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Am Fam Physician. 2003;68(7):1420

Average life expectancy has steadily climbed over the past century, greatly increasing the number of persons surviving to advanced age. If the time of onset of ill health has not been pushed back, this prolonged survival would merely increase the number of years of ill health. Haveman-Nies and co-investigators from the SENECA (Survey in Europe on Nutrition and the Elderly: A Concerted Action) Study assessed how lifestyle factors among elderly Europeans affected changes in their health status and independence.

Investigators randomly selected 759 men and 778 women aged 70 to 75 years from small towns in seven different western European nations. Participants were interviewed regarding their lifestyle habits, health status, and self-care ability three times over a decade of follow-up. About one half of the men and one fourth of the women died during the study period. Of the survivors, 58 percent successfully completed the survey at the end of the decade, and 31 percent were interviewed for all three assessments. Each interview assessed self-rated health status, independence for activities of daily living, level of exercise, smoking status, and dietary quality compared with an ideal “Mediterranean” diet (i.e., increased mono-unsaturated fats).

The one variable in the study that had no significant effect on health status or independence for both men and women was dietary quality. Lack of physical activity caused a two-to threefold increase in the risk of decline in self-rated health and independence among surviving men. Inactive women were almost three times more likely to lose their independence over the 10 years of follow-up but did not have a significant decrease in their self-rated health status. Men who smoked were twice as likely to decline in health status and independence as nonsmoking men. Not enough women who smoked were enrolled to statistically analyze the sample.

The authors conclude that physical inactivity and smoking increased the risk for ill health or loss of independence over a 10-year period in an elderly population, while dietary quality was not influential.

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