Prevalence of healthy aging among community dwelling adults age 70 and older from five European countries

Simeon Schietzel, Patricia O Chocano-Bedoya, Angelique Sadlon, Michael Gagesch, Walter C Willett, Endel J Orav, Reto W Kressig, Bruno Vellas, René Rizzoli, José A P da Silva, Michael Blauth, John A Kanis, Andreas Egli, Heike A Bischoff-Ferrari, Simeon Schietzel, Patricia O Chocano-Bedoya, Angelique Sadlon, Michael Gagesch, Walter C Willett, Endel J Orav, Reto W Kressig, Bruno Vellas, René Rizzoli, José A P da Silva, Michael Blauth, John A Kanis, Andreas Egli, Heike A Bischoff-Ferrari

Abstract

Background: To compare the prevalence of healthy aging among adults age 70 and older from 5 European countries recruited for the DO-HEALTH clinical trial. Participants were selected for absence of prior major health events.

Methods: Cross-sectional analysis of DO-HEALTH baseline data. All 2,157 participants (mean age 74.9, SD 4.4; 61.7% women) were included and 2,123 had data for all domains of the healthy aging status (HA) definition. HA was assessed based on the Nurses` Health Study (NHS) definition requiring four domains: no major chronic diseases, no disabilities, no cognitive impairment (Montreal Cognitive Assessment, MoCA ≥25), no mental health limitation (GDS-5 <2, and no diagnosis of depression). Association between HA and age, BMI, gender, and physical function (sit-to-stand, gait speed, grip strength) was assessed by multivariate logistic regression analyses adjusting for center.

Results: Overall, 41.8% of DO-HEALTH participants were healthy agers with significant variability by country: Austria (Innsbruck) 58.3%, Switzerland (Zurich, Basel, Geneva) 51.2%, Germany (Berlin) 37.6%, France (Toulouse) 36.7% and Portugal (Coimbra) 8.8% (p <0.0001). Differences in prevalence by country persisted after adjustment for age. In the multivariate model, younger age (OR = 0.95, 95% CI 0.93 to 0.98), female gender (OR = 1.36, 95% CI 1.03 to 1.81), lower BMI (OR = 0.94, 95% CI 0.91 to 0.96), faster gait speed (OR = 4.70, 95% CI 2.68 to 8.25) and faster performance in sit-to-stand test (OR = 0.90, 95% CI 0.87 to 0.93) were independently and significantly associated with HA.

Conclusions: Despite the same inclusion and exclusion criteria preselecting relatively healthy adults age 70 years and older, HA prevalence in DO-HEALTH varied significantly between countries and was highest in participants from Austria and Switzerland, lowest in participants from Portugal. Independent of country, younger age, female gender, lower BMI and better physical function were associated with HA.

Trial registration: DO-HEALTH was registered under the protocol NCT01745263 at the International Trials Registry ( clinicaltrials.gov ), and under the protocol number 2012-001249-41 at the Registration at the European Community Clinical Trial System (EudraCT).

Keywords: DO-HEALTH; Healthy Aging; Older; Senior.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
a Crude and adjusted* prevalence of healthy aging status by country. *Adjusted for by age, gender, education, faller status, timed sit-to-stand performance, grip strength, gait speed. Bars show 95% confidence intervals. b Prevalence of healthy agers by country
Fig. 2
Fig. 2
a Healthy aging status by age groups. b Participants (%) meeting requirements of single domains of the healthy aging status definition

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