Showing men how to survive and thrive

Scientists study how Japanese-American men maintain their health into old age

Men can find out how to live to a healthy old age: Just take some cues from 5,820 Japanese-American men who have been studied for 40 years.

Avoid smoking, excessive drinking and hypertension and hold down your weight, advises Dr. Bradley Willcox, National Institutes of Health-funded geriatrics scientist at the Pacific Health Research Institute and Kuakini Medical Center.

Those findings came from a four-year Hawaii Lifespan Study -- for which Willcox and Dr. David Curb are co-investigators.

Willcox discussed the study in an interview last week before leaving for New York, where he was to present findings at a news conference today for the Journal of the American Medical Association. His article, "Mid-life Risk Factors and Healthy Survival in Men," will be featured this week in the journal's newest issue.

With the nation's fast-growing aging population, including Hawaii, it is important for people to learn how to be healthy survivors, Willcox said. "Our goal is to provide aging boomers with advice -- not only how to stay healthy, but what to expect in retirement years."

One of the goals of the Lifespan Study is to define what healthy survival is and what can be done to predict it, he said.

Willcox, who studied Okinawan centenarians to learn secrets of their long, disease-free lives, found the keys were diet and exercise.

FOR THE LIFESPAN Study, the researchers gathered data from 5,820 Japanese-American men to learn how they lived to healthy old ages. The men were part of an original group of 8,006 Japanese Americans recruited in 1965 for the Honolulu Heart Program and Honolulu Asia Aging Study at Kuakini Medical Center. Those with any disease or disability were excluded from the study, Willcox said.

The average age was about 54 when the group was identified through the World War II Selective Service registration file. They were studied from 1965 until last year, Willcox said.

The men have contributed to many significant discoveries by researchers about Alzheimer's and Parkinson's diseases, memory, heart disease, stroke and other health issues.

"They've done an incredible public service," Willcox said, "not only for Hawaii, but the whole country, and internationally, should be very grateful for these men."

Of the 5,820, Willcox said, 2,451 participants, or 42 percent, survived to age 85, and 655, or 11 percent, met criteria for exceptional or healthy survival to age 85.

Exceptional survival was defined as living to a certain age, 75, 80, 85 or 90, without six major chronic diseases: chronic heart disease, stroke, cancer, diabetes, obstructive pulmonary disease and Parkinson's disease. They also had to be able to walk a half-mile and have good cognitive function.

"It's 'exceptional' because not many attain that at old ages," Willcox said. "About 11 percent of the cohort at age 85 met that definition. It's pretty impressive.

"Another 30 percent are still alive but have at least one of those conditions -- cognitive or physical impairment. Another 60 percent didn't make it to 85. We looked all the way to age 90 for these factors."

The Journal of the American Medical Association sent a crew to film the study group, and an 88-year-old participant walked to Kuakini for the filming.

"He was amazing, a typical healthy survivor," Willcox said.

Study coordinators and examiners put him through some tests, including two sets of five chair stands, and he walked home afterward, Willcox said. "He said he had a fun afternoon. He'll probably be one of these guys who lives to 100."

The film is being shown on JAMA's Web site, jama.ama-assn.org, starting today.

THE MEN who had no risk factors had a 69 percent chance of surviving to age 85, he said. "That's huge." But if they had six or more risk factors, chances of making it to age 85 fell to 22 percent, he said. "That's a big spread if you think about the difference."

Those with no risk factors had a 55 percent chance of exceptional healthy survival to age 85 but only a 9 percent chance with six or more risk factors, the study found.

A strong hand grip, suggesting the importance of physical fitness in middle age, as well as avoidance of hyperglycemia, hypertension, smoking, excessive alcohol consumption and weight were associated with overall and exceptional survival.

Willcox and co-investigator Curb, Pacific Health Research Institute president and chief executive officer/medical director, plan further studies looking at nutrition and genetics. There is probably some genetic connection to grip strength, Willcox said. "We can't precisely tell how much is genes and how much is environment in this study, but it appears that stronger people live longer.

"It's not surprising, when you think of a Mercedes Benz versus a Ford Escort. One will last longer given the same conditions."