Late-Life Factors Associated with Healthy Aging in Older Men
Corresponding Author
Christina L. Bell MD, PhD
Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Address correspondence to Christina L. Bell, Department of Geriatric Medicine, University of Hawaii John A. Burns School of Medicine, 347 N. Kuakini St. HPM 9, Honolulu, HI 96817.
E-mail: [email protected]
Search for more papers by this authorRandi Chen MS
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Search for more papers by this authorKamal Masaki MD
Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Search for more papers by this authorPriscilla Yee MD
Department of Internal Medicine, California Pacific Medical Center, San Francisco, California
Search for more papers by this authorQimei He PhD
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Veterans Affairs—Pacific Islands Healthcare System, Honolulu, Hawaii
Search for more papers by this authorJohn Grove PhD
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Search for more papers by this authorTimothy Donlon PhD
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Search for more papers by this authorJ. David Curb MD
Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Deceased.Search for more papers by this authorD. Craig Willcox MD
Department of Human Welfare, Okinawa International University, Okinawa, Japan
Search for more papers by this authorLeonard W. Poon PhD
Institute of Gerontology, University of Georgia, Athens, Georgia
Search for more papers by this authorBradley J. Willcox MD
Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Veterans Affairs—Pacific Islands Healthcare System, Honolulu, Hawaii
Search for more papers by this authorCorresponding Author
Christina L. Bell MD, PhD
Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Address correspondence to Christina L. Bell, Department of Geriatric Medicine, University of Hawaii John A. Burns School of Medicine, 347 N. Kuakini St. HPM 9, Honolulu, HI 96817.
E-mail: [email protected]
Search for more papers by this authorRandi Chen MS
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Search for more papers by this authorKamal Masaki MD
Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Search for more papers by this authorPriscilla Yee MD
Department of Internal Medicine, California Pacific Medical Center, San Francisco, California
Search for more papers by this authorQimei He PhD
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Veterans Affairs—Pacific Islands Healthcare System, Honolulu, Hawaii
Search for more papers by this authorJohn Grove PhD
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Search for more papers by this authorTimothy Donlon PhD
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Search for more papers by this authorJ. David Curb MD
Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Deceased.Search for more papers by this authorD. Craig Willcox MD
Department of Human Welfare, Okinawa International University, Okinawa, Japan
Search for more papers by this authorLeonard W. Poon PhD
Institute of Gerontology, University of Georgia, Athens, Georgia
Search for more papers by this authorBradley J. Willcox MD
Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Department of Research, Kuakini Medical Center, Honolulu, Hawaii
Veterans Affairs—Pacific Islands Healthcare System, Honolulu, Hawaii
Search for more papers by this authorAbstract
Objectives
To identify potentially modifiable late-life biological, lifestyle, and sociodemographic factors associated with overall and healthy survival to age 85.
Design
Prospective longitudinal cohort study with 21 years of follow-up (1991–2012).
Setting
Hawaii Lifespan Study.
Participants
American men of Japanese ancestry (mean age 75.7, range 71–82) without baseline major clinical morbidity and functional impairments (N = 1,292).
Measurements
Overall survival and healthy survival (free from six major chronic diseases and without physical or cognitive impairment) to age 85. Factors were measured at late-life baseline examinations (1991–1993).
Results
Of 1,292 participants, 1,000 (77%) survived to 85 (34% healthy) and 309 (24%) to 95 (<1% healthy). Late-life factors associated with survival and healthy survival included biological (body mass index, ankle–brachial index, cognitive score, blood pressure, inflammatory markers), lifestyle (smoking, alcohol use, physical activity), and sociodemographic factors (education, marital status). Cumulative late-life baseline risk factor models demonstrated that age-standardized (at 70) probability of survival to 95 ranged from 27% (no factors) to 7% (≥5 factors); probability of survival to 100 ranged from 4% (no factors) to 0.1% (≥5 factors). Age-standardized (at 70) probability of healthy survival to 90 ranged from 4% (no factors) to 0.01% (≥5 factors). There were nine healthy survivors at 95 and one healthy survivor at 100.
Conclusion
Several potentially modifiable risk factors in men in late life (mean age 75.7) were associated with markedly greater probability of subsequent healthy survival and longevity.
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