To identify potentially modifiable late-life biological, lifestyle and sociodemographic factors associated with overall and healthy survival to age 85.
Prospective longitudinal cohort study with 21 years of follow-up (1991–2012)
The Hawaii Lifespan Study
1,292 American men of Japanese ancestry (mean age 75.7 years, range 71–82 years) without baseline major clinical morbidity and functional impairments.
Overall survival and healthy survival (free from six major chronic diseases and without physical or cognitive impairment) to age 85. Factors were measured at late-life baseline examinations (1991–1993).
Of 1,292 participants, 1,000 men (77%) survived to age 85 years (34% healthy) and 309 (24%) survived to age 95 years (<1% healthy). Late-life factors associated with survival and/or healthy survival included biological (body mass index, ankle:brachial index, cognitive score, blood pressure, inflammatory markers); lifestyle (smoking, alcohol use, physical activity), and sociodemographic factors (education, marital status). Cumulative late-life baseline risk factor models demonstrated that age-standardized (at 70 years) probability of survival to age 95 years ranged from 27% (no factors) to 7% (≥5 factors); to age 100 years ranged from 4% (no factors) to 0.1% (≥5 factors). Age-standardized (at 70 years) probability of healthy survival to 90 years ranged from 4% (no factors) to 0.01% (≥ 5 factors). There were nine healthy survivors at age 95 years and one healthy survivor at age 100 years.
Several potentially modifiable risk factors in men in late-life (mean age 75.7 years) were associated with markedly increased probability of subsequent healthy survival and longevity.