1 Department of Public Health - Institute of Environmental and Occupational Medicine, Department of Public Health, Health, Aarhus University2 unknown3 Department of Public Health - Institute of Environmental and Occupational Medicine, Department of Public Health, Health, Aarhus University
A longitudinal study in Northern Europe
Background: Only a few studies have analyzed what predicts mortality for the oldest old and these studies have used complete case analysis. Hence, the studies have only analyzed a selective group of the oldest old, namely the individuals with the most robust health. Objectives: We analyzed the association between reaching 100 years of age for people aged 93 with measures of activity of daily living (ADL), physical and cognitive abilities, lifestyle factors, diseases, and the two most promising longevity genes, ApoE and FOXO3. Methods: We used a population sample from the Danish 1905 Cohort. In 1998 all Danes born in 1905 and still living in Denmark, which comprised 3,600 persons, were invited for the first time to participate in the Danish 1905 Cohort Survey. A total of 2,262 (63 %) participated, 1,814 (80.2 %) in person and 448 (19.8 %) via a proxyparticipant. We used multiple imputation analyses to perform the analyses, since this made it possible to analyze the total sample of 2,262 persons. Results: In the univariate analyses having good ADL, high physical and cognitive abilities were important for a 93 years old person to reach 100 years of age. But also a body mass index (BMI) above 22, low depression symptomatology, good self-rated health, frequent social contact, few numbers of drugs, absence of angina pectoris and stroke, and variants of ApoE and FOXO3 were associated with increased chance of reaching 100 years of age. However, socioeconomic status, education, smoking and cancer had no association with turning 100 years old. In a multivariable analysis only ADL (P-value\0.0001), physical ability (P-value = 0.0128), cognitive ability (P-value \0.0001), BMI (P-value = 0.0007), angina pectoris and stroke (P-value = 0.0014), and ApoE and FOXO3 variants (P-value = 0.0024) were significantly associated with reaching 100 years of age (area under the receiver operating characteristic curve equals 0.81 in the logistic regression). Conclusions: Physical condition, cognitive ability, not being too slim, no prior or present occurrence of angina pectoris or stroke, and specific gene variants increased the chance of making it from 93 to 100 years of age. Hence, the chance of reaching 100 years old as a nonagenarian is not a stochastic process but a number of phenotypes which are associated with mortality in the young elderly have lost their importance.
European Journal of Epidemiology, 2013, Vol 28, Issue 1, Suppl 1