Eating disorders and physical multimorbidity in the English general population

PurposePeople with eating disorders may be at increased risk for physical health problems, but there are no data on the relationship between eating disorders and physical multimorbidity (i.e., ≥ 2 physical conditions) and its potential mediators. Thus, we investigated this association in a representative sample of adults from the UK, and quantified the extent to which this can be explained by various psychological and physical conditions, and lifestyle factors.MethodsCross-sectional data of the 2007 Adult Psychiatric Morbidity Survey were analyzed. Questions from the five-item SCOFF screening instrument were used to identify possible eating disorder. Respondents were asked about 20 physical health conditions. Multivariable logistic regression and mediation analysis were conducted.ResultsData on 7403 individuals aged ≥ 16 years were analyzed [mean (SD) age 46.3 (18.6) years; 48.6% males]. After adjustment, possible eating disorder was associated with 2.11 (95%CI = 1.67–2.67) times higher odds for physical multimorbidity. Anxiety disorder explained the largest proportion this association (mediated percentage 26.3%), followed by insomnia (21.8%), perceived stress (13.4%), depression (13.1%), obesity (13.0%), and alcohol dependence (4.3%).ConclusionFuture longitudinal studies are warranted to understand potential causality and the underlying mechanisms in the association between eating disorder and multimorbidity, and whether addressing the identified potential mediators in people with eating disorders can reduce multimorbidity.</p

Factors that influence meeting the recommended weekly physical activity target among older people with physical multimorbidity: evidence from six low- and middle-income countries

Background: There is a scarcity of studies on the association between physical multimorbidity and lower levels of physical activity among older adults from low- and middle-income countries, while the potential mediating variables in this association are largely unknown.Methods: Cross-sectional, community-based, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Data on 11 chronic physical conditions were collected. Scoring <150 minutes of moderate- to high-intensity physical activity per week was considered low physical activity. Multivariable logistic regression and mediation analysis were done to assess associations and quality of life measures which might influence these associations.Results: Data on 14,585 people aged ≥65 years were analyzed (mean [SD] age 72.6 (11.5) y, maximum age 114 y; 55.0% women). After adjustment for potential confounders, compared with no chronic conditions, ≥3 conditions were associated with a significant 1.59 to 2.42 times higher odds for low physical activity. Finally, mobility mediated the largest proportion of the association between ≥3 chronic physical conditions and low physical activity (mediated percentage 50.7%), followed by activities of daily living disability (30.7%), cognition (24.0%), affect (23.6%), and pain/discomfort (22.0%).Conclusions: Physical multimorbidity was associated with higher odds for low physical activity among older adults residing in low- and middle-income countries. Mobility, disability, cognition, affect, and pain/discomfort explained the largest proportion of this association. Given the universal benefits of regular and sustained participation in physical activity, it would be prudent to implement interventions among older people with physical multimorbidity to increase levels of physical activity. Future studies should assess the impact of addressing the identified potential mediators among people with multimorbidity on physical activity levels.</p

Pain and mild cognitive impairment among adults aged 50 years and above residing in low- and middle-income countries

Previous studies on the association between pain and cognitive decline or impairment have yielded mixed results, while studies from low- and middle-income countries (LMICs) or specifically on mild cognitive impairment (MCI) are scarce. Thus, we investigated the association between pain and MCI in LMICs and quantified the extent to which perceived stress, sleep/energy problems, and mobility limitations explain the pain/MCI relationship

The relationship between severe mental illness and physical multi-morbidity: a meta-analysis and call for action

Question: People with mental illness have a higher prevalence of several chronic physical health conditions and the prevalence of physical multi-morbidity is expected to rise. The aim of this study was to assess the strength of the association between severe mental illness (SMI) and physical multi-morbidity.Study selection and analysis We systematically searched PubMed/ Medline, Scopus, Embase, Web of Science, PSYCInfo, and the behavioural sciences collection databases, from inception to the 31st of January 2023, for studies that investigated the association between SMI and physical multi-morbidity. Humans of any age either clinically diagnosed and/or currently receiving treatment for a SMI, specified as schizophrenia (and related psychotic disorders), bipolar disorder, and psychotic depression were eligible. Data from studies selected for inclusion were converted into odds ratios (ORs), with a subsequent meta-analysis conducted.Findings We included 19 studies with a total of 194,123 patients with SMI with different diagnoses and drawn from the general population. The pooled OR for physical multi-morbidity in people with versus without SMI was 1.84 (95% CI 1.33-2.54), with the analysis indicating a high level of heterogeneity (98.38%). The other 15 studies included in the systematic review, for which it was not possible to conduct a meta-analysis, showed strong associations between SMI and physical multi-morbidity.Conclusions The current evidence highlighted the link between SMI and physical multi-morbidity. A multidisciplinary approach, is now urgent, to develop the best models of services tailored to patients with SMI with physical multi-morbidities to improve physical, mental, and social outcomes</p