Avoiding health risk factors in midlife such as smoking, being overweight, excessive drinking and hypertension is associated with a longer and healthier life in men, according to a study in the November 15 issue of JAMA: The Journal of the American Medical Association, a theme issue on men's health.
Bradley J. Willcox, M.D., of the Pacific Health Research Institute and Kuakini Medical Center in Honolulu, presented the findings of the study today at a JAMA media briefing on men's health in New York.
Persons alive at age 85 years or older are the fastest-growing age group in most industrialized countries and are among the largest consumers of health care resources. Identifying strategies for remaining healthy, vigorous, and disability-free at older ages has become a major priority, according to background information in the article. Studies with substantial numbers of long-lived participants and characteristics associated with longer survival are rare but essential to identify risk factors for health and survival at older ages.
Dr. Willcox and colleagues examined potential biological, lifestyle, and sociodemographic risk factors present at middle-age to identify risk factors for healthy survival. The study included 5,820 Japanese-American middle-aged men (average age, 54) in the Kuakini Honolulu Heart Program/Honolulu Asia Aging Study. The participants were free of illness and functional impairments and were followed for up to 40 years (1965-2005) to assess overall and exceptional survival. Exceptional survival was defined as survival to a specified age (75, 80, 85, or 90 years) without incidence of 6 major chronic diseases and without physical and cognitive impairment. The diseases were coronary heart disease, stroke, cancer (excluding nonmelanoma skin cancer), chronic obstructive pulmonary disease, Parkinson disease, and treated diabetes. Of the 5,820 original participants, 2,451 participants (42 percent) survived to age 85 years and 655 participants (11 percent) met the criteria for exceptional survival to age 85 years.
The researchers found that high grip strength and avoidance of overweight, hyperglycemia, hypertension, smoking, and excessive alcohol consumption were associated with both overall and exceptional survival. In addition, high education and avoidance of hypertriglyceridemia (elevated triglyceride level) were associated with exceptional survival, and lack of a marital partner was associated with death before age 85 years.