title: Difference in adherence to and influencing factors of a healthy lifestyle between middle-aged and elderly people in Korea: A multilevel analysis.
abstract: OBJECTIVE
  Comprehensive research for factors related to healthy lifestyles of the elderly is limited. The present study aimed to elucidate the factors associated with adherence to a healthy lifestyle by age groups.
  
  
  METHODS
  The present study was based on data from the 2005 Korea National Health and Nutrition Examination Survey. We calculated crude proportions and adjusted proportions of cigarette smokers, problem alcohol drinkers, and physically inactive people in two age groups (40-59 years and ≥60 years). We carried out multilevel analysis to elucidate factors associated with healthy lifestyles.
  
  
  RESULTS
  Of 3194 respondents included in the analysis, 1154 (36.13%) were aged 60 years or older. Older participants smoked less (23.0% vs 17.4%) and exercised less frequently (52.4% vs 66.9%; all P < 0.001) than their middle-aged counterparts. After adjustment, the proportion of regular exercisers was inversed (adjusted proportion 0.468, 95% CI 0.436-0.501 vs 0.377, 95% CI 0.337-0.419, P = 0.004). In multilevel analysis, contextual factors, such as local tax per capita, was associated significantly with cigarette smoking only in the elderly (OR 1.037, 95% CI 1.005-1.070).
  
  
  CONCLUSIONS
  Different factors were associated with healthy lifestyles of elderly people when compared with middle-aged people. In addition, local tax per capita, an area level variable, was more likely to be associated with smoking in the elderly than the middle-aged group.
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.|Graduate School of Public Health, Seoul National University, Seoul, Korea.
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Son
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.|School of Family Medicine, College of Medicine, Seoul National University, Seoul, Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Park
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Juhyun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Graduate School of Public Health, Seoul National University, Seoul, Korea.
authors.forename: Chang Yup
authors.initials: CY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D008019:Life Style / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D064890:Social Determinants of Health; D012944:Social Support
keywords: contextual effect; elderly; health behavior; multilevel analysis