Healthy Behaviors and Onset of Functional Disability in Older Adults: Results of a National Longitudinal Study

Liao, Wei-Chuan; Li, Chi–Rong; Lin, Yi-Chin; Wang, Cheng-Ching; Chen, Yu‐Ju; Yen, Chi-Hua; Lin, Hui-Sheng; Lee, Meng-Chih

doi:10.1111/j.1532-5415.2010.03272.x

Cited by 67 publications

(50 citation statements)

References 45 publications

(106 reference statements)

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“…7-18 Unhealthy behaviours such as lack of physical activity, poor diet, smoking, alcohol abstinence, and heavy alcohol consumption have also been shown to be associated with an increased risk of disability in older people. [19][20][21][22][23][24][25][26][27][28] However, few studies have examined the combined effect of unhealthy behaviours on disability. 21 29 30 Furthermore, pathways involved in the association between unhealthy behaviours and disability are poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Unhealthy behaviours and disability in older adults: Three-City Dijon cohort study

Artaud

Dugravot

Sabia

et al. 2013

BMJ

115

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Objectives To examine the individual and combined associations of unhealthy behaviours (low/intermediate physical activity, consuming fruit and vegetables less than once a day, current smoking/short term ex-smoking, never/former/heavy alcohol drinking), assessed at start of follow-up, with hazard of disability among older French adults and to assess the role of potential mediators, assessed repeatedly, of these associations.Design Population based cohort study.Setting Dijon centre of Three-City study.Participants 3982 (2410 (60.5%) women) French community dwellers aged 65 or over included during 1999-2001; participants were disability-free at baseline when health behaviours were assessed.Main outcome measure Hierarchical indicator of disability (no, light, moderate, severe) combining data from three disability scales (mobility, instrumental activities of daily living, basic activities of daily living) assessed five times between 2001 and 2012.Results During the 12 year follow-up, 1236 participants (861 (69.7%) women) developed moderate or severe disability. Interval censored survival analyses (adjusted for age, sex, marital status, and education) showed low/intermediate physical activity (hazard ratio 1.72, 95% confidence interval 1.48 to 2.00), consuming fruit and vegetables less than once a day (1.24, 1.10 to 1.41), and current smoking/short term ex-smoking (1.26, 1.05 to 1.50) to be independently associated with an increased hazard of disability, whereas no robust association with alcohol consumption was found. The hazard of disability increased progressively with the number of unhealthy behaviours independently associated with disability (P<0.001); participants with three unhealthy behaviours had a 2.53 (1.86 to 3.43)-fold increased hazard of disability compared with those with none. Reverse causation bias was verified by excluding participants who developed disability in the first four years of follow-up; these analyses on 890 disability events yielded results similar to those in the main analysis. 30.5% of the association between the unhealthy behaviours score and disability was explained by body mass index, cognitive function, depressive symptoms, trauma, chronic conditions, and cardiovascular disease and its risk factors; the main contributors were chronic conditions and, to a lesser extent, depressive symptoms, trauma, and body mass index.Conclusions An unhealthy lifestyle is associated with greater hazard of incident disability, and the hazard increases progressively with the number of unhealthy behaviours. Chronic conditions, depressive symptoms, trauma, and body mass index partially explained this association.

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Section: Introductionmentioning

confidence: 99%

Unhealthy behaviours and disability in older adults: Three-City Dijon cohort study

Artaud

Dugravot

Sabia

et al. 2013

BMJ

115

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“…It is possible that stress accelerates the deterioration of health and results in maladaptive life trajectories with unhealthy lifestyle, all of which may expedite the progression of disabilities. Currently, only few longitudinal studies have examined the role of psychosocial symptoms, such as midlife depression, other aspects of mental health, and sleeping problems on later life functioning (11)(12)(13)(14)(15), and most of these studies have utilized relatively short follow-up times.…”

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confidence: 99%

Perceived Stress Symptoms in Midlife Predict Disability in Old Age: A 28-Year Prospective Cohort Study

Kulmala

Bonsdorff

Stenholm

et al. 2013

The Journals of Gerontology Series A: Biological Sciences and M

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“…HR of participants who walked <0.5 hour/day was 1.27 in our cohort. The corresponding HR was 1.34 for elderly people who reported no regular exercise14 and 1.72 for those who did not walk >1 hour/day and exercising more than once a week 16. In our results, the HRs of elderly people who consume V&F <270 g/day was 1.09 (the HRs of elderly people who consume V&F less than once a day vs who did so at least once a day was 1.08; data not shown).…”

Section: Discussionmentioning

confidence: 98%

Combined healthy lifestyle behaviours and incident disability in an elderly population: the Ohsaki Cohort 2006 Study

Zhang

Tomata

Newson

et al. 2018

J Epidemiol Community Health

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Healthy Behaviors and Onset of Functional Disability in Older Adults: Results of a National Longitudinal Study

Abstract: In the population studied, healthy behaviors were associated with lower incidence of functional disability. As the number of healthy behaviors increased, the likelihood of disability decreased.

Cited by 67 publications

References 45 publications

Unhealthy behaviours and disability in older adults: Three-City Dijon cohort study

Unhealthy behaviours and disability in older adults: Three-City Dijon cohort study

Perceived Stress Symptoms in Midlife Predict Disability in Old Age: A 28-Year Prospective Cohort Study

Combined healthy lifestyle behaviours and incident disability in an elderly population: the Ohsaki Cohort 2006 Study

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