Abstract
BackgroundDeclines in health, physical, cognitive, and mental function with age suggest a lower level of health-related quality of life (HRQoL) in late life; however, previous studies found that the associations were weak and varied, depending on the study designs and cohort characteristics.MethodsThe present study examined the paradox of aging in an East Asian context by regressing the age patterns of objective health indicators (physical, cognitive, and mental function), and subjective HRQoL (12-item Short Form, SF-12), on the independent and interactive effects of age and physical function in a cohort study of 5022 community-dwelling adults aged 55 and older in Taiwan.ResultsAge patterns differed across measures. The SF-12 mental health score (MCS) showed a slight positive association with age and this effect remained stable after controlling for various age-related covariates. The SF-12 physical health score (PCS), in turn, was negatively associated with age. Age differences in PCS were fully explained by age decrements in objective physical health. However, consistent with the so-called paradox of aging, the association between objective and subjective physical health weakened with age.ConclusionThese findings add to prior evidence indicating that — in spite of objective health decrements — subjective HRQoL is maintained in later life among Asian Chinese. Also, these paradoxical patterns appear to vary for mental and physical components of HRQoL, and future research is needed to explore the underlying mechanism.Trial registrationHealthy Aging Longitudinal Study in Taiwan (HALST) is retrospectively registered at ClinicalTrials.gov on January 24, 2016 with trial registration number NCT02677831.
Highlights
Declines in health, physical, cognitive, and mental function with age suggest a lower level of healthrelated quality of life (HRQoL) in late life; previous studies found that the associations were weak and varied, depending on the study designs and cohort characteristics
There were no significant differences in the distributions of the primary outcome variables (PCS and mental component summary score (MCS)) and any objective health indicators between the included and excluded samples
The present study studied the aging paradox in quality of life by examining cross-sectional age patterns in HRQoL, as well as the role age plays in the associations between physical health and HRQoL (PCS and MCS, respectively)
Summary
Physical, cognitive, and mental function with age suggest a lower level of healthrelated quality of life (HRQoL) in late life; previous studies found that the associations were weak and varied, depending on the study designs and cohort characteristics. In a crosssectional analysis, when potential covariates (e.g., sex, education, income, driving ability, activities of daily living (ADL), social relationship, living status, and depression) were adjusted, researchers in the English Longitudinal Study of Ageing (ELSA) observed that the quality of life increased from age 50, peaked at age 68, and, by age 86, gradually declined to the same level as at the age of 50 [35] Such consistent reports of stable or increased levels of subjective well-being among older adults suggest that the correspondence between objective health and subjective well-being weakens with age [24]. That subjective well-being is maintained or even improved later in life despite so many welldocumented losses that occur with aging has been labeled the “paradox of aging” [33]
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