@article{1da6b58aaf104f389d1dab965ebca31a,
title = "Can a Healthy Lifestyle Compress the Disabled Period in Older Adults?",
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",
author = "Jacob, {Mini E.} and Yee, {Laura M.} and Diehr, {Paula H.} and Arnold, {Alice M.} and Thielke, {Stephen M.} and Chaves, {Paulo H.M.} and Gobbo, {Liana Del} and Calvin Hirsch and David Siscovick and Newman, {Anne B.}",
note = "Funding Information: Conflict of Interest: 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. This research was supported by Contracts HHSN268201200036C, HHSN268200800007C, N01 HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, and N01HC85086 and Grant HL080295 from the National Heart, Lung, and Blood Institute, with additional contribution from the National Institute of Neurological Disorders and Stroke. Additional support was provided by AG023629 from the National Institute on Aging and P30-AG-024827 from the University of Pittsburgh Claude. D. Pepper Older Americans Independence Center. A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org. Author Contributions: Jacob: study concept and design, interpretation of results, writing the first draft, revising the manuscript. Yee: analysis, interpretation of results, writing the statistical analysis section, revising the manuscript. Newman, Diehr, Arnold: study concept and design, data acquisition, design and supervision of the analysis, interpretation of results, review of manuscript. Chaves, Hirsch, Siscovick: study concept and design, data acquisition, interpretation of results, review of manuscript. Thielke: interpretation of results, review of manuscript. Del Gobbo: analysis, interpretation of results, review of manuscript. Sponsor's Role: The funding organizations had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The findings and conclusions in this article are those of the authors, who are responsible for its contents, and do not necessarily represent the views of the National Institutes of Health. Therefore, no statement in this article should be construed as an official position of the National Institutes of Health. We thank Jon Kilner, MS, MA (Pittsburgh, PA) for editorial support. He received financial compensation for his contribution. Publisher Copyright: {\textcopyright} 2016, Copyright the Authors Journal compilation {\textcopyright} 2016, The American Geriatrics Society",
year = "2016",
month = oct,
day = "1",
doi = "10.1111/jgs.14314",
language = "English (US)",
volume = "64",
pages = "1952--1961",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "10",
}