Abstract
Background
Associations between modifiable health risk factors during middle age with disability
and mortality in later life are critical to maximizing longevity while preserving
function. Positive health effects of maintenance of normal weight, routine exercise,
and nonsmoking are known for the short and intermediate term. We studied the effects
of these risk factors into advanced age.
Methods
A cohort of 2327 college alumnae aged 60 years or more was followed annually (1986-2005)
by questionnaires addressing health risk factors, history, and Health Assessment Questionnaire
disability. Mortality data were ascertained from the National Death Index. Low-, medium-,
and high-risk groups were created on the basis of the number (0, 1, ≥2) of health
risk factors (overweight, smoking, inactivity) at baseline. Disability and mortality
for each group were estimated from unadjusted data and regression analyses. Multivariable
survival analyses estimated time to disability or death.
Results
The medium- and high-risk groups had higher disability than the low-risk group throughout
the study (P<.001). Low-risk subjects had onset of moderate disability delayed 8.3 years compared
with high-risk subjects. Mortality rates were higher in the high-risk group (384 vs
247 per 10,000 person-years). Multivariable survival analyses showed the number of
risk factors to be associated with cumulative disability and increased mortality.
Conclusion
Seniors with fewer behavioral risk factors during middle age have lower disability
and improved survival. These data document that the associations of lifestyle risk
factors on health continue into the ninth decade.
Keywords
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Article info
Footnotes
Funding: This study was supported by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR43584).
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
