Chronic physical conditions, multimorbidity and physical activity across 46 low- and middle-income countries.

Journal: The international journal of behavioral nutrition and physical activity

Volume: 14

Issue: 1

Year of Publication: 2017

Affiliated Institutions:  Department of Rehabilitation Sciences, KU Leuven, Tervuursevest , Leuven, , Belgium. davy.vancampfort@uc-kortenberg.be. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, , Sant Boi de Llobregat, Barcelona, , Spain. School of Psychiatry, UNSW, Sydney, Australia. Exercise Physiology Department, School of Medical Sciences, UNSW Australia, Sydney, Australia. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. Kyambogo University, Kampala, Uganda. School of Public Health & Charles Perkins Centre, University of Sydney, Sydney, Australia. School of Health Sciences, Division of Psychology & Mental Health, University of Manchester, Manchester, UK. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE AZ, UK.

Abstract summary 

There are no nationally representative population-based studies investigating the relationship between physical activity, chronic conditions and multimorbidity (i.e., two or more chronic conditions) in low- and middle-income countries (LMICs), and studies on a multi-national level are lacking. This is an important research gap, given the rapid increase in the prevalence of chronic diseases associated with lifestyle changes in these countries. This cross-sectional study aimed to assess the association between chronic conditions, multimorbidity and low physical activity (PA) among community-dwelling adults in 46 LMICs, and explore the mediators of these relationships.World Health Survey data included 228,024 adults aged ≥18 years from 46 LMICs. PA was assessed by the International Physical Activity Questionnaire (IPAQ). Nine chronic physical conditions (chronic back pain, angina, arthritis, asthma, diabetes, hearing problems, tuberculosis, visual impairment and edentulism) were assessed. Multivariable logistic regression and mediation analyses were used to assess the association between chronic conditions or multimorbidity and low PA.Overall, in the multivariable analysis, arthritis (OR = 1.12), asthma (1.19), diabetes (OR = 1.33), edentulism (OR = 1.46), hearing problems (OR = 1.90), tuberculosis (OR = 1.24), visual impairment (OR = 2.29), multimorbidity (OR = 1.31; 95% CI = 1.21-1.42) were significantly associated with low PA. More significant associations were observed in individuals aged ≥50 years. In older adults, depression mediated between 5.1% (visual impairment) to 23.5% (angina) of the association between a chronic condition and low PA. Mobility difficulties explained more than 25% of the association for seven of the eight chronic conditions. Pain was a strong mediator for angina (65.9%) and arthritis (64.9%), while sleep problems mediated up to 43.7% (angina) of the association.In LMICs, those with chronic conditions and multimorbidity are significantly less physically active (especially older adults). Research on the efficacy and effectiveness of PA in the management of chronic diseases in LMICs is urgently needed. Targeted promotion of physical activity to populations in LMICs experiencing chronic conditions may ameliorate associated depression, mobility difficulties and pain that are themselves important barriers for initiating or adopting an active lifestyle.

Authors & Co-authors:  Vancampfort Davy D Koyanagi Ai A Ward Philip B PB Rosenbaum Simon S Schuch Felipe B FB Mugisha James J Richards Justin J Firth Joseph J Stubbs Brendon B

Study Outcome 

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Statistics
Citations :  Murray CJ, Barber RM, Foreman KJ, Abbasoglu Ozgoren A, Abd-Allah F, Abera SF, Aboyans V, Abraham JP, Abubakar I, Abu-Raddad LJ, et al. Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition. Lancet. 2015;386:2145–91. doi: 10.1016/S0140-6736(15)61340-X.
Authors :  9
Identifiers
Doi : 6
SSN : 1479-5868
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Angina pectoris;Arthritis;Depression;Diabetes mellitus;Mobility limitation;Multimorbidity;Pain;Physical activity;Sleep
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England