Erasmus University Rotterdam, Erasmus School of Health Policy & Management, Rotterdam, the Netherlands.
National Institute of Public Health and the Environment, Bilthoven, the Netherlands; Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, the Netherlands.
Prev Med. 2020 Oct;139:106193. doi: 10.1016/j.ypmed.2020.106193. Epub 2020 Jul 9.
The Healthy Aging Index (HAI), an index of physiological aging, has been demonstrated to predicts mortality, morbidity and disability. We studied the longitudinal development of the HAI to identify aging trajectories and evaluated the role of baseline sociodemographic characteristics and lifestyle factors of the trajectories. Four measurements with intervals of 5 years were included from the Doetinchem Cohort Study. The HAI reflects levels of systolic blood pressure, non-fasting plasma glucose levels, global cognitive functioning, plasma creatinine levels and lung functioning. The HAI score ranges from 0 to 10: higher scores indicate a better health profile. Latent class mixture modelling was used to model within-person change and to identify aging trajectories. Area under the curve was calculated per trajectory to estimate total healthy years. In total, 2324 women and 2013 men were included. One HAI trajectory was identified for women, and two trajectories for men, labelled 'gradual' aging (76%) and 'early' aging (24%). Men who were medium/high educated, below 36 years at baseline, complied with guidelines on physical activity and were not obese in any round were associated with increased odds to 'gradual' aging of 1.46 (CI: 1.18-1.81), 1.93 (CI: 1.42-2.62), 1.26 (1.02-1.57) and 1.76 (1.32-2.35), respectively. Between 30 and 70 years of age, men in the 'early' aging trajectory had the least healthy years (29.6 years), followed by women (30.1 years), and 'gradual' aging men (34.7 years). This study emphasizes that 'physiological aging' is not only an issue of older ages. Between 30 and 70 years of age, 'early' aging men and women had approximately five healthy years less compared to 'gradual' aging men. Lifestyle factors (e.g. nutrition and physical activity) seem to play an important role in optimal aging.
健康老龄化指数（HAI）是衡量生理衰老的指标，已被证明可预测死亡率、发病率和残疾率。我们研究了 HAI 的纵向发展，以确定衰老轨迹，并评估基线社会人口特征和生活方式因素在轨迹中的作用。该研究纳入了多芬泰恩队列研究的 4 次测量，间隔 5 年。HAI 反映了收缩压、非空腹血糖水平、整体认知功能、血浆肌酐水平和肺功能水平。HAI 得分为 0 至 10 分：分数越高表示健康状况越好。使用潜在类别混合模型对个体内变化进行建模，并识别衰老轨迹。为每个轨迹计算曲线下面积以估计健康总年数。共纳入 2324 名女性和 2013 名男性。为女性确定了一个 HAI 轨迹，为男性确定了两个轨迹，分别标记为“渐进”衰老（76%）和“早期”衰老（24%）。在任何一轮中，中/高学历、基线时年龄在 36 岁以下、遵循体力活动指南且不肥胖的男性，与“渐进”衰老的几率增加相关，比值比分别为 1.46（95%CI：1.18-1.81）、1.93（95%CI：1.42-2.62）、1.26（95%CI：1.02-1.57）和 1.76（95%CI：1.32-2.35）。在 30 至 70 岁之间，“早期”衰老轨迹的男性健康年数最少（29.6 年），其次是女性（30.1 年），然后是“渐进”衰老的男性（34.7 年）。本研究强调，“生理衰老”不仅是老年问题。在 30 至 70 岁之间，与“渐进”衰老的男性相比，“早期”衰老的男性和女性健康年数少了大约 5 年。生活方式因素（如营养和体力活动）似乎在最佳衰老中起着重要作用。
