Perceived Functional Limitation and Health Promotion during Mid- to Late Life: The Mediating Role of Affect

  • Sarah T. Stahl West Virginia University
  • Julie Hicks Patrick West Virginia University


Engagement in health-promoting behaviors plays an important role in successful aging and may delay the onset and progression of disability in later life. The current study examined a model of health promotion using age, perceived functional limitation, and affective beliefs (e.g., positive affect and negative affect) as predictors of health-responsibility behaviors. Participants were 122 adults between the ages of 40 and 88 who completed measures via an online survey. Results indicate that perceived functional limitation both directly and indirectly, through its association with positive affect, influence health-responsibility behaviors. Adults who perceived more severe functional limitations and experienced greater positive affect reported engagement in more health-responsibility behaviors. This finding suggests that positive affect may be an underlying mechanism by which functional limitation influences engagement in health-promoting behaviors. These results may also have important clinical implications for the use of positive affect as an indicator of health functioning among middle-aged and older adults with chronic illness.


Arbuckle, J. L., & Wothke, W. (1995). Amos 4.0 User’s Manual. Chicago: Small Waters Corporation.

Baltes, P. B. (1987). Theoretical propositions of life-span developmental psychology: On the dynamics between growth and decline. Developmental Psychology, 23, 631-626. doi:10.1037/0012-1649.23.5.611

Becker, C. M., & Arnold, W. (2004). Health promoting behaviors of older Americans versus young and middle-aged adults. Educational Gerontology, 30, 835-844. doi:10.1080/03601270490507277

Breslow, L. (1999). From disease prevention to health promotion. Journal of the American Medical Association, 281, 1030-1034. doi:10.1001/jama.281.11.1030

Byrne, B. M. (2001). Structural equation modeling with AMOS: Basic concepts, applications, and programming. Mahwah, NJ: Lawrence Erlbaum Associates.

Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182. doi:10.1037/0022-3514.51.6.1173

Cohen, S., & Pressman, S., D. (2006). Positive affect and health. Current Directions in Psychological Science, 15, 122-125. doi:10.1111/j.0963-7214.2006.00420.x

Frederickson, B., L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional well-being. Psychological Science, 13, 172-175. doi:10.1111/1467-9280.00431

George, L. K. (2001). The social psychology of health. In R.H. Binstock & L.K. George (Eds.), Handbook of aging and the social sciences, (pp. 217-237). London: Academic Press.

Grzywacz, J. G., & Keyes, C. L. M. (2004). Toward health promotion: Physical and social behaviors in complete health. American Journal of Health Behavior, 28, 99-111. doi:pmed.15058511

Guralnik, J. M., & Ferrucci, I. (2003). Assessing the building blocks of function. Utilizing measures of functional limitation. American Journal of Preventive Medicine, 25, 112-121. doi:10.1016/S0749-3797(03)00174-0

Hu, J., & Gruber, K. J. (2008). Positive and negative affect and health functioning indicators among older adults with chronic illnesses. Issues in Mental Health Nursing, 29, 895-911. doi:10.1080/01612840802182938

Kelsey, K. S., DeVellis, B., Begum, M., Belton, L., Hooten, E. G., & Campbell, M. (2006). Positive affect, exercise, and self-reported health in blue-collar women. American Journal of Health Behavior, 30, 199-207. doi:pmed.1653310

Kline, R. B. (2005). Principles and practice of structural equation modeling. New York, NY: Guilford Press.

Lawton, M. P., Kleban, M. H., Dean, J., Rajagopal, D., & Parmelee, P. A. (1992). The factorial generality of brief positive and negative affect measures. Journal of Gerontology, Psychological Sciences, 47, 228-237. doi:pmed.1624699

Lee, Y., & Park, K. (2006). Health practices that predict recovery from functional limitations in older adults. American Journal Preventive Medicine, 31, 25-31. doi:10.1016/j.amepre.2006.03.018

Leventhal, H., Rabin, C., Leventhal, E. A., & Burns, E. (2001). Health risk behaviors and aging, InJ. R. Birren & K. W. Schaie (Eds.), Handbook of psychology and aging (pp.186-214). London: Academic Press.

Levy, B. R., Slafe, M. D., Kunkel, S. R., & Kasl, S. V. (2002). Longevity increased by positive self-perception of aging. Journal of Personality and Social Psychology, 83, 261-270. doi:10.1037/0022-3514.83.2.261

Mayne, T. J. (1999). Negative affect and health: The importance of being earnest. Cognition and Emotion, 13, 601-635. doi:10.1080/026999399379203

Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., & Castaneda-Sceppe, C. (2007). Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Medicine & Science in Sports & Exercise, 7, 1435-1445. doi:10.1249/mss.0b013e3180616aa2

Piazza, J. R., Charles, S. T., & Almeida, D. M. (2007). Living with chronic health conditions: Age differences in affective well-being. Journals of Gerontology, 62B, 313-321. doi:pmed.18079415

Prohaska, T., Belansky, E., Belza, B., Buchner, D., Marhsall, V., McTigue, K., & Wilcox, S. (2006). Physical activity, public health, and aging: Critical issues and research priorities. Journals of Gerontology, 61B, 267-273. doi: pmed.16960240

Rasinado, M., Hirvensalo, M., Leinonen, R., Lintunen, T., & Rantanen, T. (2007). Motives for and barriers to physical activity among older adults with mobility limitations. Journal of Aging and Physical Activity, 15, 90-102. doi:pmed.17387231

Sobel, M.E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. In S. Leinhart (Ed.), Sociological methodology (pp. 290 – 312). San Francisco: Jossey-Bass.

Stahl. S.T. (2009). Health promotion during midlife: The influence of internal health locus of control and future time perspective. Unpublished master’s thesis, West Virginia University.

Swinburn, B., Egger, G., & Razza, F. (1999). Dissecting obesogenic environments: The development and application of a framework for identifying and prioritizing environmental interventions for obesity. Preventive Medicine, 29, 563-570. doi:10.1006/pmed.1999.0585

Traywick, L. S., & Schoenberg, N. E. (2008). Determinants of exercise among older female heard attack survivors. Journal of Applied Gerontology, 27, 52-77. doi:10.1177/0733464807308604

US Census Bureau. Disability Status: 2005. Washington, DC: US Census Bureau, 2008.

Walker, S. N. & Hill-Polerecky, D. M. (1996). Psychometric evaluation of the Health-Promoting Lifestyle Profile II. Unpublished manuscript, University of Nebraska Medical Center.

World Health Organization (1998). Obesity: Preventing and managing the global epidemic. Geneva, Switzerland.

Zanjani, F. A. K., Schaie, K. W., & Willis, S. L. (2006). Age group and health status effects on health behavior change. Behavioral Medicine, 32, 36-46.doi:10.3200/BMED.32.2.36-46.