The Costa Rican Longevity and Healthy Aging Study (CRELES)

The Costa Rican Longevity and Healthy Aging Study (CRELES – Costa Rica: Estudio de Longevidad y Envejecimiento Saludable) is a nationally representative longitudinal survey of health and lifecourse experiences of 2,827 Costa Ricans aged 60 and over in 2005. The main study objective was to determine the length and quality of life, and its contributing factors in the elderly of Costa Rica. Vital statistics indicate that Costa Rica has an unusually high life expectancy for a middle-income country, even higher than that of the United States, but CRELES is the first nationally representative survey to investigate adult health levels in Costa Rica. CRELES public use data files contain information on a broad range of topics including self-reported physical health, psychological health, living conditions, health behaviors, health care utilization, social support, socioeconomic status, and nutrient intakes (from an abridged FFQ). Objective health indicators include anthropometrics, observed mobility, and biomarkers from fasting blood and overnight urine collection. Mortality events are tracked and conditions surrounding death are measured in a surviving family interview. There are also data files about the environment of public health service supply.

The study was conducted by the University of Costa Rica's Centro Centroamericano de Población (CCP) in collaboration with the Instituto de Investigaciones en Salud, with the support of the Wellcome Trust (Grant 072406). The Principle Investigator is Luis Rosero-Bixby, with Co-Principle Investigators Xinia Fernández (University of Costa Rica) and William H. Dow (University of California, Berkeley).

Data Collection
The original CRELES Pre-1945 cohort is a nationally representative sample of nearly 3000 Costa Rican residents born in 1945 or before. Baseline household interviews were conducted primarily in 2005, with 2-year follow-up interviews in 2007 and 2009. Thus, the three waves of CRELES were mostly conducted in 2005, 2007, and 2009. The original sample was drawn from Costa Rican residents in the 2000 population census who were born in 1945 or before, with an over-sample of the oldest-old (born before 1905). The baseline database (wave 1) is publicly available at the University of Michigan ICSPR NACDA repository: Waves 2 and 3 are available on request.

The CRELES 1945-1955 Retirement Cohort (RC) is a sample of Costa Rican residents born in 1945-1955, first interviewed starting in 2010 with a second wave starting in 2012. The sample includes about 2,800 baseline long-form interviews with targeted age-eligibles plus about 1,400 interviews with their spouses (regardless of age), conducted between January 2010 and December 2011. The CRELES-RC also includes a supplemental sample of short-form interviews conducted between January 2012 and January 2013 with about 500 initially non-responding target individuals so as to study response-rate patterns which may be especially systematic in working age populations.

Biomarker measures were taken by the interviewers who were trained and certified for this purpose. Anthropometric measures include weight, height, knee height, waist, hip, calf, and arm circumference, and tricipital and sub-scapular skin folds. Physical, mobility, and flexibility tests include blood pressure, hand strength, peak breathing flow (lung function), equilibrium and balance, agility, and walking speed.  CRELES also collected blood and over-night urine in the households of participants. Urine was collected only in the first wave, while blood was collected in waves 1 and 2, but not in wave 3. Urine was analyzed for creatinine clearance, epinephrine, norepinephrine, and cortisol. Fasting blood measures include glucose, glycosylated hemoglobin, total and HDL cholesterol, triglycerides, creatinine, C-reactive protein, and DHEAS. The 2010 CRELES-RC drew (non-fasting) venous blood to measure cholesterol, C-reactive protein, and HbA1c. DNA has been extracted for both cohorts. Other objective health indicators include observed mobility. The CRELES surveys are also distinguished by linkages with the Costa Rican National Death Index, which has allowed on-going monitoring and follow-up of mortality events, which are also studied through a surviving family interview. CRELES public use data files contain information on a broad range of topics including self-reported physical health, psychological health, living conditions, health behaviors, health care utilization, social support, work, and socioeconomic status.

Pre-45 Wave 1 Biomarker
Pre-45 Wave 2 Biomarker
Retirement Cohort Wave 1 Biomarker


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