Family Functionality, cognitive status and social participation are related to survival in nonagenarians and centenarians: data from a Brazilian cohort study

Aim: To evaluate whether family functionality, using the instrument “Adaptation, Partnership, Growth, Affection, and Resolve” (APGAR) and its components, as well as other health indicators, influences the survival of nonagenarians and centenarians. Methods: Participants were randomly identified and evaluated in their homes of Porto Alegre — Brazil. Death or survival information were verified by telephone or death registry system. Follow-up time measured the number of months between the first evaluation and the date of death or the last contact. Participants with APGAR ≥ 7 were classified with good functionality. The APGAR components were analyzed as yes or no. Results: Two-hundred-fourteen participants (73% women, age 92.4±3.59 years) were followed during 23±10.0 months. Sixty-on (28.5%) died. Survivors were younger (p<0.001), had better cognitive performance (p<0.001), and reported more frequently leaving home (p=0.010) and participating in social activities (p<0.001). Survivors had a similar frequency for good family functioning (90% p=0.994), but more often they were satisfied with their family time (p=0.032) and with the way the family showed affection and reacted to their feelings (p=0.083). Conclusions: Family affection and time were significantly associated with lower hazard-ratio, even adjusted for age, as well as cognitive performance, social activities and the habit of leaving home. In addition to the preservation of cognitive performance, to remain physically and socially active, family support is related to the higher survival rate in nonagenarians and centenarians in Brazil.