1. 2 Division of Geriatrics, McGill University Center, Montreal
How does the physical health of Canadian seniors fare over a three year period?
Trajectories from the NuAge Study
Sabrina Figueiredo, PhD1,3, Jose Morais MD PhD2, Nancy E. Mayo, PhD1,2, 3
1 School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal
2 Division of Geriatrics, McGill University Center, Montreal
3 Division of Clinical Epidemiology, McGill University Health Center, Montreal
Expecting the same level of deterioration from all seniors is a misconception (WHO)
The current problem
Literature on age-related changes report estimates of change as single mean. Traditional regression or growth-curve model overestimates such changes for some and underestimate for others.
The solution
Objectives
To describe trajectories of physical health over a 3-year period among Canadian seniors .
To identify factor’s associated with deteriorating physical health.
Participants
Quebec Longitudinal Study on Nutrition and Successful Aging (NuAGE).
Community dwelling seniors living in Montreal, Laval, Sherbrooke.
Inclusion criteria: French or English, free of disabilities, no cognitive impairment, able to walk one block or to climb one flight of stairs without rest.
Exclusion criteria: heart failure ≥ to Class 2, COPD requiring oxygen therapy or oral steroids, inflammatory digestive diseases, or cancer in the past five years.
Participants characteristics at study entry
Trajectories of physical health (n = seniors)
519 seniors (PCS intercept = 26, 39, 46) started at values well below Canadian norms but remained stable over time.
1,265 seniors (PCS intercept = 51, 51, 55) had values above Canadian norms.
Among the 3-above the norm groups, 1 group showed persistent excellent health (PCS intercept = 55) and 2 groups started with very good physical health (PCS intercept = 51) but 1 showed a drastic deterioration.
Risk factors of deterioration
Protective factor against deterioration
Methods
49,500 eligible participants from RAMQ. 18,695 randomly selected. 1,783 seniors included.
Annual follow-up from to 2009 included measures of socio-demographic, biological, nutritional, medical, functional, and social behavior status.
Physical health was assessed using the SF-36 Physical Component Summary (PCS).
Analysis
Group-based trajectory modelling (GBTM) identified clusters of similar physical health trajectories over 4-time points
Participants with missing data at all 4-time points were excluded
Model fit was assessed using the Bayesian and Akaike’s information criteria.
Posterior probability of group membership was (p >.7).
Logistic regression identified predictors of physical health deterioration among those with excellent or very good physical health (n= 1,265).
Conclusion
RESULTS
Characteristics
N, %
Age, mean (SD) range
74 (4) 67-84
Women, n (%)
940 (53%)
Physical health, mean (SD) range
49 (8) 19-68
Body Weight, mean (SD) range
73 (14)
Depression, mean (SD) range
5 (4) 0-25
Self-rated physical activity, mean (SD) range
100 (50) 0-64
Group-based trajectory modelling (GBTM), was applied to identify distinct aging trajectories. To date, this work is the first to document trajectories of physical health in seniors
Posterior probability ranges from
Predictor of deterioration
Odds Ratio
95%CI
Heavier body weight
1.31/30kg difference
More depressive symptoms
1.08
Inactive, seniors with excess weight and depressive symptoms do not age well.
Preventive health strategies should target obesity and depression in Older Adults.
Protective factor
Odds Ratio
95%CI
Higher physical activity (PA)
0.69 / 30% more PA