Prevalence, Incidence and Risk Factors for Overall, Physical and Cognitive Independence among those from exceptionally long-lived families: The Long Life Family Study.
BACKGROUND:The Long Life Family Study (LLFS) enrolled families exhibiting exceptional longevity. The goal of this paper 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 ADL 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/cognitive performance tasks and were determined using generalized estimating equations (α: p<0.05). 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% CI: -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 (SPPB) score and lung function, smaller waist-circumference and lower soluble receptor for advanced glycation end-product (sRAGE) levels (p<0.05). Predictors of remaining cognitively independent included no cancer history, better Digit Symbol Substitution Test performance, and higher body weight (p<0.05). 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.
Santanasto, AJ; Marron, MM; Boudreau, RM; Feitosa, MF; Wojczynski, MK; Arbeev, KG; Thyagarajan, B; Schupf, N; Stallard, E; Sebastiani, P; Cosentino, S; Christensen, K; Newman, AB
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