How to live until 90 – Factors predicting survival in 75-year-olds from the general population

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Background: The objective of the study was to explore potential predictors common in a clinical context, for survival to age 90 among 75-year-olds from Sweden’s general population. We performed a prospective community-based cohort study with 15-year follow-up among 75-year-olds from a defined geographical area. Methods: Of 1,100 inhabitants born in 1922 and living in Vasteras in 1997, 618 were invited to participate in a cardiovascular health survey, and 432 individuals accepted participation. Among them, 380 subjects (61% of those originally invited; 191 men and 189 women) had complete records for all examined variables. Variables were categorized into 4 groups: 1) Previous or present disease; 2. Exercise test variables; 3. Conventional risk factors; 4. Other potential risk factors. Through Area Under the Receiver Operating Characteristic (AUROC) curves, strong predictors for survival until age 90 (AUROC≥0.60) in men and women were selected. Results: The strongest individual predictors for reaching the age of 90 were metabolic equivalents and systolic blood pressure (BP) rise during exercise test, QTc interval in resting electrocardiogram (ECG) and peak expiratory flow (PEF) in men, and, for women, white blood cell (WBC) counts and systolic blood pressure BP rise during exercise. The strongest independent predictor in multivariable models were metabolic equivalents in men and WBC counts in women (explained variability 22 and 6%). Conclusions: High exercise capacity in men and low WBC in women were the strongest independent predictors of reaching age 90 among the clinical predictors at 75. The strongest modifiable predictor was exercise capacity in men, which can be improved by physical training.