The change and correlates of healthy ageing among Chinese older adults: findings from the China health and retirement longitudinal study

Abstract

Background This study tentatively constructs a composite measure of Chinese Healthy Ageing Index (CHAI) among older adults aged 60+ and investigates change of CHAI during 2011–2015 and its association with sociodemographic characteristics. Methods Data collected from 8182 old adults aged 60+ in the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS, a nationally representative sample) were used. Six medical measures of blood pressure, peak expiratory flow, cognitive status score, fasting glucose, kidney function and C-reactive function were used to construct CHAI (range 0–12, 0–2 = healthiest, 7–12 = unhealthiest). Ordinary least squares, logistic and random effects models examined social and spatial determinants of CHAI score and the prevalence of the ideal CHAI. Unconditional quantile regression tested heterogeneous impacts of sociodemographic determinants of CHAI score. Results Mean CHAI score declined from 5.7 to 5.2, and the proportion of the ideal CHAI (CHAI score = 0–2) increased from 5.6 to 9.4% during 2011–2015, indicating an improvement in healthy ageing over time. During 2011–2015, the highest rates of the ideal CHAI were in Southeast and East of China. Older adults, male, living in the Center and West, smoking, obesity/overweight and having chronic diseases were positively associated with total CHAI score and negatively with a higher prevalence of the ideal CHAI. Being married, having high education and regular social activities were associated with a higher rate of the ideal CHAI. The positive predictors for total CHAI were stronger in those with worse CHAI status. Conclusions In China healthy ageing has improved during 2011–2015, but substantial geographical and sociodemographic heterogeneities exist in the improvements, suggesting health equality remains a challenge in China. Future policies and interventions should especially focus on men, those in Central and West China, and combat health problems like obesity, chronic diseases and unhealthy behaviors.

Housing Poverty and Healthy Aging in China: Evidence from the China Health and Retirement Longitudinal Study

“…Given the multidimensional nature of healthy aging, similar to Wu et al [ 51 ], we formulated our corresponding composite measure as a CHAI score based on six physiologic domains, each empirically documented as a key indicator of mortality and a primary measure of a common age-associated chronic disease [ 52 , 53 ]: Systolic blood pressure (SBP): the average value of SBP measured three times at 45 s intervals and then grouped into three categories: 0 = ≤120 mmHg, 1 = 120–140 mmHg, and 2 = >140 mmHg. We designated respondents diagnosed with hypertension or taking anti-hypertensive medications as the unhealthiest group (score = 2) [ 2 , 51 ]; Pulmonary function: the average of expiratory peak flow (L/min) measured three times in a standing position, with gender-specific terciles grouped into three categories (for males: 0 = ≥320 L/min, 1 = 193–320 L/min, and 2 = ≤193 L/min; for females: 0 = ≥225 L/min, 1 = 153–225 L/min, and 2 = ≤153 L/min) [ 2 , 51 ]. We designated respondents diagnosed with pulmonary disease as the unhealthiest group (score = 2); Fasting glucose: classified into three categories: 0 = ≤100 mg/dL, 1 = 100–125 mg/dL, and 2 = ≥125 mg/dL [ 2 , 51 ].…”

“…We designated respondents diagnosed with hypertension or taking anti-hypertensive medications as the unhealthiest group (score = 2) [ 2 , 51 ]; Pulmonary function: the average of expiratory peak flow (L/min) measured three times in a standing position, with gender-specific terciles grouped into three categories (for males: 0 = ≥320 L/min, 1 = 193–320 L/min, and 2 = ≤193 L/min; for females: 0 = ≥225 L/min, 1 = 153–225 L/min, and 2 = ≤153 L/min) [ 2 , 51 ]. We designated respondents diagnosed with pulmonary disease as the unhealthiest group (score = 2); Fasting glucose: classified into three categories: 0 = ≤100 mg/dL, 1 = 100–125 mg/dL, and 2 = ≥125 mg/dL [ 2 , 51 ]. We designated respondents diagnosed with diabetes or taking antidiabetic medication as the unhealthiest group (score = 2); Cognitive function: as evaluated by the Telephone Interview for Cognitive Status (TICS), whose validity has been confirmed in different populations, including Chinese [ 54 , 55 ].…”

“…The global concern of population aging poses a special challenge for the United Nations’ Sustainable Development Goals (SDGs), especially SDG 3, which aims to ensure healthy lives and wellbeing at all ages [ 1 ]. Such aging is particularly rapid in China, which has the world’s largest population of adults aged 60 and over [ 2 , 3 , 4 ], with the 2019 number of approximately 254 million (18.1% of the total population) [ 5 ] expected to double by 2050 [ 6 ]. Such unprecedented numbers, especially in developing countries such as China, have magnified the importance of healthy aging, “of developing and maintaining the functional ability that enables well-being in older age” [ 7 ] (p. 28).…”

Geographic and Age Variations in Low Body Mass Index Among Community-Dwelling Older People in Xinjiang: A Cross-Sectional Study

“…In the older population, as age increases, food intake decreases; this is affected by factors such as society, psychology, physiology, drugs, and behavior, and ultimately leads to a high incidence of undernutrition (17,18). The reported risk of undernutrition in the people aged ≥60 years in China was 5.4%, while that in the hospitalized older individuals has been increasing continuously up to 50-70% (17,19). Studies also revealed the presence of undernutrition in 5-30% of older people living at home, 6-70% of older people in nursing homes, and 20-60% of older inpatients (20,21).…”

One-day seminar for residents for implementing abdominal pocket-sized ultrasound

“…As the worldwide population rapidly ages, a concurrent rapid increase in the global financial healthcare burden has been observed[ 1 ]. The resources available for daily clinical practice are generally limited.…”