Toggle Main Menu Toggle Search

Open Access padlockePrints

Healthy ageing and the prediction of mortality and incidence dependence in low- And middle- income countries: A 10/66 population-based cohort study

Lookup NU author(s): Professor Matthew Prina

Downloads


Licence

This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2019 The Author(s).Background: In the absence of a consensus on definition and measurement of healthy ageing, we created a healthy ageing index tallying with the functional ability framework provided by the World Health Organization. To create this index, we employed items of functional ability and intrinsic capacity. The current study aims to establish the predictive validity and discrimination properties of this healthy ageing index in settings in Latin American, part of the 10/66 cohort. Methods: Population-based cohort studies including 12,865 people ≥65 years old in catchment areas of Cuba, Dominican Republic, Venezuela, Mexico and Peru. We employed latent variable modelling to estimate the healthy ageing scores of each participant. We grouped participants according to the quintiles of the healthy ageing score distribution. Cox's proportional hazard models for mortality and sub-hazard (competing risks) models for incident dependence (i.e. needing care) were calculated per area after a median of 3.9 years and 3.7 years, respectively. Results were pooled together via fixed-effects meta-analysis. Our findings were compared with those obtained from self-rated health. Results: Participants with lowest levels, compared to participants with highest level of healthy ageing, had increased risk of mortality and incident dependence, even after adjusting for sociodemographic and health conditions (HR: 3.25, 95%CI: 2.63-4.02; sub-HR: 5.21, 95%CI: 4.02-6.75). Healthy ageing scores compared to self-rated health had higher population attributable fractions (PAFs) for mortality (43.6% vs 19.3%) and incident dependence (58.6% vs 17.0%), and better discriminative power (Harrell's c-statistic: mortality 0.74 vs 0.72; incident dependence 0.76 vs 0.70). Conclusion: These results provide evidence that our healthy ageing index could be a valuable tool for prevention strategies as it demonstrated predictive and discriminative properties. Further research in other cultural settings will assist moving from a theoretical conceptualisation of healthy ageing to a more practical one.


Publication metadata

Author(s): Daskalopoulou C, Prince M, Koukounari A, Haro JM, Panagiotakos DB, Prina AM

Publication type: Article

Publication status: Published

Journal: BMC Medical Research Methodology

Year: 2019

Volume: 19

Issue: 1

Online publication date: 05/12/2019

Acceptance date: 14/10/2019

Date deposited: 21/08/2023

ISSN (electronic): 1471-2288

Publisher: BioMed Central Ltd.

URL: https://doi.org/10.1186/s12874-019-0850-5

DOI: 10.1186/s12874-019-0850-5

Data Access Statement: The 10/66 Dementia Research Group dataset is available upon request via the official site of the study: https://www.alz.co.uk/1066. All data generated in this study are available from the corresponding author on reasonable request.

PubMed id: 31801461


Altmetrics

Altmetrics provided by Altmetric


Funding

Funder referenceFunder name
635316
ATHLOS (Ageing Trajectories of Health: Longitudinal Opportunities and Synergies)
ERC-2013-ADG 340755
European Research Council
European Union Horizon 2020 Research and Innovation Programme
FONDACIT (Venezuela)
IIRG – 04 – 1286
GR066133
GR080002
MR/K021907/1
LIFE2YEARS1066
MRC
US Alzheimer’s Association
Wellcome Trust
World Health Organization

Share