Determinants of Healthy Ageing: Studies of Disability and Survival among the Elderly

The increase in life expectancy over the last century is one of society’s major achievements. In particular in developed countries, though increasingly in developing countries, a higher life expectancy and a reduction in birth rates result in an ageing of the population, i.e. the shift of the median age in the population towards older ages. Thus, while human population growth approximates 1.2% annually, this population growth is not constant across all ages. Annually, the population older than 60 increases by 2 – 3%, while the population older than 80 increases by 4%. By 2050, more than one third of all Europeans are expected to be older than 60 years.[1] These demographic trends are supported by evidence showing that the recent increases in life expectancy in Western countries can mainly be attributed to better survival among the elderly. Ageing of the population poses a challenge for both developed and developing countries. The goal of this thesis is to identify risk factors for disability, disease-free survival, mortality and longevity. Specifically we asked the following research questions: 1. What genetic loci are associated with longevity and time to death and disease? (Chapter 2) 2. Do body mass index, physical activity, and happiness influence time to death and time spent with disability? (Chapter 3) 3. Which set of risk factors best predicts death and how do different groups of risk factors compare in their predictive power? (Chapter 4)

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