Exposome factors associated with multi-morbidity in older adults: a discovery-based cross-sectional analysis in the Longitudinal Aging Study Amsterdam

Ageing populations and longer life expectancies challenge healthcare systems due to rising noncommunicable diseases (NCDs) and multi-morbidity. Designing healthier living environments may reduce population risks of NCD onset, but knowledge is needed on environmental factors related to NCDs in older adults. We therefore examined associations between residential neighbourhood built, physico-chemical, and sociodemographic environmental factors and NCD prevalence in the Netherlands among older adults. Cross-sectional data from 1578 older adults from the Longitudinal Aging Study Amsterdam (2008-09) were matched with environmental data from the Dutch Geoscience and Health Cohort Consortium (GECCO). Multivariable logistic regression analyses were conducted to assess the odds of having a single NCD versus no NCD and multi-morbidity versus no NCD, adjusted for sociodemographic factors. Participants had a mean age of 73.2 years, 55% were female, and 77% reported at least one NCD. Multi-morbidity was more common in women, who were also older and had lower education and income. Higher green space density within 500 m was significantly associated with lower odds of single NCD [odds ratio (OR): 0.52, 95% confidence interval (CI): 0.33-0.83]. A higher number of cars in a household also showed lower odds of single NCD (OR: 0.14, 95% CI: 0.04-0.55). No significant associations were observed for physico-chemical exposures. Results were consistent in sensitivity analyses. The findings underscore the need for urban planning and policies that support healthy ageing while embracing a longevity-ready perspective, accounting for the built, physico-chemical, and sociodemographic environments across the life-course.