Andrea Z LaCroix1, Eileen Rillamas-Sun2, Nancy F Woods3, Julie Weitlauf4, Oleg Zaslavsky5, Regina Shih6, Michael J LaMonte7, Chloe Bird8, Elizabeth M Yano9, Meryl LeBoff10, Donna Washington11, Gayle Reiber12. 1. Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego. alacroix@ucsd.edu. 2. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. 3. Seattle WHI Clinical Center, Biobehavioral Nursing, University of Washington. 4. VA Palo Alto Health Care System, Sierra Pacific MIRECC and Center for Innovation to Implementation, California. Stanford Cancer Institute, Department of Psychiatry & Behavioral Sciences, Stanford University, Palo Alto, California. 5. Faculty of Health Sciences and Social Welfare, University of Haifa, Israel. 6. RAND Corporation, Arlington, Virginia. 7. Department of Epidemiology and Environmental Health, State University of New York at Buffalo. 8. RAND Corporation, Santa Monica, California. 9. VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California. Department of Health Policy and Management, UCLA Fielding School of Public Health, University of California, Los Angeles. 10. Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 11. VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California. 12. Health Services Research and Development, Department of Veteran Affairs (VA) Puget Sound Health Care System, Seattle, Washington. Departments of Health Services and Epidemiology, University of Washington School of Public Health, Seattle.
Abstract
PURPOSE OF THE STUDY: To examine whether Veteran status influences (a) women's survival to age 80 years without disease and disability and (b) indicators of successful, effective, and optimal aging at ages 80 years and older. DESIGN AND METHODS: The Women's Health Initiative (WHI) enrolled 161,808 postmenopausal women aged 50-79 years from 1993 to 1998. We compared successful aging indicators collected in 2011-2012 via mailed questionnaire among 33,565 women (921 Veterans) who reached the age of 80 years and older, according to Veteran status. A second analysis focused on women with intact mobility at baseline who could have reached age 80 years by December 2013. Multinominal logistic models examined Veteran status in relation to survival to age 80 years without major disease or mobility disability versus having prevalent or incident disease, having mobility disability, or dying prior to age 80 years. RESULTS: Women Veterans aged 80 years and older reported significantly lower perceived health, physical function, life satisfaction, social support, quality of life, and purpose in life scale scores compared with non-Veterans. The largest difference was in physical function scores (53.0 for Veterans vs 59.5 for non-Veterans; p < .001). Women Veterans were significantly more likely to die prior to age 80 years than non-Veteran WHI participants (multivariate adjusted odds ratio = 1.20; 95% confidence interval, 1.04-1.38). In both Veteran and non-Veteran women, healthy survival was associated with not smoking, higher physical activity, healthy body weight, and fewer depressive symptoms. IMPLICATIONS: Intervening upon smoking, low physical activity, obesity, and depressive symptoms has potential to improve chances for healthy survival in older women including Veterans.
PURPOSE OF THE STUDY: To examine whether Veteran status influences (a) women's survival to age 80 years without disease and disability and (b) indicators of successful, effective, and optimal aging at ages 80 years and older. DESIGN AND METHODS: The Women's Health Initiative (WHI) enrolled 161,808 postmenopausal women aged 50-79 years from 1993 to 1998. We compared successful aging indicators collected in 2011-2012 via mailed questionnaire among 33,565 women (921 Veterans) who reached the age of 80 years and older, according to Veteran status. A second analysis focused on women with intact mobility at baseline who could have reached age 80 years by December 2013. Multinominal logistic models examined Veteran status in relation to survival to age 80 years without major disease or mobility disability versus having prevalent or incident disease, having mobility disability, or dying prior to age 80 years. RESULTS:Women Veterans aged 80 years and older reported significantly lower perceived health, physical function, life satisfaction, social support, quality of life, and purpose in life scale scores compared with non-Veterans. The largest difference was in physical function scores (53.0 for Veterans vs 59.5 for non-Veterans; p < .001). Women Veterans were significantly more likely to die prior to age 80 years than non-Veteran WHI participants (multivariate adjusted odds ratio = 1.20; 95% confidence interval, 1.04-1.38). In both Veteran and non-Veteran women, healthy survival was associated with not smoking, higher physical activity, healthy body weight, and fewer depressive symptoms. IMPLICATIONS: Intervening upon smoking, low physical activity, obesity, and depressive symptoms has potential to improve chances for healthy survival in older women including Veterans.
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