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Effect of Cancer Screening and Desirable Health Behaviors on Functional Status, Self‐Rated Health, Health Service Use and Mortality
Author(s) -
Fillenbaum Gerda G.,
Burchett Bruce M.,
Kuchibhatla Maragatha N.,
Cohen Harvey J.,
Blazer Dan G.
Publication year - 2007
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2006.01009.x
Subject(s) - medicine , hazard ratio , confidence interval , odds ratio , gerontology , proportional hazards model , demography , self rated health , population , logistic regression , environmental health , sociology
OBJECTIVES: To determine whether some health behaviors of older people (e.g., obtaining cancer screens) have a limited and others (e.g., exercise) have a broad association with population‐level health status 4 to 6 years later. DESIGN: Longitudinal cohort. SETTING: North Carolina five‐county urban and rural area. PARTICIPANTS: Representative community residents aged 71 and older (Duke Established Populations for Epidemiologic Studies of the Elderly; African American, n=1,256; white, n=974) who provided information on cancer screening and health behaviors. MEASUREMENTS: Demographics, health conditions, functional status, health service use, health insurance. Dependent measures were functional status and self‐rated health 4 years later, hospitalization within 4 years, and death within 6 years. Data were analyzed using descriptive statistics, multivariable logistic regression, and Cox proportional hazards. RESULTS: In fully adjusted analyses, cancer screening had no significant protective association with functional status, self‐rated health, hospitalization, or death. Smoking was a risk factor for hospitalization (odds ratio (OR)=1.48, 95% confidence interval (CI)=1.07–2.05), and death (hazard rate (HR)=1.81, 95% CI=1.47–2.23). Sufficient food reduced hospitalization (OR=0.38, 95% CI=0.15–0.94) and mortality (HR=0.70, 95% CI=0.49–1.02). Regular exercise protected against poor mobility (OR=0.56, 95% CI=0.41–0.77), and poor self‐rated health (OR=0.61, 95% CI=0.45–0.82). Lower activity level increased the hazard of death (HR=1.18, 95% CI=1.03–1.36). CONCLUSION: Disease‐specific screens are important at an individual level but, because of low incidence of condition and comorbidity, may not be associated with population‐level health 4 to 6 years later. Practice of health behaviors with a broader focus is associated, at a population level, with better functional status and self‐rated health and lower rates of hospitalization and death 4 to 6 years later.