Relationship between multimorbidity and physical activity: secondary analysis from the Quebec health survey.
BACKGROUND
Abundant literature supports the beneficial effects of physical activity for improving health of people with chronic diseases. The relationship between multimorbidity and physical activity levels, however, has been little evaluated. The purpose of the current exploratory study was to examine the relationship between a) multimorbidity and physical activity levels, and b) long-term limitations on activity, self-rated general health, psychological distress, and physical activity levels for each sex in adults, after age, education, income, and employment factors were controlled for.


METHODS
Data from the Quebec Health Survey 1998 were used. The sample included 16,782 adults 18-69 yr of age. Independent variables were multimorbidity, long-term limitations on activity, self-rated general health, and psychological distress. The dependent variable was physical activity levels. Links between the independent and dependent variables were assessed separately for men and women with multinomial regressions while accounting for the survey sampling design and household clustering.


RESULTS
About 46% of the participants were men. Multimorbidity was not associated with physical activity levels for either men or women. Men and women with long-term limitations on activity and with poor-to-average self-rated general health were less likely to be physically active. No relationship between psychological distress and physical activity was found for men. Women with high levels of psychological distress were less likely to be physically active.


CONCLUSIONS
Multimorbidity was not associated with physical activity levels in either sex, when age, education, income, and employment factors were controlled for. Long-term limitations on activity and poor-to-average self-rated general health seem related to a reduction in physical activity levels for both sexes, whereas psychological distress was associated with a reduction in physical activity levels only among women. Longitudinal studies using a comorbidity or multimorbidity index to account for severity of the chronic diseases are needed to replicate the results of this exploratory study.
Hudon
Catherine
C
Department of Family Medicine, Sherbrooke University, Quebec, Canada. catherine.hudon@usherbrooke.ca
Soubhi
Hassan
H
Fortin
Martin
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D015444:Exercise; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life; D011792:Quebec / Q000453:epidemiology; D012044:Regression Analysis; D012737:Sex Factors; D012959:Socioeconomic Factors
Qual Life Res. 2006 Feb;15(1):83-91
16411033
AAOHN J. 2006 Jun;54(6):249-61
16800402
J Clin Epidemiol. 1988;41(3):275-84
3339381
J Fam Pract. 2001 Mar;50(3):211-6
11252208
Health Qual Life Outcomes. 2004 Sep 20;2:51
15380021
JAMA. 1995 Feb 1;273(5):402-7
7823386
Med Care. 1996 Nov;34(11):1093-101
8911426
Soc Sci Med. 1992 Jan;34(1):25-32
1738853
Eur J Public Health. 2005 Jun;15(3):317-22
15941745
Curr Sports Med Rep. 2003 Jun;2(3):173-80
12831658
Am J Med Sci. 1988 May;295(5):418-23
3132042
Diabetes Care. 1995 Jan;18(1):27-33
7698044
J Gen Intern Med. 2001 Nov;16(11):721-7
11722684
Ann Fam Med. 2003 May-Jun;1(1):4-7
15043173
Ann Fam Med. 2006 Sep-Oct;4(5):417-22
17003141
BMJ. 2003 Mar 8;326(7388):512-4
12623886
J Psychosom Res. 1993 Sep;37(6):565-74
8410742
J Clin Epidemiol. 1998 May;51(5):367-75
9619963
Clin Geriatr Med. 2002 Aug;18(3):431-62, vi-vii
12424867
Prev Med. 2005 Jan;40(1):33-40
15530578
AAOHN J. 1993 Feb;41(2):73-83
8447857
JAMA. 2001 Dec 12;286(22):2823-9
11735757
Health Qual Life Outcomes. 2004 Sep 07;2:47
15353000
Sports Med. 1991 Mar;11(3):143-82
1828608
J Cardiopulm Rehabil. 2005 May-Jun;25(3):181-3
15931024
Ann Fam Med. 2005 May-Jun;3(3):223-8
15928225
JAMA. 1991 Jul 3;266(1):73-9
2046132
J Clin Epidemiol. 2000 Jun;53(6):563-70
10880774
J Clin Epidemiol. 1999 Mar;52(3):171-9
10210233
Am J Prev Med. 2001 Nov;21(4):306-12
11701302
J Occup Med. 1989 Dec;31(12):969-73
2614536
Curr Pain Headache Rep. 2003 Oct;7(5):348-54
12946287
Psychol Rep. 1996 Dec;79(3 Pt 1):1059-69
8969117
Mayo Clin Proc. 2002 Feb;77(2):165-73
11838650
Med Sci Sports Exerc. 2004 Oct;36(10):1667-73
15595285
J Occup Health. 2005 Sep;47(5):414-23
16230835
JAMA. 1996 Jul 17;276(3):241-6
8667571