While positive health behaviors have been shown to extend life, their association with extending active life has not been well investigated. In this report, several health behaviors were investigated in relation to maintaining mobility during 4 years of follow-up among 6,981 men and women aged 65 years and older with intact mobility at baseline between 1981 and 1983 who lived in one of three communities: East Boston, Massachusetts; Iowa and Washington counties, Iowa; and New Haven, Connecticut. Intact mobility, defined as the ability to climb up and down stairs and walk a half mile, was determined annually by interview, and study subjects were classified into one of three categories at the end of 4 years of follow-up: 1) maintained mobility (55.1%); 2) lost mobility (36.2%); or 3) died without evidence of having lost mobility prior to death (8.7%). After adjustment for age and all of the health behaviors, risk of losing mobility was significantly associated with current smoking, not consuming alcohol compared with small-to-moderate amounts of alcohol consumption, high (> 80th percentile) compared with moderate (21-80th percentiles) body mass index, and low physical activity levels in both men and women. These findings suggest that positive health behaviors can not only extend longevity but also reduce the risk of losing mobility and independence in later life.

To assess the role of demographic factors and chronic conditions in maintaining mobility in older persons, this study utilized longitudinal data collected as part of the Established Populations for Epidemiologic Studies of the Elderly between 1981 and 1987 on 6,981 men and women aged 65 years and older in East Boston, Massachusetts; Iowa and Washington counties, Iowa; and New Haven, Connecticut. Results are presented for those who at baseline reported intact mobility, defined as the ability to climb stairs and walk a half mile without help, and who were followed annually for up to 4 years for changes in mobility status. Age, income, education, and chronic conditions present at baseline and occurring during follow-up were evaluated for their association with loss of mobility. Over the follow-up period, 55.1% of subjects maintained mobility, 36.2% lost mobility, and 8.7% died without evidence of mobility loss prior to death. In both men and women, increasing age and lower income levels were associated with increased risk of losing mobility, even after controlling for the presence of chronic conditions at baseline. After adjustment for age, income, and chronic conditions, lower education levels were a significant risk factor for mobility loss in men, but not in women. Baseline reports of previous heart attack, stroke, high blood pressure, diabetes, dyspnea, and exertional leg pain were associated with small but significant risks for mobility loss. There was a stepwise increase in the risk of mobility loss according to the number of chronic conditions present at baseline that was very consistent between men and women. The occurrence during the study of a new heart attack, stroke, cancer, or hip fracture was associated with a substantially greater risk of mobility loss than was associated with the presence of these conditions at baseline.