Objectives: To determine (i) the extent to which recommended lifestyle healthy behaviors are adopted and the existence of positive attitudes to health; (ii) the relative influence of socio-demographic variables on multiple healthy lifestyle behaviors and positive attitudes to health; (iii) the association between healthy lifestyle behaviors and positive attitudes to health.
Design: Two distinct healthy behavioral measures were developed: (i) healthy lifestyles based on physical activity, no cigarette smoking, no/moderate alcohol drinking, maintaining a "healthy" weight and having no sleeping problems and (ii) positive health attitudes based on having positive emotional attitudes, such as: self-perceived good health status, being calm, peaceful and happy for most of the time, not expecting health to get worse and regular health check-ups. A composite healthy lifestyle index, ranging from 0 (none of behaviors met) to 5 (all behaviors met) was calculated by summing up the individual's scores for the five healthy lifestyle items. Afterwards, each individual's index was collapsed into three levels: 0-2 equivalent to 'level 1' (subjectively regarded as 'too low'), a score of 3 equivalent to 'level 2' ('fair') and 4-5 as 'level 3' satisfactory 'healthy lifestyle' practices. The same procedure was applied to the positive health attitudes index. Multinomial logistic regression analyses by a forward selection procedure were used to calculate the adjusted odds ratio (OR) with 95% confidence interval (95% CI).
Participants: A multi-national sample consisting of 638 older Europeans from 8 countries, aged 65-74 and 75+, living alone or with others.
Results and conclusions: Maintaining a "healthy" weight was the most frequently cited factor in the healthy lifestyles index and therefore assumed to be the most important to the older Europeans in the study; positive attitudes to health were relatively low; participants achieved a 'satisfactory' level for healthy lifestyles index (level 3) more frequently than a satisfactory level for positive attitudes to health; having a satisfactory 'healthy lifestyle' was directly related to having a satisfactory level of positive attitudes to health based on the positive health attitudes index; income and geographical location in Europe appeared to be key predictors for meeting both the recommended healthy lifestyle factors in the index and having positive health attitudes however, the composition and nature of the study sample should be taken into consideration when considering the impact of the location on healthy lifestyles and attitudes to health across Europe.