How to classify the oldest old according to their health status: A study on 1160 subjects belonging to 552 90+ Italian sib-ships characterized by familial longevity recruited within the GEHA EU Project

Elisa Cevenini, Rodolfo Cotichini, Maria Antonietta Stazi, Virgilia Toccaceli, Maria Scurti, Vincenzo Mari, Maurizio Berardelli, Giuseppe Passarino, Bernard Jeune, Claudio Franceschi, Vladyslav Bezrukov, Hélené Blanché, Lars Bolund, Kaare Christensen, Luca Deiana, Efsthatios Gonos, Antti Hervonen, Tom B L Kirkwood, Peter Kristensen, Alberta LeonPier Giuseppe Pelicci, Markus Perola, Michel Poulain, Irene M. Rea, Josè Remacle, Jean Marie Robine, Stefan Schreiber, Ewa Sikora, P. Eline Slagboom, Liana Spazzafumo, Olivier Toussaint, James W. Vaupel

Research output: Contribution to journalArticlepeer-review

Abstract

The health status of the oldest old, the fastest increasing population segment worldwide, progressively becomes more heterogeneous, and this peculiarity represents a major obstacle to their classification. We compared the effectiveness of four previously proposed criteria (Franceschi et al., 2000; Evert et al., 2003; Gondo et al., 2006; Andersen-Ranberg et al., 2001) in 1160 phenotypically fully characterized Italian siblings of 90 years of age and older (90+, mean age: 93 years; age range: 90-106 years) belonging to 552 sib-ships, recruited in Northern, Central and Southern Italy within the EU-funded project GEHA, followed for a six-year-survival. Main findings were: (i) "healthy" subjects varied within a large range, i.e. 5.2% (Gondo), 8.7% (Evert), 17.7% (Franceschi), and 28.5% (Andersen-Ranberg); (ii) Central Italy subjects showed better health than those from Northern and Southern Italy; (iii) mortality risk was correlated with health status independently of geographical areas; and (iv) 90+ males, although fewer in number, were healthier than females, but with no survival advantage. In conclusion, we identified a modified version of Andersen-Ranberg criteria, based on the concomitant assessment of two basic domains (cognitive, SMMSE; physical, ADL), called "Simple Model of Functional Status" (SMFS), as the most effective proxy to distinguish healthy from not-healthy subjects. This model showed that health status was correlated within sib-ships, suggesting a familial/genetic component.

Original languageEnglish
Pages (from-to)560-569
Number of pages10
JournalMechanisms of Ageing and Development
Volume134
Issue number11-12
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Gender
  • Health status classification
  • Longevity
  • Mortality
  • Oldest old

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