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Long-Term Impact of Preventive Proactivity on Quality of Life of the Old-Old

From Case Western Reserve University (E.K., R.H.L., K.K., A.W., E.S., J.T., K.S.) and Cleveland State University (B.K.), Cleveland, Ohio.

Address reprint requests to: Eva Kahana, Department of Sociology, 226 Mather Memorial Building, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-9823. Email: exk{at}po.cwru.edu

OBJECTIVE: This research explored the long-term benefits of engaging in proactive health promotion efforts among old-old residents of Sunbelt retirement communities to empirically test components of the Preventive and Corrective Proactivity (PCP) Model of Successful Aging. Specifically, we examined the contributions of exercise, tobacco use, moderate alcohol use, and annual medical checkups to multidimensional quality of life indicators of physical health, psychological well-being, and mortality.

METHOD: Data were obtained from a longitudinal study of adaptation to aging. Annual in-home interviews were conducted with 1000 older adults over a 9-year period. Whether health promotion behaviors at baseline predicted quality of life outcomes 8 years later was examined, controlling for the baseline outcome, sociodemographic variables, and, as an additional test, baseline health conditions.

RESULTS: Exercise was predictive of fewer IADL limitations and greater longevity, positive affect, and meaning in life 8 years later. Avoiding tobacco was predictive of longevity. Before controlling for health conditions, exercise predicted decreased risk of basic activities of daily living limitations and having more goals; moderate alcohol use predicted longevity; annual health checkup predicted more IADL limitations; and having once smoked predicted having more IADL limitations and negative affect.

CONCLUSIONS: Among the old-old, exercise had long-term and multifaceted benefits over an 8-year period. Tobacco avoidance also contributed to long-term positive outcomes. These results lend support to the long-term preventive value of health-promoting proactivity spontaneously engaged in by old-old persons proposed in the framework of the PCP model.

Key Words: health promotion, • quality of life, • older adults, • prevention, • proactivity, • exercise.

Abbreviations: PCP = preventive and corrective proactivity;; ADL = activities of daily living;; IADL = instrumental activities of daily living;; OARS = Older Americans Resources Study.

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