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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The unmet needs of persons needing long-term care have recently drawn attention in China, the nation with the world's largest elderly population. Using national panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we examined the 3-year mortality of 3,089 Chinese adults above the age of 65 years who required long-term care. Long-term care needs were measured by the inability to perform any of the following six activities of daily living for 3 months: eating, dressing, bathing, getting in/out of the bed, indoor transferring, and toileting. Exponential parametric hazard models were used to investigate the association between unmet care needs on subsequent mortality. Results showed that older adults with unmet needs had an approximately 10% increased risk of mortality compared with those whose needs were met when demographics were under control. The risks were particularly elevated among older women and among urban older adults. We conclude by discussing these findings and the importance of a national social insurance program (or additional programs) specialized for the provision of long-term care in China.

Researcher-defined successful aging and self-rated successful aging are different measures with distinct social correlates. Subtypes of concordance and discordance provide a more holistic biopsychosocial conceptualization of successful aging.

In comparison to 1998, for Shanghai elders, the trend for engaging in leisure-time habits not related to physical activity increased over time, becoming statistically significant in 2005 and 2008 (e.g. OR for watching TV in 2003, 2005 and 2008 is 1.04 [0.91, 1.19], 1.17 [1.00, 1.38] and 1.78 [1.51, 2.09], respectively). Simultaneously, the trend for engaging in regular exercise declined significantly in each observation year in comparison to 1998 (OR in 2003, 2005 and 2008 is 0.70 [0.61, 0.80], 0.36 [0.30, 0.42] and 0.28 [0.24, 0.33], respectively). Discussion An increasingly sedentary lifestyle has evolved over the past decade in Shanghai. This highlights a need for public health agencies to develop effective active lifestyle interventions and physical activity promotion programs for local elders.

What are the social factors that matter most to the health of elderly Chinese? Are there any gender and age differences? Using a representative sample of elderly Chinese in Shanghai, the most developed city in China with the nation's largest proportion of elderly residents, this study found that economic conditions, chronic health status, living arrangements, social activity participation, and caring for grandchildren are factors that are most important to the health of elderly Chinese. This is true for both self-rated health and psychological well-being. The beneficial effects of participation in social activities are particularly salient for elderly women and for the old-old, whereas the salutary effects of caring for grandchildren are more substantial for elderly men and for the young-old. Our findings suggest the importance of social engagement in promoting health and successful aging of elderly Chinese and disclose the moderating roles of gender and age in this focal relationship.

We aimed to examine the psychometric properties of a modified 16-item Attitudinal Index (AI), a measure of Chinese older adults' beliefs about preventive health screenings. We used the 2013 Shanghai Elderly Life and Opinion data including 3,418 respondents age 60+ who were randomly split into training and validation samples. We examined the validity and reliability of the modified AI. Psychometric evaluation of the modified AI revealed good response patterns. The overall scale had good reliability (Cronbach's α = .835). Exploratory factor analysis yielded four factors: barriers, fatalism, unnecessary, and detects (Cronbach's α = .815-.908). Confirmatory factor analysis of the modified AI's factor structure verified its four-factor structure (comparative fit index = 0.913, standardized root mean square residual = 0.048). The validity and reliability of the modified AI support its cultural appropriateness in measuring health beliefs among Chinese elderly. Further psychometric evaluation should focus on testing concurrent and criterion validity.