Promoting Functional Health in Midlife and Old Age: Long-Term Protective Effects of Control Beliefs, Social Support, and Physical Exercise
Promoting Functional Health in Midlife and Old Age: Long-Term Protective Effects of Control Beliefs, Social Support, and Physical Exercise
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DOI：
10.1371/journal.pone.0013297
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发表时间：
2010-10-11
期刊：
影响因子：
3.7
通讯作者：
Agrigoroaei, Stefan
中科院分区：
文献类型：
--
作者：
Lachman, Margie E.;Agrigoroaei, Stefan
背景：以前的研究已经检查了与功能健康相关的身体危险因素，但很少有工作关注心理和社会因素的保护作用。我们研究了控制信念、社会支持和体育锻炼对功能健康变化的个体和联合保护作用，超越了中老年人健康状况和身体危险因素的影响。鉴于功能健康通常会在整个成年期下降，因此确定可改变的因素非常重要，这些因素可用于维持功能、改善生活质量和减少残疾。方法/主要发现：我们进行了一项全国性纵向研究“美国中年”(MIDUS)，并于 1995 年至 1996 年和 2004 年至 2006 年进行了评估，纳入了 3,626 名年龄在 32 至 84 岁的社区居住成年人。 的分析。在这两种情况下都测量了功能健康（SF-36 的身体功能子量表）和保护因素。在控制社会人口、健康状况和身体危险因素（腰围过大、吸烟、酗酒或吸毒问题）的同时，时间 1 的三个保护性变量（控制信念、社会支持和体育锻炼）的综合结果与功能健康变化显着相关。在时间 1 时这些因素越多，10 年内的健康维护就越好。在中老年人中，随着保护因素数量的增加，健康状况下降的情况显着减少。结论/意义：在那些拥有更多保护因素的人中，与年龄相关的健康状况下降的程度在早十年之前有所减少。可改变的心理、社会和身体保护因素，无论是单独的还是总体的，都与维持功能健康相关，超出了身体危险因素的破坏性影响。这些结果对于制定促进功能健康的干预措施和减少晚年身体残疾的公共卫生支出的前景令人鼓舞。
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.Methodology/Principal Findings: 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.Conclusion/Significance: 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.