Abstract
Combined exposure to several healthy behaviors (HB) is associated with reduced mortality in older adults but its impact on health-related quality of life (HRQL) is uncertain. This is a cohort study of 2,388 individuals aged ≥60 recruited in 2000–2001, whose data were updated in 2003 and 2009. At baseline, participants reported both traditional HB (non-smoking, being very or moderately active, healthy diet) and non-traditional HB (sleeping 7–8 h/d, being seated <8 h/d, and seeing friends every day). HRQL was measured with the SF-36 questionnaire at baseline, in 2003 (short-term) and in 2009 (long-term); a higher score on the SF-36 represents better HRQL. Linear regression models were used to assess the association between HB at baseline and HRQL in 2003 and 2009, with adjustment for the main confounders including baseline HRQL. In the short-term, being physically active, sleeping 7–8 h/d, and being seated <8 h/d was associated with better HRQL. Compared to having ≤1 of these HB, the β (95% confidence interval) for the score on the physical component summary of the SF-36 in 2003 was 1.42 (0.52–2.33) for 2 HB, and 2.06 (1.09–3.03) for 3 HB, p-trend <0.001. Corresponding figures for the mental component summary score were 1.89 (0.58–3.21) for 2 HB and 3.35 (1.95–4.76) for 3 HB, p-trend <0.001. Non-smoking, a healthy diet or seeing friends did not show an association with HRQL. In the long-term, being physically active was the only HB associated with better physical HRQL. As a conclusion, a greater number of HB, particularly more physical activity, adequate sleep duration, and sitting less, were associated with better short-term HRQL in older adults. However, in the long-term, being physically active was the only HB associated with better physical HRQL.
Highlights
There is evidence of the benefits of a healthy lifestyle in old age
Several healthy behaviors (HB), including traditional factors and non-traditional factors have been associated with reduced mortality in older adults; there is an inverse dose-response between the number of HB and mortality.[1]This approach, that considers the combined exposure to several HB, is relevant because it captures their synergistic impact; HB do not occur in isolation, but they aggregate in the population.[2,3,4]
A cross-sectional study in Australia investigated the combined influence of smoking, alcohol consumption, physical activity, diet, sitting time, and sleep duration on health-related quality of life (HRQL), and found that engaging in a greater number of poor lifestyle behaviours was associated with a higher prevalence of poor HRQL.[10]
Summary
There is evidence of the benefits of a healthy lifestyle in old age. several healthy behaviors (HB), including traditional factors (non-smoking, physical activity, and healthy diet) and non-traditional factors (adequate sleep duration, avoiding sedentariness, and a good social network) have been associated with reduced mortality in older adults; there is an inverse dose-response between the number of HB and mortality.[1]This approach, that considers the combined exposure to several HB, is relevant because it captures their synergistic impact; HB do not occur in isolation, but they aggregate in the population.[2,3,4]. The "Midlife in the United States" study (MIDUS) examined the joint protective contribution of control beliefs, social support and physical exercise to changes in functional health, and found that age-related declines in health were reduced among those with more protective factors, fostering the maintenance of functional health.[9] a cross-sectional study in Australia investigated the combined influence of smoking, alcohol consumption, physical activity, diet, sitting time, and sleep duration on HRQL, and found that engaging in a greater number of poor lifestyle behaviours was associated with a higher prevalence of poor HRQL.[10] These studies were conducted mostly with middle-aged individuals. As such and to our knowledge, this is the first study to assess the association between a healthy lifestyle and HRQL in older adults; it examined the short- and long-term combined impact of traditional and non-traditional HB on HRQL in older adults from Spain
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