Logo of amjphAmerican Journal of Public Health Web SiteAmerican Public Health Association Web SiteSubmissionsSubscriptionsAbout Us
Am J Public Health. 1998 October; 88(10): 1463–1468.
PMCID: PMC1508464

Predictors of healthy aging in men with high life expectancies.


OBJECTIVE: The purpose of this study was to identify risk factors that consistently predict staying healthy in contrast to developing clinical illness and/or physical and mental impairments. METHODS: More than 8000 men of Japanese ancestry were followed for 28 years with repeat examinations and surveillance for deaths and incident clinical illness. Physical and cognitive functions were measured in 1993. Measures of healthy aging included surviving and remaining free of major chronic illnesses and physical and cognitive impairments. RESULTS: Of 6505 healthy men at baseline, 2524 (39%) died prior to the final exam. Of the 3263 available survivors, 41% remained free of major clinical illnesses, 40% remained free of both physical and cognitive impairment, and 19% remained free of both illness and impairment. The most consistent predictors of healthy aging were low blood pressure, low serum glucose, not smoking cigarettes, and not being obese. CONCLUSIONS: Beyond the biological effects of aging, much of the illness and disability in the elderly is related to risk factors present at midlife.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.6M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Rowe JW, Kahn RL. Human aging: usual and successful. Science. 1987 Jul 10;237(4811):143–149. [PubMed]
  • Olshansky SJ, Carnes BA, Cassel C. In search of Methuselah: estimating the upper limits to human longevity. Science. 1990 Nov 2;250(4981):634–640. [PubMed]
  • Belloc NB. Relationship of health practices and mortality. Prev Med. 1973 Mar;2(1):67–81. [PubMed]
  • Breslow L, Enstrom JE. Persistence of health habits and their relationship to mortality. Prev Med. 1980 Jul;9(4):469–483. [PubMed]
  • Benfante R, Reed D, Brody J. Biological and social predictors of health in an aging cohort. J Chronic Dis. 1985;38(5):385–395. [PubMed]
  • Guralnik JM, Kaplan GA. Predictors of healthy aging: prospective evidence from the Alameda County study. Am J Public Health. 1989 Jun;79(6):703–708. [PMC free article] [PubMed]
  • Jette AM, Branch LG. Impairment and disability in the aged. J Chronic Dis. 1985;38(1):59–65. [PubMed]
  • Katz S, Branch LG, Branson MH, Papsidero JA, Beck JC, Greer DS. Active life expectancy. N Engl J Med. 1983 Nov 17;309(20):1218–1224. [PubMed]
  • Fried LP, Ettinger WH, Lind B, Newman AB, Gardin J. Physical disability in older adults: a physiological approach. Cardiovascular Health Study Research Group. J Clin Epidemiol. 1994 Jul;47(7):747–760. [PubMed]
  • Ettinger WH, Jr, Fried LP, Harris T, Shemanski L, Schulz R, Robbins J. Self-reported causes of physical disability in older people: the Cardiovascular Health Study. CHS Collaborative Research Group. J Am Geriatr Soc. 1994 Oct;42(10):1035–1044. [PubMed]
  • Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, Kelly-Hayes M, Wolf PA, Kreger BE, Kannel WB. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994 Mar;84(3):351–358. [PMC free article] [PubMed]
  • Branch LG, Jette AM. The Framingham Disability Study: I. Social disability among the aging. Am J Public Health. 1981 Nov;71(11):1202–1210. [PMC free article] [PubMed]
  • Grimley Evans J. Prevention of age-associated loss of autonomy: epidemiological approaches. J Chronic Dis. 1984;37(5):353–363. [PubMed]
  • Terris M. Approaches to an epidemiology of health. Am J Public Health. 1975 Oct;65(10):1037–1045. [PMC free article] [PubMed]
  • Strawbridge WJ, Cohen RD, Shema SJ, Kaplan GA. Successful aging: predictors and associated activities. Am J Epidemiol. 1996 Jul 15;144(2):135–141. [PubMed]
  • Seeman TE, Charpentier PA, Berkman LF, Tinetti ME, Guralnik JM, Albert M, Blazer D, Rowe JW. Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur studies of successful aging. J Gerontol. 1994 May;49(3):M97–108. [PubMed]
  • Kagan A, Harris BR, Winkelstein W, Jr, Johnson KG, Kato H, Syme SL, Rhoads GG, Gay ML, Nichaman MZ, Hamilton HB, et al. Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: demographic, physical, dietary and biochemical characteristics. J Chronic Dis. 1974 Sep;27(7-8):345–364. [PubMed]
  • Yano K, Reed DM, McGee DL. Ten-year incidence of coronary heart disease in the Honolulu Heart Program. Relationship to biologic and lifestyle characteristics. Am J Epidemiol. 1984 May;119(5):653–666. [PubMed]
  • White L, Petrovitch H, Ross GW, Masaki KH, Abbott RD, Teng EL, Rodriguez BL, Blanchette PL, Havlik RJ, Wergowske G, et al. Prevalence of dementia in older Japanese-American men in Hawaii: The Honolulu-Asia Aging Study. JAMA. 1996 Sep 25;276(12):955–960. [PubMed]
  • Marcus EB, Buist AS, Curb JD, MacLean CJ, Reed DM, Johnson LR, Yano K. Correlates of FEV1 and prevalence of pulmonary conditions in Japanese-American men. Am Rev Respir Dis. 1988 Dec;138(6):1398–1404. [PubMed]
  • Kannel WB, Sorlie P. Some health benefits of physical activity. The Framingham Study. Arch Intern Med. 1979 Aug;139(8):857–861. [PubMed]
  • Kagan A, Popper J, Reed DM, MacLean CJ, Grove JS. Trends in stroke incidence and mortality in Hawaiian Japanese men. Stroke. 1994 Jun;25(6):1170–1175. [PubMed]
  • Nomura A, Heilbrun LK, Stemmermann GN. Body mass index as a predictor of cancer in men. J Natl Cancer Inst. 1985 Feb;74(2):319–323. [PubMed]
  • Grandinetti A, Morens DM, Reed D, MacEachern D. Prospective study of cigarette smoking and the risk of developing idiopathic Parkinson's disease. Am J Epidemiol. 1994 Jun 15;139(12):1129–1138. [PubMed]
  • Teng EL, Hasegawa K, Homma A, Imai Y, Larson E, Graves A, Sugimoto K, Yamaguchi T, Sasaki H, Chiu D, et al. The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. Int Psychogeriatr. 1994 Spring;6(1):45–62. [PubMed]
  • Roos NP, Havens B. Predictors of successful aging: a twelve-year study of Manitoba elderly. Am J Public Health. 1991 Jan;81(1):63–68. [PMC free article] [PubMed]
  • Seeman TE, Berkman LF, Charpentier PA, Blazer DG, Albert MS, Tinetti ME. Behavioral and psychosocial predictors of physical performance: MacArthur studies of successful aging. J Gerontol A Biol Sci Med Sci. 1995 Jul;50(4):M177–M183. [PubMed]
  • Boult C, Kane RL, Louis TA, Boult L, McCaffrey D. Chronic conditions that lead to functional limitation in the elderly. J Gerontol. 1994 Jan;49(1):M28–M36. [PubMed]
  • Pinsky JL, Leaverton PE, Stokes J., 3rd Predictors of good function: the Framingham Study. J Chronic Dis. 1987;40 (Suppl 1):159S–1822. [PubMed]
  • Jette AM, Pinsky JL, Branch LG, Wolf PA, Feinleib M. The Framingham Disability Study: physical disability among community-dwelling survivors of stroke. J Clin Epidemiol. 1988;41(8):719–726. [PubMed]
  • Mor V, Murphy J, Masterson-Allen S, Willey C, Razmpour A, Jackson ME, Greer D, Katz S. Risk of functional decline among well elders. J Clin Epidemiol. 1989;42(9):895–904. [PubMed]
  • Guralnik JM. Understanding the relationship between disease and disability. J Am Geriatr Soc. 1994 Oct;42(10):1128–1129. [PubMed]
  • German PS, Fried LP. Prevention and the elderly: public health issues and strategies. Annu Rev Public Health. 1989;10:319–332. [PubMed]
  • Maddox GL. Intervention strategies to enhance well-being in later life: the status and prospect of guided change. Health Serv Res. 1985 Feb;19(6 Pt 2):1007–1032. [PMC free article] [PubMed]
  • Hermanson B, Omenn GS, Kronmal RA, Gersh BJ. Beneficial six-year outcome of smoking cessation in older men and women with coronary artery disease. Results from the CASS registry. N Engl J Med. 1988 Nov 24;319(21):1365–1369. [PubMed]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...