Adam J Santanasto1, Megan M Marron1, Robert M Boudreau1, Mary F Feitosa2, Mary K Wojczynski2, Konstantin G Arbeev3, Bharat Thyagarajan4, Nicole Schupf5, Eric Stallard3, Paola Sebastiani6, Stephanie Cosentino7, Kaare Christensen8, Anne B Newman1. 1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania. 2. Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine in St. Louis, Missouri. 3. Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, North Carolina. 4. Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, Minnesota. 5. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York. 6. Department of Biostatistics, School of Public Health, Boston University, Massachusetts. 7. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York. 8. Epidemiology Unit, Institute of Public Health, The Danish Aging Research Center, University of Southern Denmark, Sønderborg, Denmark.
Abstract
BACKGROUND: The Long Life Family Study (LLFS) enrolled families exhibiting exceptional longevity. The goal of this article was to determine the prevalence and predictors of remaining independent after 7 years in the oldest generation. METHODS: We examined 7-year change in physical (free of activities of daily living difficulty), cognitive (Mini-Mental State Examination score ≥ 24), and overall independence (physically/cognitively independent) in adults aged 90.3 ± 6.3 from LLFS's oldest generation. Potential predictors (n = 28) of remaining independent included demographics, diseases, biomarkers, anthropometrics, and physical and cognitive performance tasks and were determined using generalized estimating equations (α: p < .05). This was a discovery/exploratory analysis, so no multiple testing correction was employed and the results require independent replication. RESULTS: At baseline (n = 1442), 67.3%, 83.8%, and 79.7% were overall, physically, and cognitively independent, respectively. After 7 years, 66% died, 7.5% were lost to follow-up, and the prevalence of overall independence decreased to 59.1% in survivors (-8.2%, 95% confidence interval: -14.1%, 2.2%). Of those with baseline independence, 156/226 (69.0%) remained independent. Predictors of remaining physically independent included younger age, better Short Physical Performance Battery score and lung function, smaller waist circumference, and lower soluble receptor for advanced glycation end-product levels (p < .05). Predictors of remaining cognitively independent included no cancer history, better Digit Symbol Substitution Test performance, and higher body weight (p < .05). CONCLUSIONS: The prevalence of independence decreased by only 8.2% after 7 years, demonstrating the close correspondence between disability and mortality. Further, despite a mean baseline age of 90 years, a large proportion of survivors remained independent, suggesting this exceptional subgroup may harbor protective mechanisms.
BACKGROUND: The Long Life Family Study (LLFS) enrolled families exhibiting exceptional longevity. The goal of this article was to determine the prevalence and predictors of remaining independent after 7 years in the oldest generation. METHODS: We examined 7-year change in physical (free of activities of daily living difficulty), cognitive (Mini-Mental State Examination score ≥ 24), and overall independence (physically/cognitively independent) in adults aged 90.3 ± 6.3 from LLFS's oldest generation. Potential predictors (n = 28) of remaining independent included demographics, diseases, biomarkers, anthropometrics, and physical and cognitive performance tasks and were determined using generalized estimating equations (α: p < .05). This was a discovery/exploratory analysis, so no multiple testing correction was employed and the results require independent replication. RESULTS: At baseline (n = 1442), 67.3%, 83.8%, and 79.7% were overall, physically, and cognitively independent, respectively. After 7 years, 66% died, 7.5% were lost to follow-up, and the prevalence of overall independence decreased to 59.1% in survivors (-8.2%, 95% confidence interval: -14.1%, 2.2%). Of those with baseline independence, 156/226 (69.0%) remained independent. Predictors of remaining physically independent included younger age, better Short Physical Performance Battery score and lung function, smaller waist circumference, and lower soluble receptor for advanced glycation end-product levels (p < .05). Predictors of remaining cognitively independent included no cancer history, better Digit Symbol Substitution Test performance, and higher body weight (p < .05). CONCLUSIONS: The prevalence of independence decreased by only 8.2% after 7 years, demonstrating the close correspondence between disability and mortality. Further, despite a mean baseline age of 90 years, a large proportion of survivors remained independent, suggesting this exceptional subgroup may harbor protective mechanisms.
Authors: Vicki A Freedman; Brenda C Spillman; Patti M Andreski; Jennifer C Cornman; Eileen M Crimmins; Ellen Kramarow; James Lubitz; Linda G Martin; Sharon S Merkin; Robert F Schoeni; Teresa E Seeman; Timothy A Waidmann Journal: Demography Date: 2013-04
Authors: Kaare Christensen; Mikael Thinggaard; Anna Oksuzyan; Troels Steenstrup; Karen Andersen-Ranberg; Bernard Jeune; Matt McGue; James W Vaupel Journal: Lancet Date: 2013-07-11 Impact factor: 79.321
Authors: Anne B Newman; Nancy W Glynn; Christopher A Taylor; Paola Sebastiani; Thomas T Perls; Richard Mayeux; Kaare Christensen; Joseph M Zmuda; Sandra Barral; Joseph H Lee; Eleanor M Simonsick; Jeremy D Walston; Anatoli I Yashin; Evan Hadley Journal: Aging (Albany NY) Date: 2011-01 Impact factor: 5.682
Authors: Leon Lenchik; Ryan Barnard; Robert D Boutin; Stephen B Kritchevsky; Haiying Chen; Josh Tan; Peggy M Cawthon; Ashley A Weaver; Fang-Chi Hsu Journal: J Gerontol A Biol Sci Med Sci Date: 2021-01-18 Impact factor: 6.053