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Predictors of Independent Aging and Survival: A 16-Year Follow-Up Report in Octogenarian Men
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.ORCID iD: 0000-0002-4421-6466
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics. Med Prod Agcy, Uppsala, Sweden.
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2017 (English)In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 65, no 9, p. 1953-1960Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To examine the longitudinal associations between aging with preserved functionality, i.e. independent aging and survival, and lifestyle variables, dietary pattern and cardiovascular risk factors.

DESIGN: Cohort study.

SETTING: Uppsala Longitudinal Study of Adult Men, Sweden.

PARTICIPANTS: Swedish men (n = 1,104) at a mean age of 71 (range 69.4-74.1) were investigated, 369 of whom were evaluated for independent aging 16 years later, at a mean age of 87 (range 84.8-88.9).

MEASUREMENTS: A questionnaire was used to obtain information on lifestyle, including education, living conditions, and physical activity. Adherence to a Mediterranean-like diet was assessed according to a modified Mediterranean Diet Score derived from 7-day food records. Cardiovascular risk factors were measured. Independent aging at a mean age of 87 was defined as lack of diagnosed dementia, a Mini-Mental State Examination score of 25 or greater, not institutionalized, independence in personal activities of daily living, and ability to walk outdoors alone. Complete survival data at age 85 were obtained from the Swedish Cause of Death Register.

RESULTS: Fifty-seven percent of the men survived to age 85, and 75% of the participants at a mean age of 87 displayed independent aging. Independent aging was associated with never smoking (vs current) (odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.05-4.60) and high (vs low) adherence to a Mediterranean-like diet (OR = 2.69, 95% CI = 1.14-6.80). Normal weight or overweight and waist circumference of 102 cm or less were also associated with independent aging. Similar associations were observed with survival.

CONCLUSION: Lifestyle factors such as never smoking, maintaining a healthy diet, and not being obese at age 71 were associated with survival and independent aging at age 85 and older in men.

Place, publisher, year, edition, pages
2017. Vol. 65, no 9, p. 1953-1960
Keywords [en]
Mediterranean diet, healthy aging, longitudinal, obesity, smoking
National Category
Geriatrics Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:uu:diva-334423DOI: 10.1111/jgs.14971ISI: 000411060500016PubMedID: 28685810OAI: oai:DiVA.org:uu-334423DiVA, id: diva2:1159602
Available from: 2017-11-23 Created: 2017-11-23 Last updated: 2019-03-26Bibliographically approved
In thesis
1. Independent Ageing in Very Old Swedish Men
Open this publication in new window or tab >>Independent Ageing in Very Old Swedish Men
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Predictors for survival have been investigated thoroughly, but less is known about how to reach high age with preserved physical and cognitive function. These functions are crucial to stay independent in daily life, which is highly valued by the oldest old.

This thesis was based on data from the Uppsala Longitudinal Study in Adult Men. In 1970, all men born in 1920-24 and living in Uppsala were invited to the study, and 82% (n=2,322) participated in the first investigation. In this thesis, data are used from the investigations cycles at the ages of 50, 71, 87 and 92 years. Independent ageing was defined as follows: having independency in personal care and the ability to walk outdoors alone, being community-dwelling, having a Mini-Mental State Examination score of 25 points or greater, and having no diagnosed dementia.

Thirty-seven percent of the original cohort survived to the age of 85. At a mean age of 87, 74% of the participants were independently aged, while at a mean age of 92 the prevalence of independent ageing was 64%. In Paper I, non-smoking and normal weight at a mean age of 50 were associated with independent ageing at a mean age of 87 years. In Paper II, never smoking, not being obese, and a high adherence to a Mediterranean-like diet at a mean age of 71 were associated with independent ageing at a mean age of 87. In both Papers I and II, high leisure time physical activity was associated with survival, but not with independent ageing. In Paper III, higher gait speed and hand grip strength and a faster chair stand test were cross-sectionally associated with independent ageing at a mean age of 87. Higher gait speed was also longitudinally associated with independent ageing five years. However, muscle mass and sarcopenia were not associated with the outcome. In Paper IV, a history of stroke, osteoarthritis, hip fracture and chronic obstructive pulmonary disease were associated with loss of independent ageing at a mean age of 92.

Smoking, weight and diet are all modifiable risk factors associated with independent ageing. If decreased smoking and a normalised weight in the population could diminish stroke, hip fracture, chronic obstructive pulmonary disease and osteoarthritis, the prevalence of independent ageing could rise, even in nonagenarians. Additionally, a Mediterranean-like diet may contribute to both survival and independent ageing.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 77
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1558
Keywords
Independent ageing, survival, sarcopenia, comorbidity, body mass index, smoking, dietary pattern, dietary biomarkers, longitudinal, octogenarians, nonagenarians
National Category
Geriatrics
Research subject
Geriatrics
Identifiers
urn:nbn:se:uu:diva-380162 (URN)978-91-513-0613-1 (ISBN)
Public defence
2019-05-16, Enghoffsalen, Akademiska sjukhuset, Ingång 50, Uppsala, 09:15 (Swedish)
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Available from: 2019-04-24 Created: 2019-03-26 Last updated: 2019-06-17

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Franzon, KristinByberg, LiisaSjögren, PerZethelius, BjörnCederholm, TommyKilander, Lena

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