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

Abstract 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.