Abstract
BackgroundPrevious studies have examined physical risk factors in relation to functional health, but less work has focused on the protective role of psychological and social factors. We examined the individual and joint protective contribution of control beliefs, social support and physical exercise to changes in functional health, beyond the influence of health status and physical risk factors in middle-aged and older adults. Given that functional health typically declines throughout adulthood, it is important to identify modifiable factors that can be implemented to maintain functioning, improve quality of life, and reduce disability.Methodology/Principal FindingsWe conducted a national longitudinal study, Midlife in the United States (MIDUS), with assessments in 1995–1996 and 2004–2006, and 3,626 community-residing adults, aged 32 to 84, were included in the analyses. Functional health (Physical Functioning subscale of the SF-36) and protective factors were measured at both occasions. While controlling for socio-demographic, health status, and physical risk factors (large waist circumference, smoking, and alcohol or drug problems), a composite of the three protective variables (control beliefs, social support, and physical exercise) at Time 1 was significantly related to functional health change. The more of these factors at Time 1, the better the health maintenance over 10 years. Among middle-aged and older adults, declines in health were significantly reduced with an increased number of protective factors.Conclusion/SignificanceAge-related declines in health were reduced among those with more protective factors up to a decade earlier in life. Modifiable psychological, social, and physical protective factors, individually and in the aggregate, are associated with maintenance of functional health, beyond the damaging effects of physical risk factors. The results are encouraging for the prospect of developing interventions to promote functional health and for reducing public health expenditures for physical disability in later life.
Highlights
Recent trends in the United States show improvements in functional health [1,2], increased levels of disability remain a major public health problem [3,4,5,6], especially in later life
Greater social support, and more frequent physical exercise at Time 1 were associated with better functional health at both occasions of measurement, respectively, [Time 1: r(3576) = .22, p,.001; r(3576) = .11, p,.001; r(3576) = .33, p,.001; Time 2: [r(3576) = .23, p,.001; r(3576) = .09, p,.001; r(3576) = .29, p,.001]
The results provide support for the role of modifiable psychological, social, and physical protective factors, in addition to minimizing physical risk factors, as a means for reducing physical disability
Summary
Recent trends in the United States show improvements in functional health [1,2], increased levels of disability remain a major public health problem [3,4,5,6], especially in later life. There is increasing evidence that specific psychological, social, and physical protective factors are associated with better health in later life [24,25,26,27] Among these factors, control beliefs [28,29,30,31], social support [16,25,32,33,34,35,36,37] and physical exercise [12,38,39,40,41,42,43] are consistently identified as predictors of functional health. Given that functional health typically declines throughout adulthood, it is important to identify modifiable factors that can be implemented to maintain functioning, improve quality of life, and reduce disability
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