Promoting Functional Health in Midlife and Old Age: Long-Term Protective Effects of Control Beliefs, Social Support, and Physical Exercise

Previous studies have examined physical risk factors in relation to functional health, but less work has focused on the protective role of psychological and social factors. We examined the individual and joint protective contribution of control beliefs, social support and physical exercise to changes in functional health, beyond the influence of health status and physical risk factors in middle-aged and older adults. Given that functional health typically declines throughout adulthood, it is important to identify modifiable factors that can be implemented to maintain functioning, improve quality of life, and reduce disability.We conducted a national longitudinal study, Midlife in the United States (MIDUS), with assessments in 1995-1996 and 2004-2006, and 3,626 community-residing adults, aged 32 to 84, were included in the analyses. Functional health (Physical Functioning subscale of the SF-36) and protective factors were measured at both occasions. While controlling for socio-demographic, health status, and physical risk factors (large waist circumference, smoking, and alcohol or drug problems), a composite of the three protective variables (control beliefs, social support, and physical exercise) at Time 1 was significantly related to functional health change. The more of these factors at Time 1, the better the health maintenance over 10 years. Among middle-aged and older adults, declines in health were significantly reduced with an increased number of protective factors.Age-related declines in health were reduced among those with more protective factors up to a decade earlier in life. Modifiable psychological, social, and physical protective factors, individually and in the aggregate, are associated with maintenance of functional health, beyond the damaging effects of physical risk factors. The results are encouraging for the prospect of developing interventions to promote functional health and for reducing public health expenditures for physical disability in later life

Cognitive Functioning in Midlife and Old Age: Combined Effects of Psychosocial and Behavioral Factors

This study examined the joint protective contribution of psychosocial and behavioral factors to cognitive functioning and 10-year change, beyond the influence of sociodemographic factors, physical risk factors, health status, and engagement in cognitive activities. Participants were from the National Study of Midlife in the United States (MIDUS), ages 32-84 at Time 2, and a subsample, the Boston Longitudinal Study (BOLOS), ages 34-84 at Time 2. We computed a composite protective measure including control beliefs, quality of social support, and physical exercise variables at two occasions, 9-10 years apart. Cognition was assessed at Time 2 in MIDUS and at both occasions in BOLOS. Multiple regressions were used for analysis. In MIDUS, the more of the protective factors, the better the cognitive performance, and the protective composite moderated education differences in memory. In BOLOS, the Time 1 composite predicted change in reasoning abilities, with a greater protective effect for those with lower education. A combination of modifiable psychosocial and behavioral factors has both concurrent and long-term protective effects on cognition in adulthood. The results are promising in that educational disparities in memory and reasoning were reduced, suggesting possible interventions to protect against cognitive declines