Background: Multimorbidity is associated with poor quality of life, polypharmacy, health care costs and mortality, with those affected potentially benefitting from a healthy lifestyle. We assessed a comprehensive set of lifestyle factors in relation to multimorbidity with major chronic diseases.

Methods: This cross-sectional study utilised baseline data for adults from the prospective Lifelines Cohort in the north of the Netherlands (N = 79,345). We defined multimorbidity as the coexistence of two or more chronic diseases (i.e. cardiovascular disease, cancer, respiratory disease, type 2 diabetes) and evaluated factors in six lifestyle domains (nutrition, physical (in)activity, substance abuse, sleep, stress, relationships) among groups by the number of chronic diseases (≥2, 1, 0). Multinomial logistic regression models were created, adjusted for appropriate confounders, and odds ratios (OR) with 95% confidence intervals (95%CI) were reported.

Results: 3,712 participants had multimorbidity (4.7%, age 53.5 ± 12.5 years), and this group tended to have less healthy lifestyles. Compared to those without chronic diseases, those with multimorbidity reported physical inactivity more often (OR, 1.15; 95%CI, 1.06–1.25; not significant for one condition), chronic stress (OR, 2.14; 95%CI, 1.92–2.38) and inadequate sleep (OR, 1.70; 95%CI, 1.41–2.06); as expected, they more often watched television (OR, 1.70; 95%CI, 1.42–2.04) and currently smoked (OR, 1.91; 95%CI, 1.73–2.11), but they also had lower alcohol intakes (OR, 0.66; 95%CI, 0.59–0.74).

Conclusions: Chronic stress and poor sleep, in addition to physical inactivity and smoking, are lifestyle factors of great concern in patients with multimorbidity.

Original languageEnglish
Article numbere0287263
Number of pages15
JournalPLoS ONE
Issue number7
Publication statusPublished - 24-Jul-2023

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