Healthy lifestyle and life expectancy with and without major chronic disease - a cohort study

Health behaviors affect life expectancy, but whether disease is present can greatly impact both the individual and society. How health behavior is reflected in the utilization of health care services is yet to be investigated to support the impact of prevention efforts. Based on data from 57,053 middle-aged individuals from the Danish Diet, Cancer and Health cohort, a health score including baseline smoking status, sport activity, alcohol consumption, diet, and waist circumference was constructed as a simple measure of general health behavior. During 20 years of follow-up, healthy life expectancy among men and women aged 65 years at baseline, was 0.83 [0.74 to 0.92] and 0.86 [0.77 to 0.94] years longer on average, respectively, per one point increment in the health score. Life expectancy with disease was shorter among men (-0.18 [-0.26 to -0.09]) and women (-0.37 [-0.45 to -0.29]) with higher health scores. Among individuals with the highest scores, major chronic disease diagnosis was postponed for more than 7 years. There were fewer disability years, especially with multimorbidity, (men: -1.6 years; women: -3.3 years), and there was a clear inverse association between health score and days of hospitalization looking 20 years ahead.