Volume 62, Issue 5 p. 880-888
Clinical Investigations

Late-Life Factors Associated with Healthy Aging in Older Men

Christina L. Bell MD, PhD

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]

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Randi Chen MS

Randi Chen MS

Department of Research, Kuakini Medical Center, Honolulu, Hawaii

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Kamal Masaki MD

Kamal 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

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Priscilla Yee MD

Priscilla Yee MD

Department of Internal Medicine, California Pacific Medical Center, San Francisco, California

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Qimei He PhD

Qimei He PhD

Department of Research, Kuakini Medical Center, Honolulu, Hawaii

Veterans Affairs—Pacific Islands Healthcare System, Honolulu, Hawaii

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John Grove PhD

John Grove PhD

Department of Research, Kuakini Medical Center, Honolulu, Hawaii

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Timothy Donlon PhD

Timothy Donlon PhD

Department of Research, Kuakini Medical Center, Honolulu, Hawaii

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J. David Curb MD

J. 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 author
D. Craig Willcox MD

D. Craig Willcox MD

Department of Human Welfare, Okinawa International University, Okinawa, Japan

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Leonard W. Poon PhD

Leonard W. Poon PhD

Institute of Gerontology, University of Georgia, Athens, Georgia

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Bradley J. Willcox MD

Bradley 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

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First published: 29 April 2014
Citations: 35

Abstract

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.