Can health behaviours prolong survival and compress the period of survival with the disability? A population-based cohort study

BACKGROUND: It remains unclear whether and to what extent health behaviours may prolong survival and compress the period of survival with disability. OBJECTIVE: To identify modifiable health behaviours that are associated with later disability onset and longer disability-free survival. DESIGN: This population-based cohort study used data from the Swedish National Study on Ageing and Care in Kungsholmen (SNAC-K) ranging between 2001 and 2016. SETTING AND SUBJECTS: A total of 3,041 disability-free adults aged ≥60 years were followed up to 15 years. METHODS: Data on health behaviours were collected at baseline. Information on limitations in activities of daily living was obtained at baseline and during the follow-up. Laplace regression was used to model the median age at death and disability occurrence as a function of health behaviours. RESULTS: Never smoking, moderate alcohol drinking, rich social network and high leisure activity were individually related to longer survival by 1-3 years. Participants with high leisure activity lived 1.6 years (95% CI: 0.9-2.3) more without a disability. After combining lifestyle factors, social network, and leisure activities into a 4-level 'health behaviour profile', people with the healthiest behaviour profile lived 2.8 years (95% CI: 1.3-4.2) longer, had disability 3.5 years (95% CI: 1.7-5.3) later and lived 0.7 years (95% CI, 0.4-1.1) more without a disability compared to those with the least healthy behaviours profile. CONCLUSIONS: These findings suggest that health behaviours could prolong the lifespan, and leisure activities may further compress years lived with disability among older adults.