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Healthy ageing in the Nun Study: definition and neuropathologic correlates.

ABSTRACT: Although the concept of healthy ageing has stimulated considerable interest, no generally accepted definition has been developed nor has its biological basis been determined.To develop a definition of healthy ageing and investigate its association with longevity and neuropathology.Analyses were based on cognitive, physical, and post-mortem assessments from 1991 to 1998 in the Nun Study, a longitudinal study of ageing in participants 75+ years at baseline. We defined three mutually exclusive levels of healthy ageing (excellent, very good, and good) based on measures of global cognitive function, short-term memory, basic and instrumental activities of daily living, and self-rated function. Mortality analyses were based on 636 participants; neuropathologic analyses were restricted to 221 who had died and were autopsied.Only 11% of those meeting criteria for the excellent level of healthy ageing at baseline subsequently died, compared with 24% for the very good, 39% for the good, and 60% for the remaining participants. Survival curves showed significantly greater longevity with higher levels of healthy ageing. The risk of not attaining healthy ageing, adjusted for age, increased two-fold in participants with brain infarcts alone, six-fold in those with Alzheimer neuropathology alone, and more than thirteen-fold in those with both brain infarcts and Alzheimer neuropathology.The biological validity of our definition of healthy ageing is supported by its strong association with mortality and longevity. Avoiding Alzheimer and stroke neuropathology is critical to the maintenance of healthy ageing, and the presence of both pathologies dramatically decreases the likelihood of healthy ageing.

SUBMITTER: Tyas SL

PROVIDER: S-EPMC2243258 | biostudies-literature | 2007 Nov

REPOSITORIES: biostudies-literature

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Healthy ageing in the Nun Study: definition and neuropathologic correlates.

Tyas Suzanne L SL Snowdon David A DA Desrosiers Mark F MF Riley Kathryn P KP Markesbery William R WR

Age and ageing 20070928 6

<h4>Background</h4>Although the concept of healthy ageing has stimulated considerable interest, no generally accepted definition has been developed nor has its biological basis been determined.<h4>Objective</h4>To develop a definition of healthy ageing and investigate its association with longevity and neuropathology.<h4>Methods</h4>Analyses were based on cognitive, physical, and post-mortem assessments from 1991 to 1998 in the Nun Study, a longitudinal study of ageing in participants 75+ years ...[more]

PMID: 17906306

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Project description:BackgroundThis study tentatively constructs a composite measure of Chinese Healthy Ageing Index (CHAI) among older adults aged 60+ and investigates change of CHAI during 2011-2015 and its association with sociodemographic characteristics.MethodsData collected from 8182 old adults aged 60+ in the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS, a nationally representative sample) were used. Six medical measures of blood pressure, peak expiratory flow, cognitive status score, fasting glucose, kidney function and C-reactive function were used to construct CHAI (range 0-12, 0-2 = healthiest, 7-12 = unhealthiest). Ordinary least squares, logistic and random effects models examined social and spatial determinants of CHAI score and the prevalence of the ideal CHAI. Unconditional quantile regression tested heterogeneous impacts of sociodemographic determinants of CHAI score.ResultsMean CHAI score declined from 5.7 to 5.2, and the proportion of the ideal CHAI (CHAI score = 0-2) increased from 5.6 to 9.4% during 2011-2015, indicating an improvement in healthy ageing over time. During 2011-2015, the highest rates of the ideal CHAI were in Southeast and East of China. Older adults, male, living in the Center and West, smoking, obesity/overweight and having chronic diseases were positively associated with total CHAI score and negatively with a higher prevalence of the ideal CHAI. Being married, having high education and regular social activities were associated with a higher rate of the ideal CHAI. The positive predictors for total CHAI were stronger in those with worse CHAI status.ConclusionsIn China healthy ageing has improved during 2011-2015, but substantial geographical and sociodemographic heterogeneities exist in the improvements, suggesting health equality remains a challenge in China. Future policies and interventions should especially focus on men, those in Central and West China, and combat health problems like obesity, chronic diseases and unhealthy behaviors.

Dataset Information

Healthy ageing in the Nun Study: definition and neuropathologic correlates.

Publications

Healthy ageing in the Nun Study: definition and neuropathologic correlates.

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