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Data on their prevalence among older adults in Germany are scarce. This study examines prevalence of single BRFs \u2014 alcohol use, smoking, insufficient vegetable and fruit consumption, physical inactivity, and obesity \u2014 and identifies BRF combinations with a focus on sociodemographic disparities in adults aged 65 years and older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The nationwide\n                      <jats:italic>Gesundheit 65\u2009+<\/jats:italic>\n                      \u2009study (06\/2021\u201304\/2022) used a two-stage, stratified random sample from residents\u2019 registration offices, and a design tailored to older adults. Data from 3,139 participants with complete information on all BRFs were analysed. Weighted prevalence estimates and 95% confidence intervals (CI) for BRFs, their total number, and combinations were stratified by age, sex, and education. Non-overlapping CIs indicated statistical significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prevalence estimates were 78.4% for physical inactivity, 71.8% for insufficient vegetable and fruit consumption, 56.3% for alcohol use, 21.0% for obesity, and 9.9% for smoking. Men reported more often than women alcohol use (69.8% vs. 45.2%) and inadequate diet (77.9% vs. 66.7%). Except for inadequate diet, prevalence varied by age and education. Participants averaged 2.4 BRFs; 83.1% reported multiple BRFs. The most frequent combinations were alcohol use\u2009+\u2009inadequate diet\u2009+\u2009physical inactivity (21.8%), inadequate diet\u2009+\u2009physical inactivity (16.0%), and physical inactivity alone (8.3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multiple BRFs are highly prevalent among older adults in Germany, highlighting the need for comprehensive strategies combining policy measures (e.g. bans on alcohol advertising), community-level interventions (e.g. improved walkability), and targeted individual interventions to promote balanced diet, physical activity, and reduced alcohol use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12877-026-08007-3","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T23:43:17Z","timestamp":1786491797000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of behavioural risk factors and their combinations among older adults: cross-sectional results of the nationwide study Gesundheit 65+"],"prefix":"10.1186","volume":"26","author":[{"given":"Beate","family":"Gaertner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grit","family":"Eckert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennis","family":"Freyer-Adam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Starker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"issue":"4","key":"8007_CR1","doi-asserted-by":"publisher","first-page":"e287","DOI":"10.1016\/S2666-7568(24)00007-2","volume":"5","author":"K Nicholson","year":"2024","unstructured":"Nicholson K, Liu W, Fitzpatrick D, Hardacre KA, Roberts S, Salerno J, et al. 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WHO Regional Office for Europe; 2024."}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-026-08007-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-08007-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-08007-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T03:00:53Z","timestamp":1786590053000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12877-026-08007-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8007"],"URL":"https:\/\/doi.org\/10.1186\/s12877-026-08007-3","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"assertion":[{"value":"27 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Gesundheit 65\u2009+\u2009was conducted in strict compliance with the data protection regulations of the EU General Data Protection Regulation and the German Federal Data Protection Act. The implementation of the study was approved by the official data protection officer of the Robert Koch Institute and by the Ethics Committee of the Berlin Medical Association (Eth-50\/19). Only people with insufficient knowledge of the German language were excluded from study participation. Written or online informed consent was obtained from the study participants. Written informed consent from the legal representative was also accepted.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1047"}}