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J Gerontol A Biol Sci Med Sci. 2018 Oct 8;73(11):1538-1544. doi: 10.1093/gerona/glx251.

What Is the Impact of Physical Activity and Physical Function on the Development of Multimorbidity in Older Adults Over Time? A Population-Based Cohort Study.

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HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin.
School of Nursing and Human Sciences, Dublin City University, Ireland.
The Irish Longitudinal Study ón Ageing (TILDA), Trinity College Dublin, The University of Dublin, Ireland.
School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Ireland.



Multimorbidity is recognized internationally as having a serious impact on health outcomes. It is associated with reduced quality of life, increased health care utilization, and future functional decline. Physical activity is associated with good health and psychological well-being. The aim of this study was to identify the impact of physical activity and physical function on the development and worsening of multimorbidity over time.


Using The Irish Longitudinal Study on Ageing (TILDA), we analyzed 4,823 participants ≥50 years with and without multimorbidity. Multimorbidity was defined as the presence of ≥2 chronic conditions. Development of multimorbidity was measured as the accrual of additional conditions over a 2-year period. Physical activity and physical function were measured using the International Physical Activity Questionnaire (IPAQ), gait speed (m/sec), and grip strength (kg).


Sixteen groups of chronic conditions were included in analyses. 53.7% of included participants had multimorbidity at baseline and 71.7% at follow-up. Six hundred and thirty-eight of 2,092 (30.4%) participants without multimorbidity and 1,005 of 2,415 (41.6%) with existing multimorbidity developed new condition/s. Gait speed (relative risk [RR] = 0.67, confidence interval [CI]: 0.49-0.90), grip strength (RR = 0.98, CI: 0.97-0.99), and age (compared to 50-59 years, 60-69: RR = 1.30, CI: 1.11-1.52; ≥70: RR = 1.35, CI: 1.03-1.77) were significantly associated with the development of multimorbidity and accrual of additional conditions.


These results show that physical function is associated with the development and worsening of multimorbidity over time. They support the recent National Institute for Health & Care Excellence (NICE) Guidance on multimorbidity that suggests that patients with multimorbidity and reduced gait speed should be identified and targeted for interventions to improve health outcomes.

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