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Fauzi NBM, Huang X, Cheng LJ, Luo N, Hilal S. Association of a healthy ageing index with health-related outcomes in a multi-ethnic cohort from Singapore. BMC Geriatr 2024; 24:508. [PMID: 38862903 PMCID: PMC11165847 DOI: 10.1186/s12877-024-05099-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/21/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND The global population is ageing rapidly and it is important to promote healthy ageing. The Healthy Ageing Index (HAI) is a comprehensive measure of health, but there is limited research on its association with other age-related outcomes. The management of an aging population necessitates considerations even among generally healthy adults, as age-related diseases often remain unaccounted for until later stages of life. This study explores the association of risk factors with HAI and its association with peripheral artery disease (PAD), muscle strength, health-related quality of life (HRQoL), and psychological distress in the Singapore Multi-Ethnic Cohort study. METHODS This cross-sectional study involved 1909 participants (median (Q1, Q3) age: 53 (48, 60) years and 59.3% females) from Singapore Multi-Ethnic Cohort study. The risk factors of HAI included age, gender, ethnicity, education level, smoking, alcohol consumption, employment, BMI and past medical histories. PAD was assessed using ankle-brachial index (ABI), handgrip strength (HGS), HRQoL with the EQ-5D-5 L questionnaire and psychological distress via the Kessler Psychological Distress Scale (K10). HAI components were assessed using relevant marker tests. RESULTS Older age, Malay and Indian ethnicities, unemployment, high BMI and histories of CHD, hypercholesterolaemia, tumours and TIA/stroke were associated with lower HAI scores indicative of poorer health. Higher HAI scores were associated with females and higher education levels. Lower HAI scores were significantly associated with low ABI, high K10 scores, mobility and anxiety/depression dimensions of EQ-5D-5 L. CONCLUSION The most important factors associated with HAI were age, sex, ethnicity, education, unemployment, BMI and a history of health conditions. Lower HAI scores were significantly associated with PAD, lower HRQoL and psychological distress. Thus, the HAI demonstrates promise as an evaluation method for assessing PAD, overall muscle strength and HRQoL in a population-based setting.
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Affiliation(s)
- Nazira Binte Muhammad Fauzi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-03U, 117549, Singapore, Singapore
| | - Xiangyuan Huang
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-03U, 117549, Singapore, Singapore
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-03U, 117549, Singapore, Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-03U, 117549, Singapore, Singapore
| | - Saima Hilal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building, 12 Science Drive 2, #10-03U, 117549, Singapore, Singapore.
- Department of Pharmacology, National University of Singapore, Singapore, Singapore.
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Miķelsone M, Reine I, Tomsone S, Guðmundsson H, Ivanovs A, Guðmundsson HS. Construction of healthy aging index from two different datasets. Front Public Health 2023; 11:1231779. [PMID: 37744491 PMCID: PMC10513080 DOI: 10.3389/fpubh.2023.1231779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/15/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction The aging population presents both unique challenges and opportunities for societies around the world. To develop an effective healthy aging strategy, a tool for assessing aging process is needed. Numerous attempts to quantify the aging process have been made. However, there is still a challenge in developing and choosing a good enough score that is easy to apply, has a construct of variables that are available in most nationwide surveys for comparable results, and at the same time reflects the aging process of older individuals. The purpose of this study is to present our approach to construct a comparable Healthy Aging Index (HAI). Materials and methods In Latvia, data from Wave 8 of the Survey of Health, Aging and Retirement in Europe (SHARE), involving 420 respondents, were used. For comparative analysis, data from a HL20 study on the health and wellbeing of the older adults in Iceland, which included 1,033 respondents, were used. Results For Latvia, 13 items were selected, and for Iceland, nine items were selected. We constructed the HAI with four similar subscales for both countries-"Autonomy," "Health," "Wellbeing," and "Activities," and an additional subscale "Cognitive" for Latvia. We found matching items in all four subscales. For the Autonomy subscale, they were related to difficulties with everyday and daily tasks. In the Health subscale, the only matching item was self-rated physical health. One item related to loneliness was found for the Wellbeing subscale and one item related to social participation for the Activities subscale. Discussion In our study, we found evidence for the successful construction of a HAI in two different datasets. The strength of our construct lies in the use of data from one of the largest social science panel studies in Europe (SHARE). As we were able to apply the construct to the Icelandic study, we believe that items presented in our approach are available in other population-based studies as well, and, therefore, can be easily replicated by others. By examining the existing SHARE data, HAI could be used to analyze long-term changes and could provide a foundation for comparing and monitoring the evolution of aging over time as well as comparing the aging process across societies. This is required for the authorities to conduct further analyses, proposals, and action plans in support of healthy aging.
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Affiliation(s)
| | - Ieva Reine
- Statistics Unit, Riga Stradiņš University, Riga, Latvia
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Signe Tomsone
- Faculty of Rehabilitation, Riga Stradiņš University, Riga, Latvia
| | - Helgi Guðmundsson
- Social Science Research Institute, University of Iceland, Reykjavik, Iceland
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Behr LC, Simm A, Kluttig A, Grosskopf Großkopf A. 60 years of healthy aging: On definitions, biomarkers, scores and challenges. Ageing Res Rev 2023; 88:101934. [PMID: 37059401 DOI: 10.1016/j.arr.2023.101934] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/26/2023] [Accepted: 04/12/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND AND OBJECTIVE As the proportion of aging people in our population increases steadily, global strategies accompanied by extensive research are necessary to tackle society and health service challenges. The World Health Organization recently published an action plan: "Decade of healthy aging 2020-2030", which calls for concerted collaboration to prevent poverty of older people to provide quality education, job opportunities, and an age-inclusive infrastructure. However, scientists worldwide still struggle to find definitions and appropriate measurements of aging per se and healthy aging in particular. This literature review aims to compile concepts of healthy aging and provide a condensed overview of the challenges in defining and measuring it, along with suggestions for further research. MATERIALS AND METHODS We conducted three independent systematic literature searches covering the main scopes addressed in this review: (1) concepts and definitions of healthy aging, (2) outcomes and measures in (healthy) aging studies and (3) scores and indices of healthy aging. For each scope, the retrieved literature body was screened and subsequently synthesized. RESULTS We provide a historical overview of the concepts of healthy aging over the past 60 years. Furthermore, we identifiy current difficulties in identifying healthy agers, including dichotomous measurements, illness-centered views, study populations & designs. Secondly, markers and measures of healthy aging are discussed, including points to consider, like plausibility, consistency, and robustness. Finally, we present healthy aging scores as measurements, which combine multiple aspects to avoid a dichotomous categorization and display the bio-psycho-social concept of healthy aging. DISCUSSION AND CONCLUSION When deducting research, scientists need to consider the diverse challenges in defining and measuring healthy aging. Considering that, we recommend scores that combine multiple aspects of healthy aging, such as the Healthy Ageing Index or the ATHLOS score, among others. Further efforts are to be made on a harmonized definition of healthy aging and validated measuring instruments that are modular, easy to apply and provide comparable results in different studies and cohorts to enhance the generalization of results.
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Affiliation(s)
- Luise Charlotte Behr
- University Clinic and Outpatient Clinic for Cardiac Surgery, Medical Faculty of the Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle (Saale), Germany; Institute of Medical Epidemiology, Biostatistics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Andreas Simm
- University Clinic and Outpatient Clinic for Cardiac Surgery, Medical Faculty of the Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle (Saale), Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anne Grosskopf Großkopf
- University Clinic and Outpatient Clinic for Cardiac Surgery, Medical Faculty of the Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle (Saale), Germany.
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Healthy aging index and its link with relative education between individual and neighborhood: a population-based, cohort study. BMC Geriatr 2022; 22:778. [PMID: 36192698 PMCID: PMC9528066 DOI: 10.1186/s12877-022-03469-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/19/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES There is increasing recognition of the importance of neighborhood socioeconomic status (SES) for establishing an age-friendly society. Despite the benefits of improved neighborhood SES, little is known about the link of relative education between individuals and neighborhoods with healthy aging. This study aims to construct a healthy aging index (HAI) accounting for indicators' interlinkages and to test the association of the HAI with relative education between neighborhoods and individuals. METHODS The study used data from the China Health and Retirement Longitudinal Study from 2011 to 2018, including middle-aged and older adults (≥ 45 years). The final sample comprised 11633 participants residing in 443 neighborhoods with 34123 observations. Based on 13 health indicators, a hybrid method integrating network analysis with TOPSIS was applied to construct a HAI accounting for health interlinkages. Weighted multilevel linear and ordered logistic models were used to estimate the effects of neighborhood education. RESULTS Among the 11633 participants (mean [SD] age, 58.20 [8.91] years; 6415 women [52.82%]), the mean (SD) HAI was 48.94 (7.55) at baseline, showing a downward trend with age. Approximately 10% of participants had a HAI trajectory characterized by a low starting point and fast decline. A one-year increase in neighborhood education was independently associated with a 0.37-point increase (95% CI, 0.23-0.52) in HAI. Regardless of individual education, each participant tended to gain benefits from a neighborhood with higher education. However, the effects of increased neighborhood education were weaker for individuals whose education was lower than the neighborhood average. CONCLUSIONS The HAI is an interaction system. Improving neighborhood education was beneficial to healthy aging, but individuals with lower education relative to the neighborhood average may experience poor person-environment fit and obtain fewer benefits from improved neighborhood education. Thus, in the process of improving neighborhood SES, individual-based interventions should be conducted for individuals whose education level is lower than the neighborhood average to achieve person-environment fit.
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Ibeneme SC, Eze JC, Okonkwo UP, Ibeneme GC, Fortwengel G. Evaluating the discriminatory power of the velocity field diagram and timed-up-and-go test in determining the fall status of community-dwelling older adults: a cross-sectional observational study. BMC Geriatr 2022; 22:658. [PMID: 35948869 PMCID: PMC9367093 DOI: 10.1186/s12877-022-03282-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 07/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systematic reviews demonstrated that gait variables are the most reliable predictors of future falls, yet are rarely included in fall screening tools. Thus, most tools have higher specificity than sensitivity, hence may be misleading/detrimental to care. Therefore, this study aimed to determine the validity, and reliability of the velocity field diagram (VFD -a gait analytical tool), and the Timed-up-and-go test (TUG)-commonly used in Nigeria as fall screening tools, compared to a gold standard (known fallers) among community-dwelling older adults. METHOD This is a cross-sectional observational study of 500 older adults (280 fallers and 220 non-fallers), recruited by convenience sampling technique at community health fora on fall prevention. Participants completed a 7-m distance with the number of steps and time it took determined and used to compute the stride length, stride frequency, and velocity, which regression lines formed the VFD. TUG test was simultaneously conducted to discriminate fallers from non-fallers. The cut-off points for falls were: TUG times ≥ 13.5 s; VFD's intersection point of the stride frequency, and velocity regression lines (E1) ≥ 3.5velots. The receiver operating characteristic (ROC) area under the curves (AUC) was used to explore the ability of the E1 ≥ 3.5velots to discriminate between fallers and non-fallers. The VFD's and TUG's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. Alpha was set at p < 0.05. RESULTS The VFD versus TUG sensitivity, specificity, PPV and NPV were 71%, 27%, 55%, and 42%, versus 39%, 59%, 55%, and 43%, respectively. The ROC's AUC were 0.74(95%CI:0.597,0.882, p = 0.001) for the VFD. The optimal categorizations for discrimination between fallers/non-fallers were ≥ 3.78 versus ≤ 3.78 for VFD (fallers versus non-fallers prevalence is 60.71% versus 95.45%, respectively), with a classification accuracy or prediction rate of 0.76 unlike TUG with AUC = 0.53 (95% CI:0.353,0.700, p = 0.762), and a classification accuracy of 0.68, and optimal characterization of ≥ 12.81 s versus ≤ 12.81 (fallers and non-fallers prevalence = 92.86% versus 36.36%, respectively). CONCLUSION The VFD demonstrated a fair discriminatory power and greater reliability in identifying fallers than the TUG, and therefore, could replace the TUG as a primary tool in screening those at risk of falls.
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Affiliation(s)
- Sam Chidi Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria.
- Department of Physiotherapy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
- Department of Nursing Sciences, Ebonyi State University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
- Faculty III/Mid-Research Group, Hochschule Hannover - University of Applied Sciences and Arts, Hannover, Expo Plaza 12, 30539, Hannover, Germany.
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
| | - Joy Chinyere Eze
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria
| | | | | | - Gerhard Fortwengel
- Department of Physiotherapy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
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Figueiredo AI, Balbinot G, Brauner FO, Schiavo A, de Souza Urbanetto M, Mestriner RG. History of falls alters movement smoothness and time taken to complete a functional mobility task in the oldest-old: A case-control study. Exp Gerontol 2022; 167:111918. [DOI: 10.1016/j.exger.2022.111918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/11/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022]
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Wang J, Liu N, Zhao X. Assessing the relationship between hearing impairment and falls in older adults. Geriatr Nurs 2022; 47:145-150. [PMID: 35914491 DOI: 10.1016/j.gerinurse.2022.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 11/04/2022]
Abstract
Falls and fall-related injuries are the major sources of mortality, disability, and dysfunction among older people. The study aimed to examine the association between hearing impairment and falls in Chinese older adults, using data from the Chinese Longitudinal Healthy Longevity Survey. The outcome variable was experienced falls in the past year, and the exposure variable was hearing impairment. The odds ratio (OR) of falls was 1.51 and 1.47 for men and women with hearing impairment than those without hearing impairment after adjusting for covariates. For participants aged 60-69 years, 70-79 years, 80-89 years, and ≥ 90 years, the OR of risk of falls associated with hearing impairment was 2.80, 1.41, 1.50 and 1.44, respectively. These results suggested that there was an association between hearing impairment and falls. Older adults with hearing impairment had a higher risk of falls than those without hearing impairment in the Chinese older population.
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Affiliation(s)
- Jin Wang
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Nan Liu
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China
| | - Xiaoguang Zhao
- Faculty of Sport Science, Ningbo University, Ningbo, Zhejiang, China; Research Academy of Grand Health, Ningbo University, Ningbo, Zhejiang, China.
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