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Successful aging: the contribution of early-life and midlife risk factors.

ABSTRACT: OBJECTIVES:To test whether early-life factors (education, height, father's social position) and midlife social, behavioral, and psychosocial factors were associated with entering older age without disease and with good functioning. DESIGN:A longitudinal, British civil service-based cohort study. Participants were followed for 17 years to assess successful aging. This was defined as being free of major disease and in the top tertile of physical and cognitive functioning measured in 2002 to 2004. SETTING:Twenty London-based Civil Service departments. PARTICIPANTS:Four thousand, one hundred forty men and 1,823 women, free of major disease at baseline in 1985 to 1988 (mean age 44, range 35-55). MEASUREMENTS:Behavioral, biological, and psychosocial risk factors; physical and cognitive functioning; and disease outcomes. RESULTS:Five hundred forty eight (12.8%) men and 246 (14.6%) women were successfully aging at follow-up. Midlife socioeconomic position strongly predicted this (age-adjusted odds ratio, highest vs lowest=7.1, 95% CI=3.4-14.6, for men and 7.7, 95% CI=4.9-12.1, for women). Height, education (in men), not smoking, diet, exercise, moderate alcohol (in women), and work support (in men) were related to a favorable older life after adjustment for age and socioeconomic position. CONCLUSION:Interventions to promote healthy adult behavior may attenuate harmful effects of less-modifiable risk factors and reduce social inequalities.

SUBMITTER: Britton A

PROVIDER: S-EPMC2696176 | biostudies-literature | 2008 Jun

REPOSITORIES: biostudies-literature

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Successful aging: the contribution of early-life and midlife risk factors.

Britton Annie A Shipley Martin M Singh-Manoux Archana A Marmot Michael G MG

Journal of the American Geriatrics Society 20080512 6

<h4>Objectives</h4>To test whether early-life factors (education, height, father's social position) and midlife social, behavioral, and psychosocial factors were associated with entering older age without disease and with good functioning.<h4>Design</h4>A longitudinal, British civil service-based cohort study. Participants were followed for 17 years to assess successful aging. This was defined as being free of major disease and in the top tertile of physical and cognitive functioning measured in ...[more]

PMID: 18482302

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Project description:BackgroundMidlife cardiovascular risk factors (CVRFs) increase risk of dementia. Black Americans experience an elevated prevalence of CVRFs and dementia. However, little is known of how CVRFs prior to midlife affect late-life cognition. We examined CVRFs in adolescence, young adulthood, and midlife with late-life cognition in the Study of Healthy Aging in African Americans (STAR).MethodSTAR assesses cognitive aging among 764 Black Americans aged ≥50 (mean age = 69; SD = 9; range = 53-95). Participants' body mass index, blood pressure, glucose, and total cholesterol were collected during Multiphasic Health Checkups (MHC; 1964-1985). At STAR baseline (2018-2019), executive function, verbal episodic memory, and semantic memory were measured using the Spanish and English Neuropsychological Assessment Scales. Linear regression models examined associations between CVRFs and cognition adjusting for demographics and years since MHC.ResultsAt MHC, 36% of participants had 1 CVRF and 26% had ≥2. Twenty-two percent of participants were adolescents (age 12-20), 62% young adults (age 21-34), and 16% midlife adults (age 35-56). Overweight/obesity was not associated with cognition. Hypertension was associated with worse executive function (β [95% CI]: -0.14 [-0.28, -0.0003]) and verbal episodic memory (β [95% CI]: -0.22 [-0.37, -0.07]) compared to normotension. Diabetes was associated with worse executive function (β [95% CI]: -0.43 [-0.83, -0.03]). Having ≥2 CVRFs (vs 0) was associated with worse executive function (β [95% CI]: -0.19 [-0.34, -0.03]) and verbal episodic memory (β [95% CI]: -0.25 [-0.41, -0.08]). Adolescents with hypertension had lower late-life executive function compared to normotensive adolescents (β [95% CI]: -0.39 [-0.67, -0.11]). Young adulthood hypertension (β [95% CI]: -0.29 [-0.49, -0.09]) and midlife hyperlipidemia (β [95% CI]: -0.386 [-0.70, -0.02]) were associated with lower verbal episodic memory.ConclusionsAmong Black Americans, life-course CVRFs were associated with poorer executive function and verbal episodic memory emphasizing the importance of cardiovascular health on the aging brain.

Dataset Information

Successful aging: the contribution of early-life and midlife risk factors.

Publications

Successful aging: the contribution of early-life and midlife risk factors.

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