Variability in Old-Old Life Span: OCTO Twin Study

2. OCTO TwinOrigins of Variance in the Old-Old Life span General presentation Boo Johansson National Institute on Aging: AG 08861

3. Acknowledgements • Funded in part by Grant R13AG030995-01A1 from the National Institute on Aging • The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S. Government. Friday Harbor Psychometrics Workshop 2010

4. Major Swedish Longitudinal Aging Studies ..at that time - population-based- longitudinal design- possible to conduct- informativeH70 (70+), OCTO (84+), …. SATSA (55+) ….??

5. Background for the OCTO Twin Study-Observations of substantial individual differences in rate and patterns of aging - Understanding the origins of this variability is of fundamental importance – What are the relative contributions of genetic and environmental influences? - Limited information about the oldest old age segement in the above respect 1988

6. The planning for a Twin Study of the Old-Old (80 +) started ~ 20 years ago (1988) H70,OCTO, SATSA ..the missing ‘piece’ OCTO Twin

7. OCTO Twin - OVERALL AIM • To estimate the relative contributions of environmental and genetic influences to the variability in health and biobehavioral functioning ….. • at each measurement occasion as well as to longitudinal change and continuity during inter-occasion intervals

8. ..in a life span genetic and environmental influence perspective

9. An individual difference approach focus on variance among individuals within a population------------------------Directs our attention to the origins of variability within an age group-----------------------Thus, we become compelled to search for the fundamental sources for observed differencesin a specific phenotype

10. The prototypic twin design • Monozygotic (MZ) pairs • and • Dizygotic (like-sex) pairs • compared with respect to • intra-pair similarities

11. MZ- monozygotic twins share 100% of all genetic influences

12. Same birthday Same parents DZ - dizygotic twinsshare on average 50% of genetic influences

13. The OCTO Twin Design Wave 1 Wave 2 Wave 3 Wave 4 Wave 5 5 measurement occasions, 2-years apart 1991 1993  1995  1997 1999 March May April March March      1994 1996 1998  2000  2002 March March March March March

14. Domains at focusHealth and functional capacity Cognitive functioning Personality and personal control Psychological well-being Interpersonal functioningUsing largely the same measures as in reference studies (H70, OCTO, SATSA

15. Health and functional capacity- Self-rated health - Self-reported medical history (”checklist”) - Sensory (Vision, hearing) - PB, Pulse, BMI - Functional tests of balance and gait - Grip strength, lung capacity - Contacts with the health care system (district nurse, physicans, and hospital) - Information from medical (ICD-10 coded) and dental records - Medications (ATC –codes) - Blood chemistry panel

16. Memory and Cognition- Cog.status – MMSE, Clock Test, Coin Test- Inductive reasoning – figure logic- Psychomotor speed - Psif, Digit-Symbol- Visuospatial ability – Koh’s Block- Primary memory – Digit Span- Semantic memory – Synonyms - Information- Episodic memory – Prose, MIR, Thurstone Picture memory

17. Dementia work-up individuals suspected for dementia - Review of memory and cognitive tests - Informant neuropsychological interview - Review of medical records and supplement information - A consensus diagnosis conference(DSM, ICD, NINCDS-ADRA, NINDS-AIREN, etc)

18. Personality and Personal Control - Eysenck Personality Inventory (EPI) - Global Locus of Control - Heatlh Locus of Control

19. Psychological Well-being- Life Satisfaction Scale (LSI-Z) - Depressive symptoms scale (CES-D) - Open ended questions, e.g. significant life events

20. Interpersonal functioning- Social networks - Contact frequencies - Confidants - Loneliness

21. Functional capacity- ADL Apparatus Test - ADL and IADL Scales (Self and RN ratings) - Need for help in ADL/IADL - Home help/institutional care - Technical aids, mobility, hearing, vision

22. Testing session

23. Supplement informationTwin Registry Ratings by RNs’ and PD Medical records Dental records Death certificates Dementia work-up Autopsy/neuropathology

24. Procedure-In-person/individual examinations in place of residence across the country- by trained and supervised RNs- using a broad-based biobehavioral battery Members of a twin pair never investigated by same RN to avoid expectation bias. The RNs’ blind to zygosity.

25. The OCTO Twin Sample • Twins in complete pairs, 80 years and older at baseline (< 1913) • MZ (monozygotic) twin pairs (N=149) and same-sex DZ (dizygotic) twin pairs (N=202) • All survivors followed longitudinally across 5 waves, 2-years apart

27. Population selection in OCTO Twin: Number of tested individuals and pairs across waves (8y) R-rate > 90% W1 W2 W3 W4 W5 MZ DZ MZ DZ MZ DZ MZ DZ MZ DZ Pairs 149 202 98 137 65 79 43 43 20 23 Men 56 61 38 40 22 23 12 10 5 4 Women 93 141 60 97 43 56 32 33 15 19 Total 351 235 144 86 43 MZ % 42,5 41,7 45,1 50,0 46,5 Individuals 298 404 235 333 178 252 142 173 100 122 Men 112 122 90 101 65 77 47 43 31 26 Women 186 282 145 232 113 175 95 130 69 96 Total 702(704) 568430315222 MZ % 42,5 41,4 41,4 45,1 42,5

28. Ongoing Swedish Twin Studies on Aging • SATSA • OCTO Twin • Gender • Harmony

29. Boo Johansson