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Aging Trajectories…

AuthorsGhisla V, Chocano-Bedoya PO, Orav EJ, Abderhalden LA, Sadlon A, Egli A, Krützfeldt J, Kanis JA, Bischoff-Ferrari HA; DO-HEALTH research group
TitleProspective Study of Ageing Trajectories in the European DO-HEALTH Study
JournalGerontology 2023;69(1):57-64
doi: 10.1159/000523923 Epub 2022 Apr 20 PMID: 35443250 PMCID: PMC9148895


Introduction: Ageing trajectories range from delayed ageing with extended health to accelerated ageing, with an increased risk of frailty. We evaluated the prevalence and prospective change between health states among community-dwelling European older adults.

Methods: This prospective study is a secondary analysis of DO-HEALTH, a randomized trial that included adults aged 70 years and older across 5 European countries. Healthy agers (HA) fulfilled the Nurses’ Health Study healthy ageing criteria and accelerated agers were non-HA being at least pre-frail according to the Fried frailty criteria. We assessed the proportion of participants changing between health states over 4 assessments and evaluated the odds of changing to a more favourable category. To increase reliability and avoid regression to the mean, we averaged the first 2 years and compared them to the average of the last 2 years.

Results: Of 2,157 participants, 12.4% were excluded for meeting both healthy ageing and pre-frailty criteria simultaneously. Among the remaining 1,889 participants (mean age 75.1 years, 60.9% female), 23.1% were initially HA, 44.4% were non-HA but not pre-frail, and 32.6% were pre-frail or frail. Subsequently, 65.3% remained in the same health state, 12.0% improved to a healthier state, and 22.8% progressed to a less advantageous state. After adjusting for sex, study centre, treatment, and body mass index, each year of age was associated with 6% lower odds of improving health states. Women had 35% higher odds than men of following a disadvantageous trajectory.

Conclusion: We observed dynamic trajectories of ageing where transitioning to a healthier state became less likely with advancing age and among women.

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