Effect of Health Protective Factors on Health Deficit Accumulation and Mortality Risk in Older Adults in the Beijing Longitudinal Study of Aging

• Autores: Chunxiu Wang, Xiaowei Song, Arnold Mitnitski, Xianghua Fang, Zhe Tang, Pulin Yu, Kenneth Rockwood
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 62, Nº. 5, 2014, págs. 821-828
• Idioma: inglés
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• Resumen

  • Objectives: To evaluate transitions in health status and risk of death in older adults in relation to baseline health deficits and protective factors.

    Design: Prospective cohort study with reassessments at 5, 8, and 15 years.

    Setting: Secondary analysis of data from the Beijing Longitudinal Study on Aging.

    Participants: Urban and rural community-dwelling people aged 55 and older at baseline (n = 3,275), followed from 1992 to 2007, during which time 51% died.

    Measurements: Health status was quantified using the deficit accumulation�based frailty index (FI), constructed from 30 intrinsic health measures. A protection index was constructed using 14 extrinsic items (e.g., exercise, education). The probabilities of health changes, including death, were evaluated using a multistate transition model.

    Results: Women had more health deficits (mean baseline FI 0.13 ± 0.11) than did men (mean baseline FI 0.11 ± 0.10). Although health declined on average (mean FIs increased), improvement and stability were common. Baseline health significantly affected health transitions and survival over various follow-up durations (odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.17�1.37 for men; OR = 1.24, 95% CI = 1.16�1.33 for women for each increment of deficits). Each protective factor reduced the risk of health decline and the risk of death in men and women by 13% to 25%.

    Conclusion: Deficit accumulation�based transition modeling demonstrates persisting effects of baseline health status on age-related health outcomes. Some mitigation by protective factors can be demonstrated, suggesting that improving physical and social conditions might be beneficial.