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Objectives To describe the incidence of cardiovascular risk factors, or race-related disparities in incidence, across the age spectrum in adults. Design Longitudinal cohort. Setting National sample. Participants Community-dwelling black and white adults recruited between 2003 and 2007. Measurements Incident hypertension, diabetes mellitus, dyslipidemia and atrial fibrillation over 10 years of follow-up in 10,801 adults, stratified according to age (45-54, 55-64, 65-74, ≥75). Results There was no evidence ( P ≥ .68) of an age-related difference in the incidence of hypertension for white men (average incidence 38%), black men (48%), or black women (54%), although for white women incidence increased with age (45-54, 27%; ≥75, 40%). Incidence of diabetes mellitus was lower at older ages for white men (45-54, 15%; ≥75, 8%), black men (45-54, 29%; ≥75, 13%), and white women (45-54, 11%; ≥75, 4%), although there was no evidence ( P = .11) of age-related changes for black women (average incidence 21%). For dyslipidemia, incidence for all race-sex groups was approximately 20% for aged 45 to 54 but approximately 30% for aged 54 to 64 and 65 to 74 and approximately 22% for aged 75 and older. Incidence of atrial fibrillation was low at age 45 to 54 (<5%) but for aged 75 and older was approximately 20% for whites and 11% for blacks. The incidence of hypertension, diabetes mellitus, and dyslipidemia was higher in blacks across the age spectrum but lower for atrial fibrillation. Conclusion Incidence of risk factors remains high in older adults. Blacks have a higher incidence of hypertension, diabetes mellitus, and dyslipidemia after age 45, underscoring the ongoing importance of prevention of all three conditions in mid- to later life. [ABSTRACT FROM AUTHOR]

Objectives To study the association between total and differential white blood cell ( WBC) count and incident stroke in an older Asian population. Design Prospective population-based study with 8 years of follow-up. Setting The Honolulu Heart Program, Oahu, Hawaii. Participants Japanese-American men aged 71 to 93 who were free of stroke and had baseline WBC counts measured in 1991-93 (N = 3,342). Measurements Participants were divided into quartiles of total and differential WBC count for analysis and were followed for incident stroke (thromboembolic and hemorrhagic (hemorrhagic)) for 8 years using data from a comprehensive hospital surveillance system. Results Age-adjusted incident stroke rates increased significantly with increasing WBC quartile (Q1, 7.68; Q2, 9.04; Q3, 9.26; Q4, 14.10 per 1,000 person-years of follow-up, P = .001). Hazard ratios ( HRs) for stroke for each quartile of total and differential WBC count were obtained using Cox regression analysis, with the lowest quartile as the reference group. After full adjustment, including age; cardiovascular risk factors; fibrinogen; prevalent coronary heart disease, cancer, or chronic obstructive pulmonary disease, and nonsteroidal anti-inflammatory drug use, HRs were 1.62 (95% confidence interval ( CI) = 1.04-2.52, P = .03) in the highest quartile of total WBC and 2.19 (95% CI = 1.41-3.39, P < .001) in the highest quartile of neutrophil counts. Significant associations were also seen for thromboembolic but not for hemorrhagic strokes. No significant associations were found between lymphocyte or monocyte counts and incident stroke or subtypes. Conclusion In elderly Japanese-American men, higher total WBC and neutrophil counts were independent predictors of overall stroke, as well as thromboembolic stroke. [ABSTRACT FROM AUTHOR]

Objectives To identify potentially modifiable late-life biological, lifestyle, and sociodemographic factors associated with overall and healthy survival to age 85. Design Prospective longitudinal cohort study with 21 years of follow-up (1991-2012). Setting Hawaii Lifespan Study. Participants American men of Japanese ancestry (mean age 75.7, range 71-82) without baseline major clinical morbidity and functional impairments (N = 1,292). Measurements Overall survival and healthy survival (free from six major chronic diseases and without physical or cognitive impairment) to age 85. Factors were measured at late-life baseline examinations (1991-1993). Results Of 1,292 participants, 1,000 (77%) survived to 85 (34% healthy) and 309 (24%) to 95 (<1% healthy). Late-life factors associated with survival and healthy survival included biological (body mass index, ankle-brachial index, cognitive score, blood pressure, inflammatory markers), lifestyle (smoking, alcohol use, physical activity), and sociodemographic factors (education, marital status). Cumulative late-life baseline risk factor models demonstrated that age-standardized (at 70) probability of survival to 95 ranged from 27% (no factors) to 7% (≥5 factors); probability of survival to 100 ranged from 4% (no factors) to 0.1% (≥5 factors). Age-standardized (at 70) probability of healthy survival to 90 ranged from 4% (no factors) to 0.01% (≥5 factors). There were nine healthy survivors at 95 and one healthy survivor at 100. Conclusion Several potentially modifiable risk factors in men in late life (mean age 75.7) were associated with markedly greater probability of subsequent healthy survival and longevity. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the hypothesis that Holocaust exposure during young adulthood negatively affects physical aging, causing greater morbidity, faster deterioration in health parameters, and shorter survival. DESIGN: A longitudinal cohort study of the natural history of an age-homogenous representative sample born in 1920/21 and living in Jerusalem. SETTING: Community-based home assessments. PARTICIPANTS: Four hundred fifty-eight subjects of European origin aged 70 at baseline and 77 at follow-up. MEASUREMENTS: Comprehensive assessment of physical, functional, and psychosocial domains; biographical history of concentration camp internment (Camp), exposure to Nazi occupation during World War II (Exposure), or lack thereof (Controls); and 7-year mortality data from the National Death Registry. RESULTS: Holocaust survivors of the Camp (n=93) and Exposure (n=129) groups were more likely than Controls (n=236) to be male and less educated and have less social support ( P=.01), less physical activity ( P=.03), greater difficulty in basic activities of daily living ( P=.009), poorer self-rated health ( P=.04), and greater usage of psychiatric medication ( P=.008). No other differences in health parameters or physical illnesses were found. Holocaust survivors had similar rates of deterioration in health and illness parameters over the follow-up period, and 7-year mortality rates were identical. Proportional hazard models showed that being an elderly Holocaust survivor was not predictive of greater 7-year mortality. CONCLUSION: Fifty years after their Holocaust trauma, survivors still displayed significant psychosocial and functional impairment, although no evidence was found to support the hypothesis that the delayed effects of the trauma of the Holocaust negatively influence physical health, health trajectories, or mortality. [ABSTRACT FROM AUTHOR]