title: Effect of major lifestyle risk factors, independent and jointly, on life expectancy with and without cardiovascular disease: results from the Consortium on Health and Ageing Network of Cohorts in Europe and the United States (CHANCES).
abstract: Seldom have studies taken account of changes in lifestyle habits in the elderly, or investigated their impact on disease-free life expectancy (LE) and LE with cardiovascular disease (CVD). Using data on subjects aged 50+ years from three European cohorts (RCPH, ESTHER and Tromsø), we used multi-state Markov models to calculate the independent and joint effects of smoking, physical activity, obesity and alcohol consumption on LE with and without CVD. Men and women aged 50 years who have a favourable lifestyle (overweight but not obese, light/moderate drinker, non-smoker and participates in vigorous physical activity) lived between 7.4 (in Tromsø men) and 15.7 (in ESTHER women) years longer than those with an unfavourable lifestyle (overweight but not obese, light/moderate drinker, smoker and does not participate in physical activity). The greater part of the extra life years was in terms of "disease-free" years, though a healthy lifestyle was also associated with extra years lived after a CVD event. There are sizeable benefits to LE without CVD and also for survival after CVD onset when people favour a lifestyle characterized by salutary behaviours. Remaining a non-smoker yielded the greatest extra years in overall LE, when compared to the effects of routinely taking physical activity, being overweight but not obese, and drinking in moderation. The majority of the overall LE benefit is in disease free years. Therefore, it is important for policy makers and the public to know that prevention through maintaining a favourable lifestyle is "never too late".
authors.affiliation: UKCRC Centre of Excellence for Public Health for Northern Ireland, Queens University Belfast, Belfast, BT12 6BA, Northern Ireland, UK. m.odoherty@qub.ac.uk.
authors.forename: Mark G
authors.initials: MG
authors.lastname: O'Doherty
authors.affiliation: Centre for Statistical Science and Operational Research (CenSSOR), Queen's University Belfast, Belfast, BT7 1NN, Northern Ireland, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Cairns
authors.affiliation: UKCRC Centre of Excellence for Public Health for Northern Ireland, Queens University Belfast, Belfast, BT12 6BA, Northern Ireland, UK.
authors.forename: Vikki
authors.initials: V
authors.lastname: O'Neill
authors.affiliation: UKCRC Centre of Excellence for Public Health for Northern Ireland, Queens University Belfast, Belfast, BT12 6BA, Northern Ireland, UK.|Centre for Statistical Science and Operational Research (CenSSOR), Queen's University Belfast, Belfast, BT7 1NN, Northern Ireland, UK.
authors.forename: Felicity
authors.initials: F
authors.lastname: Lamrock
authors.affiliation: Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark.|Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.|Faculty of Medicine, University of Aalborg, Aalborg, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
authors.forename: Ben
authors.initials: B
authors.lastname: Schöttker
authors.affiliation: Department of Community Medicine, University of Tromsø, 9037, Tromsø, Norway.
authors.forename: Tom
authors.initials: T
authors.lastname: Wilsgaard
authors.affiliation: Department of Community Medicine, University of Tromsø, 9037, Tromsø, Norway.
authors.forename: Galatios
authors.initials: G
authors.lastname: Siganos
authors.affiliation: Department of Health, National Institute for Health and Welfare (THL), 00271, Helsinki, Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Kuulasmaa
authors.affiliation: The Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, NY, 10029, USA.|Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos str., 115 27, Athens, Greece.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.affiliation: Hellenic Health Foundation, Kaisareias 13 & Alexandroupoleos str., 115 27, Athens, Greece.|Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Mikras Asias 75 st, 115 27, Athens, Greece.
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.affiliation: UKCRC Centre of Excellence for Public Health for Northern Ireland, Queens University Belfast, Belfast, BT12 6BA, Northern Ireland, UK.
authors.forename: Frank
authors.initials: F
authors.lastname: Kee
mesh_terms: D000368:Aged; D000375:Aging; D000428:Alcohol Drinking / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000401:mortality*; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000401:mortality; D050177:Overweight / Q000150:complications; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology / Q000706:statistics & numerical data*
keywords: Ageing; CHANCES; Cardiovascular disease; Mortality; Obesity; Smoking