Healthy living can lessen disabled years later

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Leading a healthy lifestyle not only extends lifespan, but also shortens the time spent disabled—a finding that demonstrates the value of investing in healthy lifestyle promotion, even for elderly people.

The research shows that older adults with the healthiest lifestyles could expect to spend about 1.7 fewer years disabled at the end of their lives, compared to their unhealthiest counterparts.

“The duration of the disabled period near the end of one’s life has enormous personal and societal implications, ranging from quality of life to health care costs,” says senior author Anne B. Newman, professor of population health sciences and chair of the epidemiology department at the University of Pittsburgh. “We discovered that, fortunately, by improving lifestyle we can postpone both death and disability. In fact, it turns out that we’re compressing that disabled end-of-life period.”

For a new study in the Journal of the American Geriatrics Society, researchers examined data from the Cardiovascular Health Study, which followed 5,888 adults from Sacramento County, California; Forsyth County, North Carolina; Washington County, Maryland; and Allegheny County, Pennsylvania, for 25 years. All of the participants were aged 65 or older and were not institutionalized or wheelchair-dependent when they enrolled.

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The participants reported or were assessed for various lifestyle factors, including smoking habits, alcohol consumption, physical activity, diet, weight, and their social support system. Researchers took into account and adjusted results for such factors as participants’ age, sex, race, education, income, marital status, and chronic health conditions.

Across all the participants, the average number of disabled years directly preceding death—years when the person had difficulty eating, bathing, using the toilet, dressing, getting out of bed or a chair, or walking around the home—averaged 4.5 years for women and 2.9 years for men.

For each gender and race group, those with the healthiest lifestyle (those who were nonsmokers of a healthy weight and diet and getting regular exercise) not only lived longer, but also had fewer disabled years at the end of their lives.

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For example, a white man in the healthiest lifestyle group could expect to live 4.8 years longer than his counterpart in the unhealthiest group, and at the end of his life, he’d likely spend only two of those years disabled, compared to 3.7 years for his unhealthy counterpart.

Put another way, that man’s healthy lifestyle has given him nearly three more years of active life free of disability than his unhealthy counterpart, who not only died earlier but spent the last three-and-a-half years of his life disabled—a larger percentage of those remaining years.

“This clearly demonstrates the great value of investing in the promotion of a healthy lifestyle and encouraging people to maintain healthy behaviors into old age,” says lead author Mini E. Jacob, who completed the project during her doctoral studies at Pitt Public Health.

“We are not discounting the role of factors like income and chronic conditions, which we adjusted for in our analyses. However, our results do indicate that increasing obesity levels of older Americans can herald a disability epidemic, and by urging healthy lifestyles, we may still be able to reduce the public health burden due to disability as more adults reach old age.”

Source: University of Pittsburgh