2. OCTO Twin Origins of Variance in the Old-Old General presentation Boo Johansson National Institute on Aging: AG 08861 Life span

3. Friday Harbor Psychometrics Workshop 2010 Acknowledgements Funded in part by Grant R13AG030995-01A1 from the National Institute on Aging The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

4. Major Swedish Longitudinal Aging Studies..at that time - population-based - longitudinal design - possible to conduct - informative H70 (70+), OCTO (84+), …. SATSA (55+) ….??

5. Background for the OCTO Twin Study - Observations of substantial individual differences in rate and patterns of aging - Understanding the origins of this variability is of fundamental importance – What are the relative contributions of genetic and environmental influences? - Limited information about the oldest old age segement in the above respect 1988

6. The planning for a Twin Study of the Old-Old (80 +) started ~ 20 years ago (1988) H70,OCTO, SATSA..the missing ‘piece’ OCTO Twin

7. OCTO Twin - OVERALL AIM To estimate the relative contributions of environmental and genetic influences to the variability in health and biobehavioral functioning ….. at each measurement occasion as well as to longitudinal change and continuity during inter- occasion intervals

8. ..in a life span genetic and environmental influence perspective

9. An individual difference approach focus on variance among individuals within a population ------------------------ Directs our attention to the origins of variability within an age group ----------------------- Thus, we become compelled to search for the fundamental sources for observed differences in a specific phenotype

10. The prototypic twin design Monozygotic (MZ) pairs and Dizygotic (like-sex) pairs compared with respect to intra-pair similarities

11. MZ - monozygotic twins share 100% of all genetic influences

12. Same birthday Same parents DZ - dizygotic twins share on average 50% of genetic influences

13. Wave 1 Wave 2Wave 3 Wave 4 Wave 5 1991  1993  1995  1997  1999 MarchMayAprilMarchMarch  1994  1996  1998  2000  2002 MarchMarchMarchMarchMarch The OCTO Twin Design 5 measurement occasions, 2-years apart

14. Domains at focus Health and functional capacity Cognitive functioning Personality and personal control Psychological well-being Interpersonal functioning Using largely the same measures as in reference studies (H70, OCTO, SATSA

15. Health and functional capacity - Self-rated health - Self-reported medical history (”checklist”) - Sensory (Vision, hearing) - PB, Pulse, BMI - Functional tests of balance and gait - Grip strength, lung capacity - Contacts with the health care system (district nurse, physicans, and hospital) - Information from medical (ICD-10 coded) and dental records - Medications (ATC –codes) - Blood chemistry panel

16. Memory and Cognition - Cog.status – MMSE, Clock Test, Coin Test - Inductive reasoning – figure logic - Psychomotor speed - Psif, Digit-Symbol - Visuospatial ability – Koh’s Block - Primary memory – Digit Span - Semantic memory – Synonyms - Information - Episodic memory – Prose, MIR, Thurstone Picture memory

17. Dementia work-up individuals suspected for dementia - Review of memory and cognitive tests - Informant neuropsychological interview - Review of medical records and supplement information - A consensus diagnosis conference (DSM, ICD, NINCDS-ADRA, NINDS-AIREN, etc)

18. Personality and Personal Control - Eysenck Personality Inventory (EPI) - Global Locus of Control - Heatlh Locus of Control

19. Psychological Well-being - Life Satisfaction Scale (LSI-Z) - Depressive symptoms scale (CES-D) - Open ended questions, e.g. significant life events

20. Interpersonal functioning - Social networks - Contact frequencies - Confidants - Loneliness

21. Functional capacity - ADL Apparatus Test - ADL and IADL Scales (Self and RN ratings) - Need for help in ADL/IADL - Home help/institutional care - Technical aids, mobility, hearing, vision

22. Testing sessionTesting session

23. Supplement information Twin Registry Ratings by RNs’ and PD Medical records Dental records Death certificates Dementia work-up Autopsy/neuropathology

24. Procedure - In-person/individual examinations in place of residence across the country - by trained and supervised RNs - using a broad-based biobehavioral battery Members of a twin pair never investigated by same RN to avoid expectation bias. The RNs’ blind to zygosity.

25. The OCTO Twin Sample Twins in complete pairs, 80 years and older at baseline (< 1913) MZ (monozygotic) twin pairs (N=149) and same- sex DZ (dizygotic) twin pairs (N=202) All survivors followed longitudinally across 5 waves, 2-years apart

27. Population selection in OCTO Twin: Number of tested individuals and pairs across waves (8y) W1 W2W3W4W5 MZ DZMZ DZMZ DZMZ DZMZ DZ Pairs 149 20298 137 65 7943 4320 23 Men56 6138 4022 2312 10 5 4 Women93 14160 97 43 5632 3315 19 Total351235144 86 43 MZ %42,541,745,150,046,5 Individuals 298 404235 333178 252142 173 100 122 Men112 122 90 101 65 77 47 43 31 26 Women186 282145 232113 175 95 130 69 96 Total702 (704)568430315 222 MZ %42,541,441,445,142,5 R-rate > 90%

28. SATSA OCTO Twin Gender Harmony Ongoing Swedish Twin Studies on Aging

29. Boo Johansson