Open Access Open Badges Study protocol

Mental health in the aged: prevalence, covariates and related neuroendocrine, cardiovascular and inflammatory factors of successful aging

Maria E Lacruz1, Rebecca T Emeny1, Horst Bickel2, Barbara Cramer2, Alexander Kurz2, Martin Bidlingmaier3, Dorothea Huber4, Günther Klug4, Annette Peters1 and Karl H Ladwig14*

Author Affiliations

1 Institut für Epidemiologie - Helmholtz Zentrum München, München, Germany

2 Klinik und Poliklinik für Psychiatrie und Psychotherapie - Klinikum rechts der Isar, TU München, Germany

3 Medizinische Klinik der Innenstadt - Ludwig-Maximilians-Universität München, München, Germany

4 Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie - Klinikum rechts der Isar, TU München, Germany

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BMC Medical Research Methodology 2010, 10:36  doi:10.1186/1471-2288-10-36

Published: 30 April 2010



Although aging is accompanied by diminished functioning, many elderly individuals preserve a sense of well-being. While the concept of "successful aging" has been popular for many decades, little is known about its psycho-physiologic and endocrine underpinnings. KORA-Age is a population-based, longitudinal study designed to determine the prevalence of successfully aged men and women between 65 and 94 years old in the MONICA/KORA Augsburg cohort of randomly selected inhabitants. Specifically, we aim to identify predictors of successful aging and to elucidate bio-psychosocial mechanisms that maintain mental health and successful adaptation despite adverse experiences of life and aging.


Components of successful aging were assessed in a telephone survey of 4,127 participants (2008-2009) enrolled in the MONICA/KORA cohort, on average, 13 years earlier. Psychosocial, somatic and behavioural predictors are used to determine factors that contribute to successful aging. An age-stratified random sub-sample (n = 1,079) participated in a personal interview where further psychological mechanisms that may underlie successful adaptation (resilience, social support, attachment) were examined. The interactions among neuroendocrine systems in the aging process are investigated by studying the cortisol/dehydroepiandrosterone-sulfate ratio, the level of insulin-like growth factor I, and oxytocin.


Longitudinal determinants of successful aging can be assessed based on a follow-up of an average of 13 years. A comprehensive analysis of biological as well as physio-psychological information provides a unique opportunity to investigate relevant outcomes such as resilience and frailty in the elderly population.