Journal article
Concordance With Prevention Guidelines and Subsequent Cancer, Cardiovascular Disease, and Mortality: A Longitudinal Study of Older Adults
American journal of epidemiology, Vol.186(10), pp.1168-1179
15 Nov 2017
PMCID: PMC5860231
PMID: 29020206
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Reports on the associations between multiple clinical and behavioral health indicators and major health outcomes among older adults are scarce. We prospectively examined concordance with guidelines from the American Cancer Society and American Heart Association for disease prevention in relation to cancer, cardiovascular disease (CVD), and mortality among Cardiovascular Health Study enrollees aged 65-98 years who, at baseline assessment in 1989-1996 (n = 3,491), were free of CVD and cancer. Total and cause-specific mortality, as well as incidence of cancer and CVD, were lower with higher guideline concordance. Independent of body mass index, blood pressure, total cholesterol, and fasting plasma glucose, better health behaviors (diet, physical activity, and alcohol consumption) were associated with lower mortality (2-sided P < 0.0001). Among individuals with ideal levels for 3-4 of these 4 cardiometabolic biomarkers, those with poor concordance with health behavior recommendations had higher mortality compared with those who had the highest concordance with these behavioral recommendations (adjusted mortality hazard ratio = 1.82, 95% confidence interval: 1.25, 2.67). Older adults who are concordant with recommendations for cancer and CVD prevention have reduced rates of chronic disease and mortality. Interventions to achieve and maintain healthy lifestyle behaviors may offer benefits both in the presence and absence of adverse traditional clinical risk factors.
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Details
- Title
- Concordance With Prevention Guidelines and Subsequent Cancer, Cardiovascular Disease, and Mortality: A Longitudinal Study of Older Adults
- Creators
- Heather Greenlee - Columbia UniversityGarrett Strizich - Columbia UniversityGina S. Lovasi - Columbia UniversityRobert C. Kaplan - University of WashingtonMary L. Biggs - Cape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South AfricaChristopher I. Li - Wake Forest UniversityJohn Richardson - Columbia UniversityGregory L. Burke - University of WashingtonAnnette L. Fitzpatrick - University of WashingtonAmanda M. Fretts - Group Health CooperativeBruce M. Psaty - Cape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South AfricaLinda P. Fried - Columbia University
- Publication Details
- American journal of epidemiology, Vol.186(10), pp.1168-1179
- Publisher
- Oxford Univ Press
- Number of pages
- 12
- Grant note
- K23CA141052; R01CA116393 / National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) R01CA116393; K23CA141052 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) R01AG031890; R01AG023629 / NATIONAL INSTITUTE ON AGING; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA) HHSN268201200036C; HHSN268200800007C; N01HC55222; N01HC85079; N01HC85080; N01HC85081; N01HC85082; N01HC85083; N01HC85086; U01HL130014; HL080295 / National Heart, Lung, and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) U01HL130114; U01HL080295; R01HL080295; R01HL085083 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) National Institute of Neurological Disorders and Stroke; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) R01AG023629; R01AG031890 / National Institute on Aging; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Identifiers
- 991020100068004721
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