Association Between Healthy Lifestyle Index Trajectories and Functional Disability in Middle-Aged and Older Adults: A...

To explore the trajectories of combined healthy lifestyle index (HLI), and to examine the association between HLI at a single point, HLI trajectories, and new-onset functional disability among middle-aged and older adults.

A longitudinal cohort study. Group-based trajectory modeling and binomial logistic regression analysis were used to explore HLI trajectories and their associations with functional disability.

Data were obtained from the China Health and Retirement Longitudinal Survey (2011-2020), a nationally representative assessment of community-dwelling middle-aged and older adults spanning 150 counties across 28 provinces.

A total of 5985 community-dwelling individuals aged ≥45 years were included for cross-sectional analysis, 3213 of whom were women. In addition, 3888 individuals without functional disability at baseline were eligible for the longitudinal analysis.

Not applicable.

Activities of daily living (ADLs) disability and instrumental activities of daily living (IADLs) disability.

Three distinct HLI trajectories were identified: persistently high-level then declining group (n=742, 19.08%), persistently moderate-level then declining group (n=2416, 62.14%), and persistently low-level group (n=730, 18.78%). In comparison with persistently low-level group, persistently high-level then declining group was associated with a lower risk of ADL disability (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.23-0.67) and IADLs disability (OR, 0.51; 95% CI, 0.36-0.73), whereas persistently moderate-level then declining group only had a lower risk of ADL disability (OR, 0.70; 95% CI, 0.50-1.00).

The healthy lifestyle was stable and not susceptible to prolonged change without external influences. Sustaining the high level of healthy lifestyle benefited functional capacity in middle-aged and older adults. Future research needs to focus on improving the overall lifestyle intervention to maximize the effectiveness of the intervention.