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Prevalence, Incidence, and Risk Factors for Overall, Physical, and Cognitive Independence Among Those From Exceptionally Long-Lived Families: The Long Life Family Study

Year: 2019
Type: article
Study design: Observational Study
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.
DOI: 10.1093/gerona/glz124
Authors: Adam J Santanasto, Megan M Marron, Robert M Boudreau, Mary F Feitosa, Mary K Wojczynski, Konstantin G Arbeev, Bharat Thyagarajan, Nicole Schupf, Eric Stallard, Paola Sebastiani, Stephanie Cosentino, Kaare Christensen, Anne B Newman
Institutions: University of Pittsburgh, Washington University in St. Louis, Duke University, University of Minnesota, Columbia University, Boston University, University of Southern Denmark
Language: English
Field: Medicine
Open Access status: bronze
Awards: Long Life Family Study: Boston Field Center, Oldest-old Mortality - Demographic Models and Analysis, G3494281971, Long Life Family Study: Duke Univ./Univ. of Southern Denmark Field Center, Training in Molecular Epidemiology: Linking Genes to Physical Function in Older Adults, Long Life Family Study: University of Pittsburgh Field Center, Long Life Family Study: Data Management and Coordinating Center, Pittsburgh Older Americans Independence Center, The Long Life Family Study, Training in the Epidemiology of Aging, Cardiovascular Epidemiology Training Program, Alzheimer's Disease Research Center, Long Life Family Study: Columbia University
OpenAlex ID: W2945184681
FWCI: 1.144
Cites: 37
Cited by: 7
Related to: 10