Fewer Risk Factors in Midlife Linked to Healthier, Longer Lives for Men

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What: A new study specifically pinpoints risk factors that may increase or decrease the odds of living long and healthy lives for middle-aged men. The study, appearing in the Nov. 15, 2006, Journal of the American Medical Association, suggests that the probability of survival to 85 years and above was as high as 69 percent with no risk factors and as low as 22 percent with six or more risk factors. Among the factors associated with reduced disability and longer life were high grip strength and avoidance of overweight, hyperglycemia, high blood pressure, smoking and excessive alcohol consumption. The study tapped data from the Honolulu Heart Program and Honolulu Asia Aging Study, which for 40 years has tracked the health status of thousands of Japanese-American men living in Hawaii.

Funding for the analysis was provided by the National Institute on Aging (NIA) and the National Heart, Lung and Blood Institute, both components of the National Institutes of Health, and by the Hawaii Community Foundation.

The research team, led by Bradley J. Willcox, M.D., of the Pacific Health Research Institute and Kuakini Medical Center in Honolulu, assessed mortality, physical function, cognitive function and the incidence of six major chronic diseases in 5,280 men during periodic checkups done between 1965 and 2005. Chronic diseases of interest in the analysis were coronary heart disease, stroke, cancer (excluding nonmelanoma skin cancer), chronic obstructive pulmonary disease, Parkinson’s disease and treated diabetes.

By age 85, 13 percent of the men were living with one or more of the chronic diseases but no disability, and 18 percent were living with some disability. Another 11 percent of the men””dubbed “exceptional survivors”””reached age 85 with none of the six chronic diseases and no cognitive or physical impairment. The other 58 percent of the men died before they reached their 85th birthdays. Compared with the other groups, the exceptional survivors had greater grip strength in middle age, suggesting that they had been more physically fit. They also tended to be leaner in younger and middle adulthood, and in middle age they had lower triglyceride, glucose and uric acid levels, all key markers of insulin sensitivity, which is associated with the risk of diabetes mellitus and cardiovascular disease.

Why: People in the United States are living longer than ever before, and the “oldest old” (those age 85 and up) are the fastest-growing age group in most industrialized nations. Relatively few men live to be among the oldest old””by age 85, there are 2.2 women for every one man. This study examined the link between certain midlife biological, lifestyle and socio-demographic risk factors and survival to advanced age, shedding new light on factors associated with longer, healthy life among U.S. men. The researchers chose to examine risk factors that can be modified by individuals and easily measured in clinical and research settings.

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