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Habitual fasting duration was the longest interval between two typical eating occasions within a 24\u2010h window. Multimorbidity was the total number of chronic diseases (out of 60) at each visit, analyzed overall and within cardiovascular, neuropsychiatric, and musculoskeletal organ systems. Multivariate linear mixed models estimated the association between habitual fasting duration and the annual rate of multimorbidity accumulation, overall and stratified by age (&lt;78 vs. \u226578 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the lowest habitual fasting quartile (6\u201311.5\u00a0h), participants in the highest quartile (14\u201324\u00a0h) experienced steeper annual accumulation of total chronic diseases (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.119; 95% confidence interval: 0.070, 0.167), cardiovascular diseases (0.022 [0.006, 0.038]), and neuropsychiatric diseases (0.019 [0.005, 0.033]), but not musculoskeletal diseases. The association with total chronic disease accumulation was apparent in adults aged \u226578 years (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a00.099 [0.031, 0.168]) but absent in those &lt;78 years (\u22120.009 [\u22120.078, 0.061]). Findings remained consistent across sensitivity analyses addressing reverse causation, measurement bias, and residual confounding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In older adults, particularly the older old, longer habitual fasting duration was associated with faster chronic disease accumulation, suggesting it may be detrimental in advanced age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joim.70150","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:00:22Z","timestamp":1787223622000},"page":"642-658","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Habitual fasting duration and accelerated multimorbidity in older 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