Comparing Years of Healthy Life, Measured in 16 Ways, for Normal Weight and Overweight Older Adults

Diehr, Paula; Thielke, Stephen; O’Meara, Ellen S.; Fitzpatrick, Annette L.; Newman, Anne B.

doi:10.1155/2012/894894

Cited by 9 publications

(10 citation statements)

References 28 publications

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“…Otherwise the missing value was imputed from the person's last available value, self-rated health, and eventual date of death[28]. Over the 6-year study period, 8% of IADL values were imputed.…”

Section: Methodsmentioning

confidence: 99%

Disability and Recovery of Independent Function in Obstructive Lung Disease: The Cardiovascular Health Study

et al. 2014

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Background: Chronic obstructive lung disease frequently leads to disability. Older patients may experience transitions between states of disability and independence over time. Objective: To identify factors associated with transition between states of disability and independent function in obstructive lung disease. Methods: We analyzed data on 4,394 participants in the Cardiovascular Health Study who completed prebronchodilator spirometry. We calculated the 1-year probability of developing and resolving impairment in ≥1 instrumental activity of daily living (IADL) or ≥1 activity of daily living (ADL) using transition probability analysis. We identified factors associated with resolving disability using relative risk (RR) regression. Results: The prevalence of IADL impairment was higher with moderate (23.9%) and severe (36.9%) airflow obstruction compared to normal spirometry (22.5%; p < 0.001). Among participants with severe airflow obstruction, 23.5% recovered independence in IADLs and 40.5% recovered independence in ADLs. In the adjusted analyses, airflow obstruction predicted the development of IADL, but not ADL impairment. Participants with severe airflow obstruction were less likely to resolve IADL impairment [RR 0.67 and 95% confidence interval (CI) 0.49-0.94]. Compared to the most active individuals (i.e. who walked ≥28 blocks per week), walking less was associated with a decreased likelihood of resolving IADL impairment (7-27 blocks: RR 0.81 and 95% CI 0.69-0.86 and <7 blocks: RR 0.73 and 95% CI 0.61-0.86). Increased strength (RR 1.16 and 95% CI 1.05-1.29) was associated with resolving IADL impairment. Conclusions: Disability is common in older people, especially in those with severe airflow obstruction. Increased physical activity and muscle strength are associated with recovery. Research is needed on interventions to improve these factors among patients with obstructive lung disease and disability.

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Section: Methodsmentioning

confidence: 99%

Disability and Recovery of Independent Function in Obstructive Lung Disease: The Cardiovascular Health Study

et al. 2014

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“…A person who had no difficulties with any of those activities was defined as “Able.” We summed the number of years when a person was Alive (YOL), Healthy (YHL), Able (YABL), and both Healthy and Able (YHABL); (Diehr et al, 1995). These variables have been used as outcomes in other CHS publications (Diehr et al, 2008; Diehr, Patrick, Bild, Burke, & Williamson, 1998; Diehr, Thielke, O’Meara, Fitzpatrick, & Newman, 2012; Hirsch et al, 2010; Locke et al, 2013; Longstreth, Diehr, Yee, Newman, & Beauchamp, 2014). (Population average YABL is conceptually similar to “active life expectancy,” which is mentioned further in the “Method” section.…”

Section: Methodsmentioning

confidence: 99%

Predicting Future Years of Life, Health, and Functional Ability

Diehr

Arnold

et al. 2015

Gerontology and Geriatric Medicine

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Objective: To create personalized estimates of future health and ability status for older adults. Method: Data came from the Cardiovascular Health Study (CHS), a large longitudinal study. Outcomes included years of life, years of healthy life (based on self-rated health), years of able life (based on activities of daily living), and years of healthy and able life. We developed regression estimates using the demographic and health characteristics that best predicted the four outcomes. Internal and external validity were assessed. Results: A prediction equation based on 11 variables accounted for about 40% of the variability for each outcome. Internal validity was excellent, and external validity was satisfactory. The resulting CHS Healthy Life Calculator (CHSHLC) is available at http://healthylifecalculator.org. Conclusion: CHSHLC provides a well-documented estimate of future years of healthy and able life for older adults, who may use it in planning for the future.

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“…4 With now over two decade of follow-up, including 16 years since the MRI scan, the goal of the current work was to examine the associations of these different MRI-defined clusters with years of life (YoL), years of healthy life (YHL), and years of able life (YAL) without any limitations in activities of daily living (ADLs). 3,4 We already knew from the original cluster analysis that participants differed significantly across the clusters on many variables, 1 so the goal of this work was not to explore mechanisms for associations but to describe these outcomes. We hypothesize that the longitudinal measures of healthy life and able life would differ across the five clusters, being most preserved in those with the Normal cluster and least preserved in those with the Complex Infarct cluster.…”

Section: Introductionmentioning

confidence: 99%

“…Although associations between the MRI findings, including the five clusters, and measures of health and activity in CHS have been examined in cross‐sectional analyses, longitudinal analyses of these measures have not been performed. In addition to the occurrence of vascular events and death, years of self‐rated healthy life and self‐rated active or able life expectancy have been used in analyses of other exposures such as obesity and physical activity . With more than 2 decades of follow‐up, including 16 years since the MRI scan, the goal of the current study was to examine the associations between these different MRI‐defined clusters and years of life (YoL), years of healthy life (YHL), and years of able life (YAL) without any limitations in activities of daily living (ADLs) .…”

mentioning

confidence: 99%

Brain Imaging Findings in Elderly Adults and Years of Life, Healthy Life, and Able Life over the Ensuing 16 Years: The Cardiovascular Health Study

Longstreth

Diehr

Yee

et al. 2014

J American Geriatrics Society

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OBJECTIVES To determine whether elderly people with different patterns of MRI findings have different long-term outcomes. DESIGN longitudinal cohort study. SETTING the Cardiovascular Health Study. PARTICIPANTS 5,888 people over age 65 were recruited; 3,660 underwent MRI; and 3,230 without a stroke prior to the scan were included in these analyses. MEASUREMENTS Cluster analysis of brain MRI findings was previously used to define five clusters: Normal, Atrophy, Simple Infract, Leukoaraiosis, and Complex Infarct. Participates were subsequently classified as "healthy" if they rated their health as excellent, very good or good and as "able" if they did not report any limitations in activities of daily living (ADLs). Mean years of life (YoL), years of healthy life (YHL) and years of able life (YAL) were calculated over 16 years following the MRI and compared across clusters, using unadjusted and adjusted regression analyses. RESULTS Mean age of participants was 75.0 years. With 16 years of follow-up, mean YoL was 11.3 years; YHL, 8.0; and YAL, 8.4.Outcomes differed significantly across clusters. With or without adjustments, outcomes were all significantly better in the Normal than Complex Infarct cluster. The three remaining clusters had intermediate results, significantly different from the Normal and Complex Infarct clusters but not usually from one another. Over 16 years of follow-up, participants in the Complex Infarct cluster (n=368) spent the largest percentage of their 8.4 years alive being sick (38%) and not able (38%). CONCLUSION Findings on MRI scans in the elderly are associated not only with long-term survival but also with long-term self-rated health and limitation in ADLs. The combination of infarcts and leukoaraiosis carried the worst prognosis, presumably reflecting small vessel disease.

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Comparing Years of Healthy Life, Measured in 16 Ways, for Normal Weight and Overweight Older Adults

Cited by 9 publications

References 28 publications

Disability and Recovery of Independent Function in Obstructive Lung Disease: The Cardiovascular Health Study

Disability and Recovery of Independent Function in Obstructive Lung Disease: The Cardiovascular Health Study

Predicting Future Years of Life, Health, and Functional Ability

Brain Imaging Findings in Elderly Adults and Years of Life, Healthy Life, and Able Life over the Ensuing 16 Years: The Cardiovascular Health Study

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