title: Successful aging, dietary habits and health status of elderly individuals: a k-dimensional approach within the multi-national MEDIS study.
abstract: The definition and determinants of successful aging is still controversial. Although dietary habits have long been associated with aging, eating habits and behaviors have rarely been included in various proposed indices of successful aging. The aim of this work was to evaluate determinants of successful aging together with assessment of dietary habits in relation to healthcare facility use among elders living in the Mediterranean basin. During 2005-2011, 2663 elderly (aged 65-100 years) individuals from 21 Mediterranean islands and rural Mani region (Peloponnesus) were voluntarily enrolled in the study. A successful aging index ranging from a score of 0 to a score of 10 was constructed using 10 attributes, i.e., education, financial status, physical activity, body mass index, depression, participation in social activities with friends and family, number of yearly excursions, number of cardiovascular disease risk factors and adherence to the Mediterranean diet. The applied factor analysis on the components of the index extracted three main components for successful aging: psychosocial-economic, bioclinical and lifestyle; confirming the multiple dimensions of aging. After adjusting for confounders, a 1/10-unit increase in the successful aging index was associated with 0.8 less annual visits to healthcare centers (95% CI -1.3 to-0.2). Stratified analysis by gender revealed heterogeneity of factors predicting successful aging. These findings suggest that successful aging is a multidimensional and complex concept that exhibits gender heterogeneity. Annual use of health care services by the elders was found to be related to level of successful aging.
authors.affiliation: Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: Stefanos
authors.initials: S
authors.lastname: Tyrovolas
authors.affiliation: Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.affiliation: Health Center of Aeropolis, General Hospital of Sparta, Aeropolis, Greece.
authors.forename: Anargiros
authors.initials: A
authors.lastname: Mariolis
authors.affiliation: University of Malta, Nutrition, Family and Consumer Studies Office, Msida, Republic of Malta.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Piscopo
authors.affiliation: Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Valacchi
authors.affiliation: Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Tsakountakis
authors.affiliation: Health Center of Kalloni, General Hospital of Mitilini, Mitilini, Greece.
authors.forename: Akis
authors.initials: A
authors.lastname: Zeimbekis
authors.affiliation: Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: Dimitra
authors.initials: D
authors.lastname: Tyrovola
authors.affiliation: Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Bountziouka
authors.affiliation: Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: Efthimios
authors.initials: E
authors.lastname: Gotsis
authors.affiliation: Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Metallinos
authors.affiliation: Research Group on Community Nutrition and Oxidative Stress, Universitat de les Illes Balears & CIBERobn, Guillem Colom Bldg, Campus, E-07122 Palma de Mallorca, Spain.
authors.forename: Josep-Antoni
authors.initials: JA
authors.lastname: Tur
authors.affiliation: Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: Antonia-Leda
authors.initials: AL
authors.lastname: Matalas
authors.affiliation: Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
authors.affiliation: Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Polychronopoulos
authors.affiliation: Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece. Electronic address: dbpanag@hua.gr.
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Panagiotakos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D038441:Diet, Mediterranean; D005247:Feeding Behavior; D005260:Female; D006115:Greece; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008521:Mediterranean Islands
keywords: Dietary habits; Health; Mediterranean; Older adults; Successful aging