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

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

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)899-905
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume75
Issue number5
DOIs
StatePublished - Apr 17 2020

Bibliographical note

Funding Information:
This work was supported by the National Institute on Aging (NIA; U01-AG023712, U01-AG23744, U01-AG023746, U01-AG023749, U01-AG023755, and P01-AG08761). A.J.S was supported by a career development award from the Pittsburgh Claude D. Pepper Older Americans Independence Center (P30 AG024827) and National Institute of Health/NIA (K01 AG057726).

Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Keywords

  • Compression of morbidity
  • Dementia
  • Disability
  • Oldest old

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