Transitions among Health States Using 12 Measures of Successful Aging in Men and Women: Results from the Cardiovascular Health Study

Abstract

Introduction. Successful aging has many dimensions, which may manifest differently in men and women at different ages. Methods. We characterized one-year transitions among health states in 12 measures of successful aging among adults in the Cardiovascular Health Study. The measures included self-rated health, ADLs, IADLs, depression, cognition, timed walk, number of days spent in bed, number of blocks walked, extremity strength, recent hospitalizations, feelings about life as a whole, and life satisfaction. We dichotomized variables into “healthy” or “sick,” states, and estimated the prevalence of the healthy state and the probability of transitioning from one state to another, or dying, during yearly intervals. We compared men and women and three age groups (65–74, 75–84, and 85–94). Findings. Measures of successful aging showed similar results by gender. Most participants remained healthy even into advanced ages, although health declined for all measures. Recuperation, although less common with age, still occurred frequently. Men had a higher death rate than women regardless of health status, and were also more likely to remain in the healthy state. Discussion. The results suggest a qualitatively different experience of successful aging between men and women. Men did not simply “age faster” than women.

Decline in Health for Older Adults: Five-Year Change in 13 Key Measures of Standardized Health

“…Further, 10%-21% of persons improved their health in 5 years, depending on the measure, whereas only half or fewer got worse. Unlike the one-hoss shay, living systems can adapt and repair themselves and advanced age does not preclude such positive developments (18). Future research can expand upon these person-level findings.…”

Self-respect through ability to keep fear of frailty at a distance: Successful ageing from the perspective of community-dwelling older people

“…Gender differences have been described for many aspects of ageing and, despite their lower life expectancy, men have been shown to have a higher prevalence of “success” and health as compared to women (Hank, 2011). This difference also appears to become larger with age (Thielke & Dier, 2012). Fifth, the word success could have different meanings in different cultures which are non-English speaking.…”

“…A concept that is frequently used in these discussions is successful ageing, which has been debated in gerontology since the early 1960s (Havighurst, 1961). The dramatic increase in life expectancy during the 20th century in many parts of the world (Christensen, Doblhammer, Rau, & Vaupel, 2009) has led to a further increased interest in this concept and its overlapping terms such as healthy ageing, active ageing, ageing well (Strawbridge, Wallhagen, & Cohen, 2002), and quality of life (Bowling, 2008). The most widely accepted definition of successful ageing so far is that proposed by Rowe and Kahn (1997); absence or avoidance of disease and risk factors for disease, maintenance of physical and cognitive functioning, and engagement with life.…”

Physical activity, fitness, and gray matter volume

“…Age-related reductions in volume are thought to precede and lead to more severe memory loss and cognitive impairment, but there is considerable individual variation in the rate, extent, and regions showing gray matter atrophy in late adulthood (Fjell and Walhovd, 2010; Groves et al, 2012). This recognition of individual variation in volumetric loss has paved the way for research to examine “successful aging”, a term sometimes used to distinguish individuals that have shown less cognitive loss, or fewer markers of brain pathology or dysfunction (e.g., volume loss), than their age-matched counterparts (Thielke and Diehr, 2012). The hope has been to identify lifestyle, behavioral, genetic, and/or biological factors that distinguish “successful aging” from more precipitous losses in function, or “accelerated aging”.…”