title: How to classify the oldest old according to their health status: a study on 1160 subjects belonging to 552 90+ Italian sib-ships characterized by familial longevity recruited within the GEHA EU Project.
abstract: The health status of the oldest old, the fastest increasing population segment worldwide, progressively becomes more heterogeneous, and this peculiarity represents a major obstacle to their classification. We compared the effectiveness of four previously proposed criteria (Franceschi et al., 2000; Evert et al., 2003; Gondo et al., 2006; Andersen-Ranberg et al., 2001) in 1160 phenotypically fully characterized Italian siblings of 90 years of age and older (90+, mean age: 93 years; age range: 90-106 years) belonging to 552 sib-ships, recruited in Northern, Central and Southern Italy within the EU-funded project GEHA, followed for a six-year-survival. Main findings were: (i) "healthy" subjects varied within a large range, i.e. 5.2% (Gondo), 8.7% (Evert), 17.7% (Franceschi), and 28.5% (Andersen-Ranberg); (ii) Central Italy subjects showed better health than those from Northern and Southern Italy; (iii) mortality risk was correlated with health status independently of geographical areas; and (iv) 90+ males, although fewer in number, were healthier than females, but with no survival advantage. In conclusion, we identified a modified version of Andersen-Ranberg criteria, based on the concomitant assessment of two basic domains (cognitive, SMMSE; physical, ADL), called "Simple Model of Functional Status" (SMFS), as the most effective proxy to distinguish healthy from not-healthy subjects. This model showed that health status was correlated within sib-ships, suggesting a familial/genetic component.
authors.affiliation: DIMES - Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy; C.I.G. - Interdepartmental Centre "L. Galvani", University of Bologna, Piazza di Porta San Donato 1, 40126 Bologna, Italy. Electronic address: elisa.cevenini3@unibo.it.
authors.forename: Elisa
authors.initials: E
authors.lastname: Cevenini
authors.affiliation: National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; IFC - Institute of Clinical Physiology, CNR, Via G. Moruzzi 1, 56124 Pisa, Italy. Electronic address: rodolfo.cotichini@ifc.cnr.it.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Cotichini
authors.affiliation: National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Electronic address: antonia.stazi@iss.it.
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Stazi
authors.affiliation: National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy. Electronic address: virgilia.toccaceli@iss.it.
authors.forename: Virgilia
authors.initials: V
authors.lastname: Toccaceli
authors.affiliation: DIMES - Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy; C.I.G. - Interdepartmental Centre "L. Galvani", University of Bologna, Piazza di Porta San Donato 1, 40126 Bologna, Italy. Electronic address: maria.scurti@unibo.it.
authors.forename: Maria
authors.initials: M
authors.lastname: Scurti
authors.affiliation: Italian National Institute of Aging, INRCA, Contrada Muoio Piccolo, 87100 Cosenza, Italy. Electronic address: v.mari@inrca.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mari
authors.affiliation: Department of Biology, Ecology and Earth Science, University of Calabria, 87036 Rende, Italy. Electronic address: mberardelli@libero.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Berardelli
authors.affiliation: Department of Biology, Ecology and Earth Science, University of Calabria, 87036 Rende, Italy. Electronic address: g.passarino@unical.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Passarino
authors.affiliation: Epidemiology, Danish Ageing Research Center, Institute of Public Health, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark. Electronic address: BJeune@health.sdu.dk.
authors.forename: Bernard
authors.initials: B
authors.lastname: Jeune
authors.affiliation: DIMES - Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy; C.I.G. - Interdepartmental Centre "L. Galvani", University of Bologna, Piazza di Porta San Donato 1, 40126 Bologna, Italy. Electronic address: claudio.franceschi@unibo.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Franceschi
mesh_terms: D000369:Aged, 80 and over; D016208:Databases, Factual; D005192:Family Health; D005260:Female; D005843:Geography; D006304:Health Status; D006801:Humans; D007558:Italy; D008136:Longevity; D008297:Male; D010641:Phenotype; D012306:Risk; D012737:Sex Factors; D035781:Siblings
keywords: Gender; Health status classification; Longevity; Mortality; Oldest old