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Centre for Policy on Ageing | |
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Unhealthy behaviours and disability in older adults
— three-city Dijon cohort study | | Author(s) | Fanny Artaud, Aline Dugravot, Severine Sabia |
| Journal title | British Medical Journal, 347, f4240, 2013 |
| Pages | pp 1-15 |
| Source | http://www.bmj.com |
| Keywords | Physical disabilities ; Tobacco smoking ; Alcoholic beverages ; Exercise ; Diet ; Living in the community ; Correlation ; Longitudinal surveys ; France. |
| Annotation | The Three City Study (3C) is a community-based study of people aged 65+ in Bordeaux, Dijon and Montpellier. This study in Dijon examined the individual and combined associations of unhealthy behaviours (low/intermediate physical activity, consuming fruit and vegetables less than once a day, current smoking/short term ex-smoking, never/former/heavy alcohol drinking), assessed at start of follow-up, with hazard of disability among older French adults and to assess the role of potential mediators, assessed repeatedly, of these associations. Participants were 3982 French community dwellers aged 65+ (2410 (60.5%) women) during 1999-2001, who were disability-free at baseline when health behaviours were assessed. They were assessed five times between 2001 and 2012 for disability (no, light, moderate, severe) combining data from three disability scales (mobility, instrumental activities of daily living, basic activities of daily living). During the 12 year follow-up, 1236 participants (861 (69.7%) women) developed moderate or severe disability. Interval censored survival analyses (adjusted for age, sex, marital status, and education) showed low or intermediate physical activity (hazard ratio 1.72, 95% confidence interval 1.48 to 2.00), consuming fruit and vegetables less than once a day (1.24, 1.10 to 1.41), and current smoking or short term ex-smoking (1.26, 1.05 to 1.50) to be independently associated with an increased hazard of disability, whereas no robust association with alcohol consumption was found. The hazard of disability increased progressively with the number of unhealthy behaviours independently associated with disability (P<0.001); participants with three unhealthy behaviours had a 2.53 (1.86 to 3.43)-fold increased hazard of disability compared with those with none. Reverse causation bias was verified by excluding participants who developed disability in the first four years of follow-up; these analyses on 890 disability events yielded results similar to those in the main analysis. 30.5% of the association between the unhealthy behaviours score and disability was explained by body mass index (BMI), cognitive function, depressive symptoms, trauma, chronic conditions, and cardiovascular disease and its risk factors. The main contributors were chronic conditions and, to a lesser extent, depressive symptoms, trauma, and body mass index. An unhealthy lifestyle is associated with greater hazard of incident disability, and the hazard increases progressively with the number of unhealthy behaviours. Chronic conditions, depressive symptoms, trauma, and body mass index (BMI) partially explained this association. (OFFPRINT) (RH). |
| Accession Number | CPA-130728203 A |
| Classmark | BN: ETT: YPP: CEA: CFD: K4: 49: 3J: 765 * |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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