The relationship between clinical characteristics, sociodemographic factors and sedentary behavior in adults with chronic conditions: a cross-sectional study from the Lolland-Falster Health Study

Background
Sedentary behavior (SB) increases the risk of disease and mortality, even in physically active individuals. Adults living with multimorbidity may be particularly vulnerable. Although factors such as age, body mass index (BMI), and social support have been suggested, evidence is largely based on self-reported activity that tends to underestimate SB; therefore, correlates of objectively measured SB in adults with medical conditions remain insufficiently described. We investigated clinical and sociodemographic correlates of accelerometer-measured SB among adults with medical conditions, including multimorbidity.

Methods
We used backwards stepwise regression to investigate associations between clinical characteristics, sociodemographic factors, and SB in Danish adults (≥ 18 years) with ≥ 1 medical condition and valid accelerometer data from the Lolland-Falster Health Study (n = 1,728). Multimorbidity was present in 963 participants. SB was measured using accelerometers and expressed as daily sedentary time and weighted median sedentary bout length.

Results
BMI, number of medical conditions, civil and employment status, sex, and mental well-being were associated with sedentary time and/or weighted median sedentary bout length. Obesity class III was associated with 1.43 more sedentary hours/day compared with underweight/normal weight, and having three or ≥ 4 medical conditions was associated with 0.30 and 0.28 more sedentary hours/day, respectively, compared with one medical condition. Living alone was associated with 0.30 more sedentary hours/day and 8.50 seconds longer sedentary bout length compared with being married/living with a partner. Being unemployed/other or retired was associated with 0.64 and 0.39 more sedentary hours/day, respectively, compared with paid employment. Women spent 0.23 fewer sedentary hours/day than men, and reduced mental well-being was associated with 0.23 more sedentary hours/day compared with moderate-to-high mental well-being.

Conclusion
Several clinical and sociodemographic factors were associated with SB in adults with medical conditions. These results can inform the identification of groups who may benefit from strategies to reduce sedentariness, including people living with multimorbidity.