Envejecimiento
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Item Social connections, leukocyte telomere length, and all-cause mortality in older adults from Costa Rica : the Costa Rican longevity and healthy aging study (CRELES)(Journal of Aging and Health, DOI: 10.1177/08982643251313923, 2025) Gan, Danting; Baylin, Ana; Peterson, Karen E.; Rosero Bixby, Luis; Ruiz Narváez, Edward A.Objectives: To examine the association of social connections with blood leukocyte telomere length (LTL) and all-cause mortality in older Costa Ricans. Methods: Utilizing data from the Costa Rican Longevity and Healthy Aging Study (CRELES), a prospective cohort of 2827 individuals aged 60 and above followed since 2004, we constructed a Social Network Index (SNI) based on marital status, household size, interaction with non-cohabitating adult children, and church attendance. We used linear regression to assess SNI’s association with baseline LTL (N = 1113), and Cox proportional-hazard models to examine SNI’s relationship with all-cause mortality (N = 2735). Results: Higher SNI levels were associated with longer telomeres and decreased all-cause mortality during follow-up. Being married and regular church attendance were associated with 23% and 24% reductions of the all-cause mortality, respectively. Discussion: These findings underscore the importance of social engagement in promoting longevity among older Costa Ricans, suggesting broader implications for aging populations globally.Item Traditional rural dietary pattern and all-cause mortality in a prospective cohort study of elderly Costa Ricans: the Costa Rican Longevity and Healthy Aging Study (CRELES)(The American Journal of Clinical Nutrition, 2024) Zhang, Yundan; Cortés Ortiz, Mónica V.; Leung, Cindy W.; Baylin, Ana; Rosero Bixby, Luis; Ruiz Narváez, Edward A.Costa Rica, as many other Latin American countries, is experiencing a fast demographic aging. It is estimated that by 2030, 18.5% of the population, or almost 1 of every 5 Costa Ricans, will be 60 y or older, compared with 7.9% or 1 of every 13 Costa Ricans in 1999 [1]. As the population ages, chronic health conditions such as cardiovascular diseases (CVDs) and neurodegenerative disorders are expected to increase in prevalence posing growing challenges to the health of the Costa Rican population. With the demographic shift toward an aging population, there is an urgent need to study determinants of longevity and healthy aging. Diet—as part of a healthy lifestyle—is a key modifiable factor that may help to minimize the burden of age-related health conditions. Beans are a major source of protein and fiber in Costa Rican adults and part of traditional diets in most Latin American countries. High bean consumption has been found associated with a protective cardiometabolic prolife such as low total cholesterol and LDL cholesterol [2,3]. In the Costa Rican population specifically, intake of beans has been associated with lower risk of nonfatal myocardial infarction in middle-aged adults [4]. We recently reported that a traditional Costa Rican rural dietary pattern, rich in beans and rice, was associated with longer leukocyte telomeres—a marker of biologic aging—in Costa Rican adults 60 y and older [5]. However, no studies have examined whether adherence to a traditional diet in elderly Costa Ricans may also be associated with lower mortality. Because of the nutrition transition (i.e., a shift from traditional diets to an increased consumption of processed foods highs in sugars, fats, and salt) experienced by Costa Rica in the last decades [4,6,7], it is essential to evaluate the potential impact of traditional diets on promoting healthy aging and longevity within an aging population. In this study, we assessed the association between a traditional rural dietary pattern, as well as their major food components beans and rice, and all-cause mortality among elderly Costa Ricans aged 60 y and older at baseline. We hypothesized that higher scores on the traditional dietary pattern are associated with lower all-cause mortality in elderly Costa Ricans. We also assessed whether additional dietary patterns may be associated with all-cause mortality. We used longitudinal and nationally representative data from the Costa Rican Longevity and Healthy Aging Study (CRELES).Item Impresiones y recuerdos: José Silverio Gómez 1801- 1904(Población y Salud en Mesoamérica, Volumen 8, número 2 (enero-junio 2011), 2011) Pittier, HenriEnsayo del conservacionista Henri Pittier (1857-1950) realizado en 1904. Es posiblemente el primer testimonio sobre la excepcional longevidad de los habitantes de la Península de Nicoya, Costa Rica.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 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 Altitude and regional gradients in chronic kidney disease prevalence in Costa Rica : data from the Costa Rican longevity and healthy aging study(Tropical Medicine & International Health; Volumen 21, Número 1, 2016) Harhay, Meera N.; Harhay, Michael O.; Coto Yglesias, Fernando; Rosero Bixby, LuisObjectives Recent studies in Central America indicate that mortality attributable to chronic kidney disease (CKD) is rising rapidly. We sought to determine the prevalence and regional variation of CKD and the relationship of biologic and socio-economic factors to CKD risk in the older-adult population of Costa Rica. Methods We used data from the Costa Rican Longevity and Health Aging Study (CRELES). The cohort was comprised of 2657 adults born before 1946 in Costa Rica, chosen through a sampling algorithm to represent the national population of Costa Ricans >60 years of age. Participants answered questionnaire data and completed laboratory testing. The primary outcome of this study was CKD, defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Results The estimated prevalence of CKD for older Costa Ricans was 20% (95% CI 18.5–21.9%). In multivariable logistic regression, older age (adjusted odds ratio [aOR] 1.08 per year, 95% CI 1.07–1.10, P < 0.001) was independently associated with CKD. For every 200 m above sea level of residence, subjects' odds of CKD increased 26% (aOR 1.26 95% CI 1.15–1.38, P < 0.001). There was large regional variation in adjusted CKD prevalence, highest in Limon (40%, 95% CI 30–50%) and Guanacaste (36%, 95% CI 26–46%) provinces. Regional and altitude effects remained robust after adjustment for socio-economic status. Conclusions We observed large regional and altitude-related variations in CKD prevalence in Costa Rica, not explained by the distribution of traditional CKD risk factors. More studies are needed to explore the potential association of geographic and environmental exposures with the risk of CKD.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 Amerindian ancestry and extended longevity in Nicoya, Costa Rica(American Journal of Human Biology,vol.30(1), 2018) Azofeifa Navas, Jorge; Ruiz Narváez, Edward A.; Leal Esquivel, Alejandro; Gerlovin, Hanna; Rosero Bixby, LuisObjectives: The aim of this study was to address the hypothesis that Amerindian ancestry is associated with extended longevity in the admixed population of Nicoya, Costa Rica. The Nicoya Peninsula of Costa Rica has been considered a “longevity island,” particularly for males. Methods: We estimated Amerindian ancestry using 464 ancestral informative markers in 20 old Nicoyans aged 99 years, and 20 younger Nicoyans (60-65 years). We used logistic regression to estimate odds ratio (OR) and 95% confidence interval (CI) of the association of Amerindian ancestry and longevity. Results: Older Nicoyans had higher Amerindian ancestry compared to younger Nicoyans (43.3% vs 36.0%, P5.04). Each 10% increase of Amerindian ancestry was associated with more than twice the odds of being long-lived (OR52.32, 95% CI51.03-5.25). Conclusions and Implications: To our knowledge, this is the first time that ancestry is implicated as a likely determinant of extended longevity. Amerindian-specific alleles may protect against early mortality. The identification of these protective alleles should be the focus of future studies.Item 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.