What Matters and What Matters Most for Survival After age 80? A Multidisciplinary Exploration Based on Twin Data

Abstract

Given research and public interest for conditions related to an extended lifespan, we addressed the questions of what matters and what matters most for subsequent survival past age 80. The data was drawn from the population-based and multidisciplinary Swedish OCTO Twin Study, in which a sample (N = 699) consisting of identical and same-sex fraternal twin pairs, followed from age 80 until death, provided detailed data on health, physical functioning, life style, personality, and sociodemographic conditions. Information concerning date of birth and death were obtained from population census register. We estimated heritability using an ACE model and evaluated the role of multiple predictors for the mortality-related hazard rate using Cox regression. Our findings confirmed a low heritability of 12%. As expected, longer survival was associated with being a female, an apolipoprotein E (APOE) e4 allele non-carrier, and a non-smoker. Several diseases were found to be associated with shorter survival (cerebrovascular, dementia, Parkinson’s, and diabetes) as well as certain health conditions (high diastolic blood pressure, low body mass index, and hip fracture). Stronger grip and better lung function, as well as better vision (but not hearing), and better cognitive function (self-evaluated and measured) was related to longer survival. Social embeddedness, better self-evaluated health, and life-satisfaction were also significantly associated with longer survival. After controlling for the impact of comorbidity, functional markers, and personality-related predictors, we found that sex, cerebrovascular diseases, compromised cognitive functioning, self-related health, and life-satisfaction remained as strong predictors. Cancer was only associated with the mortality hazard when accounting for other co-morbidities. The survival estimates were mostly in anticipated directions and contained effect sizes within the expected range. Noteworthy, we found that some of the so-called “soft-markers” remained strong predictors, despite a control for other factors. For example, self-evaluation of health and ratings of life-satisfaction provide additional and valuable information.

Associations of Wellbeing Levels, Changes, and Within-Person Variability With Late-Life All-Cause Mortality Across 12 Years: Contrasting Hedonic vs. Eudaimonic Wellbeing Among Very Old Adults

“…Among middle-aged individuals, none of these indicators was significantly related to mortality risk. However, other studies have found that life satisfaction is meaningfully related to mortality (Parker et al, 1992), also in the oldest-old individuals (Johansson and Thorvaldsson, 2021). In a large US panel study (Willroth et al, 2020), a joint model including several hedonic wellbeing indicators in parallel as mortality predictors was employed.…”

Air pollution, dementia, and lifespan in the socio-economic gradient of aging: perspective on human aging for planning future experimental studies

“…Twin studies consistently show heritability of lifespan of 20%–30% that may be even lower at later ages. The Swedish OCTO Twin Study had 12% heritability of age at death after 80 years ( Johansson and Thorvaldsson, 2021 ). Decades of effort to identify longevity individual genes has identified few candidates, such as the alleles of ApoE and FOXO3A that are shared across human populations.…”

The role of psychosocial resources in explaining the development of socioeconomic inequalities in self-rated health and memory: a prospective study of older UK adults

“…These findings are important because self-rated health is a good indicator of overall health status accounting for biological, social, mental, and functional aspects perceived by individuals [8,9], and is a strong and independent predictor of premature mortality [10]. Likewise, poor self-rated memory can be a precursor of dementia and cognitive impairment in older adults [11,12], and has also been linked to increased mortality risk [13].…”