title: Smoking trajectories from midlife to old age and the development of non-life-threatening health problems: a 34-year prospective cohort study.
abstract: OBJECTIVE
  To examine how trajectories of smoking observed over a 34-year period, were associated with the progression of mobility impairment, musculoskeletal pain, and symptoms of psychological distress from midlife to old age.
  
  
  METHODS
  The Swedish Level of Living Survey (LNU) and the Swedish Panel Study of the Oldest Old (SWEOLD) were merged to create a nationally representative longitudinal sample of Swedish adults (aged 30-50 at baseline; n=1060), with four observation periods, from 1968 through 2002. Five discrete smoking trajectory groups were treated as predictors of variation in health trajectories using multilevel regression.
  
  
  RESULTS
  At baseline, there were no differences in mobility impairment between smoking trajectory groups. Over time all smokers, particularly persistent and former heavy smokers, exhibited faster increases in mobility problems compared with persistent non-smokers. Additionally, all smoking groups reported more pain symptoms than the non-smokers, at baseline and over time, but most of these differences did not reach statistical significance. Persistent heavy smokers reported elevated levels of psychological distress at baseline and over time.
  
  
  CONCLUSIONS
  Smokers, and even some former smokers, who survive into old age appear to be at increased risk for non-life-threatening conditions that can diminish quality of life and increase demands for services.
authors: Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden. neda.agahi@ki.se
authors: Neda
authors: N
authors: Agahi
authors: Benjamin A
authors: BA
authors: Shaw
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D013315:Stress, Psychological / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
keywords: Aging; Health; Middle aged; Smoking
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