Late-life factors associated with healthy aging in older men.
OBJECTIVE
To identify potentially modifiable late-life biological, lifestyle, and sociodemographic factors associated with overall and healthy survival to age 85.


METHODS
Prospective longitudinal cohort study with 21 years of follow-up (1991-2012).


METHODS
Hawaii Lifespan Study.


METHODS
American men of Japanese ancestry (mean age 75.7, range 71-82) without baseline major clinical morbidity and functional impairments (N = 1,292).


METHODS
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.


CONCLUSIONS
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.
Department of Geriatric Medicine, John A. Hartford Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.
Christina L
CL
Bell
Randi
R
Chen
Kamal
K
Masaki
Priscilla
P
Yee
Qimei
Q
He
John
J
Grove
Timothy
T
Donlon
J David
JD
Curb
D Craig
DC
Willcox
Leonard W
LW
Poon
Bradley J
BJ
Willcox
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005500:Follow-Up Studies; D005544:Forecasting; D006254:Hawaii; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008019:Life Style; D008136:Longevity / Q000502:physiology*; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D016019:Survival Analysis
healthy aging; late-life; longevity; longitudinal cohort study; risk factors