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Azzolino D, Rodrigues GD, Manzini VM, Proietti M, Arosio B, Montano N, Cesari M. Clinical research on extreme longevity: The FACET experience. Ageing Res Rev 2024; 93:102170. [PMID: 38101548 DOI: 10.1016/j.arr.2023.102170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
People with extreme longevity represent a unique model to study the biology of aging. Unfortunately, their inclusion in research projects is challenging with the consequent lack of evidence and the need to rely on small convenience samples. Given the growing global aging population, especially in the segment of the oldest old (i.e., aged 90 and older), research in this population has become crucial. Furthermore, by studying the characteristics of extremely longeval persons, it might be possible to 1) better understand the mechanisms of aging, and 2) identify endogenous or exogenous factors contributing to a long life. The design and implementation of research activities in the oldest people need special consideration and a pragmatic approach. Possible implementable solutions and suggestions are provided from experience gained during the conduction of the FAtigue in CEnTenarians (FACET) study.
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Affiliation(s)
- Domenico Azzolino
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
| | | | | | - Marco Proietti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Division of Subacute Care IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Beatrice Arosio
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Vargese SS, Jylhä M, Raitanen J, Enroth L, Halonen P, Aaltonen M. Dementia-related disability in the population aged 90 years and over: differences over time and the role of comorbidity in the vitality 90 + study. BMC Geriatr 2023; 23:276. [PMID: 37149593 PMCID: PMC10163713 DOI: 10.1186/s12877-023-03980-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/18/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND The burden of dementia, multimorbidity, and disability is high in the oldest old. However, the contribution of dementia and comorbidities to functional ability in this age group remains unclear. We examined the combined effects of dementia and comorbidities on ADL and mobility disability and differences between dementia-related disability between 2001, 2010, and 2018. METHODS Our data came from three repeated cross-sectional surveys in the population aged 90 + in the Finnish Vitality 90 + Study. The associations of dementia with disability and the combined effects of dementia and comorbidity on disability adjusted for age, gender, occupational class, number of chronic conditions, and study year were determined by generalized estimating equations. An interaction term was calculated to assess differences in the effects of dementia on disability over time. RESULTS In people with dementia, the odds of ADL disability were almost five-fold compared to people with three other diseases but no dementia. Among those with dementia, comorbidities did not increase ADL disability but did increase mobility disability. Differences in disability between people with and without dementia were greater in 2010 and 2018 than in 2001. CONCLUSION We found a widening gap in disability between people with and without dementia over time as functional ability improved mainly in people without dementia. Dementia was the main driver of disability and among those with dementia, comorbidities were associated with mobility disability but not with ADL disability. These results imply the need for strategies to maintain functioning and for clinical updates, rehabilitative services, care planning, and capacity building among care providers.
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Affiliation(s)
- Saritha Susan Vargese
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland.
- Believers Church Medical College Hospital, Thiruvalla, India.
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
| | - Pauliina Halonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
| | - Mari Aaltonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University Hospital, Tampere, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Functional Aging: Integrating Functionality to a Multidimensional Assessment of Healthy Aging. Curr Gerontol Geriatr Res 2023; 2023:9409918. [PMID: 36748046 PMCID: PMC9899138 DOI: 10.1155/2023/9409918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/15/2022] [Accepted: 01/20/2023] [Indexed: 01/29/2023] Open
Abstract
Worldwide, the number of old adults will peak in the coming decades. Relying solely on the chronological age to make treatment decisions and shape general or specific societal and medical considerations may reinforce ageism and lead to flawed reasoning. Defining physiological age using biological markers is not yet reliable, and an approach based on comorbidities without considering their impact on quality of life is inadequate. A multidimensional approach with strong integration of functionality is presented here to draw a real-world aging approach, easily accessible, clinically relevant, and of societal value.
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Rasmussen SH, Gill S, Jeune B, Nybo M, Christensen K, Andersen-Ranberg K. Improved cardiovascular profile in Danish centenarians? A comparative study of two birth cohorts born 20 years apart. Eur Geriatr Med 2022; 13:977-986. [PMID: 35218555 DOI: 10.1007/s41999-022-00620-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/31/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Cardiovascular health among middle-aged and older people has improved in high-income countries. It is unknown whether this also applies for the oldest-old and if so, is it driven by better treatment or by a health improvement? Therefore, we compared two Danish centenarian birth cohorts born in 1895 and 1915, respectively, to investigate if the cardiovascular profile had improved in the most recent born cohort. METHODS All individuals turning 100 years old in 1995 and 2015, respectively, were included with participation rates of 74% (n = 106) and 79% (n = 238), respectively. Data were collected through structured in-home interviews. Cardiovascular profile was obtained by measured blood pressure, electrocardiogram (ECG), and information on medication. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg. RESULTS Mean SBP and DBP were almost identical in the two cohorts. Yet, the prevalence of measured hypertension was non-significantly higher in the 1895 cohort [73%, 95% CI (61;82)] compared to the 1915 cohort [63%, 95% CI (55;70)]. The proportion receiving at least one type of cardiovascular drug was significantly higher in the 1915 cohort [80%, 95% CI (74;86)] compared to 1895 cohort [66%, 95% CI 55;76)]. ECG findings were similar in the two cohorts, e.g., atrial fibrillation was present in 17% of the 1895 cohort and 20% of the 1915 cohort. CONCLUSION This comparison study found a non-significant improvement in measured hypertension irrespective of medical treatment in the recent born cohort. Also, the recent born cohort was treated more intensively with cardiovascular drugs than earlier. However, the prevalence of pathological ECG-findings was unchanged.
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Affiliation(s)
- Signe Høi Rasmussen
- Department of Public Health, Danish Aging Research Center, University of Southern Denmark, J. B. Winsloews Vej 9B, 5000, Odense C, Denmark.
- Department of Geriatrics, Odense University Hospital, Odense, Denmark.
| | - Sabine Gill
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Bernard Jeune
- Department of Public Health, Danish Aging Research Center, University of Southern Denmark, J. B. Winsloews Vej 9B, 5000, Odense C, Denmark
| | - Mads Nybo
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Kaare Christensen
- Department of Public Health, Danish Aging Research Center, University of Southern Denmark, J. B. Winsloews Vej 9B, 5000, Odense C, Denmark
- Max-Planck Odense Center on the Biodemography of Aging, University of Southern Denmark, Odense, Denmark
| | - Karen Andersen-Ranberg
- Department of Public Health, Danish Aging Research Center, University of Southern Denmark, J. B. Winsloews Vej 9B, 5000, Odense C, Denmark
- Department of Geriatrics, Odense University Hospital, Odense, Denmark
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Bloomberg M, Dugravot A, Landré B, Britton A, Steptoe A, Singh-Manoux A, Sabia S. Sex differences in functional limitations and the role of socioeconomic factors: a multi-cohort analysis. THE LANCET. HEALTHY LONGEVITY 2021; 2:e780-e790. [PMID: 34901907 PMCID: PMC8636280 DOI: 10.1016/s2666-7568(21)00249-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Women are more likely to have functional limitations than are men, partly because of greater socioeconomic disadvantage. However, how sex differences vary by severity of functional limitations remains unclear. We examined sex differences in functional limitations, with attention to socioeconomic factors and severity of limitations. METHODS Longitudinal data on limitations in basic activities of daily living (ADL) and instrumental activities of daily living (IADL) and mobility activities were drawn from 62 375 participants from 14 countries. For ADL, IADL, and mobility, participants were categorised based on number of limited activities (0, 1, 2, or ≥3). Sex differences in limitations in four birth cohorts (1895-1929, 1930-38, 1939-45, and 1946-60) were analysed before and after adjustment for socioeconomic factors (education and labour force status). FINDINGS The prevalence of IADL and ADL limitations was higher in women than in men. After adjustment for socioeconomic factors, this sex difference was attenuated. The sex difference in IADL limitations at age 75 years (in the 1895-1929 cohort) was 3·7% before adjustment for socioeconomic factors (95% CI 2·6-4·7) and 1·7% (1·1-2·2) after adjustment. For ADL, the sex difference in limitations at age 75 years (in the 1895-1929 cohort) was 3·2% (2·3-4·1) before adjustment for socioeconomic factors and 1·4% (0·9-1·8) after adjustment. Sex differences in mobility limitations (16·1%, 95% CI 14·4-17·7) remained after adjustment for socioeconomic factors (14·3%, 12·7-15·9). After age 85 years, women were more likely to have three or more IADL or mobility limitations and men were more likely to have one or two limitations. INTERPRETATION Socioeconomic factors largely explain sex differences in IADL and ADL limitations but not mobility. Sex differences in mobility limitations in midlife are important targets for future research and interventions. FUNDING National Institute on Aging, UK National Institute for Health Research, European Commission, and US Social Security Administration.
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Affiliation(s)
- Mikaela Bloomberg
- Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, University College London, London, UK
| | - Aline Dugravot
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Benjamin Landré
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Annie Britton
- Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, University College London, London, UK
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Séverine Sabia
- Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, University College London, London, UK
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
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Fu S, Ping P, Li Y, Li B, Zhao Y, Yao Y, Zhang P. Centenarian longevity had inverse relationships with nutritional status and abdominal obesity and positive relationships with sex hormones and bone turnover in the oldest females. J Transl Med 2021; 19:436. [PMID: 34663361 PMCID: PMC8522151 DOI: 10.1186/s12967-021-03115-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/09/2021] [Indexed: 01/13/2023] Open
Abstract
Objective The number of older people is estimated to increase from 524 million in 2010 to 1.5 billion in 2050. The factors and models of human longevity and successful aging are questions that have intrigued individuals for thousands of years. For the first time, the current study was designed to investigate the relationships between sex hormones, bone turnover, abdominal obesity, nutritional status and centenarian longevity in the oldest females. Methods The China Hainan Centenarian Cohort Study was performed in 18 cities and counties of Hainan Province using standard methodology in 500 centenarian females and 237 oldest females aged between 80 and 99 years. Results Centenarians were inversely associated with the geriatric nutritional risk index [Exp(B) (95% CI): 0.901 (0.883–0.919)] and abdominal obesity [Exp(B) (95% CI): 0.719 (0.520–0.996)] and positively associated with prolactin [Exp(B) (95% CI): 1.073 (1.044–1.103)], progesterone [Exp(B) (95% CI): 44.182 (22.036–88.584)], estradiol [Exp(B) (95% CI): 1.094 (1.071–1.119)], osteocalcin [Exp(B) (95% CI): 1.041 (1.028–1.054)], β-crossLaps [Exp(B) (95% CI): 63.141 (24.482–162.848)] and parathyroid [Exp(B) (95% CI): 1.022 (1.013–1.031)] hormone levels (P < 0.05 for all). The geriatric nutritional risk index and abdominal obesity were inversely associated with luteinizing hormone [β coefficient (95% CI): − 0.001 (− 0.002 to 0.001)]; Exp(B) (95% CI): 0.985 (0.974–0.996)], follicle-stimulating hormone [β coefficient (95% CI): 0.000 (− 0.001 to 0.000)]; Exp(B) (95% CI): 0.990 (0.985–0.996)], osteocalcin [β coefficient (95% CI): − 0.001 (− 0.001 to 0.000)]; Exp(B) (95% CI): 0.987(0.977–0.997)] and β-crossLaps [β coefficient (95% CI): − 0.100 (− 0.130 to 0.071)]; Exp(B) (95% CI): 0.338 (0.166–0.689)] levels (P < 0.05 for all). Conclusions Centenarian longevity had inverse relationships with nutritional status and abdominal obesity and positive relationships with sex hormones and bone turnover. Nutritional status and abdominal obesity had inverse relationships with sex hormones and bone turnover. Increased sex hormones and bone turnover may be representative of centenarian longevity. Optimizing nutritional status and avoiding abdominal obesity may increase sex hormones and bone turnover and promote centenarian longevity and successful aging.
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Affiliation(s)
- Shihui Fu
- Cardiology Department, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China. .,Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Ping Ping
- Pharmacy Department, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yulong Li
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Bo Li
- Cardiology Department, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Yao Yao
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.
| | - Pei Zhang
- School of Life Science, Beijing Institute of Technology, Beijing, China.
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Song Y, Liu M, Jia WP, Han K, Wang SS, He Y. The association between nutritional status and functional limitations among centenarians: a cross-sectional study. BMC Geriatr 2021; 21:376. [PMID: 34154543 PMCID: PMC8218470 DOI: 10.1186/s12877-021-02312-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/02/2021] [Indexed: 11/25/2022] Open
Abstract
Background Although there have been studies on the association between nutritional status and functional limitations, there were few studies on Asian centenarians in community. Therefore, this study aims to identify associations between nutritional status and functional limitations among centenarians in China. Methods This cross-sectional study was conducted with the data from the China Hainan Centenarian Cohort Study. These data ultimately included basic characteristics, hematologic indicators, and chronic disease status for 1,002 centenarians. The nutritional status was evaluated using the Mini Nutritional Assessment Short-Form scale. The functional limitations were assessed using the activities of daily living (ADL) scale, namely Barthel Index and Lawton Scale. The association between nutritional status and ADL was assessed using multivariate logistic regression models. Results In this study, the prevalence of malnutrition was 20.8 % among centenarians, basic ADL (BADL) limitation was 28.6 %, and instrumental ADL (IADL) limitation was 64.7 %. As the nutritional status deteriorated, the risk of ADL limitations increased in total population (BADL limitation: OR = 17.060, 95 % CI: 8.093-35.964; IADL limitation: OR = 11.221, 95 % CI: 5.853-21.511; p for trend < 0.001). Similar results were found in both men and women after stratifying sex but were more prominent in women. Conclusions Malnutrition is associated with functional limitations among centenarians in China and more pronounced among women.
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Affiliation(s)
- Yang Song
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.,Graduate school of Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Miao Liu
- Graduate school of Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Wang-Ping Jia
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.,Graduate school of Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Ke Han
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.,Graduate school of Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Sheng-Shu Wang
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China
| | - Yao He
- Institute of geriatrics, the 2nd Medical Center, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, 28 Fuxing Road, 100853, Beijing, China.
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Cachioni M, Cipolli GC, Borim FSA, Batistoni SST, Yassuda MS, Neri AL, Paúl C. Factors Associated With Positive Self-Rated Health: Comparing Older Adults in Brazil and in Portugal. Front Public Health 2021; 9:650294. [PMID: 33869133 PMCID: PMC8044971 DOI: 10.3389/fpubh.2021.650294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/01/2021] [Indexed: 01/22/2023] Open
Abstract
Introduction: Self-rated health is a multidimensional health indicator and a predictor of adverse events in old age. Answers to this assessment are influenced by social, cultural and personality factors. Aim: Exploring common and distinctive characteristics of Brazilian and Portuguese older adults aged 70 and over regarding positive self-rated health according to sociodemographic variables, to functional capacity, to independent performance of basic activities of daily living and to neuroticism, as well as analyzing associations between positive self-rated health and these variables. Methods: The present paper is a comparative and cross-sectional study based on secondary data contained in the databases of the FIBRA (Frailty in Brazilian Older Adults) follow-up study, with 418 Brazilian older adults, and of the DIA (From Disability to Activity: The Challenge of Aging) study, with 380 Portuguese older adults. Both samples had higher percentages of women: 68.4% for Portugal and 69.9% for Brazil. The Brazilian sample had a higher average age (80.31 ± 4.67) than the Portuguese sample (76.80 ± 5.28). Results: The Portuguese older adults had better overall cognition scores, higher handgrip strength and higher neuroticism values than the Brazilian older adults. In the simple and multiple logistic regression analyses, it was found that among Brazilian older adults, subjects with higher scores in the MMSE (OR 1.16; 95% CI 1.08-1.24), regardless of ADL performance (OR 2.13; 95% CI 1.31-3.47) and with scores 24-29 (OR 1.92; 95% CI 1.07-3.43) or 11-23 (OR 2.09; 95% CI 1.15-3.79) in neuroticism were more likely to assess their health as very good/good. On the other hand, the Portuguese older adults with intermediate 24-9 (OR 2.38; 95% CI 1.31-4.33) or low 11-23 (OR 5.31; 95% CI 2.69-10.45) scores in neuroticism were more likely to evaluate their health as very good/good. Conclusion: Based on the findings of the present study and on the existing literature, it may be said that it is possible for people to age while keeping a positive perception of their own health, even in advanced old age; comparisons between the above-mentioned countries, however, point to the need for investments in healthcare systems so that older adults may enjoy greater physical independence and improved mental health.
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Affiliation(s)
- Meire Cachioni
- University of São Paulo, São Paulo, São Paulo, Brazil.,Institute of Biomedical Sciences Abel Salazar (ICBAS), Center for Research in Health Technologies and Services (CINTESIS), University of Porto, Porto, Portugal
| | | | | | | | | | - Anita Liberalesso Neri
- Graduate Studies in Gerontology, State University of Campinas, Campinas, São Paulo, Brazil
| | - Constança Paúl
- Institute of Biomedical Sciences Abel Salazar (ICBAS), Center for Research in Health Technologies and Services (CINTESIS), University of Porto, Porto, Portugal
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Enroth L, Raitanen J, Halonen P, Tiainen K, Jylhä M. Trends of Physical Functioning, Morbidity, and Disability-Free Life Expectancy Among the Oldest Old: Six Repeated Cross-Sectional Surveys Between 2001 and 2018 in the Vitality 90+ Study. J Gerontol A Biol Sci Med Sci 2020; 76:1227-1233. [PMID: 32506117 DOI: 10.1093/gerona/glaa144] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It remains unclear whether increasing longevity is accompanied by a compression or expansion of poor health and disability. We examined trends of physical functioning and morbidity in a population aged 90 and older, and disease- and disability-free life expectancy (LE) at age 90 between 2001 and 2018 in Finland's third most populated city. METHODS We used survey data from the Vitality 90+ Study, which comprises a series of six repeated mailed surveys (7,590 observations). Information on mortality came from Statistics Finland. We examined trends of functioning (activities of daily living [ADL] and mobility) and cardiovascular and dementia morbidity using age-adjusted generalized estimating equation models stratified by sex. In addition, age-, sex-, and period-specific health expectancies were calculated using Sullivan's method. RESULTS Over time, functioning improved, especially, in women, and morbidity increased in men. From 2001 to 2018, LE at age 90 increased by 5.3 months for men and 6.4 months for women. LE without ADL disability increased by 5.0 months for men and 8.4 months for women, and LE without mobility disability by 6.0 months for men and 4.4 months for women. LE without cardiovascular and dementia morbidity decreased for men (2.6 months) and increased for women (1.9 months). CONCLUSIONS In relative terms, we found a compression of disability for both sexes and an expansion of morbidity for men. Although the trends overall are rather positive, the increase in absolute morbidity and, to some extent, in disability will inevitably mean increasing care needs with population aging.
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Affiliation(s)
- Linda Enroth
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
| | - Jani Raitanen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Pauliina Halonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
| | - Kristina Tiainen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center, Tampere University, Finland
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Dupraz J, Andersen-Ranberg K, Fors S, Herr M, Herrmann FR, Wakui T, Jeune B, Robine JM, Saito Y, Santos-Eggimann B. Use of healthcare services and assistive devices among centenarians: results of the cross-sectional, international5-COOP study. BMJ Open 2020; 10:e034296. [PMID: 32209627 PMCID: PMC7202712 DOI: 10.1136/bmjopen-2019-034296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To measure the use of healthcare services and assistive devices by centenarians in five countries. DESIGN Cross-sectional study using a survey questionnaire. SETTING Community-dwelling and institutionalised centenarians living in Japan, France, Switzerland, Sweden and Denmark. PARTICIPANTS 1253 participants aged 100 or in their 100th year of life, of whom 1004 (80.1%) were female and 596 (47.6%) lived in institutions. MAIN OUTCOME MEASURES Recent use of medical visits, nursing care at home, home-delivered meals, acute care hospital stays overnight, professional assessments such as sight tests, mobility aids and other assistive devices. A set of national healthcare system indicators was collected to help interpret differences between countries. RESULTS There was considerable variability in the healthcare services and assistive devices used by centenarians depending on their country and whether they were community-dwelling or institutionalised. In contrast to the relatively homogeneous rates of hospitalisation in the past year (around 20%), community-dwelling centenarians reported widely ranging rates of medical visits in the past 3 months (at least one visit, from 32.2% in Japan to 86.6% in France). The proportion of community-dwellers using a mobility device to get around indoors (either a walking aid or a wheelchair) ranged from 48.3% in Japan to 79.2% in Sweden. Participants living in institutions and reporting the use of a mobility device ranged from 78.6% in Japan to 98.2% in Denmark. CONCLUSIONS Our findings suggest major differences in care received by centenarians across countries. Some may result from the characteristics of national healthcare systems, especially types of healthcare insurance coverage and the amounts of specific resources available. However, unexplored factors also seem to be at stake and may be partly related to personal health and cultural differences.
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Affiliation(s)
- Julien Dupraz
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Karen Andersen-Ranberg
- Epidemiology and Biostatistics, Institute of Public Health, and Danish Aging Research Centre, University of Southern Denmark, Odense, Denmark
- Department of Geriatrics, Odense University Hospital, Odense, Denmark
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Marie Herr
- U1168, VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, INSERM, Villejuif, France
- UMR-S 1168, Université de Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France
- Département Hospitalier d'Epidémiologie et Santé Publique, Hôpitaux Universitaires Paris Ile-de-France Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Francois R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Tomoko Wakui
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Bernard Jeune
- Epidemiology and Biostatistics, Institute of Public Health, and Danish Aging Research Centre, University of Southern Denmark, Odense, Denmark
| | - Jean-Marie Robine
- MMDN, Université de Montpellier, EPHE, INSERM, U1198, PSL Research University, Montpellier, France
| | - Yasuhiko Saito
- College of Economics and Population Research Institute, Nihon University, Tokyo, Japan
| | - Brigitte Santos-Eggimann
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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11
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Jia W, Wang S, Han K, Liu M, Yang S, Cao W, He Y. Association of Anemia with Activities of Daily Living in Chinese Female Centenarian. J Nutr Health Aging 2020; 24:346-351. [PMID: 32115618 DOI: 10.1007/s12603-020-1326-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Although anemia and activities of daily living (ADL) disability in female elderly are common conditions and are more likely to occur as people age, little is known about the association of anemia with ADL in female centenarians. The objective of this study was to examine the relationship between anemia and ADL disability in Chinese female centenarians. DESIGN, SETTING AND PARTICIPANTS We conducted a population-based cross-sectional study of a sample of 822 Chinese female centenarians from 2014 to 2016. MEASUREMENTS Blood analysis, home interview, and physical examination were performed following standard procedures. ADL disability was defined as a Barthel Index total score≤60. RESULTS The prevalence of anemia and ADL disability were 66.8% and 29.7% respectively in Chinese female centenarians. Multiple logistic regression analyses revealed that inflammation (OR = 2.280, 95% CI, 1.524-3.410), underweight (OR = 1.653, 95% CI, 1.186-2.303), anemia (OR = 1.775, 95% CI, 1.250-2.521), and living with family (OR = 0.518, 95% CI, 0.302-0.888) were significant factors related to ADL disability. Centenarians with severe anemia had an approximately fourfold greater likelihood of ADL disability than those without anemia (OR =3.747; 95% CI 1.525-9.206). An apparent dose-response relationship was found between anemia and ADL disability. CONCLUSION These findings may provide some insights into targeted intervention for maintaining ADL independence in female centenarians, especially encouraging the interventions of anemia to improve ADL.
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Affiliation(s)
- W Jia
- Yao He, Institute of geriatrics, the 2nd Medical Center, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Chinese PLA General Hospital, Beijing, China, ; Tel.: 86-10-66876411
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12
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Scheel-Hincke LL, Möller S, Lindahl-Jacobsen R, Jeune B, Ahrenfeldt LJ. Cross-national comparison of sex differences in ADL and IADL in Europe: findings from SHARE. Eur J Ageing 2019; 17:69-79. [PMID: 32158373 DOI: 10.1007/s10433-019-00524-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Women experience greater longevity than men, but have poorer health, although sex differences vary across health measures and geographical regions. We aim to examine sex differences in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) over age across European regions in a cross-sectional setting including 51,292 men and 62,007 women aged 50+ from a pooled sample of waves 1 (2004-2005) to 6 (2015) in the Survey of Health, Ageing and Retirement in Europe. ADL and IADL were dichotomised into no limitations and at least one limitation. Binomial regression models were used to estimate absolute and relative sex differences. Women had higher risk than men of ADL limitations (RR = 1.21, 95% CI 1.16; 1.27) and IADL limitations (RR = 1.54, 95% CI 1.48; 1.60), corresponding to risk differences of 1.3% and 5.7%, respectively. When we stratified by age groups and regions, sex differences in ADL were found in all age groups in Southern Europe, in the age groups 65-79 years and 80+ years in Western and Eastern Europe, and from the age of 80 in Northern Europe. For IADL, sex differences were found in all age groups in the four European regions, except from ages 50-64 in Eastern Europe. The absolute sex differences increased with age in all European regions. In conclusion, our results lend support for the male-female health survival paradox by showing that European women have higher risk of ADL and IADL limitations than European men and that sex differences increase with advancing age.
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Affiliation(s)
- Lasse Lybecker Scheel-Hincke
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| | - Sören Möller
- 2OPEN - Odense Patient data Explorative Network, Odense University Hospital, 5000 Odense, Denmark.,3Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Rune Lindahl-Jacobsen
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| | - Bernard Jeune
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| | - Linda Juel Ahrenfeldt
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
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13
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Medford A, Christensen K, Skytthe A, Vaupel JW. A Cohort Comparison of Lifespan After Age 100 in Denmark and Sweden: Are Only the Oldest Getting Older? Demography 2019; 56:665-677. [PMID: 30659510 PMCID: PMC6449298 DOI: 10.1007/s13524-018-0755-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although Denmark and Sweden have close cultural and historical ties, lifespans for Danes have generally been lower than those of Swedes. Recent improvements in Danish mortality after a period of stagnation have led to the suspicion that there may be positive trends at the very high ages at death within that population and that these trends could be quite different from those observed in Sweden. Although the mean ages at death for Danish and Swedish centenarians have been relatively constant at about 102 years for the cohorts born 1870-1904, the oldest-old in Denmark have been getting older, but no evidence has suggested any increase in lifespan for Swedes. Using quantile regression, we show that Danish centenarian lifespans in the 90th percentile have been lengthening, with those in 94th percentile (6 % longest-lived individuals) having a trend that is statistically significant at the 5 % level. We demonstrate that the increase observed is not due to the increasing sizes of birth cohorts and thus must be due to improving survival among this select top tier. We postulate that this super-select group in Denmark is best able to take advantage of the factors driving mortality reduction, whereas the majority of centenarians are not.
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Affiliation(s)
- Anthony Medford
- Interdisciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark.
| | - Kaare Christensen
- Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Axel Skytthe
- Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - James W Vaupel
- Interdisciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark
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Abstract
Exceptional longevity represents an extreme phenotype. Current centenarians are survivors of a cohort who display delayed onset of age-related diseases and/or resistance to otherwise lethal illnesses occurring earlier in life. Characteristics of aging are heterogeneous, even among long-lived individuals. Associations between specific clinical or genetic biomarkers exist, but there is unlikely to be a single biomarker predictive of long life. Careful observations in the oldest old offer some empirical strategies that favor increased health span and life span, with implications for compression of disability, identification and implementation of lifestyle behaviors that promote independence, identification and measurement of more reliable markers associated with longevity, better guidance for appropriate health screenings, and promotion of anticipatory health discussions in the setting of more accurate prognostication. Comprehensive PubMed literature searches were performed, with an unbiased focus on mechanisms of longevity. Overall, the aggregate literature supports that the basis for exceptional longevity is multifactorial and involves disparate combinations of genes, environment, resiliency, and chance, all of which are influenced by culture and geography.
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Affiliation(s)
- Robert J Pignolo
- Division of Geriatric Medicine and Gerontology, Mayo Clinic, Rochester, MN.
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15
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[The purpose and findings of international corroboration study of centenarian]. Nihon Ronen Igakkai Zasshi 2018; 55:570-577. [PMID: 30542022 DOI: 10.3143/geriatrics.55.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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