Abstract

Successful aging may be a solution to the major challenges that population aging poses to healthcare systems, financial security, and labor force supply. Hence, we studied the value of factors discovered by exploratory factor analysis in predicting four main indicators of successful aging, and their association with mortality. We followed-up a nationally representative sample of 1284 older adults for a median of 50 months. Successful aging was defined by fast walking, independence, emotional vitality, and self-rated health. Exploratory factor analysis revealed five determinants: physical activity, life satisfaction and financial status, health status, stress, and cognitive function. Physical activity and health status were significant factors in living independently. Life satisfaction and financial status were associated with walking speed. Stress was solely associated with emotional vitality. Life satisfaction and financial status, and health status, were important predictors of self-rated health. Compared to people without any successful aging indicators, those with one, two, three, or four showed dose-dependent lessening of mortality risk, with respective hazard ratios of 0.39 (95% CI 0.25–0.59), 0.29 (95% CI 0.17–0.50), 0.23 (95% CI 0.11–0.51), and 0.09 (95% CI 0.01–0.66). These associations were stronger in males, older adults, smokers, and drinkers, than in their counterparts.

Highlights

  • The outstanding success of 20th century clinical medicine and public health considerably increased longevity and population growth

  • We previously identified several factors potentially implicated in frailty, including physical activity, life satisfaction, health status, stress, and cognition, and demonstrated an association with mortality [9]

  • This study included 1284 adults > 50 years old from Taiwan who participated in The Social Environment and Biomarkers of Aging Study (SEBAS) [10], representing total follow-up of 5088 person-years

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Summary

Introduction

The outstanding success of 20th century clinical medicine and public health considerably increased longevity and population growth. Increased longevity combined with lower fertility rates will make the 21st century one of population aging. This demographic transition poses multi-dimensional challenges at individual, society and national levels; increasing complexity and utilization of healthcare, care burden and costs for individuals and society, and a diminishing labor force, with profound impacts on healthcare and social care systems [1]. Frailty may be considered a measure of biological age, in terms of accumulated multi-system deficits [3], and frailty and successful aging to represent opposite sides of the same coin, www.aging-us.com because they are both defined by functional capacity and share common targets for preventive/health promotion interventions [4]

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