Physical activity, multimorbidity, and life expectancy: a UK Biobank longitudinal study
Open accessAbstract
BACKGROUND: Multimorbidity is an emerging public health priority. Physical activity (PA) is recommended as one of the main lifestyle behaviours, yet the benefits of PA for people with multimorbidity are unclear. We assessed the benefits of PA on mortality and life expectancy in people with and without multimorbidity. METHODS: Using the UK Biobank dataset, we extracted data on 36 chronic conditions and defined multimorbidity as (a) 2 or more conditions, (b) 2 or more conditions combined with self-reported overall health, and (c) 2 or more top-10 most common comorbidities. Leisure-time PA (LTPA) and total PA (TPA) were measured by questionnaire and categorised as low (< 600 metabolic equivalent (MET)-min/week), moderate (600 to < 3000 MET-min/week), and high (≥ 3000 MET-min/week), while objectively assessed PA was assessed by wrist-worn accelerometer and categorised as low (4 min/day), moderate (10 min/day), and high (22 min/day) walking at brisk pace. Survival models were applied to calculate adjusted hazard ratios (HRs) and predict life expectancy differences. RESULTS: 491,939 individuals (96,622 with 2 or more conditions) had a median follow-up of 7.0 (IQR 6.3-7.6) years. Compared to low LTPA, for participants with multimorbidity, HR for mortality was 0.75 (95% CI 0.70-0.80) and 0.65 (0.56-0.75) in moderate and high LTPA groups, respectively. This finding was consistent when using TPA measures. Using objective PA, HRs were 0.49 (0.29-0.80) and 0.29 (0.13-0.61) in the moderate and high PA groups, respectively. These findings were similar for participants without multimorbidity. In participants with multimorbidity, at the age of 45 years, moderate and high LTPA were associated with an average of 3.12 (95% CI 2.53, 3.71) and 3.55 (2.34, 4.77) additional life years, respectively, compared to low LTPA; in participants without multimorbidity, corresponding figures were 1.95 (1.59, 2.31) and 1.85 (1.19, 2.50). Similar results were found with TPA. For objective PA, moderate and high levels were associated with 3.60 (- 0.60, 7.79) and 5.32 (- 0.47, 11.11) life years gained compared to low PA for those with multimorbidity and 3.88 (1.79, 6.00) and 4.51 (2.15, 6.88) life years gained in those without. Results were consistent when using other definitions of multimorbidity. CONCLUSIONS: There was an inverse dose-response association between PA and mortality. A moderate exercise is associated with a longer life expectancy, also in individuals with multimorbidity.
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In inactive people, a 6 min/day difference in brisk walking (corresponding to ~500 steps in 5 min) was associated with significant health benefits (~4 life years gained).
“This interpretation is consistent with a recent UK Biobank longitudinal study showing that, in inactive people, a 6 min Á day À1 difference in brisk walking (corresponding to $500 steps in 5 min [37]) was associated with significant health benefits ($4 life years gained) (38).”
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- Authors
- Chudasama, Y. V., Khunti, K. K., Zaccardi, F., Rowlands, A. V., Yates, T., Gillies, C. L., Davies, M. J., & Dhalwani, N. N.
- Affiliations
- University of Leicester (GB)
- Corresponding author
- Chudasama, Yogini V.
- ORCID
- Venue
- BMC Medicine
- Published
- 2019-06-12
- Volume
- 17
- Issue
- 1
- Pages
- 108-108
- ISSN
- 1741-7015 (ISSN-L)
- PMC
- PMC6560907
- OpenAlex
- W2945576732
- Cited by
- 353
- References
- 34
- Citations by year
- 2026: 42 · 2025: 69 · 2024: 84 · 2023: 45 · 2022: 51 · 2021: 37 · 2020: 24 · 2019: 1
- FWCI
- 19.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion, cc-by)
- UniSA Research Outputs Repository (University of South Australia) (submittedVersion, cc-by)
- Funders
- University of Leicester (PhD studentship in collaboration with Collaboration for Leadership in Applied Health Research and Care - East Midlands)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- physical activity, multimorbidity, life expectancy, mortality, leisure-time physical activity, total physical activity, accelerometer-measured activity, chronic disease, comorbidities, health benefits of physical activity, UK Biobank, survival analysis, hazard ratio, walking speed, brisk walking, lifestyle habits, health disparities
- MeSH terms
- Multimorbidity, Adult, Aged, Female, United Kingdom, Humans, Life Expectancy, Life Style, Longitudinal Studies, Male, Middle Aged, Mortality, Motor Activity, Surveys and Questionnaires, Exercise, Comorbidity, Biological Specimen Banks
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