Increases in longevity are leading to a substantial growth in the elderly population, and this trend is expected to continue. Opposing opinions hold that this will result in an enormous growth of hale and hearty elderly or a pandemic of dependency, disability, and dementia. This debate has focused attention on issues related to quality of life. We know little about the factors that are associated with development of functional limitations and decreased quality of life, or factors that modify the impact of disease on functional limitations. The proposed study uses data collected in a population-based, prospective study with one of the broadest collections of behavioral, social, psychological, socio-environmental, biological, and physiological risk factors of any study. Data from extensive laboratory tests, medical history, ultrasonographic examination of the carotid arteries, maximal exercise testing, and extensive spirometry are also available. Substantial information is available on physical, social, and psychological functioning. In a sample of 1,036, there was a four-year re-examination. Computerized linkage will allow determination of sickness absence, disability, and early retirement. These data will allow the investigators to examine if incidence, and changes in physical, social, and psychological functioning, and sickness absence, disability, and early retirement, are associated with the following: 1) behavioral factors (e.g., smoking, physical activity, alcohol consumption, body mass index); 2) social factors (e.g., social network participation, social support); 3) psychological factors (e.g., depression, hopelessness, hostility); 4) job characteristics (e.g., psychological job strain, physical strain); 5) diagnosed conditions (e.g., cardiovascular disease, claudication), subclinical pathology (e.g., carotid atherosclerosis) and physiological impairments (e.g., reduced lung function, poor fitness); 6) if diagnosed conditions, subclinical pathology, and physiological impairments confound these associations; and 7) if behavioral, social, psychological, and work-related factors modify the associations between diagnosed conditions, subclinical pathology, and physiological impairments and these outcomes.
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