title: Successful Aging among Elders Living in the Mani Continental Region vs. Insular Areas of the Mediterranean: the MEDIS Study.
abstract: To evaluate the role of geography i.e., continental vs. insular Mediterranean, on successful aging among older inhabitants. During 2005-2014, 2693 elderly (aged 65 to 100 years) individuals from 21 Mediterranean islands in Greece, Italy and Spain as well as Cyprus, Malta, and the rural region of Mani (southeast continental region of Greece keeping old-time traditions), were voluntarily recruited. Successful aging was evaluated using a validated index composed of 10 health-related socio-lifestyle and clinical characteristics. After accounting for age, sex, body mass index (BMI), physical activity, smoking habits, MedDietScore and access to health care services, the older inhabitants of islands were found to have a higher level of the successful aging index when compared to their counterparts in Mani (Beta=0.174, p<0.001); moreover, islanders exhibited slightly more years of "good" health (68.7 vs 68.4 years for Mani residents (p=0.99)). However, compared to the residents of Mani, islanders had 1.64 times higher odds (95%CI, 1.08-2.48) for having hypertension, 2.4-times higher odds (95%CI, 1.34-4.21) for having diabetes and 1.52 times higher odds (95%CI, 0.97-2.38) for having hypercholesterolemia. Engaging in physical activities and healthy dietary habits were the major determinants of healthy aging, among islanders as compared to their counterparts of continental Mani region. Elder residents of the continental Mani area enjoyed a better health status, whereas elder islanders had a higher level of successful aging; a finding which could be attributed to differences in lifestyle among elders.
authors.affiliation: 1Health Center of Areopolis, General Hospital of Sparta, Areopolis, Greece.
authors.forename: Anargiros
authors.initials: A
authors.lastname: Mariolis
authors.affiliation: 2Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Foscolou
authors.affiliation: 2Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; 3Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Stefanos
authors.initials: S
authors.lastname: Tyrovolas
authors.affiliation: 4University of Malta, Nutrition, Family and Consumer Studies Office, Msida, Republic of Malta.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Piscopo
authors.affiliation: 5Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Valacchi
authors.affiliation: 6Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Tsakountakis
authors.affiliation: 7Health Center of Kalloni, General Hospital of Mitilini, Mitilini, Greece.
authors.forename: Akis
authors.initials: A
authors.lastname: Zeimbekis
authors.affiliation: 2Department 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: 2Department 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: 2Department 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: 2Department 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: 8Research Group on Community Nutrition and Oxidative Stress, Universitat de les Illes Balears & CIBERobn, E-07122 Palma de Mallorca, Spain.
authors.forename: Josep-Antoni
authors.initials: JA
authors.lastname: Tur
authors.affiliation: 2Department 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: 6Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
authors.affiliation: 2Department 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: 1Health Center of Areopolis, General Hospital of Sparta, Areopolis, Greece.
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Panagiotakos
keywords: Mani region; Mediterranean islands; cardiometabolic risk; lifestyle; longevity; successful aging