Abstract
Background: Healthy lifestyle (HL) practices such as not smoking, frequent exercise and having normal BMI are related to better health-related quality of life (HRQoL). However, data on associations of long-term patterns on the combined effects of these HL practices in older age and in HRQoL is limited. Methods: We included 4,074 participants mean age 70 in 1996 from the CHA study who participated in a health survey in 1996 and at least two more in 2001, 2003, and 2012. HRQoL was assessed by Health Status Questionnaire-12 (HSQ-12) on health perception, and physical and mental well-being. The higher the HSQ-12 score, the better the quality of life. The number of HL practices was defined as a sum of the following three HL factors: never smoked, exercised frequently, and had a normal BMI. Results: Using Group-Based modelling, we identified three HL practice trajectories [practiced high (15.8%), medium (45.0%), and low number (39.1%) over time], and three HSQ-12 score trajectories for the total sum of scores and for the physical and mental component score separately (see Table for group identifications). With adjustment for age, sex, race, education attainment, marital status, alcohol intake, and comorbidities in 1996, odds ratios (95% confidence intervals) for having the best (high score and slow decline) QoL over 16 years of follow-up were highest in persons who maintained a high and moderate number of HL practices compared to those with a low number of HL practices were 8.72 (6.23-12.22) and 2.54 (1.92-3.37), respectively; findings were similar for having moderate (medium score and fast decline) QoL over time, and after stratifying by sex. Conclusions: Highly maintained healthy lifestyle practices in older ages is associated with high score and slow decline in health-related quality of life over time. This finding underscores the importance of consistently maintaining ideal healthy lifestyle practices in older age for better maintenance of quality of life.
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