LIfestyle predictors among healthy aging men

1. Lifestyle
Predictors of
Healthy Aging Men
MARC EVANS M. ABAT, MD, FPCP, FPCGM
Head, Center for Healthy Aging, The Medical City

2. Healthy
AgingDiet
Exercise
Sleep
Smoking
Alcohol Stress

3. • 12,201 men aged 65-83 years and followed for 10-13 years
• Active men
• lower HR for death (HR=0.74, 95% CI=0.68 to 0.81)
• Higher completion of follow-up among survivors (risk ratio,
RR=1.18, 95% CI=1.08 to 1.30)
• greater chance of fulfilling criteria for healthy ageing (RR=1.35,
95% CI=1.19 to 1.53)
Br J Sports Med. 2014 Feb;48(3):220-5. doi:
10.1136/bjsports-2013-092814.

4. Heiret al. BMC Public Health2013,13:831
Low BMI and increasing physical fitness are associated with longevity

5. Br J Sports Med. 2014 Feb;48(3):233-8. doi:
10.1136/bjsports-2012-092038
• 4232 individuals, 60 years old, assessed for non-exercise physical
activity (NEPA)
• High NEPA
• lower risk of a first CVD event (HR=0.73; 95% CI 0.57 to 0.94)
• lower all-cause mortality (0.70; 0.53 to 0.98)
• Observe for regularly- and non-regular exercising individuals

6. J Am Geriatr Soc. 2014 May ; 62(5): 880–888. doi:10.1111/jgs.12796
In essence, there is less chance of survival if you are:
• Unmarried
• BMI < 19
• Low FEV1
• Slow walking speed
If you do survive to 85 years old, you are probably unhealthy if:
• Low education (<12 years)
• BMI >25

7. J Am Geriatr Soc. 2014 May ; 62(5): 880–888. doi:10.1111/jgs.12796
In essence, there is less chance of survival if you are:
• Current smoker
• Past smoker (but OR less than current smoker)
• Drinks 15 ounces alcohol per month
• Low physical activity

8. • 1004 respondents in Łódź, Poland
• Tobacco smoking has a negative influence on male longevity
• Alcohol consumed in moderate amounts favours male longevity
• physical activity was too low to affect longevity
• A diet rich in fish and consumption of yellow cheese are positive
predictors of longevity
• additional use of table salt at meals and consumption of sweets
(cakes) are negative ones
International Journal of Occupational Medicine and
Environmental Health 2013;26(3):337 – 348

9. Exercise in Swedish Men
In general…
Higher activity levels lead to
less chances of dying
(i.e. longer time for the 10th
percentile of a particular
activity level to possibly die)
International Journal of Behavioral Nutrition and Physical
Activity2013,10:94

10. Education, Cognitive Activities
JAMA Neurol. 2014 Aug;71(8):1017-24. doi:
10.1001/jamaneurol.2014.963.
For both APOε4 carriers and
non-carriers, high educational
attainment and higher
occupational scores are
related to higher cognitive
levels.
High lifetime continuous
educational activities might
delay cognitive decline

11. • a cohort of 120,852 men and women aged 55–69 y
Non-significant HR if BMI is
18.5 to < 25
Significant HR if non-smoker
or stopped > 10 years
Am J Clin Nutr2011;94:913–20.
Significant HR if physical
activity > 30 min/day
Significant HR if more
adherent to Mediterranean
diet

12. • cross-sectional data from the Fourth Korea National Health and
Nutrition Examination Survey in 2008-09
• 823 community-dwelling men aged ≥65 years.
• Risk for sarcopenia
• highest quintile of vegetables intake [odds ratio (OR) = 0.48; 95% confidence
interval (CI): 0.24-0.95]
• Fruit intake (OR = 0.30; 95% CI: 0.13-0.70)
• vegetables and fruits consumption (OR = 0.32; 95% CI: 0.16-0.67)
Age Ageing. 2015 Jan;44(1):96-102. doi:
10.1093/ageing/afu028. Epub 2014 Mar 18.
Sarcopenia-loss of muscle mass, strength and
endurance

13. • Swedish men investigated in 1970-74 (aged 48.6-51.1) and followed
up for four decades (N=2,293)
• midlife BMI was negatively associated (OR=0.80/SD, 95% CI=0.65-
0.99/SD) with independent aging
• never or former smoking was positively associated (OR=1.66, 95%
CI=1.07-2.59), with independent aging.
J Am Geriatr Soc. 2015 May;63(5):877-85. doi:
10.1111/jgs.13352

14. • Sleep duration was related to mortality
• age-, sex-, and race-adjusted hazard ratios (HR) were highest for those with
the shortest (< 6 h HR: 1.30, CI: 1.05–1.61) and longest (> 8 h HR: 1.49, CI:
1.15–1.93) sleep durations
• Short sleepers (<6 hours): mortality associated with inflammatory
markers, lifestyle and health status
• Long sleepers (8 hours or more): mortality associated with lifestyle
and health status
• Directionality cannot be determined by analysis
Sleep. 2015 Feb 1; 38(2): 189–195.

15. • 1293 men (Mean age=65.58, SD=7.01), participants in the VA
Normative Aging Study
• moderate stressful life event (SLE) trajectories (38%) more likely to die
than those with low SLE trajectories
• HR=1.42, 95% CI [1.16, 3.45]
• Compared to those with low hassles trajectory,
• moderate non-linear hassles trajectory, HR=1.63, 95% CIg [1.19, 2.23]
• high hassles trajectory, HR=3.30, 95% CI [1.58, 6.89]
Exp Gerontol. 2014 Nov;59:74-80. doi:
10.1016/j.exger.2014.06.019.
Stressful life event (SLE) – big, major events like death in family
Hassles – small, daily nuiances like chores, traffic

16. • (N = 2,149) aged 65 and older at baseline, in a developing country
characterized by low life expectancy
• Men who aged successfully
• more likely never to have smoked (adjusted odds ratio (aOR) = 4.7, 95%
confidence interval (CI) = 1.55-14.46)
• at baseline, having contacts with friends (aOR = 4.2, 95% CI = 1.0-18.76)
• or participating in community activities (aOR = 16.0, 95% CI = 1.23-204.40)
J Am Geriatr Soc. 2014 May;62(5):836-42.

17. In Summary
Normal body
weight
Physical
Activity
Favorable
Diet
Avoidance of
vices (e.g.
smoking)
Moderate
alcohol intake
Sleep?
Stress
Management

18. Features of the
Super Senior
• Excellent functionality
• Excellent cognition
• Minimal and
controlled co-
morbidities
• Excellent perception of
general health
• Look younger for their
age