Successful ageing, dietary habits and health status of elderly individuals: A k-dimensional approach within the multi-national MEDIS study.

The definition and determinants of successful ageing is still controversial. Although dietary habits have long been associated with ageing, eating habits and behaviours have rarely been included in various proposed indices of successful ageing. The aim of this work was to evaluate determinants of successful ageing together with assessment of dietary habits in relation to healthcare facility use among elders living in the Mediterranean basin. During 2005-2011, 2663 elderly (aged 65-100 years) individuals from 21 Mediterranean islands and rural Mani region (Peloponnesus) were voluntarily enrolled in the study. A successful ageing index ranging from a score of 0 to a score of 10 was constructed using 10 attributes, i.e., education, financial status, physical activity, body mass index, depression, participation in social activities with friends and family, number of yearly excursions, number of cardiovascular disease risk factors and adherence to the Mediterranean diet. The applied factor analysis on the components of the index extracted three main components for successful ageing: phychosocial-economic, bioclinical and lifestyle; confirming the multiple dimensions of ageing. After adjusting for confounders, a 1/10-unit increase in the successful ageing index was associated with 0.8 less annual visits to healthcare centers (95%CI -1.2 to -0.4). Stratified analysis by gender revealed heterogeneity of factors predicting successful ageing. These findings suggest that successful ageing is a multidimensional and complex concept that exhibits gender heterogeneity. Annual use of health care services by the elders was found to be related to level of successful ageing.