Influence of life-style choices on locomotor disability, arthritis and cardiovascular disease in older women: prospective cohort study.

BACKGROUND: many chronic conditions have their roots in modifiable health-related behaviours. METHODS: a total of 4,286 women aged 60-79 in the British Women's Heart and Health Study are followed up for incident cardiovascular disease (CVD), arthritis and locomotor disability over 7 years. Self-reported smoking, alcohol consumption, exercise and fruit intake at baseline is also available. Associations between these and each outcome, plus a composite outcome, are investigated in those without prevalent disease at baseline using logistic regression with multiple imputation. RESULTS: ex-smokers and current smokers showed increased odds of locomotor disability, CVD and the combined outcome. Less regular exercisers had increased odds of all outcomes, particularly locomotor disability. There was no evidence that alcohol or fruit intake was associated with any outcome. Population attributable fractions (PAFs) suggest in addition to the influence of smoking and alcohol, exercise accounts for 9% of incident locomotor disability, 5% of CVD and 4% of arthritis. All four lifestyle factors combined account for 17% of incident locomotor disability and 9% of incident conditions combined. CONCLUSIONS: never smokers and regular exercisers had substantially reduced odds of 7-year disability onset. Low PAFs suggest changes in health-related behaviours in older women would result in only modest reductions in common chronic conditions.