title: Mental health in the aged: prevalence, covariates and related neuroendocrine, cardiovascular and inflammatory factors of successful aging.
abstract: BACKGROUND
  Although aging is accompanied by diminished functioning, many elderly individuals preserve a sense of well-being. While the concept of "successful aging" has been popular for many decades, little is known about its psycho-physiologic and endocrine underpinnings. KORA-Age is a population-based, longitudinal study designed to determine the prevalence of successfully aged men and women between 65 and 94 years old in the MONICA/KORA Augsburg cohort of randomly selected inhabitants. Specifically, we aim to identify predictors of successful aging and to elucidate bio-psychosocial mechanisms that maintain mental health and successful adaptation despite adverse experiences of life and aging.
  
  
  METHODS
  Components of successful aging were assessed in a telephone survey of 4,127 participants (2008-2009) enrolled in the MONICA/KORA cohort, on average, 13 years earlier. Psychosocial, somatic and behavioural predictors are used to determine factors that contribute to successful aging. An age-stratified random sub-sample (n = 1,079) participated in a personal interview where further psychological mechanisms that may underlie successful adaptation (resilience, social support, attachment) were examined. The interactions among neuroendocrine systems in the aging process are investigated by studying the cortisol/dehydroepiandrosterone-sulfate ratio, the level of insulin-like growth factor I, and oxytocin.
  
  
  CONCLUSIONS
  Longitudinal determinants of successful aging can be assessed based on a follow-up of an average of 13 years. A comprehensive analysis of biological as well as physio-psychological information provides a unique opportunity to investigate relevant outcomes such as resilience and frailty in the elderly population.
authors.affiliation: Institut für Epidemiologie - Helmholtz Zentrum München, München, Germany.
authors.forename: Maria E
authors.initials: ME
authors.lastname: Lacruz
authors.forename: Rebecca T
authors.initials: RT
authors.lastname: Emeny
authors.forename: Horst
authors.initials: H
authors.lastname: Bickel
authors.forename: Barbara
authors.initials: B
authors.lastname: Cramer
authors.forename: Alexander
authors.initials: A
authors.lastname: Kurz
authors.forename: Martin
authors.initials: M
authors.lastname: Bidlingmaier
authors.forename: Dorothea
authors.initials: D
authors.lastname: Huber
authors.forename: Günther
authors.initials: G
authors.lastname: Klug
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.forename: Karl H
authors.initials: KH
authors.lastname: Ladwig
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology*; D002320:Cardiovascular Physiological Phenomena; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006728:Hormones / Q000502:physiology; D006801:Humans; D008297:Male; D008603:Mental Health; D011788:Quality of Life; D012944:Social Support
chemical_list: D006728:Hormones