Annina Ropponen1, Pia Svedberg2. 1. 1 Finnish Institute of Occupational Health, Helsinki, Finland annina.ropponen@ttl.fi. 2. 2 Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Abstract
BACKGROUND: This prospective cohort study aimed to investigate single and additive effects of health behaviours for risk of future disability pension (DP) due to musculoskeletal diagnoses, DP due to mental diagnoses, DP due to circulatory system diagnoses or DP due to other diagnoses. A secondary aim was to evaluate the role of familial confounding in these associations. METHODS: A sample of 31,206 Swedish twin individuals was followed from 1998-2003 to the end of 2008 via national registries for DP supplemented with additional baseline questionnaire data. Cox proportional hazard ratios (HRs) were estimated. RESULTS: The single effect of moderate to heavy alcohol consumption was associated with decreased risk of DP irrespective of diagnosis group in analyses accounting for background and familial factors (HR 0.42-0.88). Low frequency of physical activity (HR 1.17-1.63) or being past or regular user of tobacco products (HR 1.38-3.49) predicted increased risk for DP in all diagnosis groups. Interactions between physical activity and alcohol or tobacco consumption were significant for DP due to musculoskeletal diagnoses and mental diagnoses. CONCLUSION: Health behaviours are important risk factors for DP irrespective of diagnosis groups. The effect of health behaviours is independent from familial effects (genetics and shared environment) pointing to a direct effect of health behaviours on DP, but education, body mass index, number and severity of diseases and marital status may confound the associations. The complex interrelationships between the health behaviours revealed by interactions suggest that prevention of future DP should attempt to influence these co-existent behaviours.
BACKGROUND: This prospective cohort study aimed to investigate single and additive effects of health behaviours for risk of future disability pension (DP) due to musculoskeletal diagnoses, DP due to mental diagnoses, DP due to circulatory system diagnoses or DP due to other diagnoses. A secondary aim was to evaluate the role of familial confounding in these associations. METHODS: A sample of 31,206 Swedish twin individuals was followed from 1998-2003 to the end of 2008 via national registries for DP supplemented with additional baseline questionnaire data. Cox proportional hazard ratios (HRs) were estimated. RESULTS: The single effect of moderate to heavy alcohol consumption was associated with decreased risk of DP irrespective of diagnosis group in analyses accounting for background and familial factors (HR 0.42-0.88). Low frequency of physical activity (HR 1.17-1.63) or being past or regular user of tobacco products (HR 1.38-3.49) predicted increased risk for DP in all diagnosis groups. Interactions between physical activity and alcohol or tobacco consumption were significant for DP due to musculoskeletal diagnoses and mental diagnoses. CONCLUSION: Health behaviours are important risk factors for DP irrespective of diagnosis groups. The effect of health behaviours is independent from familial effects (genetics and shared environment) pointing to a direct effect of health behaviours on DP, but education, body mass index, number and severity of diseases and marital status may confound the associations. The complex interrelationships between the health behaviours revealed by interactions suggest that prevention of future DP should attempt to influence these co-existent behaviours.
Authors: Gareth Hagger-Johnson; Ewan Carr; Emily Murray; Stephen Stansfeld; Nicola Shelton; Mai Stafford; Jenny Head Journal: BMC Public Health Date: 2017-01-17 Impact factor: 3.295
Authors: Annina Ropponen; Syed Ghulam Rahman; Pia Svedberg; Magnus Helgesson; Thomas Ernst Dorner; Ellenor Mittendorfer-Rutz Journal: BMJ Open Date: 2019-09-17 Impact factor: 2.692
Authors: Rachel Visontay; Matthew Sunderland; Tim Slade; Jack Wilson; Louise Mewton Journal: BMC Med Res Methodol Date: 2022-01-14 Impact factor: 4.615
Authors: Annina Ropponen; Mo Wang; Jurgita Narusyte; Karri Silventoinen; Petri Böckerman; Pia Svedberg Journal: Int J Environ Res Public Health Date: 2021-05-28 Impact factor: 3.390