MacArthur Study of Successful Aging

The MacArthur Study of Successful Aging was initiated in 1988 to study factors associated with “successful aging”; that is, living longer while avoiding major cognitive and physical disability. Participants were recruited on the basis of age (70 to 79 years only) and physical and cognitive functioning from three communities in the eastern United States: Durham, North Carolina; East Boston, Massachusetts; and New Haven, Connecticut. More than 4,000 age-eligible men and women were screened using four criteria of physical functioning and two criteria of cognitive functioning to identify those functioning in the top third of the age group. The screening criteria were as follows: (a) no self-reported disability on the Katz Activities of Daily Living (ADLs) scale, (b) no more than one disability on the Rosow–Breslau and Nagi self-reported scales of physical function and mobility, (c) ability to hold a semitandem balance for at least 10 seconds, (d) ability to stand up from a seated position five times within 20 seconds, (e) score of at least 6 on the 9-item Short Portable Mental Status Questionnaire, and (f) ability to recall at least three of six elements from a short story after delay. Of the 1,313 potential participants who met the screening criteria, 1,189 (91%) agreed to participate in the study and provided informed consent.

Baseline data were collected during 1988–1989 and included a 90-minute face-to-face interview for standard sociodemographic and socioeconomic data, health status, chronic illnesses, medications, psychosocial characteristics, and health behaviors as well as an examination for vital signs, height, weight, waist and hip circumference measurement, and detailed assessments of physical and cognitive performance. Participants were also asked to provide blood samples at the time of the face-to-face interview/ examination as well as 12-hour overnight urine samples collected from 8 o'clock the evening of the interview to 8 o'clock the next morning.

Beginning in 1991, surviving cohort members were reinterviewed and all measures from the baseline interview/examination were reassessed between 24 and 32 months after the first interview. Of the 1,118 surviving members of the original cohort, 1,012 (90%) completed this second interview and examination. A majority also provided blood samples, and overnight 12-hour urines samples were collected from a randomly selected subset of 200 participants.

A third interview and examination was conducted during 1995–1997 after a mean interval of 57 months from the second interview. No blood or urine samples were collected. Of the 916 surviving cohort members, 722 (79%) completed the interview and examination.

In addition to detailed health and functioning assessments from the two face-to-face follow-up contacts, other ongoing follow-up health outcomes data are being collected from two sources: (a) Medicare Provider Analysis and Review claims records from the Centers for Medicare and Medicaid Services [Page 342]documenting health events serious enough to cause hospitalization and (b) causes and dates of death from the National Death Index. There were 489 deaths in the cohort through 2000.

The MacArthur Study of Successful Aging was, and continues to be, unique among large-scale prospective cohort studies because it recruited older adults who had been aging well (with respect to maintaining a high level of physical and cognitive functioning ability), collected a wealth of data on psychosocial and biological factors (including assessments of resting levels of the stress hormones epinephrine and cortisol) as well as detailed physical and cognitive performance assessments, and followed these older adults to see which of them continued to age well. There was 7.5 years of follow-up on physical and cognitive functioning and 14 years (and growing) of follow-up on total and cause-specific mortality and major morbidity (based on Medicare hospitalization claims data).

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