Health Practices That Predict Recovery from Functional Limitations in Older Adults Yunhwan Lee, MD, DrPH, Kyung-hye Park, MA Background: Although previous studies show the benefits of certain health behaviors in reducing physical disability in older people, their effects on functional limitation, an antecedent of disability, are not well established. This study aims to identify health behavioral practices that affect recovery from functional limitations in older adults. Methods: A total of 312 community-dwelling adults aged 65 and older with functional limitations were examined in 2002 for functional recovery in 2003. Functional limitations were measured by self-reports of difficulty performing upper- and lower-body movements. Positive health practices included regular physical activity, normal body mass index (BMI), periodic medical checkups, and moderate alcohol consumption. Logistic regression models were fitted to identify individual as well as combined health practices that predict functional recovery, adjusting for sociodemographic and health-related covariates. Results: Although each of the positive health practices was significantly associated with functional recovery in the bivariate analyses, only physical activity continued to be a strong indepen- dent predictor in the multivariate analysis. The likelihood of functional recovery tended to increase with the number of health practices adopted by the elderly. Physical activity, in combination with normal BMI, proved to be one of the most influential health practice profiles, resulting in a high percentage of functional recovery. Conclusions: Health behaviors, especially physical activity, contribute to an older person’s functional independence. The benefit of an increased number of health practices on recovery from functional limitations suggests that targeting multiple behavioral risks may help delay the onset of disability in later life. (Am J Prev Med 2006;31(1):25–31) © 2006 American Journal of Preventive Medicine Introduction A ccumulating evidence on the dynamic nature of the disability process suggests that recovery from physical disability by older adults is not an uncommon event. In longitudinal studies of physical function, 1–5 up to 81% of the disabled elderly has been reported to regain independence. These results indi- cate that the reversal of disability as a goal in healthy aging may be both feasible and attainable. Most studies, however, have focused on the endpoint of the disablement process, that is, disability as defined by measures of activities of daily living (ADL). Func- tional limitation, an intermediate outcome in the path- way from disease to disability, 6 has received relatively less attention. Functional limitation is a valid indicator of the physical functional status of older people as well as a strong predictor of incident disability. 7 It is thus vital to consider functional limitation in interventions aimed at disability prevention. 8 Improvements in func- tional limitation have been noted in previous stud- ies, 3,4,9 –11 signifying its relevance to the reversibility of the disabling process. In understanding the factors associated with func- tional recovery, it is important to consider the complex interplay of multiple factors affecting the disablement process as described in the International Classification of Functioning, Disability and Health (ICF) con- struct. 12 Among the diverse environmental and per- sonal factors affecting functioning, age, 13–15 socioeco- nomic status, 10 baseline functional status, 3,5,10,13–15 and chronic conditions 3,10,11 have been observed to predict functional recovery in older adults. This study focuses on health-related behaviors that are more amenable to intervention and change, controlling for other contex- tual factors. Several studies suggest that health behav- iors may play an independent role in recovery from disability. Physical activity 14 and maintenance of nor- mal weight 13,15 were significantly associated with recov- ery from ADL disability in older adults. Reductions in disability levels have been reported among nonsmok- ers, moderate drinkers, and those having regular health checkups. 16 –18 The role of health behaviors in the From the Department of Preventive Medicine & Public Health, Ajou University School of Medicine, Suwon, South Korea Address correspondence and reprint requests to: Yunhwan Lee, San 5, Wonchun-dong, Youngtong-gu, Suwon 443-721, Republic of Korea. E-mail: yhlee@ajou.ac.kr. 25 Am J Prev Med 2006;31(1) 0749-3797/06/$–see front matter © 2006 American Journal of Preventive Medicine • Published by Elsevier Inc. doi:10.1016/j.amepre.2006.03.018