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Purpose: The aim of the present work was to evaluate the relation between car use and the level of successful aging of a random sample of older adults living in the Mediterranean basin.Methods: During 2005-2011, 2749 older (aged 65-100 years) from 22 islands and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled in the Mediterranean islands cross-sectional study. Sociodemographics, medical conditions, and dietary and lifestyle habits were derived throughout standard procedures. Car use was recorded with a standard binary question. A successful aging index ranging from 0-10 was used.Results: Older adults who used a car on regular basis had significantly higher levels of successful aging, as well as less prevalence of obesity and hypertension while were more physically active (P < .001). After adjusting for several confounders car use was still positively related with elderly islander's successful aging level (beta coefficient [95% confidence interval]: 0.65 [0.54-0.77]).Conclusions: In conclusion, the activity of car use seems to be an indicator of quality of life among older adults, as measured through successful aging. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the role of parental longevity and parental cardiovascular disease (CVD) history in CVD risk and successful aging of a random sample of older adults living in the Mediterranean basin and who participated in the MEDiterranean Islands (MEDIS) study. During 2005 to 2011, 2663 elders were voluntarily enrolled. A multidimensional successful aging index consisting of 10 components was used. Paternal and maternal longevity was defined as those older participants of whom both parents lived above the age of 90. The burden of CVD-related factors (CVD-RFs) was calculated as the total score of 4 major CVD-RFs (range 0-4). After adjustment, parental longevity was inversely associated with the burden of CVD-RFs (P = .04). Moreover, parental longevity was positively associated with the older adults’ successful aging score (β-coefficient [95% confidence interval]: .38 [0.06-0.71]). Parent’s long living was revealed as an important factor for successful aging and for reduced CVD risk, suggesting that further research is needed in the genetic predisposition of longevity. [ABSTRACT FROM AUTHOR]

Background The determinants that promote successful ageing still remain unknown. The aim of the present work was to evaluate the role of skeletal muscle mass and body fat percentage (BF%), in the level of successful ageing. Methods during 2005–2011, 2663 older (aged 65–100 years) from 21 Mediterranean islands and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled in the study. Appendicular skeletal muscle mass (ASM), skeletal muscle mass index (SMI) and BF% were calculated using population formulas. Dietary habits, energy intake, expenditure and energy balance were derived throughout standard procedures. A successful ageing index ranging from 0 to 10 was used. Results The mean ASM mass was 24 ± 6.0 kg, the SMI was 0.84 ± 0.21 and the BF% was 44%. Females had lower SMI and higher BF% in comparison with males, respectively [(SMI: 0.66 ± 0.09 vs. 1.03 ± 0.11; BF%: 51% vs. 34%, (p < 0.001)]. High successful agers had better rates in ASM (p = 0.01), SMI (p < 0.001) and BF% (p < 0.001), compared with the medium and low successful ones. Changes in SMI [b-coefficient (95% CI):2.14 (1.57 to 2.71)] were positively associated with successful ageing, while changes in BF% [b-coefficient (95% CI): −0.04 (−0.05 to −0.03)] were inversely associated with successful ageing. Results from sensitivity analysis showed that the effects of variations on body composition were consistent, less pronounced in the positive energy balance group and more pronounced among the oldest old. Conclusions Body composition changes seem to be associated with lower quality of life in the older adults, as measured through successful ageing. [ABSTRACT FROM AUTHOR]

Data regarding the factors associated with depressive symptoms are limited, especially in postmenopausal women. The aim of this study was to investigate to what extent depressive symptoms were present in postmenopausal women, to explore characteristics associated with depressive symptoms and to determine if time since menopause was independently associated with depressive symptoms. Data collected within the Mediterranean Islands (MEDIS) Study, a health and nutrition survey of elderly people living on Mediterranean islands was used. A total of 851 postmenopausal women living in various Greek islands, Cyprus, and Malta participated in the study. Depressive symptoms were evaluated using the Geriatric Depression Scale (GDS). Age-adjusted logistic regression analysis showed that a year’s increase in the time since menopause increased the likelihood of postmenopausal women having severe depressive symptoms by 3% (odds ratio [OR] per 1 year = 1.03, 95% CI 1.001–1.05). This positive association was also evident when other potential confounding factors (i.e, living conditions, financial status, physical activity, adherence to the Mediterranean diet, smoking habits, and several clinical conditions) were also taken into account in multivariable analyses. Primary health care practitioners and public health care authorities could use the findings of this study to identify depressive symptoms early in postmenopausal women. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to evaluate the crucial role that nutritional services provided both to public or private health-care systems on dietary habits among older people. Methods During 2005-2009, 744 men and 742 women (>65 years) from nine Greek Islands and Cyprus Republic were voluntarily enrolled in the Mediterranean Islands study ( MEDIS). Sociodemographic, clinical and lifestyle characteristics has been recorded. Information regarding practicing dietitians (n = 88) and nutritional services provided in these islands were also recorded. Results It has been demonstrated that the long-term presence of dietitian on an island increase the adherence to the Mediterranean diet by the participants ( P = 0.03). A positive association was also found between level of adherence to the Mediterranean diet by the older people and dietitian's education status (i.e. basic vs postgraduate, P = 0.003). According to the dietitians' reports, 40% of older adults have improved their dietary habits after the nutritional consultation. Conclusions Implementing nutritional services within the healthcare system seems to contribute to healthier dietary habits among older adults that may lead to a better quality of life. [ABSTRACT FROM AUTHOR]

In the 1960s, the recorded dietary pattern of Southern European populations was typical of the traditional Mediterranean diet. However, diets have been rapidly changing. The aim of the current work was to examine the extent by which present food habits of inhabitants residing in various Mediterranean islands uphold past dietary traditions of the Mediterranean diet. A population-based, multi-stage sampling method was used to voluntarily enroll 876 men and 936 women (aged > 65 years) from 12 Mediterranean islands. Demographic, behavioral, clinical, and dietary data were collected. Principal component analysis derived fruits, vegetables, and greens as part of the main dietary pattern across most Mediterranean regions. Surprisingly, Crete had the highest frequency of fast-food and sweets consumption. Malta had the lowest frequency of fish and vegetable consumption and the lowest MedDietScore. As Mediterranean populations gradually move away from traditional dietary patterns, public-health efforts to preserve these diets are needed. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To evaluate the prevalence of low energy reporting (LER) and associations between LER and lifestyle, psychological and clinical parameters, in elderly people living in eastern Mediterranean islands. Methods: 1190 men and women, aged 65–100 years, participated in this cross-sectional study. Socio-demographic, clinical and lifestyle characteristics were recorded for the study participants. Among others, the ratio of energy intake to estimated basal metabolic rate (EI/BMR) was calculated and was used for the assessment of LER. Results: Prevalence of LER was 47.7%. Lower EI/BMR (i.e., higher risk for LER) was associated with older age (p =0.001), male sex (p <0.001), higher body mass index (BMI; p =0.04), lower adherence to the Mediterranean diet (p <0.001) and non-current smoking (p =0.007). The sex-specific analysis revealed that, lower EI/BMR values were associated with lower adherence to the Mediterranean diet and being non-current smoker in both men and women (p ≤0.05), as well as with older age (p =0.01), higher BMI (p =0.02) and hypercholesterolemia (p =0.02), only in women. Conclusion: In elderly, several clinical and lifestyle factors seem to be related to LER, and they should be taken into account in their nutritional assessment. [Copyright &y& Elsevier]

Background: The aim of the present work was to evaluate various socio-demographic, clinical, lifestyle and psychological characteristics of elderly (>65 years) and very elderly (>90 years) individuals without known cardiovascular disease. Methods: During 2005–7, 1190 elderly (aged >65) men and women (from Cyprus, Mitilini, Samothraki, Cephalonia, Crete, Lemnos, Corfu and Zakynthos) were randomly enrolled. Socio-demographic, clinical, psychological and lifestyle factors were assessed using standard questionnaires and procedures. Results: From all islands, the proportion of males aged 65–80, 80–90 and >90 years was 71.8, 24.8 and 3.4%, respectively. The proportion of women, for the same age categories, was 80.4, 17.9 and 1.7%, respectively. Walking and other activities significantly declined with age (P < 0.001); however, nearly one in five participants over the age of 90 years remained physically active. Current smoking significantly declined in males as age increased (P < 0.001). All participants above the age of 90 years reported sleeping at noon. The proportion of participants living alone differs significantly (P < 0.001) across the three age groups. However, considerably more women live alone (men vs. women living alone: aged 65–80 years 12 vs. 37%; 80–90 years 16 vs. 55%; >90 years 52 vs. 55%). Dietary characteristics of The Mediterranean Islands Study (MEDIS) sample display a favourable adherence to dietary recommendations (Mediterranean diet). Conclusion: A favourable adherence to the Mediterranean diet, mid-day naps and smoking cessation with an increase in age was characteristic of our elderly population. Future research should further evaluate whether the aforementioned characteristics are associated with longevity beyond the average life expectancy. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether the socio-economic status (SES) of elderly eastern Mediterranean islanders is associated with their dietary habits, particularly with adherence to the traditional Mediterranean diet. Design: Cross-sectional. Setting: Adherence to the Mediterranean diet was measured by the MedDietScore (range: 0-55), whereas SES was estimated using education and financial status. Subjects: During 2005-2007, 300 men and women from Cyprus, 100 from Samothraki, 142 from Mitilini, 114 from Kefalonia, 131 from Crete, 150 from Lemnos, 150 from Corfu and 103 from Zakynthos (aged 65-100 years), free of known chronic diseases, participated in the survey. Results: Multiple linear regression analysis revealed that belonging to the highest SES was associated with a higher MedDietScore (P<0·01), after adjusting for potential sociodemographic, lifestyle, dietary and clinical confounders. A significant positive association was also found between MedDietScore and years of school (P=0·004), as well as financial status (P=0·001). Conclusions: Older Greek people of higher SES seem to follow a relatively healthier diet. Both education and income seem to play a role in this issue. Thus, public health policy makers should focus on people with low SES in order to improve their quality of diet and, consequently, their health status. [ABSTRACT FROM AUTHOR]

The aim of the present work was to evaluate the association between the level of adherence to the Mediterranean diet and successful aging, taking into consideration the overall dietary pattern, rather than individual foods, among middle-aged and older individuals. A harmonized dataset of middle-aged and older participants (>50 years old) from the ATTICA (n = 1,128) and MEDIS (n = 2,221) population-based cross-sectional studies was used. Socio-demographic, anthropometric, clinical and lifestyle characteristics were measured in both studies and harmonized using standardized procedures. Level of adherence to the Mediterranean diet was evaluated using the MedDietScore (range 0–55, "Low" adherence <34, "High">38). Successful aging was evaluated using the validated successful aging index (SAI, range 0−10) comprising of health-related, social, lifestyle and clinical characteristics. Adherence to the Mediterranean diet was positively associated with SAI (b ± SE "High" vs. "Low": 1.094 ± 0.130, p < 0.001 and "Moderate" vs "Low": 0.476 ± 0.156, p = 0.003). Higher adherence to the Mediterranean diet was independently associated with a higher level of successful aging. Mediterranean diet or dietary patterns that are close to this pattern, should be actively promoted and encouraged to middle aged and older people to achieve successful aging. [ABSTRACT FROM AUTHOR]