Objectives. This study investigated the effect of healthy lifestyle behaviors on self-rated health and self-care ability over a 10-year follow-up period in older persons in the SENECA study. Methods. Health status and lifestyle behaviors were examined in 1988/1989, 1993, and 1999 in 216 men and 264 women, born between 1913 and 1918, from 7 European countries. Results. Self-rated health and self-care ability declined in men and women with healthy and unhealthy lifestyle habits over the 10-year follow-up period. Inactive and smoking persons had an increased risk for a decline in health status as compared with active and nonsmoking people. No effect of a healthy, Mediterranean-like diet on the deterioration in health status was observed. Conclusions. Being physically active and nonsmoking delayed deterioration in health status in older participants aged 70 to 75 years in the SENECA study. (Am J Public Health. 2003;93:318–323)