HEALTH BEHAVIORS AND SURVIVAL AMONG MIDDLE-AGED AND OLDER MEN AND WOMEN IN THE NHANES-I EPIDEMIOLOGIC FOLLOW-UP-STUDY

Background. Since the 1960s there has been a decline in mortality rates for older U.S. adults, suggesting the importance of examining the role of prevention and health promotion in improving the health and survival of older adults. Epidemiologic studies of age and gender differences in the impact of health behaviors on survival for older U.S. adults are needed to provide information for intervention and health promotion efforts for older Americans. Methods. We examined whether health behavior risk factors (smoking, drinking, physical activity, and body weight) for mortality vary by age and gender among 6,109 adults 45-74 years old in the National Health and Nutrition Examination Survey 1971-1975 (NHANES I) who were traced during the 1982-1984 NHANES I Follow-up Survey. Results. For middle-aged men (45-54 years old) and for older men (65-74 years old), both smoking and nonrecreational physical activity were predictors of survival time. Additionally, for older men, drinking and low body mass index were associated with shorter survival time. Among women, there was less consistency of associations across age groups. As with men, nonrecreational physical activity and low body mass index were associated with shorter survival among older women. Conclusions. These findings suggest that health behaviors are associated with survival in older adults as well as in middle-aged adults, although the specific behavioral risk factors may vary by age and gender. (C) 1994 Academic Press, Inc.