To examine how body mass index (BMI) and change in BMI are associated with mortality in old (70-79) and very old (=80) individuals.
Pooled data from three multidisciplinary prospective population-based studies: OCTO-twin, Gender, and NONA.
Eight hundred eighty-two individuals aged 70 to 95.
BMI was calculated from measured height and weight as kg/m(2) . Information about survival status and time of death was obtained from the Swedish Civil Registration System.
Mortality hazard was 20% lower for the overweight group than the normal-underweight group (relative risk (RR)?=?0.80, P?=?.011), and the mortality hazard for the obese group did not differ significantly from that of the normal-underweight group (RR?=?0.93, P?=?.603), independent of age, education, and multimorbidity. Furthermore, mortality hazard was 65% higher for the BMI loss group than for the BMI stable group (RR?=?1.65, P?
Cites: J Am Geriatr Soc. 2010 Jul;58(7):140720649700
Gerontological research suggests that depressive symptoms show antecedent and consequent relations with late-life disability. Less is known, however, about how depressive symptoms change with the progression of disability-related processes and what factors moderate such changes.
We applied multiphase growth models to longitudinal data pooled across 4 Swedish studies of very old age (N = 779, M age = 86 years at disability onset, 64% women) to describe change in depressive symptoms prior to disability onset, at or around disability onset (the measurement wave at which assistance in personal activities of daily living was first recorded), and postdisability onset.
Results indicate that, on average, depressive symptoms slightly increase with approaching disability, increase at onset, and decline in the postdisability phase. Age, study membership, being a woman, and multimorbidity were related to depressive symptoms, but social support emerged as the most powerful predictor of level and change in depressive symptoms.
Our findings are consistent with conceptual notions implicating disability-related factors as key contributors to late-life change and suggest that contextual and psychosocial factors play a pivotal role for how well people adapt to late-life challenges.
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Developmental processes are inherently time-related, with various time metrics and transition points being used to proxy how change is organized with respect to the theoretically underlying mechanisms. Using data from 4 Swedish studies of individuals aged 70-100+ (N = 453) who were measured every 2 years for up to 5 waves, we tested whether depressive symptoms (according to the Center for Epidemiologic Studies Depression Scale; Radloff, 1977) are primarily driven by aging-, disablement-, or mortality-related processes, as operationally defined by time-from-birth, time-to/from-disability-onset (1st reported impairment in Personal Activities of Daily Living; Katz, Ford, Moskowitz, Jackson, & Jaffe, 1963), and time-to-death metrics. Using an approach based on Akaike weights, we tested whether developmental trajectories (for each time metric) of depressive symptoms in late life are more efficiently described as a single continuous process or as a 2-phase process. Comparing fits of linear and multiphase growth models, we found that 2-phase models demonstrated better fit than did single-phase models across all time metrics. Time-to-death and time-to/from-disability-onset models provided more efficient descriptions of changes in depressive symptoms than did time-from-birth models, with time-to-death models representing the best overall fit. Our findings support prior research that late-life changes in depressive symptoms are driven by disablement and, particularly, mortality processes, rather than advancing chronological age. From a practical standpoint, time-to/from-disability-onset and, particularly, time-to-death metrics may provide better "base" models from which to examine changes in late-life depressive symptoms and determine modifiable risk and protective factors. Developmental researchers across content areas can compare age with other relevant time metrics to determine if chronological age or other processes drive the underlying developmental change in their construct of interest.
Life-span developmentalists have long been interested in the nature of and the contributing factors to successful aging. Using variable-oriented approaches, research has revealed critical insights into the intricacies of human development and successful aging. In the present study, we opted instead for a more subgroup-oriented approach and examined multiple-indicator information of late-life change at the person level. We applied latent profile analysis to 8-year longitudinal data pooled together across 4 Swedish studies of the oldest old (N = 1,008; Mage = 81 years at Time 1; 61% women). Results revealed 4 psychosocial aging profiles with uneven patterns of successful (and less successful) aging characterized by distinct trajectories of change across indicators of depressive symptoms, social, and memory functions: a preserved system integrity group of participants who maintained functioning across very old age; an aging in isolation group with a persistent lack of social support, and 2 groups of people with average well-being and social functions but distinctive memory profiles. A compromised memory group was characterized by poor memory throughout late life, whereas participants in a memory failing group exhibited dramatic memory declines late in life. The subgroups were also differentiated by sociodemographic characteristics, functional limitations, and mortality hazards, which may have served as antecedents, correlates, or consequents of profile trajectories. We discuss the promises and challenges of using subgroup-oriented approaches in the study of successful aging.