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Item Insurance and other socioeconomic determinants of elderly longevity in a Costa Rican panel(Journal of Biosocial Science: 37(6), 2005) Rosero Bixby, Luis; Dow, William H.; Laclé Murray, AdrianaOfficial figures show that life expectancy in Costa Rica is longer than in the United States (US), in spite of the fact that per capita health expenditure is only one-tenth that of the US. To check whether this is for real and to explore some of its determinants, 900 Costa Ricans aged 60+ were followed from 1984 to 2001. Follow-up household visits were made, deaths were tracked in the national death registry, and survival status in the voting registry was double-checked. In addition, the survivors were contacted in 2002. Two-thirds of the panel had died by December 2001. Kaplan—Meier curves, life tables and Cox regression were used to analyse the panel's survival. Mortality in the panel was slightly higher than the Costa Rican average and similar to that in the US, confirming the exceptional longevity of Costa Ricans. Survival was substantially lower among unmarried men and individuals with limited autonomy at the beginning of the study. The effect of socioeconomic status is weak. Insurance effects seem to be confounded by selection biases.Item The Nicoya region of Costa Rica : a high longevity island for elderly males(Vienna Yearbook of Population Research, Vol 11, 2013) Rosero Bixby, Luis; Dow, William H.; Rehkopf, David H.Reliable data show that the Nicoyan region of Costa Rica is a hot spot of high longevity. A survival follow-up of 16,300 elderly Costa Ricans estimated a Nicoya death rate ratio (DRR) for males 1990–2011 of 0.80 (0.69–0.93 CI). For a 60-yearold Nicoyan male, the probability of becoming centenarian is seven times that of a Japanese male, and his life expectancy is 2.2 years greater. This Nicoya advantage does not occur in females, is independent of socio-economic conditions, disappears in out-migrants and comes from lower cardiovascular (CV) mortality (DRR = 0.65). Nicoyans have lower levels of biomarkers of CV risk; they are also leaner, taller and suffer fewer disabilities. Two markers of ageing and stress—telomere length and dehydroepiandrosterone sulphate—are also more favourable. The Nicoya diet is prosaic and abundant in traditional foods like rice, beans and animal protein, with low glycemic index and high fibre content.Item Longer leukocyte telomere length in Costa Rica's Nicoya Peninsula: A population-based study(Experimental Gerontology; Volumen 48, Número 11, 2013) Rehkopf, David H.; Dow, William H.; Rosero Bixby, Luis; Lin, Jue; Epel, Elissa S.; Blackburn, Elizabeth H.Studies in humans suggest that leukocyte telomere length may act as a marker of biological aging. We investigated whether individuals in the Nicoya region of Costa Rica, known for exceptional longevity, had longer telomere length than those in other parts of the country. After controlling for age, age squared, rurality, rainy season and gender, mean leukocyte telomere length in Nicoya was substantially longer (81 base pairs, p<0.05) than in other areas of Costa Rica, providing evidence of a biological pathway to which this notable longevity may be related. This relationship remains unchanged (79 base pairs, p<0.05) after statistically controlling for nineteen potential biological, dietary and social and demographic mediators. Thus the difference in mean leukocyte telomere length that characterizes this unique region does not appear to be explainable by traditional behavioral and biological risk factors. More detailed examination of mean leukocyte telomere length by age shows that the regional telomere length difference declines at older ages.Item Differential DNA methylation and lymphocyte proportions in a Costa Rican high longevity region(Epigenetics & Chromatin,vol.10(21), 2017) McEwen, Lisa M.; Morin, Alexander M.; Edgar, Rachel D.; MacIsaac, Julia L.; Jones, Meaghan J.; Dow, William H.; Rosero Bixby, Luis; Kobor, Michael S.; Rehkopf, David H.Background: The Nicoya Peninsula in Costa Rica has one of the highest old-age life expectancies in the world, but the underlying biological mechanisms of this longevity are not well understood. As DNA methylation is hypothesized to be a component of biological aging, we focused on this malleable epigenetic mark to determine its association with current residence in Nicoya versus elsewhere in Costa Rica. Examining a population’s unique DNA methylation pattern allows us to differentiate hallmarks of longevity from individual stochastic variation. These differences may be characteristic of a combination of social, biological, and environmental contexts. Methods: In a cross-sectional subsample of the Costa Rican Longevity and Healthy Aging Study, we compared whole blood DNA methylation profiles of residents from Nicoya (n = 48) and non-Nicoya (other Costa Rican regions, n = 47) using the Infinium HumanMethylation450 microarray. Results: We observed a number of differences that may be markers of delayed aging, such as bioinformatically derived differential CD8+ T cell proportions. Additionally, both site- and region-specific analyses revealed DNA methylation patterns unique to Nicoyans. We also observed lower overall variability in DNA methylation in the Nicoyan population, another hallmark of younger biological age. Conclusions: Nicoyans represent an interesting group of individuals who may possess unique immune cell proportions as well as distinct differences in their epigenome, at the level of DNA methylationItem Costa Rican Longevity and Healthy Aging Study(Encyclopedia of Gerontology and Population Aging. Springer Cham, 2019) Rosero Bixby, Luis; Dow, William H.; Brenes Camacho, GilbertThe Costa Rican Longevity and Healthy Aging Study (CRELES, or Costa Rica Estudio de Longevidad y Envejecimiento Saludable) is a set of nationally representative longitudinal surveys of health and life-course experiences of older Costa Ricans, conducted by the University of Costa Rica’s Centro Centroamericano de Población in collaboration with the University of California at Berkeley. CRELES is part of the growing set of Health and Retirement Surveys being conducted around the world (See “Health and Retirement Study”). Costa Rica is of particular interest to study given its high longevity: life expectancy is greater than that of the United States, despite being a middle-income country. CRELES comprises five waves of data from two birth cohort panels (See “Cross-Sectional Research/Panel Studies (Longitudinal Studies)”). The original CRELES Pre-1945 cohort is a sample of more than 2,800 Costa Rica residents born in 1945 or before. There are three waves of interviews for this panel conducted mainly in 2005, 2007, and 2009. Wellcome Trust funded this panel (Grant N. 072406). The CRELES 1945–1955 Retirement Cohort (RC) is a sample of about 2800 Costa Rica residents born in 1945–1955 plus 1400 of their spouses, interviewed mainly in 2011 and 2013 (waves 4 and 5). The US National Institute on Aging (grant R01AG031716) funded this panel through the University of California, Berkeley. CRELES data are well-suited for studying longevity and health determinants, relationships between socioeconomic status and health, stress and health, patterns of health behaviors, and prospective mortality.Item Correlates of longitudinal leukocyte telomere length in the Costa Rican Longevity Study of Healthy Aging (CRELES): On the importance of DNA collection and storage procedures(PLoS ONE, vol.14(10), 2019) Rosero Bixby, Luis; Rehkopf, David H.; Dow, William H.; Lin, Jue; Epel, Elissa S.; Azofeifa Navas, Jorge; Leal Esquivel, AlejandroThe objective is to identify cofactors of leukocyte telomere length (LTL) in a Latin American population, specifically the association of LTL with 36 socio-demographic, early childhood, and health characteristics, as well as with DNA sample collection and storage procedures. The analysis is based on longitudinal information from a subsample of 1,261 individuals aged 60+ years at baseline from the Costa Rican Study of Longevity and Healthy Aging (CRELES): a nationally representative sample of elderly population. Random effects regression models for panel data were used to estimate the associations with LTL and its longitudinal changes. Sample collection procedures and DNA refrigerator storage time were strongly associated with LTL: telomeres are longer in blood collected in October-December, in DNA extracted from <1-year-old blood cells, and in DNA stored at 4°C for longer periods of time up to five years. The data confirmed that telomeres are shorter at older ages, as well as among males, and diabetic individuals, whereas telomeres are longer in the high-longevity Nicoya region. Most health, biomarkers, and early childhood indicators did not show significant associations with LTL. Longitudinal LTL variation over approximately two years was mainly associated with baseline LTL levels, as found in other studies. Our findings suggest that if there is unavoidable variability in season of sample collection and DNA storage time, these factors should be controlled for in all demographic and epidemiologic studies of LTL. However, due to unobserved components of measurement variation, statistical control may be inadequate as compared to standardization of data collection procedures.