Determinants Of Healthy Ageing Research Articles

Aging and health among migrants in a European perspective.

Population aging and the associated changes in demographic structures and healthcare needs is a key challenge across Europe. Healthy aging strategies focus on ensuring the ability to maintain health, quality of life and independent living at old age. Concurrent to the process of population aging, the demographics of Europe are affected by increased migration resulting in substantial ethnic diversity. In this paper, we narratively review the health profile of the growing proportion of aging migrants in Europe, outline key factors shaping health among this diverse group and consider ways of addressing their healthcare needs.Although factors shaping aging processes are largely similar across populations, migrant-specific risk factors exist. These include exposure to health risks before and during migration; a more disadvantaged socioeconomic position; language barriers and low health literacy; cultural factors influencing health-seeking behaviours; and psychosocial vulnerability and discrimination affecting health and quality of life. Overall, migrants experience the same morbidity and mortality causes as the native populations, but with different relative importance, severity and age of onset and with substantial differences within and between migrant groups. Little is known regarding health behaviours among aging migrants, although differences in cancer screening behaviours have been identified. Indications of widening health differentials between migrants and native populations with age and informal barriers to quality healthcare for aging migrants are causes of concern.In conclusion, there is a need for attention to migration alongside other determinants of healthy aging. The diversity in individual characteristics, life course processes and contextual factors shaping aging processes among migrants point to the need for a sensitive and comprehensive approach to policies, practices and research within the field of healthy aging. This is important to accommodate for the needs of the growing number of aging migrants in Europe and counter inequities in health and well-being at old age.

Tissue-specific down-regulation of S-adenosyl-homocysteine via suppression of dAhcyL1/dAhcyL2 extends health span and life span in Drosophila.

Aging is a risk factor for many human pathologies and is characterized by extensive metabolic changes. Using targeted high-throughput metabolite profiling in Drosophila melanogaster at different ages, we demonstrate that methionine metabolism changes strikingly during aging. Methionine generates the methyl donor S-adenosyl-methionine (SAM), which is converted via methylation to S-adenosyl-homocysteine (SAH), which accumulates during aging. A targeted RNAi screen against methionine pathway components revealed significant life span extension in response to down-regulation of two noncanonical Drosophila homologs of the SAH hydrolase Ahcy (S-adenosyl-L-homocysteine hydrolase [SAHH[), CG9977/dAhcyL1 and Ahcy89E/CG8956/dAhcyL2, which act as dominant-negative regulators of canonical AHCY. Importantly, tissue-specific down-regulation of dAhcyL1/L2 in the brain and intestine extends health and life span. Furthermore, metabolomic analysis of dAhcyL1-deficient flies revealed its effect on age-dependent metabolic reprogramming and H3K4 methylation. Altogether, reprogramming of methionine metabolism in young flies and suppression of age-dependent SAH accumulation lead to increased life span. These studies highlight the role of noncanonical Ahcy enzymes as determinants of healthy aging and longevity.

Gut Microbiota and Extreme Longevity

The study of the extreme limits of human lifespan may allow a better understanding of how human beings can escape, delay, or survive the most frequent age-related causes of morbidity, a peculiarity shown by long-living individuals. Longevity is a complex trait in which genetics, environment, and stochasticity concur to determine the chance to reach 100 or more years of age [1]. Because of its impact on human metabolism and immunology, the gut microbiome has been proposed as a possible determinant of healthy aging [2, 3]. Indeed, the preservation of host-microbes homeostasis can counteract inflammaging [4], intestinal permeability [5], and decline in bone and cognitive health [6, 7]. Aiming at deepening our knowledge on the relationship between the gut microbiota and a long-living host, we provide for the first time the phylogenetic microbiota analysis of semi-supercentenarians, i.e.,105-109 years old, in comparison to adults, elderly,and centenarians, thus reconstructing the longest available human microbiota trajectory along aging. We highlighted the presence of a core microbiota ofhighly occurring, symbiotic bacterial taxa (mostly belonging to the dominant Ruminococcaceae, Lachnospiraceae, and Bacteroidaceae families), with a cumulative abundance decreasing along withage. Aging is characterized by an increasing abundance of subdominant species, as well as a rearrangementintheir co-occurrence network. These features are maintained in longevity and extreme longevity, but peculiarities emerged, especially in semi-supercentenarians, describing changes that, even accommodating opportunistic and allochthonous bacteria, might possibly supporthealth maintenance during aging, such as an enrichment and/or higher prevalence of health-associated groups (e.g., Akkermansia, Bifidobacterium, and Christensenellaceae).

Exercise Prevents Diet-Induced Cellular Senescence in Adipose Tissue.

Considerable evidence implicates cellular senescence in the biology of aging and chronic disease. Diet and exercise are determinants of healthy aging; however, the extent to which they affect the behavior and accretion of senescent cells within distinct tissues is not clear. Here we tested the hypothesis that exercise prevents premature senescent cell accumulation and systemic metabolic dysfunction induced by a fast-food diet (FFD). Using transgenic mice that express EGFP in response to activation of the senescence-associated p16INK4a promoter, we demonstrate that FFD consumption causes deleterious changes in body weight and composition as well as in measures of physical, cardiac, and metabolic health. The harmful effects of the FFD were associated with dramatic increases in several markers of senescence, including p16, EGFP, senescence-associated β-galactosidase, and the senescence-associated secretory phenotype (SASP) specifically in visceral adipose tissue. We show that exercise prevents the accumulation of senescent cells and the expression of the SASP while nullifying the damaging effects of the FFD on parameters of health. We also demonstrate that exercise initiated after long-term FFD feeding reduces senescent phenotype markers in visceral adipose tissue while attenuating physical impairments, suggesting that exercise may provide restorative benefit by mitigating accrued senescent burden. These findings highlight a novel mechanism by which exercise mediates its beneficial effects and reinforces the effect of modifiable lifestyle choices on health span.

Assessment of the Determinants of Healthy Ageing among the Rural Elderly of North-Eastern Nigeria

Healthy ageing is a lifelong process optimizing opportunities for improving and preserving health and physical, social and mental wellness, independence, quality of life and enhancing successful life-course transition. In Sub-Saharan Africa, it is estimated that the number of elderly persons will rise from about 37.1 million in 2005 to 155.4 million in 2050. The elderly population in Nigeria is estimated at 4 percent and is expected to triple by the year 2020. The increasing number of the older population will increase the burden on the health resources. The objective of this study was to evaluate the determinants of healthy ageing among rural elderly in northern Nigeria in order to promote those that have positive correlation with healthy aging. A cross sectional descriptive study was conducted among 1600 rural elderly aged ≥60 years using interviewer administered semi-structured questionnaire between June and July, 2011. Majority (53.8%) are 60 - 64 years, 24.6% >69 years, 72.4% are males while most are Muslims (85.6%) and 81. 4% are still married. Most are farmers (48.9%) while 73.6% have no formal education. 85.3% earn less than $100 monthly while 47.6% have no income. 93.5% do not take alcohol, 92.1% do not smoke and 89.8% are physically active. 83.1% have normal blood pressure (on examination), 88.3% normal blood glucose level (on examination). Diet, no smoking, high physical activity and adequate sleep are positively correlated with healthy aging (p < 0.05). Good health practices and family support should be sustained while special care for the aged should be established by the government.

Correlates of frailty, prediction of functional decline and preventative approaches – selected results from the lausanne cohort 65+ (lc65+) study (switzerland) (lausanne) and the longitudinal urban cohort ageing study (lucas) (Germany)

Overall introduction.- Longitudinal studies have been designed to investigate prospectively, from their beginning, the pathway leading from health to frailty and to disability. Knowledge about determinants of healthy ageing and health behaviour (resources) as well as risks of functional decline is required to propose appropriate preventative interventions. The functional status in older people is important considering clinical outcome in general, healthcare need and mortality. Part I.- Results and interventions from lucas (longitudinal urban cohort ageing study). Authors.- J. Anders, U. Dapp, L. Neumann, F. Profener, C. Minder, S. Golgert, A. Daubmann, K. Wegscheider,. W. von Renteln-Kruse Methods.- The LUCAS core project is a longitudinal cohort of urban community-dwelling people 60 years and older, recruited in 2000/2001. Further LUCAS projects are cross-sectional comparative and interventional studies (RCT). Results.- The emphasis will be on geriatric medical care in a population-based approach, discussing different forms of access, too. (Dapp et al. BMC Geriatrics 2012, 12:35; http://www.biomedcentral.com/1471-2318/12/35): - longitudinal data from the LUCAS urban cohort (n = 3.326) will be presented covering 10 years of observation, including the prediction of functional decline, need of nursing care, and mortality by using a self-filling screening tool; - interventions to prevent functional decline do focus on first (pre-clinical) signs of pre-frailty before entering the frailty-cascade ("Active Health Promotion in Old Age", "geriatric mobility centre") or disability ("home visits"). Conclusions.- The LUCAS research consortium was established to study particular aspects of functional competence, its changes with ageing, to detect pre-clinical signs of functional decline, and to address questions on how to maintain functional competence and to prevent adverse outcome in different settings. The multidimensional data base allows the exploration of several further questions. Gait performance was exmined by GAITRite®-System. Supported by the Federal Ministry for Education and Research (BMBF Funding No. 01ET1002A). Part II.- Selected results from the lausanne cohort 65+ (Lc65 + ) Study (Switzerland). Authors.- Prof Santos-Eggimann Brigitte, Dr Seematter-Bagnoud Laurence, Prof Bula Christophe, Dr Rochat Stephane. Methods.- The Lc65+ cohort was launched in 2004 with the random selection of 3054 eligible individuals aged 65 to 70 (birth year 1934-1938) in the non-institutionalized population of Lausanne (Switzerland). Results.- Information is collected about life course social and health-related events, socio-economics, medical and psychosocial dimensions, lifestyle habits, limitations in activities of daily living, mobility impairments, and falls. Gait performance are objectively measured using body-fixed sensors. Frailty is assessed using Fried's frailty phenotype. Follow-up consists in annual self-completed questionnaires, as well as physical examination and physical and mental performance tests every three years. - Lausanne cohort 65+ (Lc65 + ): design and longitudinal outcomes. The baseline data collection was completed among 1422 participants in 2004-2005 through self-completed questionnaires, face-to-face interviews, physical examination and tests of mental and physical performances. Information about institutionalization, self-reported health services utilization, and death is also assessed. An additional random sample (n = 1525) of 65-70 years old subjects was recruited in 2009 (birth year 1939-1943). - lecture no 4: alcohol intake and gait parameters: prevalent and longitudinal association in the Lc65+ study. The association between alcohol intake and gait performance was investigated.

European and global approaches to survey ageing populations and perspectives for joint approaches to measure age-related health outcomes

European and global approaches to survey ageing populations and perspectives for joint approaches to measure age-related health outcomes

老龄健康影响因素的跨学科研究国际动态

This review first summarizes the background of the rapid population aging. The second part of this article reviews the international dynamic progress and trends of interdisciplinary research on healthy aging: (1) The developed countries continuously strengthen interdisciplinary research on healthy aging; the theoretical and empirical bases for the strategies of international studies on determinants of healthy longevity; (2) Research on social, behavioral and environmental factors affecting healthy aging; (3) Genetic factors related to healthy aging; (4) Effects of interactions among social, behavioral, environmental, and genetic factors on healthy aging. The third part briefly summarizes and discusses some international cases of interdisciplinary studies on healthy aging. In the fourth part, the progress of longitudinal surveys on determinants of healthy aging and the healthy longevity related candidate genes studies, as well as the currently weak status of the interdisciplinary research in this field in China were briefly reviewed and discussed. Finally, the article discusses the importance and perspectives of research crossover natural and social sciences on healthy aging in China. The review concludes that it is necessary and imperative that China strengthens interdisciplinary research on healthy aging, and Chinese scholars may make useful contributions for human beings to face the serious challenges of population aging worldwide.

Health and quality of life among older rural people in Purworejo District, Indonesia

Introduction: Increasing life expectancy and longevity for people in many highly populated low- and middle-income countries has led to an increase in the number of older people. The population aged 60 years and over in Indonesia is projected to increase from 8.4% in 2005 to 25% in 2050. Understanding the determinants of healthy ageing is essential in targeting health-promotion programmes for older people in Indonesia.Objective: To describe patterns of socio-economic and demographic factors associated with health status, and to identify any spatial clustering of poor health among older people in Indonesia.Methods: In 2007, the WHO Study on global AGEing and adult health (SAGE) was conducted among 14,958 people aged 50 years and over in Purworejo District, Central Java, Indonesia. Three outcome measures were used in this analysis: self-reported quality of life (QoL), self-reported functioning and disability, and overall health score calculated from self-reported health over eight health domains. The factors associated with each health outcome were identified using multivariable logistic regression. Purely spatial analysis using Poisson regression was conducted to identify clusters of households with poor health outcomes.Results: Women, older age groups, people not in any marital relationship and low educational and socio-economic levels were associated with poor health outcomes, regardless of the health indices used. Older people with low educational and socio-economic status (SES) had 3.4 times higher odds of being in the worst QoL quintile (OR=3.35; 95% CI=2.73–4.11) as compared to people with high education and high SES. This disadvantaged group also had higher odds of being in the worst functioning and most disabled quintile (OR=1.67; 95% CI=1.35–2.06) and the lowest overall health score quintile (OR=1.66; 95% CI=1.36–2.03). Poor health and QoL are not randomly distributed among the population over 50 years old in Purworejo District, Indonesia. Spatial analysis showed that clusters of households with at least one member being in the worst quintiles of QoL, functioning and health score intersected in the central part of Purworejo District, which is a semi-urban area with more developed economic activities compared with other areas in the district.Conclusion: Being female, old, unmarried and having low educational and socio-economic levels were significantly associated with poor self-reported QoL, health status and disability among older people in Purworejo District. This study showed the existence of geographical pockets of vulnerable older people in Purworejo District, and emphasized the need to take immediate action to address issues of older people's health and QoL.Access the supplementary material to this article: INDEPTH WHO-SAGE questionnaire (including variants of vignettes), a data dictionary and a password-protected dataset (see Supplementary files under Reading Tools online). To obtain a password for the dataset, please send a request with ‘‘SAGE data’’ as its subject, detailing how you propose to use the data, to global.health@epiph.umu.se

Ageing and food consumption in Portugal: new or old paradigms?

PurposeThe purpose of this paper is to illustrate the effects of ageing on food choice according to Portuguese elderly narratives within an eight‐country research project, the Food in Later Life (www.foodinlaterlife.org).Design/methodology/approachThe project was organized into eight interrelated but independent work packages (WPs) using semi‐structured interviews, structured questionnaires and food diaries. Each interview took approximately one hour and was complemented by a background questionnaire (SF36) and seven day food diaries (shopping and consumption). The data from the interviews were transcribed and analysed using MaxQDA. Data from the Portuguese sample are presented and complemented by the eight country samples in the case of meal patterns, functional and convenience products. The sentences used to illustrate the memories of older people are quoted.FindingsHealth problems and physiological restraints along with social changes, loss of a partner and/or loneliness were identified as major factors behind the elderly food choice. Functional and convenience products are still not familiar to the elderly in Europe.Research limitations/implicationsMore research on determinants of healthy ageing, especially in what concerns foods, and satisfaction with food, is required since efficient policies are needed to enable older populations to maintain their independence and a good satisfaction with food‐related life.Originality/valueThis cross‐cultural qualitative research provides important information about elderly food choice and the factors behind that choice.

Protocol for an experimental investigation of the roles of oxytocin and social support in neuroendocrine, cardiovascular, and subjective responses to stress across age and gender

BackgroundSubstantial empirical evidence has demonstrated that individuals who are socially isolated or have few positive social connections seem to age at a faster rate and have more chronic diseases. Oxytocin is a neurohypophyseal hormone hypothesized to coordinate both the causes and effects of positive social interactions, and may be involved in positive physiological adaptations such as buffering the deleterious effects of stress and promoting resilience. The proposed research will examine whether and how oxytocin influences responses to stress in humans and will consider effects in relation to those of social support.Methods/DesignExperimental research will be used to determine whether exogenously administered oxytocin (intranasal) influences psychological and physiological outcomes under conditions of stress across gender and age in adulthood. Hypotheses to be tested are: 1) Oxytocin ameliorates the deleterious neuroendocrine, cardiovascular, and subjective effects of stress; 2) Oxytocin and social support have similar and additive stress-buffering effects; 3) Oxytocin effects are stronger in women versus men; and 4) Oxytocin effects are similar across a range of adult ages. Hypotheses will be tested with a placebo-controlled, double-blind study using a sample of healthy men and women recruited from the community. Participants are randomly assigned to receive either oxytocin or placebo. They undergo a social stress manipulation with and without social support (randomly assigned), and outcome measures are obtained at multiple times during the procedure.DiscussionUnderstanding the determinants of healthy aging is a major public health priority and identifying effective measures to prevent or delay the onset of chronic diseases is an important goal. Experimental research on oxytocin, social relationships, and health in adulthood will contribute to the scientific knowledge base for maximizing active life and health expectancy. At conclusion of the study we will have solid evidence concerning the effects of oxytocin on stress response and whether it has similar effects across age and gender groups. A neurobiological understanding of resilience can inform efforts for both prevention and intervention of diseases or problems common in later life.Trial registrationClinical trial identification number is NCT01011465.

Healthy Aging as an Intervention to Minimize Injury from Falls among Older People

With global trends toward population aging, many countries are adopting healthy aging policies to minimize disability and increase quality in the extended years of life. Falls in older people are a major contributor to functional decline generally associated with aging. Based on a study quantifying the relationship between healthy aging factors and risk of fall-related hip fracture in community-dwelling older people, this paper discusses evidence for the promotion of healthy aging as a population-based intervention for prevention of injuries from falls. To examine the protective effect of healthy aging on the risk of fall-related hip fractures, a case-control study was conducted with 387 participants. Persons aged 65 and over hospitalized with a fall-related hip fracture were matched with community-based controls recruited via electoral roll sampling. A questionnaire designed to assess lifestyle risk factors, identified as determinants of healthy aging, was administered during face-to-face interviews. After adjustment for health status and demographic factors, a number of lifestyle factors were seen to have a significant independent protective effect on the risk of hip fracture. These included never smoking, moderate alcohol consumption, being active, maintaining normal weight, and being proactive in preventive health care. Psychosocial factors included having supportive environments and personal resources to cope with stress. This study identified a range of modifiable lifestyle factors associated with fall-related hip fracture, suggesting that the "healthy aging" paradigm offers a comprehensive approach to falls injury prevention, and thus supports the adoption of healthy aging policies to extend years of quality life among older persons.

People who live alone have a higher risk of sustaining hip fractures.

This study examined the relationship between psychosocial determinants of healthy ageing and the risk of fall-related hip fracture. People living alone were found to have a higher risk of fracture. This may be because these people have a poorer diet, greater intake of medication and lower level of physical activity. Measures of active engagement with life were found to be significantly protective of hip fracture as was living in the same place for more than five years. The challenge is to develop strategies to enhance the psychosocial environments for older people. Opportunities for healthy and productive ageing can be increased by helping with participation in paid and volunteer work. Older people should also be able to stay in their own homes using assistive technology to help them remain independent.

Health-protective behaviours and risk of fall-related hip fractures: a population-based case–control study

Fall-related hip fractures are one of the most common causes of disability and mortality in older age. The study aimed to quantify the relationship between lifestyle behaviours and the risk of fall-related hip fracture in community-dwelling older people. The purpose was to contribute evidence for the promotion of healthy ageing as a population-based intervention for falls injury prevention. A case-control study was conducted with 387 participants, with a case-control ratio of 1:2. Incident cases of fall-related hip fracture in people aged 65 and over were recruited from six hospital sites in Brisbane, Australia, in 2003-04. Community-based controls, matched by age, sex and postcode, were recruited via electoral roll sampling. A questionnaire designed to assess lifestyle risk factors, identified as determinants of healthy ageing, was administered at face-to-face interviews. Behavioural factors which had a significant independent protective effect on the risk of hip fracture included never smoking [adjusted odds ratio (AOR): 0.33 (0.12-0.88)], moderate alcohol consumption in mid- and older age [AOR: 0.49 (0.25-0.95)], not losing weight between mid- and older age [AOR: 0.36 (0.20-0.65)], playing sport in older age [AOR: 0.49 (0.29-0.83)] and practising a greater number of preventive medical care [AOR: 0.54 (0.32-0.94)] and self-health behaviours [AOR: 0.56 (0.33-0.94)]. With universal exposures, clear associations and modifiable behavioural factors, this study has contributed evidence to reduce the major public health burden of fall-related hip fractures using readily implemented population-based healthy ageing strategies.

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Title: Comparison of characteristics in study participants and nonparticipants in the Louisiana Healthy Aging Study

Purpose Differences between study participants and nonparticipants are a concern in epidemiologic studies. Study results may be biased if those participating are not representative of the reference population for whom the research in question is targeted. The purpose of this study is to compare demographic characteristics of individuals who choose or refuse to participate in the Louisiana Healthy Aging Study. Methods Louisiana Healthy Aging Study is a population-based study which examines the determinants of healthy aging in adulthood in eight Louisiana parishes. The Louisiana Voter Registration File (VRF) and Medicare Beneficiary Enrollment Data Files (CMS) were used to generate sampling populations of age 20 to 64 and age 65 and older, respectively. An introductory letter with a prepaid postcard was mailed to potential participants and a follow-up letter was sent after two weeks of lag time from initial attempt. Potential subjects who did not respond to the mailing were contacted by phone to check on their potential interest in study participation. Chi-square test and logistic regression were used to determine what factors were associated with those participating in the study. Results Overall, 1729 potential subjects have been identified. Participation rate declined with age (p Conclusion Studies involving in-clinic examination may under-represent elderly, especially those with health and physical difficulties, even transportation is offered. However, gender and race do not seem to affect the decision to participate in research studies.

Healthy Aging: Insights for Research and Policy

In times of health reform, fiscal restraint and population aging, it becomes increasingly imperative to understand what must be done to better link research and policy in the health area. In this paper, the major determinants of healthy aging are discussed in terms of current conceptual frameworks of health, measurement, methodologies, and data sources. In order to maximize the benefits for the health of current and future Canadian seniors, policy recommendations are made to Statistics Canada, Health Canada, and the Seniors Independence Research Program (SIRP) which cover a range of issues related to measurement and data sources, health services, health status, economic status, and education. Coauthors are J. Dawe, R. Evans, V. Marshall, P. Clarke, D. Norris, J. Hagey, E. Shapiro, R. Wilkins, and B. Havens.

Determinants of healthy aging: Follow-up study of elderly residents in Sao Paulo Brazil

Determinants of healthy aging: Follow-up study of elderly residents in Sao Paulo Brazil