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Aging and disease    2016, Vol. 7 Issue (3) : 285-294     DOI: 10.14336/AD.2015.1002
Original Article |
Successful Aging among Elders Living in the Mani Continental Region vs. Insular Areas of the Mediterranean: the MEDIS Study
Mariolis Anargiros1, Foscolou Alexandra2, Tyrovolas Stefanos2,3, Piscopo Suzanne4, Valacchi Giuseppe5, Tsakountakis Nikos6, Zeimbekis Akis7, Bountziouka Vassiliki2, Gotsis Efthimios2, Metallinos George2, Tyrovola Dimitra2, Tur Josep-Antoni8, Matalas Antonia-Leda2, Lionis Christos6, Polychronopoulos Evangelos2, Panagiotakos Demosthenes, for the MEDIS study group
1Health Center of Areopolis, General Hospital of Sparta, Areopolis, Greece
2Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
3Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
4University of Malta, Nutrition, Family and Consumer Studies Office, Msida, Republic of Malta
5Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
6Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
7Health Center of Kalloni, General Hospital of Mitilini, Mitilini, Greece
8Research Group on Community Nutrition and Oxidative Stress, Universitat de les Illes Balears & CIBERobn, E-07122 Palma de Mallorca, Spain
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To evaluate the role of geography i.e., continental vs. insular Mediterranean, on successful aging among older inhabitants. During 2005-2014, 2693 elderly (aged 65 to 100 years) individuals from 21 Mediterranean islands in Greece, Italy and Spain as well as Cyprus, Malta, and the rural region of Mani (southeast continental region of Greece keeping old-time traditions), were voluntarily recruited. Successful aging was evaluated using a validated index composed of 10 health-related socio-lifestyle and clinical characteristics. After accounting for age, sex, body mass index (BMI), physical activity, smoking habits, MedDietScore and access to health care services, the older inhabitants of islands were found to have a higher level of the successful aging index when compared to their counterparts in Mani (Beta=0.174, p<0.001); moreover, islanders exhibited slightly more years of “good” health (68.7 vs 68.4 years for Mani residents (p=0.99)). However, compared to the residents of Mani, islanders had 1.64 times higher odds (95%CI, 1.08-2.48) for having hypertension, 2.4-times higher odds (95%CI, 1.34-4.21) for having diabetes and 1.52 times higher odds (95%CI, 0.97-2.38) for having hypercholesterolemia. Engaging in physical activities and healthy dietary habits were the major determinants of healthy aging, among islanders as compared to their counterparts of continental Mani region. Elder residents of the continental Mani area enjoyed a better health status, whereas elder islanders had a higher level of successful aging; a finding which could be attributed to differences in lifestyle among elders.

Keywords successful aging      longevity      Mani region      Mediterranean islands      cardiometabolic risk      lifestyle     
Corresponding Authors: Panagiotakos Demosthenes   
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These authors equally contribute this work

Issue Date: 09 January 2016
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Mariolis Anargiros
Foscolou Alexandra
Tyrovolas Stefanos
Piscopo Suzanne
Valacchi Giuseppe
Tsakountakis Nikos
Zeimbekis Akis
Bountziouka Vassiliki
Gotsis Efthimios
Metallinos George
Tyrovola Dimitra
Tur Josep-Antoni
Matalas Antonia-Leda
Lionis Christos
Polychronopoulos Evangelos
Panagiotakos Demosthenes
for the MEDIS study group
Cite this article:   
Mariolis Anargiros,Foscolou Alexandra,Tyrovolas Stefanos, et al. Successful Aging among Elders Living in the Mani Continental Region vs. Insular Areas of the Mediterranean: the MEDIS Study[J]. Aging and disease, 2016, 7(3): 285-294.
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Mediterranean Islands
Mani continental region
Age (years)74±875±70.30
Men, %49.553.20.23
Retired, %76.798.00.001
Basic school (up to 6 years)66.151.7<0.001
Adequate financial status, %18.625.40.05
Outdoor activities (t/wk)2.4±1.41.5±1.1<0.001
Social events (t/wk)1.8±0.91.3±0.9<0.001
Participation in social networks, %3814<0.001
Living alone, %30250.24
Physical activity, %44.513.9<0.001
Smoking habit, %
MedDietScore (range 0-55)36±532±4<0.001
Body Mass Index (Kg/m2)28.3±4.727.8±4.10.05
Obesity, %
Central fat, %75.586.00.001
History of hypertension, %63.553.90.001
History of diabetes, %
History of hypercholesterolemia, %49.735.60.001
Adherence to medication, %9255<0.001
Geriatric Depression Scale (range 0-20)4.1±3.62.4±3.3<0.001
Successful Aging Index (range 0-10)1.55±0.881.40±0.63<0.001
Access to health care services (visits/year)2.6±1.21.1±0.4<0.001
Table 1  Lifestyle, psychosocial and clinical characteristics of the MEDIS study participants.
Model 1Model 2
Islanders vs. Mani continental residents0.05
Age (per 1 year)-0.13
Men vs. women0.16
Body Mass Index (kg/m2)--0.06
Physical Activity (yes vs. no)-0.16
Smoking habits (yes vs. no)--0.03
MedDietScore (per 1/55 unit)-0.100
Access to health care services (yes vs. no)--0.100
Table 2  Results from linear regression models that evaluated the association between area of living (islanders vs. Mani continental region) (independent variable) and successful aging index, SAI (outcome), among MEDIS study participants.
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