HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hubert, H. B. Articles by Fries, J. F. Search for Related Content PubMed PubMed Citation Articles by Hubert, H. B. Articles by Fries, J. F.

Lifestyle Habits and Compression of Morbidity

^a Departments of Medicine, Stanford University School of Medicine, California
^b Departments of Health Research and Policy, Stanford University School of Medicine, California

Helen B. Hubert, Stanford University School of Medicine, 701 Welch Road, Suite 3305, Palo Alto, CA 94304 E-mail: hhubert{at}stanford.edu.

Background. There has been much debate regarding the degree to which healthy lifestyles can increase longevity and whether added years will be offset by increased morbidity at older ages. This study was designed to test the compression of morbidity hypothesis, proposing that healthy lifestyles can reduce and compress disability into a shorter period toward the end of life.

Methods. Functional status in 418 deceased members of an aging cohort was observed between 1986 and 1998 in relationship to lifestyle-related risk factors, including cigarette smoking, physical inactivity, and under- or overweight. Three risk groups were created based on the number of these factors at study entry. Disability scores prior to death were modeled for each risk group to compare levels and rates of change, as well as to determine if and when acceleration in functional decline occurred.

Results. The risk-factor-free group showed average disability scores near zero 10–12 years before death, rising slowly over time, without evidence of accelerated functional decline. In contrast, those with two or more factors maintained a greater level of disability throughout follow-up and experienced an increase in the rate of decline 1.5 years prior to death. For those at moderate risk, the rate of decline increased significantly only in the last 3 months of life. Other differences between groups provided no alternative explanations for the findings.

Conclusions. These results make a compelling argument for the reduction and postponement of disability with healthier lifestyles as proposed by the compression of morbidity hypothesis.

This article has been cited by other articles:

				W J Nusselder, C W N Looman, O H Franco, A Peeters, A S Slingerland, and J P Mackenbach The relation between non-occupational physical activity and years lived with and without disability J. Epidemiol. Community Health, September 1, 2008; 62(9): 823 - 828. [Abstract] [Full Text] [PDF]

				E. Guilley and C. J. Lalive d'Epinay Social Status and Mortality With Activity of Daily Living Disability in Later Life J. Gerontol. B. Psychol. Sci. Soc. Sci., May 1, 2008; 63(3): S192 - S196. [Abstract] [Full Text] [PDF]

				J.-P. Michel, J. L. Newton, and T. B. L. Kirkwood Medical Challenges of Improving the Quality of a Longer Life JAMA, February 13, 2008; 299(6): 688 - 690. [Full Text] [PDF]

				L. C. McGuire, T. W. Strine, C. A. Okoro, I. B. Ahluwalia, and E. S. Ford Modifiable Characteristics of a Healthy Lifestyle in U.S. Older Adults With or Without Frequent Mental Distress: 2003 Behavioral Risk Factor Surveillance System Am J Geriatr Psychiatry, September 1, 2007; 15(9): 754 - 761. [Abstract] [Full Text] [PDF]

				C. Jagger, R. Matthews, F. Matthews, T. Robinson, J.-M. Robine, C. Brayne, and the Medical Research Council Cognitive Function an The Burden of Diseases on Disability-Free Life Expectancy in Later Life J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2007; 62(4): 408 - 414. [Abstract] [Full Text] [PDF]

				The LIFE Study Investigators* [*See Appendix for L Effects of a Physical Activity Intervention on Measures of Physical Performance: Results of the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P) Study J. Gerontol. A Biol. Sci. Med. Sci., November 1, 2006; 61(11): 1157 - 1165. [Abstract] [Full Text] [PDF]

				J F Fries, B Bruce, J Bjorner, and M Rose More relevant, precise, and efficient items for assessment of physical function and disability: moving beyond the classic instruments Ann Rheum Dis, November 1, 2006; 65(suppl_3): iii16 - iii21. [Abstract] [Full Text] [PDF]

				R. Simons and R. Andel The Effects of Resistance Training and Walking on Functional Fitness in Advanced Old Age J Aging Health, February 1, 2006; 18(1): 91 - 105. [PDF]

				D. R. Berk, H. B. Hubert, and J. F. Fries Associations of Changes in Exercise Level With Subsequent Disability Among Seniors: A 16-Year Longitudinal Study J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2006; 61(1): 97 - 102. [Abstract] [Full Text] [PDF]

				M. L. Daviglus, K. Liu, A. Pirzada, L. L. Yan, D. B. Garside, P. Greenland, L. M. Manheim, A. R. Dyer, R. Wang, J. Lubitz, et al. Cardiovascular Risk Profile Earlier in Life and Medicare Costs in the Last Year of Life Arch Intern Med, May 9, 2005; 165(9): 1028 - 1034. [Abstract] [Full Text] [PDF]

				K. N. Murtagh and H. B. Hubert Gender Differences in Physical Disability Among an Elderly Cohort Am J Public Health, August 1, 2004; 94(8): 1406 - 1411. [Abstract] [Full Text] [PDF]

				O Ethgen and J-Y Reginster Degenerative musculoskeletal disease Ann Rheum Dis, January 1, 2004; 63(1): 1 - 3. [Full Text] [PDF]

				M. L. Daviglus, K. Liu, A. Pirzada, L. L. Yan, D. B. Garside, J. Feinglass, J. M. Guralnik, P. Greenland, and J. Stamler Favorable Cardiovascular Risk Profile in Middle Age and Health-Related Quality of Life in Older Age Arch Intern Med, November 10, 2003; 163(20): 2460 - 2468. [Abstract] [Full Text] [PDF]

				S. A. Hawkins, R. A. Wiswell, and T. J. Marcell Exercise and the Master Athlete--A Model of Successful Aging? J. Gerontol. A Biol. Sci. Med. Sci., November 1, 2003; 58(11): M1009 - 1011. [Abstract] [Full Text] [PDF]

				J. E. Morley Editorial: Sarcopenia Revisited J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2003; 58(10): M909 - 910. [Full Text] [PDF]

				J. F. Fries Measuring and Monitoring Success in Compressing Morbidity Ann Intern Med, September 2, 2003; 139(5_Part_2): 455 - 459. [Abstract] [Full Text] [PDF]

				J. E. Morley Editorial. Mobility Performance: A High-Tech Test for Geriatricians J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2003; 58(8): M712 - 714. [Full Text] [PDF]

				Public Health and Aging: Trends in Aging--United States and Worldwide JAMA, March 19, 2003; 289(11): 1371 - 1373. [Full Text] [PDF]

				J. E. Morley Editorial: Hot Topics in Geriatrics J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2003; 58(1): M30 - 36. [Full Text] [PDF]

				J. E. Morley and J. H. Flaherty Editorial It's Never Too Late: Health Promotion and Illness Prevention in Older Persons J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2002; 57(6): M338 - 342. [Full Text]