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The Impact of Smoking and Obesity on Disability-Free Life Expectancy in Older Australians

Lookup NU author(s): Dr Andrew Kingston, Emerita Professor Carol Jagger



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America.BACKGROUND: Smoking and obesity are 2 modifiable risk factors for disability. We examine the impact of smoking and obesity on disability-free life expectancy (DFLE) at older ages, using 2 levels of disability. METHOD: We used the DYNOPTA dataset, derived by harmonizing and pooling risk factors and disability outcomes from 5 Australian longitudinal aging studies. We defined mobility disability as inability to walk 1 km, and more severe (activities of daily living [ADL]) disability by the inability to dress or bathe. Mortality data for the analytic sample (N = 20 401; 81.2% women) were obtained from Government Records via data linkage. We estimated sex-specific total life expectancy, DFLE, and years spent with disability by Interpolated Markov Chain (IMaCh) software for each combination of smoking (never vs ever), obesity (body mass index ≥30 vs 18.5 to <30), and education (left school age 14 or younger vs age 15 or older). RESULTS: Compared to those without either risk factor, high educated nonobese smokers at age 65 lived shorter lives (men and women: 2.5 years) and fewer years free of mobility disability (men: 2.1 years; women: 2.0 years), with similar results for ADL disability. Obesity had the largest effect on mobility disability in women; high educated obese nonsmoking women lived 1.3 years less than nonsmoking, not obese women but had 5.1 years fewer free of mobility disability and 3.2 fewer free of ADL disability. Differences between risk factor groups were similar for the low educated. CONCLUSIONS: Our findings suggest eliminating obesity would lead to an absolute reduction of disability, particularly in women.

Publication metadata

Author(s): Kingston A, Byles J, Kiely K, Anstey KJ, Jagger C

Publication type: Article

Publication status: Published

Journal: The Journals of Gerontology. Series A, Biological sciences and medical sciences

Year: 2021

Volume: 76

Issue: 7

Pages: 1265-1272

Print publication date: 01/07/2021

Online publication date: 29/11/2020

Acceptance date: 09/11/2020

Date deposited: 05/07/2021

ISSN (print): 1079-5006

ISSN (electronic): 1758-535X

Publisher: Oxford University Press


DOI: 10.1093/gerona/glaa290

PubMed id: 33249489


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Funder referenceFunder name
DYNOPTA was funded by the National Health and Medical Research Council (NHMRC: grant no. 410215);
personal fellowship awarded to A.K. from Newcastle University, UK.