Lifestyle, nutritional status, health, and mortality in elderly people across Europe: a review of the longitudinal results of the SENECA study.

This article provides an overview of the longitudinal Survey in Europe on Nutrition and the Elderly: a Concerted Action (SENECA) study, which was designed to assess differences in dietary and lifestyle factors among elderly Europeans, and to identify the factors that contribute to healthy aging. Elderly people from Belgium, Denmark, France, Italy, Portugal, Spain, Switzerland, and The Netherlands participated in the SENECA study. Standardized measurements were conducted at baseline in 1988-1989 and were repeated in 1993 and 1999. Diet, physical activity, and smoking, as well as maintenance of health and survival, were assessed. At baseline, considerable differences in lifestyle factors existed among elderly people. Mealtime patterns as well as dietary intake varied across Europe, and geographical patterns were apparent. Similar results were found for engagement in sport or professional activities. The smoking prevalence among women was generally low. Distinct geographical differences were also observed in percentages of deaths during the SENECA study and in overall survival time. A healthy lifestyle was related to stable self-perceived health, a delay in functional dependence, and mortality. Inactivity and smoking, and to a lesser extent a low-quality diet, increased mortality risk. A combined effect of multiple unhealthy lifestyle factors was also observed. The SENECA study showed that a healthy lifestyle at older ages is related to a delay in the deterioration of health status and a reduced mortality risk. Improving and maintaining a healthy lifestyle in elderly people across Europe is a great challenge for the European Community.

The SENECA study: potentials and problems in relating diet to survival over 10 years.

OBJECTIVE: To give an overview of the evaluation of the modified diet history applied in the SENECA study (Survey in Europe on Nutrition and the Elderly; a Concerted Action). DESIGN: Nineteen centres in 12 countries participated at baseline. Nine of these SENECA centres conducted a repeat measurement scheme in elderly people born between 1913 and 1918. These longitudinal centres included 100 subjects per sex per site. METHODS: The relative validity of the method was tested by comparing results of the modified diet history with results obtained from a weighed record in 82 subjects. In the follow-up we compared changes in energy intake with changes in body weight and calculated the physical activity ratio in all longitudinal centres. In SENECA's finale we examined the predictive value of dietary patterns observed at baseline for survival 10 years later, making use of the original and an adapted Mediterranean Diet Score. RESULTS: The modified diet history overestimated intake, compared with the weighed record. However, the physical activity ratio and an in-depth study in a metabolic room indicated that the diet history rather underestimated energy intake. We did not find a relationship between changes in energy intake and changes in body weight, but this could be explained by the fact that most likely we did not measure intake in the dynamic phase of body weight change. Based on the adapted Mediterranean Diet Score, the study results showed a positive relation between a healthy diet and survival. CONCLUSION: We conclude that the modified diet history has given sufficiently reliable results for the purposes of the study.