ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2023
Association Between the Healthy Lifestyle Index and Risk of Multimorbidity in the Women's Health Initiative.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Lifestyle Mediates the Associations of Social Media and Smartphone Use Addiction with Sleep Quality and Mental Health Problems in Adults: An Exploratory Study.Psychology research and behavior management · 2026Article
- The Role of Nutrition and Other Lifestyle Patterns in Mortality Risk in Older Adults with Multimorbidity.Nutrients · 2025Article
- The association between the healthy lifestyle index and MRI-derived body composition measurements in the UK Biobank study.Scientific reports · 2025Article
- Sleep quality moderated the mediating effect of BMI and waist circumference on the relationship between screen time and mental health in Chinese adolescents.Frontiers in pediatrics · 2025Article
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Authors and funding
11 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundMultimorbidity, defined as the presence of 2 or more chronic health conditions, is increasingly common among older adults. The combination of lifestyle characteristics such as diet quality, smoking status, alcohol intake, physical activity (PA), sleep duration, and body fat as assessed by body mass index (BMI) or waist circumference, and risk of multimorbidity are not well understood.
objectivesWe investigated the association between the healthy lifestyle index (HLI), generated by combining indicators of diet quality, smoking, alcohol, PA, sleep amount, and BMI, and risk of multimorbidity, a composite outcome that included cardiovascular disease (CVD), diabetes, cancer, and fracture.
methodsWe studied 62 037 postmenopausal women aged 50-79 years at enrollment in the Women's Health Initiative, with no reported history of CVD, diabetes, cancer, or fracture at baseline. Lifestyle characteristics measured at baseline were categorized and a score (0-4) was assigned to each category. The combined HLI (0-24) was grouped into quintiles, with higher quintiles indicating a healthier lifestyle. Multivariable adjusted estimates of hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the risk of developing multimorbidity were obtained using Cox proportional hazard models.
resultsOver an average follow-up period of 16.3 years, 5 656 women developed multimorbidity. There was an inverse association between the HLI levels and risk of multimorbidity (compared to the HLI_1st quintile: HR_2nd quintile = 0.81 95% CI 0.74-0.83, HR_3rd quintile = 0.77 95% CI 0.71-0.83, HR_4th quintile = 0.70 95% CI 0.64-0.76, and HR_5th quintile = 0.60 95% CI 0.54-0.66; p trend < .001). Similar associations were observed after stratification by age or BMI categories.
conclusionsAmong postmenopausal women, higher levels of the HLI were associated with a reduced risk of developing multimorbidity.
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