Changes in combined lifestyle risks and disability transition in older adults: Korean Longitudinal Study of Aging, 2006-2008

Objective. This study examined associations between changes in lifestyle risks and disability in late life. Methods. A national sample of Koreans aged >= 65 years was surveyed at baseline (2006) and 2-year follow-up (n = 3511). Disability transition was categorized as disability-free, improved, maintained, and declined, based on activities of daily living (ADL) and instrumental ADL (IADL) scales. Lifestyle risk factors included current smoking, heavy alcohol consumption, low physical activity, and unhealthy weight. Changes in lifestyle risks were categorized as risk-free, positive (decreased risk), stable, and negative (increased risk). Multinomial logistic regression, models examined the influence of changes in lifestyle risks on disability transition. Results. A higher percentage (82.9%) of respondents who were risk-free remained disability-free than those who exhibited positive (71.8%), stable (64.9%), or negative (63.8%) change (p<0.001). Sustaining no lifestyle risks, compared with negative change, was associated with a higher likelihood of remaining disability-free than decline (odds ratio = 2.68, 95% confidence interval (CI): 1.32-5.42), adjusting for covariates. Among individual lifestyle factors, physical activity was predictive of not only functional independence but also improvement and maintenance. Conclusions. Older adults adopting more healthy lifestyles are more likely to maintain functional independence than decline. Making healthy lifestyle choices may delay disability progression in later life. (c) 2012 Elsevier Inc. All rights reserved.