Multimorbidity and obesity in older adults from six low- and middle-income countries

TY - JOUR

T1 - Multimorbidity and obesity in older adults from six low- and middle-income countries

AU - Romano, Eugenia

AU - Ma, Ruimin

AU - Vancampfort, Davy

AU - Firth, Joseph

AU - Felez-Nobrega, Mireia

AU - Haro, Josep Maria

AU - Stubbs, Brendon

AU - Koyanagi, Ai

N1 - Funding Information: This paper uses data from WHO's Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Ageing through Interagency Agreements OGHA 04034785, YA1323-08-CN-0020, Y1-AG-1005-01 and through research grants R01-AG034479 and R21-AG034263.Brendon Stubbs is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. Brendon Stubbs also holds active grants with the Medical Research Council (GCRF and multimorbidity calls) and Guys and St Thomas Charity (GSTT). Brendon Stubbs has received consultancy fees from ASICS Europe BV.Joseph Firth is currently supported by a University of Manchester Presidential Fellowship (P123958) and a UK Research and Innovation Future Leaders Fellowship (MR/T021780/1) and has received support from a NICM-Blackmores Institute Fellowship. Funding Information: Brendon Stubbs is supported by a Clinical Lectureship ( ICA-CL-2017-03-001 ) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust . Brendon Stubbs also holds active grants with the Medical Research Council (GCRF and multimorbidity calls) and Guys and St Thomas Charity (GSTT). Brendon Stubbs has received consultancy fees from ASICS Europe BV. Funding Information: This paper uses data from WHO's Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Ageing through Interagency Agreements OGHA 04034785 , YA1323-08-CN-0020 , Y1-AG-1005-01 and through research grants R01-AG034479 and R21-AG034263 . Funding Information: Joseph Firth is currently supported by a University of Manchester Presidential Fellowship ( P123958 ) and a UK Research and Innovation Future Leaders Fellowship ( MR/T021780/1 ) and has received support from a NICM-Blackmores Institute Fellowship . Publisher Copyright: © 2021 Elsevier Inc.

PY - 2021/12

Y1 - 2021/12

N2 - Prevalence of multimorbidity (i.e., ≥2 chronic conditions), chronic diseases, and obesity is increasing in low- and middle-income countries (LMICs), posing a potential threat to the health of older adults living in these areas. This study hence investigates the unexplored association between obesity and multimorbidity among older adults from LMICs. Cross-sectional, community-based data from the WHO Study on global Ageing and adult health (SAGE) were analysed. The sample consisted of 20,198 individuals aged ≥60 years [Mean age (SD) = 69.3 (13.1) years; 54.1% female] from China, India, Ghana, Mexico, Russia, South Africa. Twelve chronic conditions were assessed. Multivariable logistic regression was conducted to assess the association between BMI ≥ 30 kg/m2, high waist circumference (WC, cut-points > 102 cm for males and > 88 cm for females) and multimorbidity. After adjusting for potential confounders, overall, BMI ≥ 30 kg/m2 was associated with 1.43 (95%CI = 1.21–1.69) times higher odds for multimorbidity, while this estimate for high WC was 1.50 (95%CI = 1.21–1.86). Significant associations emerged between obesity measures and five out of twelve chronic conditions. Results from this study underline the need to reduce obesity among older adults in areas where its prevalence is increasing, as it is associated with increased odds for multimorbidity. Future longitudinal research in this setting is required to assess the impact of obesity reduction on multimorbidity incidence.

AB - Prevalence of multimorbidity (i.e., ≥2 chronic conditions), chronic diseases, and obesity is increasing in low- and middle-income countries (LMICs), posing a potential threat to the health of older adults living in these areas. This study hence investigates the unexplored association between obesity and multimorbidity among older adults from LMICs. Cross-sectional, community-based data from the WHO Study on global Ageing and adult health (SAGE) were analysed. The sample consisted of 20,198 individuals aged ≥60 years [Mean age (SD) = 69.3 (13.1) years; 54.1% female] from China, India, Ghana, Mexico, Russia, South Africa. Twelve chronic conditions were assessed. Multivariable logistic regression was conducted to assess the association between BMI ≥ 30 kg/m2, high waist circumference (WC, cut-points > 102 cm for males and > 88 cm for females) and multimorbidity. After adjusting for potential confounders, overall, BMI ≥ 30 kg/m2 was associated with 1.43 (95%CI = 1.21–1.69) times higher odds for multimorbidity, while this estimate for high WC was 1.50 (95%CI = 1.21–1.86). Significant associations emerged between obesity measures and five out of twelve chronic conditions. Results from this study underline the need to reduce obesity among older adults in areas where its prevalence is increasing, as it is associated with increased odds for multimorbidity. Future longitudinal research in this setting is required to assess the impact of obesity reduction on multimorbidity incidence.

KW - Ageing

KW - Chronic conditions

KW - Comorbidity

KW - Elderly

KW - Low- and middle-income countries

KW - Multimorbidity

KW - Obesity

UR - https://www.scopus.com/pages/publications/85118155475

U2 - 10.1016/j.ypmed.2021.106816

DO - 10.1016/j.ypmed.2021.106816

M3 - Article

C2 - 34599928

AN - SCOPUS:85118155475

SN - 0091-7435

VL - 153

JO - Preventive Medicine

JF - Preventive Medicine

M1 - 106816

ER -