Health and Aging

A new study may shift how we define health and aging. Instead of focusing on diseases, researchers looked at 54 health measures to see which factors or clusters of factors had the greatest association with mortality or incapacity. These factors fell into six major health categories: diseases, health behaviors, psychological health, sensory function, immunity, and frailty. Six clusters of conditions emerged from this analysis: The first cluster was, surprisingly, the “robust obese group”. None of these individuals had a normal BMI, but they had the fewest diseases or vulnerabilities. This group had the lowest prevalence of dying or incapacity 5 years later! The second cluster was “one minor condition group”, comprised of individuals of normal weight with a low prevalence of cardiovascular disease and diabetes. As the group’s name suggests, these individuals tended to have one minor condition or disease. While still classified as robust, their prevalence of death five years later was significantly higher than the robust obese group, suggesting their “minor” conditions could be early warnings of vulnerability. Individuals in these two clusters had stronger social lives than the general population. The two intermediate clusters are “broken bones group” and “poor mental health group”. Those in the first group had broken a bone past 45 years old—but this group was average or above average in mobility. However, they were five times more likely to be incapacitated by frailty or accidents five years later. And the poor mental health group, characterized primarily by depression, was the only group more likely than average to be incapacitated by alcohol, drug abuse, or suicide attempts. The most vulnerable clusters were characterized by multiple comorbid diseases, including diabetes, hypertension, and immobility. Most vulnerable was a group with extensive comorbidity and frailty, which had a high prevalence of 47 of the 54 measures, with an average of 17 vulnerable health measures. Forty-four percent passed away five years later. The outcomes from this study are mostly consistent with many other articles about healthy aging. Many factor combine to affect the health of individuals and communities. Moreover, there is a growing recognition that a broad range of social, economic, and environmental factors shape individuals’ opportunities and barriers to engage in healthy behavior. You may be surprised to learn the impact of different factors on the health and wellness of individuals. An individual’s risk of premature death are most greatly affected by: individual behaviors (such as smoking) having the greatest impact at 40%; Genetics is at 30%; social and environmental factors is 20% and health care is at 10%. This information may help us re-conceptualize health and aging. One main finding is that “Health status in older adults does not correspond to chronological age.” And as the authors conclude, “a shift of attention is needed from disease-focused management… to overall health,” so that risks can be more accurately identified and addressed.