Development and Validation of a Multidimensional Population-Based Healthy Aging Scale: Results From the China Health and Retirement Longitudinal Study

Abstract

BackgroundThe World Health Organization proposed a multidimensional concept of healthy aging in 2015; there was limited evidence about how the concept was constructed and measured. The current study aims to develop a health aging scale (HAS) following the WHO framework and validate it using data from the China Health and Retirement Longitudinal Study (CHARLS).MethodsA total of 13,233 adults aged ≥ 45 years old from the CHARLS included in current study. Based on the WHO framework, 37 self-reported indicators were used to determine healthy aging. Exploratory factor analysis and second-order and bi-factor modeling, as well as psychometric coefficients, were used to examine the structure of healthy aging. To assess concurrent validity of the HAS, regression analyses were used to examine the associations of HAS and its subscales with sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction in Wave 1. The predictive validity of HAS and subscales was assessed by their associations with mortality in Wave 2 follow-up using Cox regressions.ResultsThe general HAS and its five subscales were generated according to bi-factor modeling [CFI = 0.949; TLI = 0.942; SRMSR = 0.030; and RMSEA = 0.033 (95% CI, 0.032–0.034)] and psychometric coefficients (ω = 0.903; ωH = 0.692; ECV = 0.459). The general HAS presented solid evidence of concurrent validity with various sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction; and predictive validity with mortality.ConclusionsThe population-based multidimensional healthy aging scale and its subscales can be used to monitor the trajectories of general healthy aging and its subdomains to support the development of healthy aging policies and interventions.

Construction of healthy aging index from two different datasets

“…Such domains as vitality, cognition, and psychology are the most commonly used, i.e., 76% of the reviewed studies reported them. Such domains as locomotion and sensory were reported in only 4–5 studies ( 7 , 10 , 23 – 25 ).…”

Examining dynamic developmental trends: the interrelationship between age-friendly environments and healthy aging in the Chinese population—evidence from China Health and Retirement Longitudinal Study, 2011–2018

“…We selected the established factors that have been clearly identified in previous research as control variables for healthy aging (Appendix 2 in the Supplement), including: physical condition (chronic diseases, teeth) [ 2 – 4 , 34 , 35 , 38 , 40 ], SES (education, ACE, household income) [ 3 , 4 , 6 , 8 , 9 , 34 , 35 , 40 – 44 ], lifestyle habits (smoke, drink) [ 3 , 6 , 7 , 34 , 35 , 41 , 43 , 45 ], and demographic factors (geographical distribution, urban–rural distribution, age, gender, and marital status) [ 3 , 4 , 6 , 9 , 34 , 35 , 40 , 42 ].…”