Mental health in the aged: prevalence, covariates and related neuroendocrine, cardiovascular and inflammatory factors of successful aging

Background: Although aging is accompanied by diminished
functioning, many elderly individuals preserve a sense of
well-being. While the concept of "successful aging" has been
popular for many decades, little is known about its
psycho-physiologic and endocrine underpinnings. KORA-Age is a
population-based, longitudinal study designed to determine the
prevalence of successfully aged men and women between 65 and 94
years old in the MONICA/KORA Augsburg cohort of randomly selected
inhabitants. Specifically, we aim to identify predictors of
successful aging and to elucidate bio-psychosocial mechanisms that
maintain mental health and successful adaptation despite adverse
experiences of life and aging. Methods/Design: Components of
successful aging were assessed in a telephone survey of 4,127
participants (20082009) enrolled in the MONICA/KORA cohort, on
average, 13 years earlier. Psychosocial, somatic and behavioural
predictors are used to determine factors that contribute to
successful aging. An age-stratified random sub-sample (n = 1,079)
participated in a personal interview where further psychological
mechanisms that may underlie successful adaptation (resilience,
social support, attachment) were examined. The interactions among
neuroendocrine systems in the aging process are investigated by
studying the cortisol/dehydroepiandrosterone-sulfate ratio, the
level of insulin-like growth factor I, and oxytocin. Discussion:
Longitudinal determinants of successful aging can be assessed based
on a follow-up of an average of 13 years. A comprehensive analysis
of biological as well as physio-psychological information provides
a unique opportunity to investigate relevant outcomes such as
resilience and frailty in the elderly population.