A Multidimensional Model of Healthy Ageing: Proposal and Evaluation of Determinants Based on a Population Survey in Ecuador.

Abstract

Background: Healthy ageing is a complex construct, which involves multiple dimensions. The objective of this study was to design a multidimensional model of healthy ageing and to identify its determinants from national data in Ecuador. Methods: A cross-sectional analytical study was carried out from the National Survey of Health and Well-being of the Older Adult, 2010. Sample was 1797 adults aged 65 years or more (sample expanded to 898,152). A multidimensional model was designed based on the domains involved in the concept of healthy ageing from the World Organization Health´s approach, and the environment dimension. For the analysis, two groups were created per bi-stage cluster: healthy ageing and less healthy ageing. The probability of belonging to the healthiest group was analyzed with bivariate and multivariate logit for complex samples.Results: The 53.15% of the sample was classified in the healthy ageing group. Women and the poorest older adults are less likely to be in the healthy ageing group (OR 0.58; CI 95% 0.464 - 0.737; OR 0.44; CI 95% 0.343 - 0.564). Older adults with secondary education or higher, who consider their health as excellent and who are satisfied with their life have a greater probability of being in healthy ageing (OR 2.61; 95% CI 1.586 - 4.309; OR 28.49; 95% CI 3.623 - 224.02; OR 0.23; 95% CI 0.165 - 0.341). Conclusions: The model of healthy ageing addresses multidimensional variables which are summarized in three components: the intrinsic capacity, referring to the physical and mental health, the social and political environment, and the interaction of the elderly with the environment. It was found that the poorest older adults and women are less likely to belong to the healthiest group. Healthy aging plans must focus on socioeconomic conditions and gender equity.

The Relationship between Successful Aging and Health Literacy in Older Adults

“…Unlike our fndings, a number of studies reported higher levels of SA in female participants [30,40]. Te study of Rivadeneira et al [35] in Ecuador found lower levels of SA in female participants. Similarly, Roberts et al [41] found lower levels of SA in females in Canada.…”

“…Other studies in China and Taiwan also reported a negative relationship between SA perception and age [36,37]. Tese fndings may be explained with reference to chronic diseases associated with aging and the negative efects of aging on the functional capacities of older adults [35].…”

“…In our study, the participants with a degree of high school and above obtained higher scores from the AHLS and the SAS. Te study of Rivadeneira et al [35] also found a signifcant diference between the level of education and SA perception. Existing studies suggested that education had a positive impact on medical adherence, access to health services, and understanding health problems [45,46].…”

“…Contrary to our study, Kozar Westmen et al [34] did not fnd any signifcant diference between age and SA perception in Northern Carolina. On the other hand, a study in Ecuador found a signifcant diference between age and healthy aging [35]. Other studies in China and Taiwan also reported a negative relationship between SA perception and age [36,37].…”