Determinants of Health Trajectories in England and the United States: An Approach to Identify Different Patterns of Healthy Aging

J, de la Fuente; Caballero, Francisco Félix; Sánchez-Niubò, Albert; Panagiotakos, Demosthenes B.; Prina, Matthew; Arndt, Holger; Haro, Josep María; Chatterji, Somnath; Ayuso-Mateos, José Luís

doi:10.1093/gerona/gly006

Cited by 37 publications

(39 citation statements)

References 43 publications

(49 reference statements)

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“…Based on a representative sample of older adults from Mexico, we generated a metric of health status in older age incorporating multiple dimensions of functioning measures and identified different groups of ageing trajectories across 14 years of follow-up. The findings in our study are consistent with previous research indicating that health outcome in older life is quite a heterogeneous process 45–48 . In our dataset, we identified four distinct latent trajectories of health which we named as follows: “decliners”, “moderate-stable”, “high-stable” and “low-stable”.…”

Section: Discussionsupporting

confidence: 93%

Healthy ageing trajectories and lifestyle behaviour: the Mexican Health and Aging Study

Daskalopoulou

Koukounari

et al. 2019

Sci Rep

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Projections show that the number of people above 60 years old will triple by 2050 in Mexico. Nevertheless, ageing is characterised by great variability in the health status. In this study, we aimed to identify trajectories of health and their associations with lifestyle factors in a national representative cohort study of older Mexicans. We used secondary data of 14,143 adults from the Mexican Health and Aging Study (MHAS). A metric of health, based on the conceptual framework of functional ability, was mapped onto four waves (2001, 2003, 2012, 2015) and created by applying Bayesian multilevel Item Response Theory (IRT). Conditional Growth Mixture Modelling (GMM) was used to identify latent classes of individuals with similar trajectories and examine the impact of physical activity, smoking and alcohol on those. Conditional on sociodemographic and lifestyle behaviour four latent classes were suggested: high-stable, moderate-stable, low-stable and decliners. Participants who did not engage in physical activity, were current or previous smokers and did not consume alcohol at baseline were more likely to be in the trajectory with the highest deterioration (i.e. decliners). This study confirms ageing heterogeneity and the positive influence of a healthy lifestyle. These results provide the ground for new policies.

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Section: Discussionsupporting

confidence: 93%

Healthy ageing trajectories and lifestyle behaviour: the Mexican Health and Aging Study

Daskalopoulou

Koukounari

et al. 2019

Sci Rep

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“…Whilst most of the population exhibited a stable trajectory at a high level of health, we found two subgroups with alternative trajectories: one with a stable lower level of health; and a third subgroup starting at a similar point as the majority of the population but whose health severely deteriorated over time. These results were similar to those reported in previous studies in terms of the number and shape of the different trajectories [9,29,30], although in some of these studies the declining trajectories comprised a higher percentage of the population. Our findings were replicated in the sensitivity analyses, supporting the existence of heterogeneity in ageing trajectories and the importance of accounting for this heterogeneity when studying healthy ageing [3,4].…”

Section: Interpretation Of Findingssupporting

confidence: 92%

The impact of physical activity on healthy ageing trajectories: evidence from eight cohort studies

Moreno-Agostino

Daskalopoulou

et al. 2020

Int J Behav Nutr Phys Act

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Background: Research has suggested the positive impact of physical activity on health and wellbeing in older age, yet few studies have investigated the associations between physical activity and heterogeneous trajectories of healthy ageing. We aimed to identify how physical activity can influence healthy ageing trajectories using a harmonised dataset of eight ageing cohorts across the world. Methods: Based on a harmonised dataset of eight ageing cohorts in Australia, USA, Mexico, Japan, South Korea, and Europe, comprising 130,521 older adults (M age = 62.81, SD age = 10.06) followed-up up to 10 years (M follow-up = 5.47, SD follow-up = 3.22), we employed growth mixture modelling to identify latent classes of people with different trajectories of healthy ageing scores, which incorporated 41 items of health and functioning. Multinomial logistic regression modelling was used to investigate the associations between physical activity and different types of trajectories adjusting for sociodemographic characteristics and other lifestyle behaviours. Results: Three latent classes of healthy ageing trajectories were identified: two with stable trajectories with high (71.4%) or low (25.2%) starting points and one with a high starting point but a fast decline over time (3.4%). Engagement in any level of physical activity was associated with decreased odds of being in the low stable (OR: 0.18; 95% CI: 0.17, 0.19) and fast decline trajectories groups (OR: 0.44; 95% CI: 0.39, 0.50) compared to the high stable trajectory group. These results were replicated with alternative physical activity operationalisations, as well as in sensitivity analyses using reduced samples. Conclusions: Our findings suggest a positive impact of physical activity on healthy ageing, attenuating declines in health and functioning. Physical activity promotion should be a key focus of healthy ageing policies to prevent disability and fast deterioration in health.

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“…However, the studies often involve complex, resource-intensive study designs, are conducted among a relatively small sample, and might not be generalisable or comparable across study settings. The measures are often not identical or similarly understood and tested across study populations or over time, making these studies and the longitudinal waves difficult to compare or to be aggregated into population-level metrics 13, 14, 15. Another challenge is that none of these studies and measures take most diseases and their severity into account.…”

Section: Introductionmentioning

confidence: 99%

Measuring population ageing: an analysis of the Global Burden of Disease Study 2017

Chang

Skirbekk

Tyrovolas

et al. 2019

The Lancet Public Health

447

302

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Background Sustainable Development Goal (SDG) 3.3, targets to eliminate HIV from being a public health threat by 2030. For better tracking of this target interim Fast Track milestones for 2020 and composite complementary measures have been indicated. This study measured the Fast Track progress in the epidemiology of HIV/AIDS in Ethiopia across ages compared to neighboring countries. Methods The National Data Management Center for health's research team at the Ethiopian Public Health Institute has analyzed the Global Burden of Disease (GBD) 2017 secondary data for the year 2010 to 2017 for Ethiopia and its neighbors. GBD 2017 data sources were census, demographic and a health survey, prevention of mother-to-child HIV transmission, antiretroviral treatment programs, sentinel surveillance, and UNAIDS reports. Age-standardized and age-speci c HIV/AIDS incidence, prevalence, mortality, Disability-Adjusted Life Years (DALYs), incidence:mortality ratio and incidence:prevalence ratio were calculated with corresponding 95% con dence intervals. Results Ethiopia and neighboring countries recorded slow progress in reducing new HIV infection since 2010. Only Uganda would achieve the 75% target by 2020. Ethiopia, Tanzania, and Uganda already achieved the 75% mortality reduction target set for 2020. The incidence: prevalence ratio for Ethiopia, Rwanda, and Uganda were < 0.03, indicating the countries were on track to end HIV by 2030. Ethiopia had an incidence: mortality ratio <1 due to high mortality; while Kenya, Rwanda, Tanzania and Uganda had a ratio of >1 due to high incidence. The HIV incidence rate in Ethiopia was dropped by 76% among under 5 children in 2017 compared to 2010 and the country would likely to attain the 2020 national target, but far behind achieving the target among the 15-49 age group. Conclusions Ethiopia and neighboring countries have made remarkable progress towards achieving the 75% HIV/AIDS mortality reduction target by 2020, although they progressed poorly in reducing HIV incidence. By recording an incidence:prevalence ratio benchmark of less than 0.03, Ethiopia, Rwanda, and Uganda are well heading towards epidemic control. Nonetheless, the high HIV/AIDS mortality rate in Ethiopia for its incidence requires innovative strategies to reach out undiagnosed cases and to build institutional capacity for generating strong evidence to ensure sustainable epidemic control.

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Determinants of Health Trajectories in England and the United States: An Approach to Identify Different Patterns of Healthy Aging

Cited by 37 publications

References 43 publications

Healthy ageing trajectories and lifestyle behaviour: the Mexican Health and Aging Study

Healthy ageing trajectories and lifestyle behaviour: the Mexican Health and Aging Study

The impact of physical activity on healthy ageing trajectories: evidence from eight cohort studies

Measuring population ageing: an analysis of the Global Burden of Disease Study 2017

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