Franzon Kristin, Zethelius Björn, Cederholm Tommy, Kilander Lena
Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Medical Products Agency, Uppsala, Sweden.
J Am Geriatr Soc. 2015 May;63(5):877-85. doi: 10.1111/jgs.13352. Epub 2015 Apr 27.
To examine relationships between modifiable midlife factors, aging, and physical and cognitive function (independent aging) and survival in very old age.
Prospective cohort.
Uppsala Longitudinal Study of Adult Men, Uppsala, Sweden.
Swedish men investigated in 1970-74 (aged 48.6-51.1) and followed up for four decades (N=2,293).
Conventional cardiovascular risk factors, body mass index (BMI), and dietary biomarkers were measured, and a questionnaire was used to gather information on lifestyle variables at age 50. Four hundred seventy-two men were reinvestigated in 2008-09 (aged 84.8-88.9). Independent aging was defined as survival to age 85, Mini-Mental State Examination score of 25 or greater, not living in an institution, independent in personal care and hygiene, able to walk outdoors without personal help, and no diagnosis of dementia. The National Swedish Death Registry provided survival data.
Thirty-eight percent of the cohort survived to age 85. Seventy-four percent of the participants in 2008-09 were aging independently. In univariable analyses, high leisure-time physical activity predicted survival but not independent aging. Low work-time physical activity was associated more strongly with independent aging (odds ratio (OR)=1.84, 95% confidence interval (CI)=1.18-2.88) than with survival (OR=1.27, 95% CI=1.05-1.52). In multivariable analyses, midlife BMI was negatively associated (OR=0.80/SD, 95% CI=0.65-0.99/SD), and never or former smoking was positively associated (OR=1.66, 95% CI=1.07-2.59), with independent aging. As expected, conventional cardiovascular and lifestyle risk factors were associated with mortality.
A normal midlife BMI and not smoking were associated with independent aging close to four decades later, indicating that normal weight at midlife has the potential not only to increase survival, but also to preserve independence with aging.
研究可改变的中年因素、衰老、身体和认知功能（独立衰老）与高龄生存之间的关系。
前瞻性队列研究。
瑞典乌普萨拉成年男性纵向研究，瑞典乌普萨拉。
1970 - 1974年接受调查的瑞典男性（年龄48.6 - 51.1岁），随访40年（N = 2293）。
测量传统心血管危险因素、体重指数（BMI）和饮食生物标志物，并使用问卷收集50岁时生活方式变量的信息。2008 - 2009年对472名男性进行了再次调查（年龄84.8 - 88.9岁）。独立衰老定义为存活至85岁、简易精神状态检查表得分25分或更高、不住在机构中、个人护理和卫生自理、无需他人帮助能在户外行走且无痴呆诊断。瑞典国家死亡登记处提供生存数据。
38%的队列成员存活至85岁。2008 - 2009年74%的参与者独立衰老。在单变量分析中，高休闲时间体力活动可预测生存，但不能预测独立衰老。低工作时间体力活动与独立衰老的关联（优势比（OR）= 1.84，95%置信区间（CI）= 1.18 - 2.88）比与生存的关联（OR = 1.27，95% CI = 1.05 - 1.52）更强。在多变量分析中，中年BMI呈负相关（OR = 0.80/标准差，95% CI = 0.65 - 0.99/标准差），从不吸烟或曾经吸烟呈正相关（OR = 1.66，95% CI = 1.07 - 2.59），与独立衰老相关。正如预期的那样，传统心血管和生活方式危险因素与死亡率相关。
中年时正常的BMI和不吸烟与近四十年后的独立衰老相关，表明中年时正常体重不仅有可能提高生存率，还能在衰老过程中保持独立性。
