Background The oldest-old (≥80 years) are the most rapidly growing age group globally, and they are most in need of health care and assistance. The aim of this study was to explore whether increased longevity is leading to populations of healthier oldest-old (compression of disability; benefits of success), or to less healthy and disabled oldest-old (expansion of disability, costs of success). Methods Data are from Chinese Longitudinal Healthy Longevity Study (CLHLS). Three pairs of cohorts aged 80–89, 90–99 and 100–105 (in total 19,528 oldest-old participants) were examined; the two cohorts in each pair were born ten years apart, with the same age at the time of the assessment in the CLHLS 1998 and 2008 surveys. Findings Controlling for various confounding factors, compared to cohorts born 10-years earlier, death rates at oldest-old ages among later cohorts were substantially reduced annually by 0.2%–1.3%, and their disabilities of Activities of Daily Living had significantly reduced annually by 0.8%–2.6%; however, the later cohorts’ cognitive impairment rates increased annually by 0.7%–2.2% and objective physical performance capacity (stand-up from a chair, pick-up a book from floor, turning around 360°) decreased annually by 0.4%–3.8%. We also found that mortality of female oldest-old was substantially lower, but their functional capacities in ADL, cognition and physical performance were worse, compared to their male counterparts (mostly P<0.001). Interpretation These empirical findings can be explained by the theoretical framework of mixed effects of two opposing processes: advances in medications, lifestyle and socioeconomics may compress ADL disability, that is, “benefits of success”, but lifespan extension may expand disability of physical and cognitive functioning as more frail elderly survive with health problems, that is “costs of success”. Recent improvements in living standards and availability of facilities for daily living among Chinese elderly may also contribute to the contrasting trends of ADL disability and physical performance.

Successful ageing is often defined as a later life with less disease and disease-related disability, high level of cognitive and physical functions, and an active life style. Few studies have compared successful ageing across different societies in a non-Western social context. This study aims to compare prevalence and correlates of successful ageing between China and South Korea. The data come from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and the Korean Longitudinal Study of Ageing (KLoSA). A total of 19,346 community-dwelling elders over 65 years were included, 15,191 from China and 4,155 from Korea. A multidimensional construct of successful ageing was used, with the criteria of no major comorbidity, being free of disability, good mental health, engaging in social or productive activity, and satisfaction on life. Correlates of successful ageing included demographics (gender, age, and rural/urban residence), socioeconomic features (financial status, education, and spouse accompany), and health behaviours (smoking, alcoholdrinking, and exercising). The results showed that 18.6 % of the older adults in China was successful agers, which was less than 25.2 % in Korea. When gender and age were adjusted, older adults were 51 % less likely to be successful agers in China than Korea (p \ 0.001).

Shanghai elders experienced substantial improvements in both ADL and IADL disability prevalence over the past decade. The trend toward improvement in IADL function is more consistent and substantial than that of ADL function.

Although there is some difference between IRH and SRH, IRH captures similar health information as SRH and is strongly predictive of mortality independent of SRH; thus, IRH could be a good supplementary measurement for well-adopted SRH.

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After a brief introduction to the background, significance and unique features of the centenarian population in China, we describe the Chinese Longitudinal Healthy Longevity Study (CLHLS), which is the world’s largest study of centenarians, nonagenarians, octogenarians, and compatible young-old aged 65–79. Based on the CLHLS data and other relevant studies, we summarize demographic and socioeconomic characteristics as well as self-reported and objectively-tested health indicators of centenarians in China, with an emphasis on gender differences and rural/urban disparities. We then compare five-year-age-specific trajectories of physical and cognitive functions, self-reported health, and life satisfactions from ages 65–69 to 100+, concluding that good psychological resilience and optimism are keys to the exceptional longevity enjoyed by centenarians. We discuss recent findings of novel loci and pathways that are significantly associated with longevity based on the genome-wide association study (GWAS) of the CLHLS centenarian sample, which is 2.7 times as large as prior GWAS of longevity. We also highlight colleagues’ and our own studies on longevity candidate genes and gene-environment interaction analyses. Finally, we discuss limitations inherent in our studies of centenarians in China and further research perspectives.

As compared with the western model of successful aging, the elderly individuals in Singapore perceived successful aging with a strong focus on familism. These lay perceptions also significantly varied among these elderly individuals.

Background and Purpose Better understanding of fall risk post-stroke is required for developing screening and prevention programs. This study characterizes falls in the Locomotor Experience Applied Post Stroke (LEAPS) randomized clinical trial, describes the impact of two walking recovery interventions on falls, and examines the value of clinical assessments for predicting falls. Methods Community-dwelling ambulatory stroke survivors enrolled in LEAPS were assessed 2-months post-stroke. Falls were monitored until 12-months post-stroke and participants were characterized as multiple or injurious (M/I); single, non-injurious (S/NI); or non-fallers. Incidence and time to M/I falls was compared across interventions [home exercise (HEP) and locomotor training initiated 2-months (early-LTP) or 6-months (late-LTP) post-stroke]. Predictive value of 2-month clinical assessments for falls outcome was assessed. Results Among the 408 participants, 36.0% were M/I, 21.6% S/NI, and 42.4% non-fallers. Most falls occurred at home in the first three months after assessment. Falls incidence was highest for those with severe walking impairment who received early-LTP.(p=0.025). Berg Balance Scale (BBS) score ≤42/56 was the single best predictor of M/I falls. Conclusions As individuals with stroke improve walking capacity, risk for M/I falls remains high. Individuals walking <0.4 m/s are at higher risk for M/I falls if they receive early-LTP training. BBS, at 2-months post-stroke, is useful for informing falls risk but cannot account for the multifactorial nature of the problem. Falls prevention in stroke will require multifactorial risk assessment and management provided concomitantly with exercise interventions to improve mobility.