Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Am J Geriatr Psychiatry. 2011 Jun;19(6):581-8. doi: 10.1097/JGP.0b013e3181f17ec9.
To examine alternative models of defining and characterizing successful aging.
A retrospective cohort study.
Olmsted County, MN.
Five hundred sixty community-dwelling nondemented adults, aged 65 years and older.
Three models were developed. Each model examined subtests in four cognitive domains: memory, attention/executive function, language, and visuospatial skills. A composite domain score was generated for each of the four domains. In Model 1, a global z score was further generated from the four cognitive domains, and subjects with mean global z score in the top 10% were classified as "successful agers," whereas those in the remaining 90% were classified as "typical agers." In Model 2, subjects with all four domain scores above the 50th percentile were classified as "successful agers." In Model 3, a primary neuropsychological variable was selected from each domain, and subjects whose score remained above - 1 standard deviation compared with norms for young adults were labeled successful agers. Validation tests were conducted to determine the ability of each model to predict survival and conversion to mild cognitive impairment (MCI).
Model 1 showed 65% lower mortality in successful agers compared with typical agers and also a 25% lower conversion rate to MCI.
Model 1 was most strongly associated with longevity and cognitive decline; as such, it can be useful in investigating various predictors of successful aging, including plasma level, APOE genotype, and neuroimaging measurements.
研究成功老龄化的定义和特征的替代模型。
回顾性队列研究。
明尼苏达州奥姆斯特德县。
560 名居住在社区、无痴呆的 65 岁及以上非痴呆成年人。
开发了三种模型。每种模型都检查了四个认知领域的子测试：记忆、注意力/执行功能、语言和视空间技能。为四个领域中的每一个生成了一个综合领域分数。在模型 1 中，进一步从四个认知领域生成一个全球 z 分数，将平均全球 z 分数处于前 10%的受试者分类为“成功老龄化者”，而其余 90%的受试者则被分类为“典型老龄化者”。在模型 2 中，将所有四个领域得分均高于第 50 百分位的受试者分类为“成功老龄化者”。在模型 3 中，从每个领域选择一个主要神经心理学变量，与年轻成年人的正常水平相比，其得分仍高于-1 个标准差的受试者被标记为成功老龄化者。进行验证测试以确定每个模型预测生存和向轻度认知障碍（MCI）转化的能力。
与典型老龄化者相比，模型 1 显示成功老龄化者的死亡率降低了 65%，向 MCI 的转化率也降低了 25%。
模型 1与长寿和认知衰退的相关性最强；因此，它可用于研究成功老龄化的各种预测因素，包括血浆水平、APOE 基因型和神经影像学测量。
