THE DEVELOPMENT OF HEALTHY AGEING INDEX BASED ON AGEING STUDIES IN THE U.S. ENGLAND AND CHINA

摘要

Background Creating a multidimensional measure of healthy ageing at the individual level could become a sensible approach to comprehensively assess healthy ageing status. Methods A healthy ageing index (HAI, 0–100) with 33 indicators of physical, cognitive, physiological functions and psychological and social well-being was created, using data from Health and Retirement Study (US, N=13790), English Longitudinal Study of Ageing (England, N=7225) and China Health and Retirement Longitudinal Study (China, N=7385). Pearson’s r, Cronbach’s α, ROC curve and survival analyses were applied to assess the test-retest reliability, internal consistency and the predictive validity of HAI respectively. Results Values of Pearson’s r and Cronbach’s α were greater than 0.70 and 0.80, respectively. According to the ROC estimates, the accuracy of predicting mortality from the HAI were 0.687 (95%CI: 0.662 to 0.711) in the US, 0.684 (95%CI: 0.664 to 0.705) in England and 0.589 (95%CI: 0.528 to 0.649) in China. One unit increase in HAI was associated with a 3.8% (95% CIs: 3.4% to 4.1%), 2.5% (95%CIs: 2.1% to 2.8%) and 2.3% (95%CIs: 1.5% to 3.1%) reduction in subsequent mortality risk in the US, England and China, respectively. Conclusion The overall reliability and validity of the HAI are acceptable. The HAI acts as an independent predictor of mortality risk in later life in the studied datasets. It can be applied as a preliminary screening of healthy agers in both western and Asian countries, which may help clinicians to identify patients’ healthy ageing profiles in both prevention and intervention trials.