AGS: For Older Adults, Healthy Body Follows Healthy Mind

SEATTLE, May 4 -- Emotional wellbeing protects physical health for older adults, researchers said here.

Patients ages 70 to 79 with the fewest depressive symptoms were 37% less likely to develop any physical health problem over the next five years than those with more than a few symptoms at baseline.

So found Gretchen A. Brenes, Ph.D., of Wake Forest University in Winston-Salem, N.C., and colleagues after evaluating 2,622 patients in the Health Aging, and Body Composition Study.

"We knew that high functioning in a particular area protects against developing limitations further down the road," she said at the American Geriatrics Society meeting.

The study, though, is the first to show that "high functioning in one area also protects functioning in another area," she continued.

"You want hopefully to address all of these areas of functioning," she said. "You can't just focus on how someone is doing physically or even mentally. They are all important."

All participants started with no physical, cognitive, or emotional limitations at baseline and were followed for five years.

The researchers categorized participants as functionally limited, well functioning, or high functioning for each health domain. They controlled for factors ranging from age to cardiovascular disease to obesity, and censored those who died over the five-year follow-up.

For emotional health, functional impairment was defined by depression on the Center for Epidemiologic Studies Short Depression Scale (score 10 or higher). High functioning was defined by a score of less than six.

The findings for high- versus well-functioning adults in emotional domains were:

• 37% less likely to develop a physical limitation (odds ratio 0.63, 95% confidence interval 0.48 to 0.83).
• 30% less likely to develop dementia (OR 0.70, 95% CI 0.46 to 1.07).
• 76% less likely to develop depression (OR 0.24, 95% CI 0.18 to 0.33).

For physical health, those with difficulty in one or more activity of daily living were classified as limited. High functioning individuals not only had no impairment but found walking one mile "easy" or "very easy."

The findings for high- versus well-physically functioning individuals were:

• 48% less likely to develop a physical limitation (OR 0.52, 95% CI 0.43 to 0.64).
• 25% less likely to develop dementia (OR 0.75, 95% CI 0.54 to 1.05).
• 16% less likely to develop depression (OR 0.84, 95% CI 0.63 to 1.14).
• 29% less likely to die (OR 0.71, 95% CI 0.53 to 0.95).

For cognition, functional limitation was defined as dementia measured by the modified Mini-Mental State Examination (score less than 75 for those with less than a high school education or 80 with a high school education or 83 with more extensive education). High functioning was defined by a score of at least 85, 90, or 93, respectively by education category.

The high- versus well-functioning findings for cognition were:

• 12% less likely to develop a physical limitation (OR 0.88, 95% CI 0.72 to 1.08).
• 77% less likely to develop dementia (OR 0.23, 95% CI 0.15 to 0.26).
• 17% less likely to develop depression (OR 0.83, 95% CI 0.61 to 1.12).
• 23% less likely to die (OR 0.77, 95% CI 0.58 to 1.04).

After adjusting for covariates some of the associations between high function in one domain and preservation of function in other domains lost statistical significance. This suggests that the mechanism behind the relationships seen across domains may be because of common co-morbidities affecting multiple health domains, such as chronic obstructive pulmonary disease, and the relationship between high baseline functioning and decreased mortality, Dr. Brenes said.

"The exception to this is that high levels of emotional functioning protect against the development of physical limitations," she noted. "The mechanism that underlies this relationship is not known."