Stronger seniors do dishes, laundry: How household chores can benefit an ageing body

Spending time doing even light housework can enrich the health and wellbeing of older people, with a recent study from Singapore showing that performing chores around the house confers some protection against frailty and helps keep seniors fit.

In the study, older adults aged ≥65 years who consistently completed high vs low levels of housework—either light (eg, washing the dishes, dusting, making the bed, doing the laundry, ironing, tidying up, cooking meals) or heavy (eg, window cleaning, changing beddings, vacuuming, scrubbing the floor, sawing, carpeting, repairing, and painting)—had about 40-percent lower odds of becoming prefrail (odds ratio [OR], 0.61, 95 percent confidence interval [CI], 0.40–0.94) or frail (OR, 0.56, 95 percent CI, 0.34–0.90) at an average follow-up of more than 4 years. [BMC Geriatr 2022;22:962]

“This is in agreement with a previous longitudinal study in older Chinese adults, which showed that housework participation at baseline was independently associated with a lower risk of incident physical phenotype of frailty at follow-up,” the investigators noted. [Front Med 2021;8:775518]

“We used a different measure of frailty (Frailty Index), which represents a broader construct of frailty that reflects multisystem functional and physiological decline and which includes psychological, biological, and social domains. The Frailty Index has been consistently shown to predict adverse health outcomes, including falls, cognitive impairment, multimorbidity, disability, impaired quality of life, and mortality,” they added. [J Gerontol A Biol Sci Med Sci 2007;62:722-727]

Sex-related differences

Notably, the association between chores and decreased frailty was pronounced among men who consistently performed heavy housework but not women. Meanwhile, engaging regularly in light housework had favourable effects on older women but not men.

In sex-stratified analysis, regular participation in high levels of heavy housework was associated with lower prevalence of prefrailty or frailty at follow-up among older men only (OR, 0.31, 95 percent CI, 0.13–0.72; p=0.009). On the other hand, regular participation in high levels of light housework was associated with lower risk of all-cause mortality among older women only (hazard ratio, 0.59, 95 percent CI, 0.36–0.96; p=0.033).

“Given that housework is a form of physical activity, these results collectively suggest that higher intensities of housework might be protective of frailty in men, suggesting that sex-specific physical activity interventions and guidelines should be considered,” the investigators pointed out.

The total study population included 3,270 community-dwelling participants with data on light (n=2,996; mean age 66.9 years, 62.6 percent female, mean body mass index 24.1 kg/m²) and heavy housework (n=3,022; mean age 66.9 years, 62.9 percent female, mean body mass index 24.2 kg/m²).

Participants who performed high levels of light housework tended to be women, younger, widowed, never smokers, engaged frequently in brisk walking, have higher socioeconomic status, lower education, lower nutritional risk, and not consume alcohol . On the other hand, those who engaged in high levels of heavy housework were more likely to be women, younger, never smokers, married, have lower body mass index and education, and not engage in brisk walking.

Sustainable form of physical activity

According to the investigators, household chores represent a sustainable form of physical activity that can improve health and survival outcomes for older adults, who are less likely to participate in moderate-to-vigorous recreational physical activity owing to factors such as increased vulnerability, accessibility of facilities, and safety concerns. [Singapore Med J 2013;54:581-586; BMC Geriatrics 2021;21:12]

“Housework tasks account for a significant proportion of self-reported physical activity and are a large part of everyday activities in older people, especially among women. Housework is a productive activity and a component of instrumental activities of living, which are both key factors for successful ageing,” they explained. [BMC Public Health 2013;13:966]

While unclear, the mechanisms underlying the link between housework and reduced mortality may have been attributed to improvements in physical, cognitive, and executive functions, as well as decreased frailty. Frailty is a common geriatric syndrome characterized by multidimensional function decline and is a red flag for functional disability and mortality. [BMJ Open 2021;11:e052557; Neuropsychiatr Dis Treat 2018;14:61-72; BMC Geriatrics 2021;21:104; Prev Med 2016;86:64-69; Age Ageing 2018;47:193-200]

“In this study, we found that regardless of the level of housework participation, ~70 percent of older adults engaged frequently in brisk walking and ~7 percent in sports, suggesting similar functional ability between high and low housework groups. Our data show that indeed other forms of physical activity including sport participation might be beneficial in reducing [the] risk of frailty and mortality in older adults,” the investigators said.

“While it is crucial that older adults engage in sustainable and meaningful physical activities, such as sports, depending on preferences, abilities and needs, housework may be an important form of physical activity that should not be ignored… Older adults should be encouraged to participate in housework as a meaningful occupation to continue, even with advancing age, to sustain health and wellbeing,” they added.