Promoting functional health in midlife and old age: long-term protective effects of control beliefs, social support, and physical exercise.
BACKGROUND
Previous studies have examined physical risk factors in relation to functional health, but less work has focused on the protective role of psychological and social factors. We examined the individual and joint protective contribution of control beliefs, social support and physical exercise to changes in functional health, beyond the influence of health status and physical risk factors in middle-aged and older adults. Given that functional health typically declines throughout adulthood, it is important to identify modifiable factors that can be implemented to maintain functioning, improve quality of life, and reduce disability.


RESULTS
We conducted a national longitudinal study, Midlife in the United States (MIDUS), with assessments in 1995-1996 and 2004-2006, and 3,626 community-residing adults, aged 32 to 84, were included in the analyses. Functional health (Physical Functioning subscale of the SF-36) and protective factors were measured at both occasions. While controlling for socio-demographic, health status, and physical risk factors (large waist circumference, smoking, and alcohol or drug problems), a composite of the three protective variables (control beliefs, social support, and physical exercise) at Time 1 was significantly related to functional health change. The more of these factors at Time 1, the better the health maintenance over 10 years. Among middle-aged and older adults, declines in health were significantly reduced with an increased number of protective factors.


CONCLUSIONS
Age-related declines in health were reduced among those with more protective factors up to a decade earlier in life. Modifiable psychological, social, and physical protective factors, individually and in the aggregate, are associated with maintenance of functional health, beyond the damaging effects of physical risk factors. The results are encouraging for the prospect of developing interventions to promote functional health and for reducing public health expenditures for physical disability in later life.
Psychology Department, Brandeis University, Waltham, Massachusetts, United States of America. Lachman@brandeis.edu
Margie E
ME
Lachman
Stefan
S
Agrigoroaei
D000203:Activities of Daily Living; D000368:Aged; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires