Midlife predictors of active and healthy aging (AHA) among older businessmen.

BACKGROUND: Active and healthy aging (AHA) is an important phenomenon in aging societies. AIMS: Our aim was to investigate midlife predictors of AHA in a socioeconomically homogenous male cohort. METHODS: In 2010, AHA was defined in the Helsinki Businessmen Study (men born in 1919-1934) with six criteria: (1) being alive, (2) responding to the mailed survey, (3) no reported cognitive problems, (4) feeling of happiness, (5) no difficulties in activities of daily living (ADL), and (6) no significant chronic diseases. Midlife factors were assessed in 1974 (n = 1759, mean age 47 years). Of the survivors in 2010 (n = 839), 10.0% (n = 84) fulfilled all AHA criteria, whilst 13.7% (n = 115) had chronic diseases but fulfilled other five criteria. Midlife predictors of AHA were analyzed with logistic models. RESULTS: Of the midlife factors, smoking [Odds ratio (OR) 0.44, 95% confidence interval (CI) 0.25-0.77], higher body mass index (BMI) (OR 0.75, 0.59-0.96), and higher total cholesterol (OR 0.76, 0.60-0.97) prevented significantly full AHA criteria, whereas higher self-rated health (SRH) (OR 1.73, 1.07-2.80) predicted significantly of fulfilling all AHA criteria. Midlife smoking (OR 0.87, 0.84-0.91), higher BMI (OR 0.73, 0.61-0.86), and higher alcohol consumption (OR 0.73, 0.60-0.90) prevented significantly of fulfilling the five AHA criteria with chronic diseases, and higher SRH (OR 1.90, 1.37-2.63) predicted significantly the five AHA criteria (chronic diseases present). DISCUSSION: Our study suggests that midlife factors, especially good SRH and low levels of cardiovascular risk factors, are associated with AHA. CONCLUSIONS: The study emphasizes the importance of life-course predictors of healthy aging.

Do you want to live to be 100? Answers from older people.

BACKGROUND: little is known about the oldest-olds' views on ageing. OBJECTIVE: to investigate older people's desire and the reasons they give for wanting to live to 100. DESIGN: a postal questionnaire, analysed both quantitatively and qualitatively. SETTING: population based in Helsinki, Finland. SUBJECTS: a random sample (response rate 64%; N = 1,405) of community-dwelling older people (aged 75-96). METHODS: a structured self-completed questionnaire with an open-ended question on the reasons why/why not participants wished/did not wish to live to 100. RESULTS: one-third (32.9%) of home-dwelling older people wanted to live to be 100. Those who did were older, more often male and self-rated their health better than those who did not. Often the desire for long life was conditional: 'Yes, if I stay healthy'. Among the reasons is that many were curious to see what would happen. Many stated that they loved life, they had twinkle in their eye or significant life roles. Those who did not want to live extremely long lives gave various rationales: they would become disabled, life would be meaningless, they were reluctant to become a burden to others or they feared loss of autonomy or suffering pain or loneliness. Some people also shared the view that they should not intervene in destiny or they felt that they had accomplished what they wanted in life. CONCLUSIONS: one-third of the oldest-old participants wanted to live to 100. Identifying what motivated them to desire long life could be a resource in their care plans.

Association of Self-Rated Health in Midlife With Mortality and Old Age Frailty: A 26-Year Follow-Up of Initially Healthy Men.

BACKGROUND: The aim was to investigate the relationship between self-rated health (SRH) in healthy midlife, mortality, and frailty in old age. METHODS: In 1974, male volunteers for a primary prevention trial in the Helsinki Businessmen Study (mean age 47 years, n = 1,753) reported SRH using a five-step scale (1 = "very good," n = 124; 2 = "fairly good," n = 862; 3 = "average," n = 706; 4 = "fairly poor," or 5 = "very poor"; in the analyses, 4 and 5 were combined as "poor", n = 61). In 2000 (mean age 73 years), the survivors were assessed using a questionnaire including the RAND-36/SF-36 health-related quality of life instrument. Simplified self-reported criteria were used to define phenotypic prefrailty and frailty. Mortality was retrieved from national registers. RESULTS: During the 26-year follow-up, 410 men had died. Frailty status was assessed in 81.0% (n = 1,088) of survivors: 434 (39.9%), 552 (50.7%), and 102 (9.4%) were classified as not frail, prefrail, and frail, respectively. With fairly good SRH as reference, and adjusted for cardiovascular risk in midlife and comorbidity in old age, midlife SRH was related to mortality in a J-shaped fashion: significant increase with both very good and poor SRH. In similar analyses, average SRH in midlife (n = 425) was related to prefrailty (odds ratio: 1.52, 95% confidence interval: 1.14-2.04) and poor SRH (n = 31) both to prefrailty (odds ratio: 3.56, 95% confidence interval: 1.16-10.9) and frailty (odds ratio: 8.38, 95% confidence interval: 2.32-30.3) in old age. CONCLUSIONS: SRH in clinically healthy midlife among volunteers of a primary prevention trial was related to the development of both prefrailty and frailty in old age, independent of baseline cardiovascular risk and later comorbidity.