Factors Associated with Healthy Aging: The Cardiovascular Health Study

Authors: Burke G.L.¹; Arnold A.M.²; Bild D.E.³; Cushman M.⁴; Fried L.P.⁵; Newman A.⁶; Nunn C.¹; Robbins J.⁷

Source: Journal of the American Geriatrics Society, Volume 49, Number 3, March 2001 , pp. 254-262(9)

Publisher: Wiley-Blackwell

Abstract:

OBJECTIVES: To identify factors associated with remaining healthy in older adults.

DESIGN: Longitudinal cohort study.

SETTING: Data were collected at the four Cardiovascular Health Study field centers.

PARTICIPANTS: 5,888 participants age 65 years and older in the Cardiovascular Health Study.

MEASUREMENTS: Presence of chronic disease was assessed at baseline and over a maximum 7-year followup period. Participants who were free of chronic disease (no cardiovascular disease (CVD), chronic obstructive pulmonary disease, or self-reported cancer, except nonmelanoma skin cancer) at the baseline examination were then monitored for the onset of incident cancer, cardiovascular disease, and fatal outcomes.

RESULTS: A high proportion of these older adults was healthy at the initial examination and remained healthy over the follow-up period. Numerous behavioral factors were associated with continued health, including physical activity, refraining from cigarette smoking, wine consumption (women), higher educational status, and lower waist circumference. A number of CVD risk factors and subclinical disease measures were associated with continued health, including higher high-density lipoprotein (HDL) cholesterol, lack of diabetes, thinner common carotid intimal medial thickness, lower blood pressure, lower C-reactive protein, and higher ankle-arm blood pressure ratio. Among the behavioral factors, exercise, not smoking, and not taking aspirin remained significant predictors of health even after controlling for CVD risk factors and subclinical disease in older adults.

CONCLUSIONS: These data suggest that a number of modifiable behavioral factors (physical activity, smoking, and obesity) and cardiovascular risk factors (diabetes, HDL cholesterol, and blood pressure) are associated with maintenance of good health in older adults.

J Am Geriatr Soc 49: 254–262, 2001.

Keywords: epidemiology; cardiovascular disease; cancer; health; risk factors; disease prevention; aging

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1532-5415.2001.4930254.x

Affiliations: 1: Department of Public Health Sciences and JP Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina; 2: Department of Biostatistics, University of Washington, Seattle, Washington; 3: Division of Epidemiology and Clinical Applications, National Heart, Lung and Blood Institute, Bethesda, Maryland; 4: Department of Medicine, University of Vermont, Bington, Vermont; 5: Departments of Medicine and Epidemiology, The Johns Hopkins Medical Institutions, Baltimore, Maryland; 6: Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; 7: Department of Internal Medicine, University of California at Davis, Davis, California.

Publication date: 2001-03-01

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