• Shu Zhang, Yasutake Tomata, Andrea Discacciati, Tatsui Otsuka, Yumi Sugawara, Fumiya Tanji, and Ichiro Tsuji.
• Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Miyagi, Japan. zhangshu@med.tohoku.ac.jp.
• J Gen Intern Med. 2019 Sep 1; 34 (9): 172417291724-1729.

BackgroundPrevious studies have suggested that a healthy lifestyle (HL) may prolong the years of life spent in good health. However, the impact of HL on disability-free survival (DFS) among the elderly is still uncertain.ObjectiveTo investigate the relationship between HL and DFS in the general elderly population.DesignProspective cohort study with a 10-year follow-up (2006-2016).Participants9910 community-dwelling elderly people (≥ 65 years).Main MeasuresA HL index derived by summing the number of HL behaviors. Data on incident disability were retrieved from the public Long-term Care Insurance database. Multivariate-adjusted 50th percentile differences (PDs) in age at disability or death (months) and their 95% CIs were estimated with the Laplace regression model.Key ResultsDuring the 10 years, 4562 disability or death events occurred. Participants who adhered to all three HL behaviors lived 17.1 (95% CI 12.7, 21.5) months longer without disability than those who adhered to zero or one. Each 1-point increase of the index score conferred 8.8 months additional life without disability. The tendency for the 50th PDs to increase with a higher HL index score did not differ according to age (< 75 or ≥ 75 years), sex, or the presence of chronic conditions (none, or ≥ 1 chronic condition).ConclusionsA combination of HL behaviors may substantially increase DFS, even for late-elderly (≥ 75 years), or elderly people with chronic conditions.

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