Abstract
BackgroundAgainst the backdrop of rising statutory retirement age in Germany, we analyzed time trends in self-rated health (SRH) among the elderly population between 50 and 70 years of age and explored the mediating role of leisure time physical activity (LTPA) on the relationship between time period and self-rated health (SRH).MethodsWe used longitudinal survey data (n = 23,161) from a national panel study (GSOEP) to analyze time trends in SRH and regular LTPA (at least once a week) by means of Generalized Estimation Equation (GEE) analysis for logistic regression. The Karlson-Holm-Breen (KHB) method was applied for decomposing trend effects into direct and indirect parts via LTPA. In addition to odds ratios (OR), we illustrated the results by means of predicted probabilities and average partial effects (APE).ResultsOver time, the predicted probabilities of good SRH and regular LTPA increased while those of poor SRH decreased. After adjusting for socioeconomic status (SES) 53.4% of the trend in good SRH in women (OR = 1.34 / APE = 6.8%-points) could be attributed to the rise in regular LTPA. In men, the remaining smaller effect (OR = 1.13 / APE = 2.7%) could be fully assigned to temporal changes in regular LTPA. With respect to poor health we found a suppression effect of LTPA in the adjusted model, indicating that without improvements in regular LTPA over time an increase in poor SRH would have occurred.ConclusionsThe increase of regular LTPA accounted for improved SRH from 1995 to 2015 among the elderly, indicating that promoting LTPA might be a key factor to raise healthy working life expectancy.
Highlights
Against the backdrop of rising statutory retirement age in Germany, we analyzed time trends in selfrated health (SRH) among the elderly population between 50 and 70 years of age and explored the mediating role of leisure time physical activity (LTPA) on the relationship between time period and self-rated health (SRH)
Statistical analyses The analyses were performed in two steps: First, we examined the preconditions for a mediating effect of regular LTPA on time trends in SRH
Analyzing the preconditions for mediation From 1995 to 2015, the predicted probability of good SRH increased in men from 32.3 to 40.0% and in women from 26.0 to 37.7%
Summary
Against the backdrop of rising statutory retirement age in Germany, we analyzed time trends in selfrated health (SRH) among the elderly population between 50 and 70 years of age and explored the mediating role of leisure time physical activity (LTPA) on the relationship between time period and self-rated health (SRH). The compression of morbidity hypothesis originally proposed by Fries [1] stated that better health care, an active lifestyle, and advances in preventive health behavior would lead to increased active life expectancy and decreasing duration of morbidity and disability in the population. In support of this assumption several studies revealed a significant reduction in proportions of functional impairment and increases of disability-free life expectancy and expected lifetime in good self-rated health (SRH) [2,3,4,5,6,7,8]. Leisure time and occupational physical activity appear to have distinct effects on health: high doses of LTPA are associated with reduced risk whereas high doses of occupational physical activity are accompanied
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