Abstract
This study aimed to investigate the effect of disability in activities of daily living (ADLs) on successful aging, and the possible moderators between them. Based on data from the Chinese Longitudinal Healthy Longevity Surveys (CLHLS), we used the Cox proportional hazards model of survival analysis and multivariate regression analysis (SPSS 16.0) to test our hypotheses. Mortality or cognition impairment were the dependents variables, and disability in ADLs was the independent variable. Well-being and residence location were the moderators. The results showed that in survey 2005, the Chinese elders with disability in ADLs, after controlling elder's gender, age, residence place, and marital status, often experienced more mortality and cognition impairment risk in the next 3 years. Our findings also showed that the increased mortality risk among elders with disability in ADLs was lower in those with higher well-being or younger age. The increased cognitive impairment risk among elders with disability in ADLs was lower in those living in the city than those living in a rural area or small towns. These findings contribute to a better understanding of the relationship between disability in ADLs and successful aging among Chinese elders. Our findings also expose other elements to consider such as psychological factors (e.g., well-being) and residence location in the relationships between the disability in ADLs and mortality (or cognition impairment), which have a psychological impact in successful aging of the Chinese elders.
Highlights
An aging population is a significant challenge for most countries in the world, including China [1]
Attention should be paid on aging population due to their physical decline, high mortality, possible depression symptom, and cognition impairment, which are regarded as important obstacles in reaching the goals of successful aging [2,3,4,5]
Model 1 shows that one-point increase in disability in the ADLs index was associated with an increased hazard ratio (HR) of 35% (HR = 1.35, 95% CI: 1.32–1.39), after controlling for elder’s gender, age, residence place, and well-being
Summary
An aging population is a significant challenge for most countries in the world, including China [1]. Due to the declining ability in making their own choice and shrinking social network [2, 5], elders often experience low self-control and a strong sense of loneliness or meaninglessness, which are risk factors that increase elder’s cognition impairment, suicide, and ADLs and Elders’ Successful Aging mortality risk [10,11,12,13,14]. Comparing with low well-being elders or those living in Chinese rural area, elders with high well-being or those living in Chinese urban area might have high internal (e.g., positive attitude to life) or external resources (e.g., social or medical support) against adversity (e.g., disability in ADLs) [1, 10, 12, 15], which could reduce the increased risk of disability in ADLs on elder’s mortality or cognitive impairment.
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