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Association of Behavioral Risk Factors for Chronic Diseases With Physical and Mental Health in European Adults Aged 50 Years or Older, 2004–2005

ORIGINAL RESEARCH — Volume 12 — July 29, 2015

PEER REVIEWED

Figure 1. Weighted mean number of physical and mental health status components among participants with different behavioral risk factors in 11 European countries, Survey of Health, Ageing and Retirement in Europe, 2004–2005. Comparisons were examined using analysis of covariance (according to the complex sample design procedure), with sex, age (y), education (y), living with a partner or spouse, self-rated health, income, and retirement status as covariates. Abbreviations: CI, confidence interval; (I)ADL, activities and instrumental activities of daily living; Euro-D score, European Depression Scale Score.

Country Chronic Disease, Mean (95% CI) Disease Symptoms, Mean (95% CI) (I)ADL Limitations, Mean (95% CI) Euro-D Score, Mean (95% CI)
Overweight or obese
Austria 1.24 (1.16–1.31) 1.47 (1.38–1.56) 0.58 (0.49–0.68) 1.95 (1.83–2.07)
Switzerland 1.31 (1.19–1.42) 1.46 (1.34–1.58) 0.46 (0.36–0.56) 2.25 (2.06–2.44)
Netherlands 1.34 (1.27–1.41) 1.46 (1.37–1.54) 0.54 (0.46–0.63) 2.24 (2.12–2.37)
Germany 1.35 (1.27–1.43) 1.56 (1.48–1.65) 0.45 (0.36–0.54) 2.06 (1.94–2.18)
Sweden 1.35 (1.28–1.42) 1.84 (1.75 –1.93) 0.49 (0.41 –0.56) 2.13 (2.01 –2.24)
Spain 1.43 (1.35–1.51) 1.73 (1.63 –1.84) 0.51 (0.41 –0.61) 2.84 (2.68 –3.00)
Greece 1.47 (1.41–1.53) 1.54 (1.46–1.62) 0.48 (0.41–0.55) 2.30 (2.19–2.41)
Italy 1.50 (1.42–1.59) 1.56 (1.45–1.66) 0.70 (0.55–0.85) 2.74 (2.54–2.94)
France 1.60 (1.53–1.68) 1.82 (1.72–1.91) 0.62 (0.54–0.70) 2.85 (2.72–2.97)
Denmark 1.63 (1.52–1.73) 1.83 (1.71–1.95) 0.57 (0.48–0.66) 2.18 (2.02–2.33)
Belgium 1.69 (1.63–1.76) 1.81 (1.74–1.88) 0.71 (0.63–0.79) 2.50 (2.40–2.59)
Smoking habits
Sweden 0.84 (0.72–0.96) 1.33 (1.19–1.46) 0.32 (0.21–0.43) 1.93 (1.72–2.13)
Germany 0.86 (0.76–0.96) 1.17 (1.03–1.31) 0.23 (0.13–0.33) 1.82 (1.60–2.04)
Austria 0.87 (0.74–1.00) 1.10 (0.94–1.26) 0.36 (0.22–0.51) 1.80 (1.57–2.04)
Netherlands 0.94 (0.84–1.04) 1.14 (1.01–1.26) 0.31 (0.23–0.40) 2.34 (2.13–2.54)
Switzerland 0.97 (0.79–1.14) 1.05 (0.88–1.23) 0.25 (0.13–0.37) 2.27 (1.96–2.58)
Greece 1.05 (0.96–1.14) 1.23 (1.12–1.33) 0.24 (0.17–0.31) 2.20 (2.03–2.38)
Denmark 1.13 (1.00–1.25) 1.48 (1.32–1.64) 0.50 (0.36–0.63) 2.00 (1.81–2.20)
Spain 1.13 (0.99–1.27) 1.40 (1.22–1.58) 0.31 (0.18–0.45) 2.42 (2.14–2.71)
Italy 1.15 (1.01–1.30) 1.35 (1.16–1.53) 0.76 (0.44–1.08) 2.69 (2.35–3.03)
France 1.16 (1.02–1.30) 1.39 (1.24–1.54) 0.30 (0.21–0.40) 2.81 (2.55–3.06)
Belgium 1.35 (1.24–1.46) 1.57 (1.45–1.70) 0.54 (0.41–0.68) 2.58 (2.38–2.79)
Physical inactivity
Switzerland 1.20 (1.11–1.29) 1.44 (1.33–1.54) 0.60 (0.50–0.69) 2.37 (2.20–2.54)
Austria 1.23 (1.16–1.30) 1.54 (1.46–1.62) 0.74 (0.65–0.83) 2.29 (2.17–2.41)
Germany 1.30 (1.23–1.37) 1.60 (1.51–1.69) 0.67 (0.56–0.78) 2.21 (2.08–2.33)
Netherlands 1.32 (1.26–1.39) 1.58 (1.49–1.68) 0.75 (0.64–0.85) 2.52 (2.39–2.64)
Sweden 1.33 (1.26–1.40) 1.91 (1.81–2.00) 0.73 (0.63–0.83) 2.35 (2.24–2.46)
Spain 1.44 (1.36–1.52) 1.82 (1.71–1.92) 0.68 (0.57–0.79) 3.11 (2.96–3.27)
Greece 1.49 (1.43–1.55) 1.58 (1.50–1.66) 0.59 (0.52–0.66) 2.41 (2.30–2.52)
Italy 1.52 (1.44–1.60) 1.64 (1.54–1.74) 0.75 (0.60–0.90) 2.79 (2.60–2.98)
France 1.54 (1.47–1.60) 1.84 (1.76–1.92) 0.77 (0.69–0.86) 3.08 (2.97–3.20)
Denmark 1.54 (1.44–1.65) 1.89 (1.76–2.02) 0.93 (0.79–1.07) 2.21 (2.05–2.36)
Belgium 1.71 (1.65–1.77) 1.94 (1.87–2.00) 0.88 (0.80–0.96) 2.76 (2.67–2.85)
Risky alcohol consumption
Austria 0.79 (0.59–0.99) 0.96 (0.74–1.18) 0.16 (0.04–0.29) 1.59 (1.19–1.98)
Germany 0.94 (0.61–1.27) 0.97 (0.59–1.35) 0.42 (0.08–0.76) 2.27 (1.63–2.91)
Greece 0.97 (0.69–1.25) 1.02 (0.66–1.38) 0.29 (0.01–0.57) 1.86 (1.38–2.34)
Netherlands 0.98 (0.76–1.20) 1.03 (0.80–1.26) 0.26 (0.11–0.41) 1.67 (1.28–2.06)
Spain 1.00 (0.76–1.24) 1.18 (0.88–1.48) 0.13 (0.02–0.25) 2.32 (1.85–2.78)
Italy 1.02 (0.74–1.31) 1.03 (0.74–1.31) 0.62 (0.08–1.16) 3.22 (2.43–4.01)
Switzerland 1.06 (0.69–1.44) 0.84 (0.53–1.16) 0.20 (0.06–0.34) 1.85 (1.44–2.26)
France 1.20 (1.03–1.37) 1.22 (1.02–1.42) 0.33 (0.16–0.49) 2.58 (2.26–2.91)
Sweden 1.21 (0.85–1.58) 1.02 (0.53–1.51) 0.23 (0.08–0.55) 1.88 (1.41–2.36)
Denmark 1.30 (1.00–1.60) 1.39 (1.06–1.71) 0.62 (0.24–1.01) 1.62 (1.17–2.06)
Belgium 1.31 (1.13–1.50) 1.29 (1.08–1.50) 0.32 (0.16–0.48) 2.12 (1.80–2.44)

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Figure 2. Prevalence of chronic diseases, disease symptoms, and limitations of activities and instrumental activities of daily living according to clustering score of behavioral risk factors. Survey of Health, Ageing and Retirement in Europe, 2004–2005. Abbreviation: (I)ADL, limitations of activities and instrumental activities of daily living.

Characteristic No. of Behavioral Risk Factors
≥2, % (95% Confidence Interval) ≤1, % (95% Confidence Interval)
Chronic diseases
Stroke 4.0 (3.5–4.6) 2.9 (2.4–3.5)
Asthma 4.5 (3.9–5.1) 3.9 (3.4–4.5)
Cancer 5.4 (4.7–6.0) 5.5 (4.9–6.2)
Stomach or duodenal ulcer, peptic ulcer 6.2 (5.6–6.9) 4.9 (4.3–5.6)
Chronic lung disease 6.6 (6.0–7.4) 4.6 (4.0–5.3)
Osteoporosis 8.1 (7.3–8.9) 8.1 (7.3–9.0)
Heart attack 13.2 (12.3–14.1) 10.5 (9.6–11.5)
Diabetes or high blood glucose 13.6 (12.6–14.6) 8.0 (7.2–8.9)
High blood cholesterol 21.8 (20.7–23.0) 18.5 (17.4–19.7)
Arthritis 24.2 (23.0–25.4) 19.2 (18.0–20.4)
High blood pressure 37.8 (36.4–39.1) 28.2 (26.9–29.6)
Disease symptoms
Falling 4.4 (3.9–5.0) 3.6 (3.1–4.2)
Incontinence 5.5 (5.0–6.2) 4.4 (3.9–5.1)
Persistent cough 6.7 (6.0–7.4) 4.5 (3.9–5.2)
Heart trouble 8.6 (7.9–9.5) 7.0 (6.2–7.9)
Dizziness, faints or blackouts 10.1 (9.3–10.9) 8.5 (7.7–9.5)
Fear of falling 10.4 (9.6–11.3) 7.5 (9.7–8.4)
Stomach or intestine problems 14.3 (13.3–15.3) 14.4 (13.4–15.5)
Breathlessness 14.3 (13.4–15.3) 8.7 (7.9–9.6)
Swollen legs 17.7 (16.7–18.8) 10.6 (9.6–11.6)
Sleeping problems 21.0 (19.9–22.2) 18.2 (17.1–19.4)
Pain in back, knees, hips, or other joint 55.3 (54.0–56.7) 48.3 (46.8–49.8)
Limitations of activities and instrumental activities of daily living
Eating, cutting up food 1.4 (1.1–1.7) 1.4 (1.1–1.9)
Making telephone calls 1.8 (1.5–2.2) 2.1 (1.6–2.6)
Taking medications 1.9 (1.5–2.3) 1.7 (1.3–2.2)
Walking across a room 1.9 (1.6–2.4) 1.8 (1.4–2.4)
Using the toilet, including getting up or down 2.2 (1.8–2.6) 1.6 (1.2–2.1)
Preparing a hot meal 3.3 (2.8–3.9) 3.2 (2.6–3.8)
Getting in or out of bed 3.4 (2.9–4.0) 2.6 (2.1–3.1)
Managing money 4.2 (3.7–4.9) 3.1 (2.6–3.7)
Bathing or showering 6.5 (5.8–7.3) 4.5 (3.9–5.3)
Shopping for groceries 6.7 (6.0–7.5) 5.1 (4.4–5.9)
Dressing, including shoes and socks 8.2 (7.5–9.0) 5.3 (4.6–6.1)
Using a map in a strange place 9.6 (8.8–10.5) 7.5 (6.7–8.4)
Doing work around the house or garden 10.4 (9.6–11.3) 7.2 (6.4–8.1)
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