Sixteen-year predictors of successful aging from a Southern Brazilian cohort The PALA study

ABSTRACT Successful aging (SA) is a current positive aging-related perspective and it is important to determine the variables associated with this concept. Most longitudinal population-based studies on predictors of SA were carried out in developed countries. Objective: This investigation evaluated which baseline characteristics predicted successful aging in 16 years of follow-up in a southern Brazilian cohort - the Porto Alegre Longitudinal Aging study. Methods: At baseline, 345 community-dwelling healthy independent individuals aged 60 or older were assessed for medical and psychiatric conditions, memory, orientation, judgment and problem solving, functioning in the community and at home, and hobbies. SA, according to Rowe and Kahn’s definition, was the outcome assessed in the last evaluation at a maximum 16-year follow-up. All baseline variables were evaluated as potential predictors for the outcome SA. Results: Of the 345 individuals evaluated at baseline, 32 (9.3%) participants were classified as successful agers in the follow-up. Younger age (OR=0.926, 95%CI=0.863-0.994), female gender (OR=0.226, 95%CI=0.072-0.711) and higher MMSE (OR=1.220, 95%CI=1.031-1.444) were predictors of SA for the 16-year follow-up in a logistic regression model. Conclusion: In contrast with our previous hypothesis, the impact of the socioeconomic and socio-environmental characteristics was small, as was the baseline classification into successful and normal aging.

摘要：成功老化（Successful Aging，SA）是当前主流的积极老龄化视角，明确与该概念相关的影响变量具有重要研究价值。现有针对成功老化预测因素的纵向人群队列研究多开展于发达国家。
研究目的：本研究依托巴西南部阿雷格里港纵向老龄化队列（Porto Alegre Longitudinal Aging Study），旨在明确该队列16年随访周期内，基线特征对成功老化的预测作用。
研究方法：本研究于基线阶段纳入345名年龄≥60岁、居住于社区且健康独立的受试者，对其医疗与精神状况、记忆、定向力、判断力与问题解决能力、社区与家庭生活功能及个人爱好进行评估。本研究以鲁与卡恩（Rowe and Kahn）提出的成功老化定义作为结局指标，在最长16年随访的末次评估中完成结局判定，并将所有基线变量作为成功老化结局的潜在预测因素开展分析。
研究结果：基线阶段纳入的345名受试者中，最终有32名（9.3%）在随访阶段被归类为成功老化者。经逻辑回归（Logistic Regression）分析显示，较年轻的年龄（优势比（Odds Ratio，OR）=0.926，95%置信区间（Confidence Interval，CI）=0.863~0.994）、女性性别（OR=0.226，95%CI=0.072~0.711）及更高的简易精神状态检查表（Mini-Mental State Examination，MMSE）得分（OR=1.220，95%CI=1.031~1.444）是16年随访中成功老化的独立预测因素。
研究结论：与本研究团队此前的假设相悖，社会经济与社会环境特征对成功老化的预测作用较弱，基线时的成功老化与正常老化分类的预测价值同样有限。