title: Effect of cancer screening and desirable health behaviors on functional status, self-rated health, health service use and mortality.
abstract: OBJECTIVE
  To determine whether some health behaviors of older people (e.g., obtaining cancer screens) have a limited and others (e.g., exercise) have a broad association with population-level health status 4 to 6 years later.
  
  
  METHODS
  Longitudinal cohort.
  
  
  METHODS
  North Carolina five-county urban and rural area.
  
  
  METHODS
  Representative community residents aged 71 and older (Duke Established Populations for Epidemiologic Studies of the Elderly; African American, n=1,256; white, n=974) who provided information on cancer screening and health behaviors.
  
  
  METHODS
  Demographics, health conditions, functional status, health service use, health insurance. Dependent measures were functional status and self-rated health 4 years later, hospitalization within 4 years, and death within 6 years. Data were analyzed using descriptive statistics, multivariable logistic regression, and Cox proportional hazards.
  
  
  RESULTS
  In fully adjusted analyses, cancer screening had no significant protective association with functional status, self-rated health, hospitalization, or death. Smoking was a risk factor for hospitalization (odds ratio (OR)=1.48, 95% confidence interval (CI)=1.07-2.05), and death (hazard rate (HR)=1.81, 95% CI=1.47-2.23). Sufficient food reduced hospitalization (OR=0.38, 95% CI=0.15-0.94) and mortality (HR=0.70, 95% CI=0.49-1.02). Regular exercise protected against poor mobility (OR=0.56, 95% CI=0.41-0.77), and poor self-rated health (OR=0.61, 95% CI=0.45-0.82). Lower activity level increased the hazard of death (HR=1.18, 95% CI=1.03-1.36).
  
  
  CONCLUSIONS
  Disease-specific screens are important at an individual level but, because of low incidence of condition and comorbidity, may not be associated with population-level health 4 to 6 years later. Practice of health behaviors with a broader focus is associated, at a population level, with better functional status and self-rated health and lower rates of hospitalization and death 4 to 6 years later.
authors.affiliation: Center for the Study of Aging and Human Development, Durham, NC 27710, USA. ggf@geri.duke.edu
authors.forename: Gerda G
authors.initials: GG
authors.lastname: Fillenbaum
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Burchett
authors.forename: Maragatha N
authors.initials: MN
authors.lastname: Kuchibhatla
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Cohen
authors.forename: Dan G
authors.initials: DG
authors.lastname: Blazer
mesh_terms: D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D009026:Mortality; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis*; D016016:Proportional Hazards Models; D044465:White People / Q000706:statistics & numerical data