Healthy ageing and the prediction of mortality and incidence dependence in low- and middle- income countries: a 10/66 population-based cohort study.
Por:
Daskalopoulou C, Prince M, Koukounari A, Haro JM, Panagiotakos DB and Prina AM
Publicada:
5 dic 2019
Ahead of Print:
5 dic 2019
Resumen:
BACKGROUND: In the absence of a consensus on definition and measurement of healthy ageing, we created a healthy ageing index tallying with the functional ability framework provided by the World Health Organization. To create this index, we employed items of functional ability and intrinsic capacity. The current study aims to establish the predictive validity and discrimination properties of this healthy ageing index in settings in Latin American, part of the 10/66 cohort. METHODS: Population-based cohort studies including 12,865 people =65 years old in catchment areas of Cuba, Dominican Republic, Venezuela, Mexico and Peru. We employed latent variable modelling to estimate the healthy ageing scores of each participant. We grouped participants according to the quintiles of the healthy ageing score distribution. Cox's proportional hazard models for mortality and sub-hazard (competing risks) models for incident dependence (i.e. needing care) were calculated per area after a median of 3.9 years and 3.7 years, respectively. Results were pooled together via fixed-effects meta-analysis. Our findings were compared with those obtained from self-rated health. RESULTS: Participants with lowest levels, compared to participants with highest level of healthy ageing, had increased risk of mortality and incident dependence, even after adjusting for sociodemographic and health conditions (HR: 3.25, 95%CI: 2.63-4.02; sub-HR: 5.21, 95%CI: 4.02-6.75). Healthy ageing scores compared to self-rated health had higher population attributable fractions (PAFs) for mortality (43.6% vs 19.3%) and incident dependence (58.6% vs 17.0%), and better discriminative power (Harrell's c-statistic: mortality 0.74 vs 0.72; incident dependence 0.76 vs 0.70). CONCLUSION: These results provide evidence that our healthy ageing index could be a valuable tool for prevention strategies as it demonstrated predictive and discriminative properties. Further research in other cultural settings will assist moving from a theoretical conceptualisation of healthy ageing to a more practical one.
Filiaciones:
Daskalopoulou C:
Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, David Goldberg Centre, De Crespigny Park, London, SE5 8AF, UK.
Prince M:
Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, David Goldberg Centre, De Crespigny Park, London, SE5 8AF, UK
Koukounari A:
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Faculty of Epidemiology and Population Health, London, WC1E 7HT, UK
Haro JM:
Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
Panagiotakos DB:
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
Prina AM:
Department of Health Service and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, David Goldberg Centre, De Crespigny Park, London, SE5 8AF, UK
Green Accepted, Green Published, gold
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