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. 2016 Oct;64(10):1952-1961.
doi: 10.1111/jgs.14314. Epub 2016 Sep 7.

Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?

Mini E Jacob  1   2   3 , Laura M Yee  4 , Paula H Diehr  4   5 , Alice M Arnold  4 , Stephen M Thielke  6   7 , Paulo H M Chaves  8 , Liana Del Gobbo  9 , Calvin Hirsch  10 , David Siscovick  11 , Anne B Newman  12
Affiliations

Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?

Mini E Jacob et al. J Am Geriatr Soc. 2016 Oct.

Abstract

Objectives: To determine whether lifestyle factors, measured late in life, could compress the disabled period toward the end of life.

Design: Community-based cohort study of older adults followed from 1989 to 2015.

Setting: Four U.S. communities.

Participants: Community-living men and women aged 65 and older (N = 5,248, mean age 72.7 ± 5.5, 57% female, 15.2% minority) who were not wheelchair dependent and were able to give informed consent at baseline.

Measurements: Multiple lifestyle factors, including smoking, alcohol consumption, physical activity, diet, body mass index (BMI), social networks, and social support, were measured at baseline. Activities of daily living (ADLs) were assessed at baseline and throughout follow-up. Years of life (YoL) was defined as years until death. Years of able life (YAL) was defined as years without any ADL difficulty. YAL/YoL%, the proportion of life lived able, was used to indicate the relative compression or expansion of the disabled period.

Results: The average duration of disabled years was 4.5 (out of 15.4 mean YoL) for women and 2.9 (out of 12.4 mean YoL) for men. In a multivariable model, obesity was associated with 7.3 percentage points (95% confidence interval (CI) = 5.4-9.2) lower YAL/YoL% than normal weight. Scores in the lowest quintile of the Alternate Healthy Eating Index were associated with a 3.7% (95% CI = 1.6-5.9) lower YAL/YoL% than scores in the highest quintile. Every 25 blocks walked in a week was associated with 0.5 percentage points (95% CI = 0.3-0.8) higher YAL/YoL%.

Conclusion: The effects of healthy lifestyle factors on the proportion of future life lived free of disability indicate that the disabled period can be compressed, given the right combination of these factors.

Keywords: active life expectancy; disability; lifestyle; older adults.

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Conflict of interest statement

The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

Figures

Figure 1
Figure 1
Predicted Number of YAL, Disabled Years, YoL, and YAL/YoL% in Different Race and Gender Groups With Healthy and Unhealthy Lifestyles. Abbreviations: YAL, Years of able life; YOL, Years of life
See this image and copyright information in PMC

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