Abstract
To evaluate the role of geography i.e., continental vs. insular Mediterranean, on successful aging among older inhabitants. During 2005-2014, 2693 elderly (aged 65 to 100 years) individuals from 21 Mediterranean islands in Greece, Italy and Spain as well as Cyprus, Malta, and the rural region of Mani (southeast continental region of Greece keeping old-time traditions), were voluntarily recruited. Successful aging was evaluated using a validated index composed of 10 health-related socio-lifestyle and clinical characteristics. After accounting for age, sex, body mass index (BMI), physical activity, smoking habits, MedDietScore and access to health care services, the older inhabitants of islands were found to have a higher level of the successful aging index when compared to their counterparts in Mani (Beta=0.174, p<0.001); moreover, islanders exhibited slightly more years of “good” health (68.7 vs 68.4 years for Mani residents (p=0.99)). However, compared to the residents of Mani, islanders had 1.64 times higher odds (95%CI, 1.08-2.48) for having hypertension, 2.4-times higher odds (95%CI, 1.34-4.21) for having diabetes and 1.52 times higher odds (95%CI, 0.97-2.38) for having hypercholesterolemia. Engaging in physical activities and healthy dietary habits were the major determinants of healthy aging, among islanders as compared to their counterparts of continental Mani region. Elder residents of the continental Mani area enjoyed a better health status, whereas elder islanders had a higher level of successful aging; a finding which could be attributed to differences in lifestyle among elders.
Highlights
It is true that the aged population is increasing in all over the world and the percentage of 60-year-old people follows the same trend
Given the lack of current data regarding successful aging in combination with the accessibility and visitability at health services by those who live in insular regions, where health care services are poorer than those who live in continental regions of Greece, it is proved that the latters have certainly better health care services the geographic and cultural profiles are similar to those of the formers
According to the design of the study, individuals who resided in assistedliving centers, had a clinical history of cardiovascular disease (CVD) or cancer, or had left the island for a considerable period of time during their life (i.e., >5 years) were not included in the study; these exclusion criteria were applied because the study aimed to assess lifestyle patterns that were not subject to modifications due to existing chronic health care conditions or by environmental factors, other than living milieu
Summary
It is true that the aged population is increasing in all over the world and the percentage of 60-year-old people follows the same trend. On islands, where the health care services provided nutritional services as well, it seemed that the islanders had better results during the third age, since incidents of diabetes or hypercholesterolemia, cardiovascular diseases (CVD) and obesity, were clearly reduced [10] proving that in this way nutrition is the factor, which can secure the “healthy aging” As it was proved from a research carried out in Portugal, the aged couples do not pay particular attention to their nutrition standards whereas the single aged persons, who live on their own, seem to have higher score on Health Diet Indicator. It is notable that Mani and the Mediterranean islands have common cultural characteristics and during the past centuries, they had developed extensive trading, sharing goods and local products, as well as various cultural and behavioral particularities
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