title: Changes in physical functioning among men and women aged 50-79 years in Germany: an analysis of National Health Interview and Examination Surveys, 1997-1999 and 2008-2011.
abstract: This study examines changes in physical functioning among adults aged 50-79 years in Germany based on data from two German National Health Interview and Examination Surveys conducted in 1997-1999 (GNHIES98) and 2008-2011 (DEGS1).
  
  
  
  Using cross-sectional data from the two surveys (GNHIES98, n = 2884 and DEGS1, n = 3732), we examined changes in self-reported physical functioning scores (Short Form-36 physical functioning subscale (SF-36 PF)) by sex and age groups (50-64 and 65-79 years). Covariables included educational level, living alone, nine chronic diseases, polypharmacy (≥5 prescribed medicines), body mass index, sports activity, smoking and alcohol consumption. Multimorbidity was defined as ≥2 chronic diseases. Multivariable models were fitted to examine consistency of changes in physical functioning among certain subgroups and to assess changes in mean SF-36 PF scores, adjusting for changes in covariables between surveys.
  
  
  
  Mean physical functioning increased among adults aged 50-79 years between surveys in unadjusted analyses, but this change was not as marked among men aged 65-79 years who experienced rising obesity (20.6 to 31.5%, p = 0.004) and diabetes (13.0 to 20.0%, p = 0.014). Prevalence of multimorbidity and polypharmacy use increased among men and women aged 65-79 years. In sex and age specific multivariable analyses, changes in physical functioning over time were consistent across subgroups. Gains in physical functioning were explained by improved education, lower body mass index and improved health-related behaviours (smoking, alcohol consumption, sports activity) in women, but less so among men.
  
  
  
  Physical functioning improved in Germany among adults aged 50-79 years. Improvements in the population 65-79 years were less evident among men than women, despite increases in multimorbidity prevalence among both sexes. Changes in health behaviours over time differed between sexes and help explain variations in physical functioning. Targeted health behaviour interventions are indicated from this study.
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany.|Faculty of Life Sciences and Medicine, King's College London, Guy's Campus, London, SE1 1UL, UK.
authors.forename: A K
authors.initials: AK
authors.lastname: Buttery
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany.
authors.forename: Y
authors.initials: Y
authors.lastname: Du
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany.
authors.forename: M A
authors.initials: MA
authors.lastname: Busch
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Fuchs
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Gaertner
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Knopf
authors.affiliation: Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany. Scheidt-NaveC@rki.de.
authors.forename: C
authors.initials: C
authors.lastname: Scheidt-Nave
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D017567:Karnofsky Performance Status / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors
keywords: Chronic disease; DEGS1; Disability; GNHIES98; Multimorbidity; Physical functioning