ReviewLifestyle predictors of healthy ageing in men
Introduction
Worldwide, it is well-recognized that the population is ageing and that this will have significant economic and social impacts [1], [2]. Accompanying these increasing life expectancies is an awareness of the need to promote positive ageing and healthy lifestyles for older populations. The major challenge, with ageing populations is to maintain physical and cognitive functions, quality of life and independence.
Ageing is a continuous process, that includes loss of functional capability and changes that depend on numerous genetic, environmental, and lifestyle factors [3]. Ageing is usually viewed as being distinct from major chronic diseases, but there are often shared exposure factors or mechanisms, for example, oxidative processes that cause mutations in DNA. A study by Newman et al. showed a graded relationship between the extent of vascular disease and the likelihood of an individual maintaining good health and function as they age [4]. Previous studies have also found that an increased central distribution of fat with advancing age are associated with chronic metabolic and cardiovascular abnormalities [5]. Chronic diseases such as cardiovascular disease, diabetes, and chronic respiratory diseases are projected by the WHO to become the leading causes of disability throughout the world by the year 2020 [2]. Three modifiable health risk behaviours—lack of physical activity, tobacco use, and poor nutrition—are responsible for much of the illness, suffering, and early death related to chronic diseases [1], [2]. In addition, sedentary behaviours are emerging as an important component of the physical activity and health equation [6].
The link between physical activity and health has caused a surge in physical activity research, and the evidence is overwhelming that physical activity has a protective effect on cardiovascular health and reduces all-cause mortality [7]. Physical activity has also the power to attenuate the decline in appendicular lean tissue as an individual age and to reduce the risk of abdominal adiposity and degradation of skeletal muscles in the elderly (sarcopenia) [8]. Several studies have reported a role for physical activity in preventing depression and in maintaining cognitive function in older adults [9], [10]. It is also well known that physical activity and a sedentary lifestyle have opposing effects on telomere length and thus may slow down or accelerate or the ageing process, respectively [11].
Cigarette smoking is considered to be the “number one killer” and is the leading cause of death worldwide [1], [2]. There is an adverse relationship between smoking and functional ability, and strong and consistent associations have been observed between sustained smoking from age 50 to 70 and reduced functional ability at age 75, even after adjustment for physical activity [12], [13]. Furthermore, smoking is reported to be positively correlated with alcohol consumption, and an unhealthy diet [14]. Conversely, older adults who exercise regularly report a lower intake of dietary fat compared to non-exercising older adults. It is clear that there are multiple determinants for healthy ageing, and gender differences have been observed in various lifestyle behaviours and in how these behaviours affect health outcomes [15], [16]. The current short review, therefore, takes a male perspective when exploring lifestyle predictors of healthy ageing.
Section snippets
Lifestyle factors
The MEDLINE and EMBASE databases were reviewed for English-language publications concerning lifestyle predictors of healthy ageing, such as physical activity and sedentary behaviours, smoking, diet, and alcohol consumption. Of the studies found, 20 included a significant number of men and were deemed suitable for the current analysis (Table 1).
Discussion
This review shows that not only do men with healthy lifestyles survive longer, but they also do so in good health and tend to suffer disabilities later and over the course of fewer years at the end of life. It is also clear that healthy ageing in later life can be predicted by lifestyle factors assessed in midlife and late adulthood.
It is difficult to compare the studies due to their varying designs, sample sizes, and methods, so the estimated effects of these lifestyle factors might,
Competing interest
There are no competing interests to declare.
Funding
No funding.
Provenance and peer review
Commissioned and externally peer reviewed.
Acknowledgement
The author was supported by Signhild Engkvists Foundation, Sweden.
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