Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.

<h4>Background</h4>Whether a healthy lifestyle impacts longevity in the presence of multimorbidity is unclear. We investigated the associations between healthy lifestyle and life expectancy in people with and without multimorbidity.<h4>Methods and findings</h4>A total of 480,...

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Main Authors: Yogini V Chudasama, Kamlesh Khunti, Clare L Gillies, Nafeesa N Dhalwani, Melanie J Davies, Thomas Yates, Francesco Zaccardi
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-09-01
Series:PLoS Medicine
Online Access:https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1003332&type=printable
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author Yogini V Chudasama
Kamlesh Khunti
Clare L Gillies
Nafeesa N Dhalwani
Melanie J Davies
Thomas Yates
Francesco Zaccardi
author_facet Yogini V Chudasama
Kamlesh Khunti
Clare L Gillies
Nafeesa N Dhalwani
Melanie J Davies
Thomas Yates
Francesco Zaccardi
author_sort Yogini V Chudasama
collection DOAJ
description <h4>Background</h4>Whether a healthy lifestyle impacts longevity in the presence of multimorbidity is unclear. We investigated the associations between healthy lifestyle and life expectancy in people with and without multimorbidity.<h4>Methods and findings</h4>A total of 480,940 middle-aged adults (median age of 58 years [range 38-73], 46% male, 95% white) were analysed in the UK Biobank; this longitudinal study collected data between 2006 and 2010, and participants were followed up until 2016. We extracted 36 chronic conditions and defined multimorbidity as 2 or more conditions. Four lifestyle factors, based on national guidelines, were used: leisure-time physical activity, smoking, diet, and alcohol consumption. A combined weighted score was developed and grouped participants into 4 categories: very unhealthy, unhealthy, healthy, and very healthy. Survival models were applied to predict life expectancy, adjusting for ethnicity, working status, deprivation, body mass index, and sedentary time. A total of 93,746 (19.5%) participants had multimorbidity. During a mean follow-up of 7 (range 2-9) years, 11,006 deaths occurred. At 45 years, in men with multimorbidity an unhealthy score was associated with a gain of 1.5 (95% confidence interval [CI] -0.3 to 3.3; P = 0.102) additional life years compared to very unhealthy score, though the association was not significant, whilst a healthy score was significantly associated with a gain of 4.5 (3.3 to 5.7; P < 0.001) life years and a very healthy score with 6.3 (5.0 to 7.7; P < 0.001) years. Corresponding estimates in women were 3.5 (95% CI 0.7 to 6.3; P = 0.016), 6.4 (4.8 to 7.9; P < 0.001), and 7.6 (6.0 to 9.2; P < 0.001) years. Results were consistent in those without multimorbidity and in several sensitivity analyses. For individual lifestyle factors, no current smoking was associated with the largest survival benefit. The main limitations were that we could not explore the consistency of our results using a more restrictive definition of multimorbidity including only cardiometabolic conditions, and participants were not representative of the UK as a whole.<h4>Conclusions</h4>In this analysis of data from the UK Biobank, we found that regardless of the presence of multimorbidity, engaging in a healthier lifestyle was associated with up to 6.3 years longer life for men and 7.6 years for women; however, not all lifestyle risk factors equally correlated with life expectancy, with smoking being significantly worse than others.
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spelling doaj-art-423b666a4bd249deb5fc893f32f1df6c2025-08-20T02:33:11ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762020-09-01179e100333210.1371/journal.pmed.1003332Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.Yogini V ChudasamaKamlesh KhuntiClare L GilliesNafeesa N DhalwaniMelanie J DaviesThomas YatesFrancesco Zaccardi<h4>Background</h4>Whether a healthy lifestyle impacts longevity in the presence of multimorbidity is unclear. We investigated the associations between healthy lifestyle and life expectancy in people with and without multimorbidity.<h4>Methods and findings</h4>A total of 480,940 middle-aged adults (median age of 58 years [range 38-73], 46% male, 95% white) were analysed in the UK Biobank; this longitudinal study collected data between 2006 and 2010, and participants were followed up until 2016. We extracted 36 chronic conditions and defined multimorbidity as 2 or more conditions. Four lifestyle factors, based on national guidelines, were used: leisure-time physical activity, smoking, diet, and alcohol consumption. A combined weighted score was developed and grouped participants into 4 categories: very unhealthy, unhealthy, healthy, and very healthy. Survival models were applied to predict life expectancy, adjusting for ethnicity, working status, deprivation, body mass index, and sedentary time. A total of 93,746 (19.5%) participants had multimorbidity. During a mean follow-up of 7 (range 2-9) years, 11,006 deaths occurred. At 45 years, in men with multimorbidity an unhealthy score was associated with a gain of 1.5 (95% confidence interval [CI] -0.3 to 3.3; P = 0.102) additional life years compared to very unhealthy score, though the association was not significant, whilst a healthy score was significantly associated with a gain of 4.5 (3.3 to 5.7; P < 0.001) life years and a very healthy score with 6.3 (5.0 to 7.7; P < 0.001) years. Corresponding estimates in women were 3.5 (95% CI 0.7 to 6.3; P = 0.016), 6.4 (4.8 to 7.9; P < 0.001), and 7.6 (6.0 to 9.2; P < 0.001) years. Results were consistent in those without multimorbidity and in several sensitivity analyses. For individual lifestyle factors, no current smoking was associated with the largest survival benefit. The main limitations were that we could not explore the consistency of our results using a more restrictive definition of multimorbidity including only cardiometabolic conditions, and participants were not representative of the UK as a whole.<h4>Conclusions</h4>In this analysis of data from the UK Biobank, we found that regardless of the presence of multimorbidity, engaging in a healthier lifestyle was associated with up to 6.3 years longer life for men and 7.6 years for women; however, not all lifestyle risk factors equally correlated with life expectancy, with smoking being significantly worse than others.https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1003332&type=printable
spellingShingle Yogini V Chudasama
Kamlesh Khunti
Clare L Gillies
Nafeesa N Dhalwani
Melanie J Davies
Thomas Yates
Francesco Zaccardi
Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.
PLoS Medicine
title Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.
title_full Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.
title_fullStr Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.
title_full_unstemmed Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.
title_short Healthy lifestyle and life expectancy in people with multimorbidity in the UK Biobank: A longitudinal cohort study.
title_sort healthy lifestyle and life expectancy in people with multimorbidity in the uk biobank a longitudinal cohort study
url https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1003332&type=printable
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