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PLoS One. 2017 Jan 25;12(1):e0170513. doi: 10.1371/journal.pone.0170513. eCollection 2017.

Combined Impact of Traditional and Non-Traditional Healthy Behaviors on Health-Related Quality of Life: A Prospective Study in Older Adults.

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  • 1Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid /IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
  • 2Nefrology Department, "12 de Octubre" Hospital, Madrid, Spain.
  • 3School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador.
  • 4Complejo Hospitalario de Navarra, Pamplona, Spain.
  • 5Department of Physical Education, Sports and Human Movement, Universidad Autónoma de Madrid, Madrid, Spain.


Combined exposure to several healthy behaviors (HB) is associated with reduced mortality in older adults but its impact on health-related quality of life (HRQL) is uncertain. This is a cohort study of 2,388 individuals aged ≥60 recruited in 2000-2001, whose data were updated in 2003 and 2009. At baseline, participants reported both traditional HB (non-smoking, being very or moderately active, healthy diet) and non-traditional HB (sleeping 7-8 h/d, being seated <8 h/d, and seeing friends every day). HRQL was measured with the SF-36 questionnaire at baseline, in 2003 (short-term) and in 2009 (long-term); a higher score on the SF-36 represents better HRQL. Linear regression models were used to assess the association between HB at baseline and HRQL in 2003 and 2009, with adjustment for the main confounders including baseline HRQL. In the short-term, being physically active, sleeping 7-8 h/d, and being seated <8 h/d was associated with better HRQL. Compared to having ≤1 of these HB, the β (95% confidence interval) for the score on the physical component summary of the SF-36 in 2003 was 1.42 (0.52-2.33) for 2 HB, and 2.06 (1.09-3.03) for 3 HB, p-trend <0.001. Corresponding figures for the mental component summary score were 1.89 (0.58-3.21) for 2 HB and 3.35 (1.95-4.76) for 3 HB, p-trend <0.001. Non-smoking, a healthy diet or seeing friends did not show an association with HRQL. In the long-term, being physically active was the only HB associated with better physical HRQL. As a conclusion, a greater number of HB, particularly more physical activity, adequate sleep duration, and sitting less, were associated with better short-term HRQL in older adults. However, in the long-term, being physically active was the only HB associated with better physical HRQL.

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