Lifestyle habits and compression of morbidity
ABSTRACT 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.
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.
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.
These results make a compelling argument for the reduction and postponement of disability with healthier lifestyles as proposed by the compression of morbidity hypothesis.
Full-textDOI: · Available from: John W Oehlert, Jul 17, 2015
- SourceAvailable from: Bonnie Zell
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- "Strategies delaying both death and functional loss may still increase the relative and absolute amount of time spent with functional loss (Nusselder and Peeters 2006). Various studies have shown that improving lifestyle and health behaviors, such as eating more nutritious food, not smoking, losing weight, and being more physically active, reduces morbidity more than mortality and thus decreases the amount of time spent with illness (Hubert et al. 2002; Nusselder et al. 2000). In addition, other studies have found that more disability-free years than total life years were gained for persons free of stroke, cognitive impairment , arthritis, and/or visual impairment, suggesting that reducing the "
ABSTRACT: Good health is the most important outcome of health care, and healthy life expectancy (HLE), an intuitive and meaningful summary measure combining the length and quality of life, has become a standard in the world for measuring population health. This article critically reviews the literature and practices around the world for measuring and improving HLE and synthesizes that information as a basis for recommendations for the adoption and adaptation of HLE as an outcome measure in the United States. This article makes the case for adoption of HLE as an outcome measure at the national, state, community, and health care system levels in the United States to compare the effectiveness of alternative practices, evaluate disparities, and guide resource allocation. HLE is a clear, consistent, and important population health outcome measure that can enable informed judgments about value for investments in health care.Milbank Quarterly 03/2010; 88(1):30-53. DOI:10.1111/j.1468-0009.2010.00588.x
Research on Aging 06/2008; 30(5):572-591. DOI:10.1177/0164027508319473
- "As the eradication of diseases could be viewed as the elimination or reduction of forces external to individuals and their lifestyle choices, individual choices about behavior and lifestyle may play a very important role in longevity and physical function in old age. Recently, there has been a controversy regarding the degree to which healthy lifestyles can increase longevity and postpone functional decline (Hubert et al. 2002). Some studies have examined the relationship between disability and specific types of lifestyle behaviors. "
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- "Proponents of the compression of morbidity theory believe that a favorable health-risk profi le can compress morbidity. They cite studies that show that persons with good health habits not only live longer but have less disability in their fi nal years (Hubert et al. 2002; Leveille et al. 1999; Vita et al. 1998). The risk profi le of the U.S. population has been improving in many areas (e.g., reduced cholesterol levels and less smoking) but not in others (being obese, and recent hypertension trends; NCHS 2004). "
ABSTRACT: Medical advances and the growth of the elderly population have focused interest on trends in the health of the elderly. Three theories have been advanced to describe these trends: compression of morbidity, expansion of morbidity, and dynamic equilibrium. We applied multistate life table methods to the Medicare Current Beneficiary Survey to estimate active and disabled life expectancy from 1992 to 2003, defining disability as having difficulty with instrumental activities of daily living or activities of daily living. We found increases in active life expectancy past age 65 and decreases in life expectancy with severe disability. These trends are consistent with elements of both the theory of compression of morbidity and the theory of dynamic equilibrium.Demography 09/2007; 44(3):479-95. DOI:10.1353/dem.2007.0022