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Mortality in Relation to Changes in a Healthy Aging Index: The Health, Aging, and Body Composition Study
Matthew D L O'Connell1,2,3, Megan M Marron1, Robert M Boudreau1
1Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.
Insights
The Healthy Aging Index (HAI) can predict mortality. Worsening HAI scores over nine years in older adults were associated with increased mortality risk.
Area of Science:
- Gerontology
- Public Health
- Biostatistics
Background:
- The Healthy Aging Index (HAI) is a composite measure assessing physiologic health.
- Baseline HAI scores are known predictors of health outcomes.
- Understanding changes in HAI over time is crucial for aging research.
Purpose of the Study:
- To analyze 9-year changes in the Healthy Aging Index (HAI) among older adults.
- To investigate the association between HAI changes and subsequent mortality risk.
Main Methods:
- Utilized data from the Health, Aging, and Body Composition study (N=2,264 initially).
- Constructed HAI scores at years 1 and 10, incorporating systolic blood pressure, lung function, cognitive tests, and biomarkers.
- Employed Cox proportional hazards models to assess relationships between HAI, HAI change, and mortality until year 17.
Main Results:
- HAI scores generally worsened over the 9-year period (mean change: 1.5 points).
- Both year 1 and year 10 HAI scores were significantly associated with increased mortality risk.
- The magnitude of HAI change over time also independently predicted mortality.
Conclusions:
- Increasing HAI scores correlate with advancing age and predict mortality in older adults.
- The HAI is a valuable tool for monitoring health trajectories and understanding aging processes.
- Changes in physiologic function measured by HAI offer prognostic information regarding mortality.
Background:
Baseline scores on a Healthy Aging Index (HAI), including five key physiologic domains, strongly predict health outcomes. This study aimed to characterize 9-year changes in a HAI and explore their relationship to subsequent mortality.
Methods:
Data are from the Health, Aging, and Body Composition study of well-functioning adults aged 70-79 years. A HAI, which ranges from 0 to 10, was constructed at years 1 and 10 of the study including systolic blood pressure, forced expiratory volume, digit symbol substitution test, cystatin C, and fasting glucose. The relationships between the HAI at years 1 and 10 and the change between years and subsequent mortality until year 17 were estimated from Cox proportional hazards models.
Results:
Two thousand two hundred sixty-four participants had complete data on a HAI at year 1, of these 1,122 had complete data at year 10. HAI scores tended to increase (i.e. get worse) over 9-year follow-up, from (mean [SD]) 4.3 (2.1) to 5.7 (2.1); mean within-person change 1.5 (1.6). After multivariable adjustment, HAI score was related to mortality from year 1 (hazard ratio [95% confidence interval] = 1.17 [1.13-1.21] per unit) and year 10 (1.20 [1.14-1.27] per unit). The change between years was also related to mortality (1.08 [1.02-1.15] per unit change).
Conclusions:
HAI scores tended to increase with advancing age and stratified mortality rates among participants remaining at year 10. The HAI may prove useful to understand changes in health with aging.
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