21 Jan Life Enjoyment Predicts Less Physical Decline with Age

MedicalResearch.com Interview with:
Professor Andrew Steptoe, MA, DPhil, DSc, FMedSci
Director, Institute of Epidemiology and Health Care
University College London
British Heart Foundation Professor of Psychology
Department of Epidemiology and Public Health
London WC1E 6BT

MedicalResearch.com: What are the main findings of the study?

Dr. Steptoe: We are trying to understand whether positive well-being has beneficial effects as far as health and physical function is concerned.  The main findings are that the risk of developing impairments in activities of daily living (things life being able to bath or shower without help) over the next few years among older people is lower in people who enjoy life more. In addition, enjoyment of life predicted less decrease in walking speed over our 8 year study period in this sample of older men and women. Of course, these associations could be due to many things: the people with greater enjoyment of life could be more affluent, have less physical illness or disability to start with, or have healthier lifestyles at the outset, and these factors could predict the changes in physical function over time. But what we found is that baseline health, economic circumstances, and lifestyle explain only part of the association between enjoyment of life and deterioration in function. So the research suggests that enjoyment of life contributes to healthier and more active old age.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Steptoe: We have previously found that enjoyment of life is a predictor of longer life; so older people who report greater enjoyment are less likely to die over the next 5 to 8 years than those with lower enjoyment of life. What this study showed was that older people who enjoy life are also at lower risk for developing problems of disability and declining physical function as well.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Steptoe: As life expectancy improves in the population, we need to attend to the quality of life at older ages.  Limitations in how well people can perform ordinary activities are very important for quality of life. So we need to understand better the factors that contribute to good physical function and capacity at older ages.  Of course, this is an observational study, which means that we cannot be certain about cause.  Although it seems plausible to us that low positive well-being causes faster acceleration of age-related declines in physical function, we cannot be certain that other factors were not responsible.  We tried to measure as many other factors as we could – baseline health, impairments in mobility, socioeconomic position, lifestyle factors such as regular physical activity, and so on – but there were other factors that we did not measure that might have been relevant.

This research suggests that among other things, we should think about the positive aspects of life and experience of older people.  Not only are these important issues in themselves, they might have benefits in terms of physical function.  These could in turn help us contain the spiraling costs of social and health care among older sectors of society.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Steptoe: We need to understand better the biological pathways that link positive well-being and physical function. We need to find out whether we can improve enjoyment of life for older people, and if so, whether this will have an impact on their physical function. And we need to know how these factors operate across different parts of the world, particularly in lower and middle income countries where longevity is increasing at a high rate.

Citation:

Enjoyment of life and declining physical function at older ages: a longitudinal cohort study

Andrew Steptoe, Cesar de Oliveira, Panayotes Demakakos, and Paola Zaninotto

CMAJ cmaj.131155; published ahead of print January 20, 2014, doi:10.1503/cmaj.131155

Last Updated on January 21, 2014 by Marie Benz MD FAAD