Behavioural Risk Factors in Mid-Life Associated with Successful Ageing, Disability, Dementia and Frailty in Later Life: A Rapid Systematic Review

Abstract

BackgroundSmoking, alcohol consumption, poor diet and low levels of physical activity significantly contribute to the burden of illness in developed countries. Whilst the links between specific and multiple risk behaviours and individual chronic conditions are well documented, the impact of these behaviours in mid-life across a range of later life outcomes has yet to be comprehensively assessed. This review aimed to provide an overview of behavioural risk factors in mid-life that are associated with successful ageing and the primary prevention or delay of disability, dementia, frailty and non-communicable chronic conditions.MethodsA literature search was conducted to identify cohort studies published in English since 2000 up to Dec 2014. Multivariate analyses and a minimum follow-up of five years were required for inclusion. Two reviewers screened titles, abstracts and papers independently. Studies were assessed for quality. Evidence was synthesised by mid-life behavioural risk for a range of late life outcomes.FindingsThis search located 10,338 individual references, of which 164 are included in this review. Follow-up data ranged from five years to 36 years. Outcomes include dementia, frailty, disability and cardiovascular disease. There is consistent evidence of beneficial associations between mid-life physical activity, healthy ageing and disease outcomes. Across all populations studied there is consistent evidence that mid-life smoking has a detrimental effect on health. Evidence specific to alcohol consumption was mixed. Limited, but supportive, evidence was available relating specifically to mid-life diet, leisure and social activities or health inequalities.ConclusionsThere is consistent evidence of associations between mid-life behaviours and a range of late life outcomes. The promotion of physical activity, healthy diet and smoking cessation in all mid-life populations should be encouraged for successful ageing and the prevention of disability and chronic disease.

The association between frailty, the metabolic syndrome, and mortality over the lifespan

“…This finding also demonstrates that health-related deficits accumulate gradually over the lifespan, rather than only appearing in old age. This supports other literature, especially in relation to late life cognitive impairment (Lafortune et al 2016), on the importance of midlife health status to late life illness. Further, viewed from a frailty perspective, variability about results in relation to similar age cut-points is likely to be less important than is understanding not just a person's age, but their overall health status, which is what the FI seeks to quantify.…”

Midlife contributors to socioeconomic differences in frailty during later life: a prospective cohort study

“…We observed the expected association between frailty and disability. Low energy expenditure from physical activity is one of the five frailty criteria, and (as expected) physical activity level, particularly physical inactivity, at age 50 years was a risk factor for frailty 16, 30. Physical activity level at age 50 years is also an important contributor to the socioeconomic difference in frailty, reflecting the association of inactivity with lower employment grade and conversely of higher physical activity with higher grade in midlife in the present study.…”

Preventive Healthcare: A Neural Network Analysis of Behavioral Habits and Chronic Diseases

“…These factors are not equally distributed through the population but tend to concentrate and affect the most vulnerable segments [20]. The exposure to behavioral risk factors is temporal and varies with demographic characteristics such as age and income, among others [21]. Also, behavioral habits occur on a long-term basis and can have an impact on the health of individuals [21].…”

“…The exposure to behavioral risk factors is temporal and varies with demographic characteristics such as age and income, among others [21]. Also, behavioral habits occur on a long-term basis and can have an impact on the health of individuals [21]. Epidemiological studies emphasize the importance of measuring the impact of multiple lifestyle risk behaviors on people’s health [21].…”

“…Also, behavioral habits occur on a long-term basis and can have an impact on the health of individuals [21]. Epidemiological studies emphasize the importance of measuring the impact of multiple lifestyle risk behaviors on people’s health [21]. …”