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After a Health Crisis: A Window of Opportunity for Major Lifestyle Change


New Haven, Conn. — Older adults with poor health habits appear to be much more likely to quit smoking or lose weight following a serious health diagnosis, a Yale School of Public Health researcher has found.

This “window of opportunity” was found to exist for adults recently diagnosed with a stroke, cancer, lung disease, heart disease or diabetes. They were 3.2 times more likely to quit smoking than their healthy peers who smoked. Overweight or obese individuals diagnosed with lung disease, heart disease, or diabetes on average lost 2 or 3 pounds more than their peers.

And there is substantial potential for even further health behavior changes within this group if the healthcare system could provide the information, support and counseling that many people need, said Patricia S. Keenan, an assistant professor in the division of Health Policy and Administration and the study’s lead author.

“A serious diagnosis can serve as a trigger to motivate older adults to make difficult health behavior changes,” said Keenan. “As the population ages, taking advantage of this window of opportunity should be a priority for the healthcare system and policymakers.”

The research used data from the Health and Retirement Study, a survey of middle-aged
and older adults. A total of 20,221 overweight or obese individuals younger than 75 years and 7,764 smokers participated in the study and were surveyed at least twice.

Over the eight-year period of the study, 18 percent of smokers quit and the average body mass index increased by 0.04 units in the overweight and obese group. About 13 percent of smokers were diagnosed with stroke, cancer, lung disease, heart disease or diabetes, while 8 percent of overweight or obese individuals received a diagnosis of lung disease, heart disease or diabetes.

Participants with multiple diagnoses exhibited even greater willingness to change­ their lifestyle compared with those who received no new diagnoses. People with multiple new diagnoses were 6.1 times more likely to quit smoking, while obese individuals with more than one diagnosis lost an average of 3 to 4 pounds.

Smoking, poor dietary habits and a lack of physical activity are among the leading underlying causes of death in the United States. One-fifth of adults older than 25 smoke, and two-thirds of adults between 20 to 75 years old are overweight or obese. Clinical guidelines recommend weight loss and smoking cessation to prevent health risks in these individuals, and advise physicians to counsel their patients about making these changes.

“Targeting individuals with recent new diagnoses may be particularly effective in middle-aged and older individuals, who are increasingly likely to receive a major diagnosis or to be hospitalized as they age,” Keenan writes. “Individuals with new adverse health events are accessible through contact with the healthcare system or through the Internet or other written information about their disease, and this study suggests that they are more motivated to change health habits.”

Details of the research are published in the February 9 issue of Archives of Internal Medicine.


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