Implications and future research
Health-harming behaviours evidently occur in very typical
combinations, which can be taken into account when
developing effective and efficient prevention and intervention
measures. For instance, there are two high-risk groups among
older adults: individuals who drink too much alcohol on a
regular basis (who tend to be men with higher SES) and those
who are regular smokers (who tend to be younger seniors with
lower SES). Both risk groups exhibit specific sociodemographic
attributes (male, living alone, social class affiliation) and
behavioural patterns (physical inactivity and an unhealthy
diet). Another target group is the ‘Physically Inactives’, who
tend to have a lower SES and live alone. This cluster can be
expected to be responsive to an entirely different target group
approach.
There is evidence that combinations of these four important
and most prevalent risk factors are more detrimental to
people’s health than would be expected from the addition of
the individual effects alone.18 This multiplicative rather than
additive effect suggests a need for a multimodal approach
such as is the established gold standard in the diagnosis and
management of many diseases.42 For example, in addiction
therapy, current discussions have centred on treating alcohol
and tobacco dependency at the same time and including
exercise programmes as part of therapy programmes. To the
37% 39% 41%
6%
4%
5%
9%
7%
12%
11%
10%
8%
14%
15%
13%
16%
17%
No Risk Behaviours
(25.3%)
35%
Physically Inactives
(21.1%)
Fruit and Vegetable
Avoiders
(18.2%)
Smokers with
Risk Behaviours
(12.7%)
Drinkers with Risk
Behaviours
(22.7%)
18%
Socioeconomic status (upper class)
Gender (male)
43% 45% 47% 49% 51% 53% 55% 57% 59% 61%
Cluster 1
Cluster 2
Cluster 3
Cluster 5
Cluster 4
Figure 2 Cluster description on the basis of gender and socioeconomic status
Risk clusters in the over-50 population 275
extent that future research work identifies similarly stable and
complex health behaviour types for other countries and age
groups, this would open up an additional opportunity to
implement larger scale prevention strategies.
In the face of the demographical change, there will have to
be more specific programmes and interventions for younger
seniors in the future. The basis of this recommendation is the
typical cumulative risk patterns observed among the elderly.
Individual and societal lifestyle changes can also be worthwhile
among the elderly.