Association between the Healthy Lifestyle Index and risk of multimorbidity in the Women’s Health Initiative
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences ( IF 4.3 ) Pub Date : 2023-07-18 , DOI: 10.1093/gerona/glad170
Rita Peila 1 , Xiaonan Xue 1 , Aladdin H Shadyab 2 , Jean Wactawski-Wende 3 , Mark A Espeland 4 , Linda G Snetselaar 5 , Nazmus Saquib 6 , Farha Ikramuddin 7 , JoAnn E Manson 8 , Robert B Wallace 5 , Thomas E Rohan 1

Background Multimorbidity, defined as the presence of two or more chronic health conditions, is increasingly common among older adults. The combination of lifestyle characteristics such as diet quality, smoking status, alcohol intake, physical activity, sleep duration, and body fat as assessed by body mass index (BMI) or waist circumference, and risk of multimorbidity is not well understood. Objective We investigated the association between the healthy lifestyle index (HLI), generated by combining indicators of diet quality, smoking, alcohol, physical activity, sleep amount, and BMI, and risk of multimorbidity, a composite outcome that included cardiovascular disease, diabetes, cancer and fracture. Methods We studied 62,037 postmenopausal women ages 50-79 years at enrollment in the Women’s Health Initiative, with no reported history of cardiovascular disease, diabetes, cancer or fracture at baseline. Lifestyle characteristics measured at baseline were categorized and a score (0-4) was assigned to each category. The combined HLI (0-24) was grouped into quintiles, with higher quintiles indicating a healthier lifestyle. Multivariable adjusted estimates of hazard ratios (HR) and 95% confidence intervals (95%CI) for the risk of developing multimorbidity were obtained using Cox proportional hazard models. Results Over an average follow-up period of 16.3 years, 5,656 women developed multimorbidity. There was an inverse association between the HLI levels and risk of multimorbidity (compared to the HLI_1 stquintile: HR_2 ndquintile=0.81 95%CI 0.74-0.83, HR_3 rdquintile=0.77 95%CI 0.71-0.83, HR_4 thquintile=0.70 95%CI 0.64-0.76, and HR_5 thquintile=0.60 95%CI 0.54-0.66; p-trend<0.001). Similar associations were observed after stratification by age or BMI categories. Conclusions Among postmenopausal women, higher levels of the HLI were associated with a reduced risk of developing multimorbidity.

更新日期：2023-07-18

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