Abstract
BackgroundThe World Health Organization proposed a multidimensional concept of healthy aging in 2015; there was limited evidence about how the concept was constructed and measured. The current study aims to develop a health aging scale (HAS) following the WHO framework and validate it using data from the China Health and Retirement Longitudinal Study (CHARLS).MethodsA total of 13,233 adults aged ≥ 45 years old from the CHARLS included in current study. Based on the WHO framework, 37 self-reported indicators were used to determine healthy aging. Exploratory factor analysis and second-order and bi-factor modeling, as well as psychometric coefficients, were used to examine the structure of healthy aging. To assess concurrent validity of the HAS, regression analyses were used to examine the associations of HAS and its subscales with sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction in Wave 1. The predictive validity of HAS and subscales was assessed by their associations with mortality in Wave 2 follow-up using Cox regressions.ResultsThe general HAS and its five subscales were generated according to bi-factor modeling [CFI = 0.949; TLI = 0.942; SRMSR = 0.030; and RMSEA = 0.033 (95% CI, 0.032–0.034)] and psychometric coefficients (ω = 0.903; ωH = 0.692; ECV = 0.459). The general HAS presented solid evidence of concurrent validity with various sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction; and predictive validity with mortality.ConclusionsThe population-based multidimensional healthy aging scale and its subscales can be used to monitor the trajectories of general healthy aging and its subdomains to support the development of healthy aging policies and interventions.
Highlights
The pace of population aging around the world is increasing dramatically [1]
According to the World Health Organization (WHO)’s model, healthy aging is a multidimensional concept that includes both intrinsic capacity and functional ability [5], which was confirmed by a previous study [10]
This study confirmed the multidimensionality of healthy aging and developed and validated a population-based multidimensional healthy aging scale and associated subscales
Summary
The pace of population aging around the world is increasing dramatically [1]. Between 2015 and 2050, the proportion of the world’s population older than 60 years of age is expected to nearly double from 12 to 22% [1]. The world’s rapidly aging population poses huge challenges to health and social care systems. To address these challenges, the World Health Organization (WHO) in 2015 proposed a public-health framework for healthy aging [3], which defined healthy aging as “the process of developing and maintaining the functional ability that enables well-being in older age.”. Healthy aging pays more attention to an individual’s functional ability across life-course. A healthy aging measure should broadly combine an individual’s intrinsic capacity and functional ability and could sensitively capture the changes in a person’s healthy aging level over life-course. The current study aims to develop a health aging scale (HAS) following the WHO framework and validate it using data from the China Health and Retirement Longitudinal Study (CHARLS)
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