The Effect of a Healthy Lifestyle on Future Physical Functioning in Midlife Women

Abstract

Purpose: This study aimed to examine the prospective association between healthy lifestyle behaviors and objectively measured physical function in midlife women.

Methods: Participants included 1769 racially/ethnically diverse women, ages 56-68 yr, from the Study of Women's Health Across the Nation cohort. Physical function was assessed at the 13th follow-up visit with the Short Physical Performance Battery (4-m walk, repeated chair stands, and balance test) and grip strength. A healthy lifestyle score (HLS), which ranged from 0 to 6, was calculated by averaging as many as three repeated measures of self-reported smoking, physical activity, and diet, all assessed before the 13th follow-up. Multivariable linear and logistic regressions modeled each component of physical performance as a function of HLS and, in separate models, of each lifestyle behavior, adjusted for the other behaviors.

Results: In multivariable analyses, the time for the 4-m walk was 0.06 s faster (P = 0.001) for every 1 point increase in the HLS. The time for the repeated chair stands was significantly shorter by approximately 0.20 s. Neither grip strength nor balance problems were significantly associated with the HLS (P = 0.28 and P = 0.19, respectively). The model examining the individual health behaviors showed that only physical activity was significantly associated with physical performance.

Conclusion: Regular physical activity in early midlife has the potential to reduce the likelihood of physical functional limitations later in midlife.

Figure 1

a. Multivariable prospective^a associations (standardized betas) between continuous physical performance measures and 1) total Healthy Lifestyle Score^b and 2) each healthy lifestyle behavior^b adjusted for the other behaviors. a. Healthy lifestyle behaviors measured at least 4 years prior to physical performance measures b. Total healthy lifestyle score and each component score are treated as a continuous average over all available visits and ranges from 0-6 for total score and 0 to 2 for components scores; results are presented as the average increase in standard deviation of each outcome for one standard deviation of the total healthy lifestyle score or each of the behavior component scores. Note: Results are from two separate linear regression models: one included the total healthy lifestyle score; the other included all three behavior component scores. Confounders included: for all models: age, race, site, BMI, overall self-rated health, and arthritis; for 4 m walk: number of comorbidities and foot covering; for 40 ft walk: marital status, CES-D, diabetes, type of menopause, alcohol use, and floor surface; for grip strength: difficulty paying for basics, dominant hand and dynamometer setting; for chair stand: difficulty paying for basics, foot covering; for decile score: number of comorbidities, difficulty paying for basics, and education; b. Multivariable prospective^a risk (odds ratios) of balance limitations associated with 1) total Healthy Lifestyle Score^b and 2) each healthy lifestyle behavior^b adjusted for other behaviors. a. Healthy lifestyle behaviors measured at least 4 years prior to physical performance measures b. Total healthy lifestyle score and each component score are treated as a continuous average over all available visits and range from 0-6 for the total healthy lifestyle score and 0 to 2 for component scores; results are presented as the odds ratio of any balance limitations for each increase in one point of the average score. Note: Results are from two separate logistic regression models: one included the total healthy lifestyle score; the other included all three behavior component scores. Confounders included age, race, site, BMI, overall self-rated health, and arthritis, CES-D, foot covering, alcohol use and hormone use