Genetic, Physiological, and Lifestyle Predictors of Mortality in the General Population

Walter, Stefan; Mackenbach, Johan P.; Vokó, Zoltán; Lhachimi, Stefan K.; Ikram, M. Arfan; Uitterlinden, André G.; Newman, Anne B.; Murabito, Joanne M.; García, Melissa; Gudnason, Vilmundur; Tanaka, Toshiko; Tranah, Gregory J.; Wallaschofski, Henri; Kocher, Thomas; Launer, Lenore J.; Franceschini, Nora; Schipper, Maarten; Hofman, Albert; Tiemeier, Henning

doi:10.2105/ajph.2011.300596

Cited by 48 publications

(41 citation statements)

References 47 publications

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“…41 Our study population was homogeneous for age, which enabled us to examine associations free from the strong confounding effect of chronological age; in samples heterogeneous for age, age is consistently found to be one of the strongest predictors of survival and once it is included in the model, inclusion of other factors does little to improve prediction. 42 Another important strength of the analyses was the inclusion of those people unable to perform each test for health reasons.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study

Cooper

Strand

Hardy

et al. 2014

BMJ

140

131

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Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study OPEN AbstractObjectives To examine associations between three commonly used objective measures of physical capability assessed at age 53 and a composite score of these measures and all cause mortality; to investigate whether being unable to perform these tests is associated with mortality. Design Cohort study.Setting MRC National Survey of Health and Development in England, Scotland, and Wales.Participants 1355 men and 1411 women with data on physical capability at age 53 who were linked to the National Health Service (NHS) central register for death notification.Main outcome measure All cause mortality between ages 53 (1999) and 66 (2012).Results For each of the three measures of physical capability (grip strength, chair rise speed, and standing balance time) those participants unable to perform the test and those in the lowest performing fifth were found to have higher mortality rates than those in the highest fifth. Adjustment for baseline covariates partially attenuated associations but in fully adjusted models the main associations remained. For example, the fully adjusted hazard ratio of all cause mortality for the lowest compared with the highest fifth of a composite score of physical capability was 3.68 (95% confidence interval 2.03 to 6.68). Those people who could not perform any of the tests had considerably higher rates of death compared with those people able to perform all three tests (8.40, 4.35 to 16.23). When a series of models including different combinations of the measures were compared by using likelihood ratio tests, all three measures of physical capability were found to improve model fit, and a model including all three measures produced the highest estimate of predictive ability (Harrell's C index 0.71, 95% confidence interval 0.65 to 0.77). There was some evidence that standing balance time was more strongly associated with mortality than the other two measures.Conclusions Lower levels of physical capability at age 53 and inability to perform capability tests are associated with higher rates of mortality. Even at this relatively young age these measures identify groups of people who are less likely than others to achieve a long and healthy life. IntroductionA recent systematic review and additional meta-analyses have provided robust evidence of associations between better performance in objective tests of physical capability, including stronger grip and faster walking speed, and lower rates of all cause mortality in older populations living in the community. Informed by such evidence, these easily administrable tests have been included in recent studies of candidate biomarkers of ageing and have been found to perform well, as assessed by a range of criteria, when compared with more traditional biomarkers including inflammatory markers, blood pressure, and telomere length. Various explanations of the associations between physical capability and mortality have been proposed. Levels of ...

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Section: Methodological Considerationsmentioning

confidence: 99%

Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study

Cooper

Strand

Hardy

et al. 2014

BMJ

140

131

View full text Add to dashboard Cite

show abstract

“…Long-term mortality was also examined in the Rotterdam Study among more than 5,000 participants who were aged ≥55 years at enrollment and were followed up for a median of 15 years, with a focus on genetic markers in addition to lifestyle, risk factors, and prevalent diseases (30). Although genetic factors independently contributed to mortality risk, the joint contribution to risk prediction was modest.…”

Section: Behavioral and Cardiovascular Risk And Longevitymentioning

confidence: 99%

“…Although genetic factors independently contributed to mortality risk, the joint contribution to risk prediction was modest. Beyond age and sex, physiologic parameters, prevalent disease, lifestyle, general health, and socioeconomic factors contributed to mortality risk (30). Six longitudinal studies of older persons from Europe and Israel found similar predictors of death across countries, including age, male sex, smoking, prevalent diseases, and disability (31).…”

Section: Behavioral and Cardiovascular Risk And Longevitymentioning

confidence: 99%

“…The mechanism of the benefit of caloric restriction appears to involve a reduction in growth factor signaling in response to nutrient deprivation. These findings are controversial, as it is clear from existing studies that caloric restriction is not essential for longevity and that the longest-lived older adults often have body mass indices in the overweight range (i.e., [25][26][27][28][29][30].…”

Section: Genetic Factorsmentioning

confidence: 99%

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The Epidemiology of Longevity and Exceptional Survival

Newman¹,

Murabito²

2013

Epidemiologic Reviews

103

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“…Apart from a few genetic factors, such as APOE, that remain stable throughout life, not many long-term predictors of mortality have been identified. 26 Our findings that microvascular damage, both arteriolar and venular, associate with mortality beyond a 10-year horizon might open the way for further risk prediction and prognostic research incorporating these markers. Given the semiautomated and noninvasive nature of measuring retinal vessels, there might thus be an opportunity for translation to clinical practice and public health.…”

Section: Discussionmentioning

confidence: 78%

Retinal Microvasculature Is Associated With Long-Term Survival in the General Adult Dutch Population

et al. 2016

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Genetic, Physiological, and Lifestyle Predictors of Mortality in the General Population

Abstract: Mortality can be predicted reasonably well over a long period. Genetic factors independently predict mortality, but only modestly more than other risk indicators.

Cited by 48 publications

References 47 publications

Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study

Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study

The Epidemiology of Longevity and Exceptional Survival

Retinal Microvasculature Is Associated With Long-Term Survival in the General Adult Dutch Population

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