalence of activity limitations, and their association with multimorbidity, among adults 50 to 64 years old.<h4>Objective</h4>To describe the prevalence of activity limitations and the association with multimorbidity in middle-aged adults.<h4>Design</h4>Cross-sectional analysis of US population-based National Health and Nutrition Examinati ...[more]

PMID: 31435766

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Project description:ImportanceA growing body of literature suggests that having a strong sense of purpose in life leads to improvements in both physical and mental health and enhances overall quality of life. There are interventions available to influence life purpose; thus, understanding the association of life purpose with mortality is critical.ObjectiveTo evaluate whether an association exists between life purpose and all-cause or cause-specific mortality among older adults in the United States.Design, setting, and participantsThe Health and Retirement Study (HRS) is a national cohort study of US adults older than 50 years. Adults between the ages of 51 to 61 were enrolled in the HRS, and their spouses or partners were enrolled regardless of age. Initially, individuals born between 1931 and 1941 were enrolled starting in 1992, but subsequent cohort enrichment was carried out. The present prospective cohort study sample was drawn from 8419 HRS participants who were older than 50 years and who had filled out a psychological questionnaire during the HRS 2006 interview period. Of these, 1142 nonresponders with incomplete life purpose data, 163 respondents with missing sample weights, 81 participants lost to follow-up, 1 participant with an incorrect survival time, and 47 participants with missing information on covariates were excluded. The final sample for analysis was 6985 individuals. Data analyses were conducted between June 5, 2018, and April 22, 2019.ExposuresPurpose in life was assessed for the 2006 interview period with a 7-item questionnaire from the modified Ryff and Keyes Scales of Psychological Well-being evaluation using a Likert scale ranging from 1 to 6, with higher scores indicating greater purpose in life; for all-cause and cause-specific mortality analyses, 5 categories of life purpose scores were used (1.00-2.99, 3.00-3.99, 4.00-4.99, 5.00-5.99, and 6.00).Main outcomes and measuresAll-cause and cause-specific mortality were assessed between 2006 and 2010. Weighted Cox proportional hazards models were used to evaluate life purpose and mortality.ResultsOf 6985 individuals included in the analysis, 4016 (57.5%) were women, the mean (SD) age of all participants was 68.6 (9.8) years, and the mean (SD) survival time for decedents was 31.21 (15.42) months (range, 1.00-71.00 months). Life purpose was significantly associated with all-cause mortality in the HRS (hazard ratio, 2.43; 95% CI, 1.57-3.75, comparing those in the lowest life purpose category with those in the highest life purpose category). Some significant cause-specific mortality associations with life purpose were also observed (heart, circulatory, and blood conditions: hazard ratio, 2.66; 95% CI, 1.62-4.38).Conclusions and relevanceThis study's results indicated that stronger purpose in life was associated with decreased mortality. Purposeful living may have health benefits. Future research should focus on evaluating the association of life purpose interventions with health outcomes, including mortality. In addition, understanding potential biological mechanisms through which life purpose may influence health outcomes would be valuable.

Dataset Information

Prevalence of Activity Limitations and Association with Multimorbidity Among US Adults 50 to 64 Years Old.

Publications

Prevalence of Activity Limitations and Association with Multimorbidity Among US Adults 50 to 64 Years Old.

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