Preventive Interventions for the Second Half of Life: A Systematic Review

Abstract

Objective: Recent improvements in life expectancy globally require intensified focus on noncommunicable diseases and age-related conditions. The purpose of this article is to inform the development of age-specific prevention guidelines for adults aged 50 and above, which are currently lacking.

Data source: PubMed, Cochrane database, and Google Scholar and explicit outreach to experts in the field.

Study inclusion and exclusion criteria: Meta-analyses, intervention-based, and prospective cohort studies that reported all-cause mortality, disease-specific mortality, or morbidity in adults were included.

Data extraction: A systematic review was undertaken in 2015 using search terms of a combination of <risk factor> and "intervention," "mortality," "reduction," "improvement," "death," and "morbidity."

Data synthesis: Interventions were categorized according to the Center for Evidence-Based Medicine Level of Evidence framework.

Results: A summary table reports for each intervention the impact, strength of evidence, initiation, duration, and details of the intervention. Age-decade-specific preventive recommendations have been proposed relating to physical activity, diet, tobacco and alcohol use, medication adherence, screening and vaccination, and mental and cognitive health.

Conclusion: Clear recommendations have been made according to the existing evidence base, but further research investment is needed to fill the many gaps. Further, personalized approaches to healthy aging complemented by population-wide approaches and broader cross-sector partnerships will help to ensure greater longevity is an opportunity, rather than a burden, for society.

Keywords: age-specific; aging; lifestyle; longevity; morbidity; mortality; prevention.