Risk and protective factors for physical functioning in older adults with and without chronic conditions: MacArthur studies of successful aging

Objectives. Older age continues to be seen as a period of declining health and functioning. The inevitability of declines, however, may be exaggerated, including declines for those with chronic health conditions. Methods. Data from the MacArthur Study of Successful Aging were used to examine the impact of sociodemographic, health status, health behavior, and social and psychological factors on patterns of change in physical functioning over a 2.5-year interval for groups of older adults reporting prevalent hypertension, diabetes, cardiovascular disease, cancer, or fractures, and those reporting no chronic conditions at baseline. Results. Findings from multiple regression analyses revealed a consistently protective effect of regular physical activity with respect to patterns of change in physical functioning in nearly all groups. For those with cardiovascular disease, greater emotional support was associated with higher baseline levels and less declines in functioning. whereas greater social conflict was associated with greater decline among those with hypertension or diabetes. For those with a history of cancer, instrumental self-efficacy beliefs were protective, whereas lower psychological symptomatology was associated with less risk of decline among those with a history of fracture. Social and psychological factors were unrelated to changes in functioning for those with no chronic conditions. Discussion. These findings suggest that risks for decline in physical functioning are influenced by a number of potentially modifiable factors that could be targets for interventions to promote better functioning, even among older adults with various types of chronic conditions.