Successful Aging and Mortality Risk: The Korean Longitudinal Study of Aging (2006-2014)

Prevalence of successful aging in older adults: A systematic review and meta-analysis

BACKGROUND

Successful aging (SA) describes the multidimensional aspects of achieving optimal physical and mental health and social well-being combinations in old age. Recent years have seen increasing interest in understanding SA prevalence. This study systematically evaluates the current state of SA globally, defined as multidimensional outcomes.

OBJECTIVE

To systematically evaluate the global prevalence of SA in older adults.

METHODS

We searched PubMed, Embase, Web of Science, Cochrane Library, China Biomedical Database, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and Weipu Database from inception to February 14, 2024. Two researchers independently conducted literature screening, data extraction, and quality evaluation. Meta-analysis was performed using Stata 16.0.

RESULTS

Thirty studies comprising 250,460 older adults were included. Meta-analysis showed the overall global prevalence of SA was 24.0 % [95 % CI (20.7 %, 27.3 %)]. Prevalence rates were 25.1 % in Asia, 21.5 % in Europe, 20.6 % in the Americas; 16.8 % in developed and 27.1 % in developing countries. Subgroup analyses indicated higher SA rates among male older adults, married/cohabiting, living in urban areas, and having higher education levels.

CONCLUSIONS

The global prevalence of SA among older adults is low, with variations across age groups, regions, and education levels. Due to the limitations of the included studies, further high-quality research is needed to validate these findings.

Changes in successful aging and its related indicators among community-dwelling older adults: The Korean Frailty and Aging Cohort Study (KFACS)

This study aims to determine the prevalence of successful aging (SA) and examine the association of changes in the indicators of SA and variations in SA status between 2016 and 2020. The study included 548 participants recruited for the Korean Frailty and Aging Cohort Study (KFACS). Compared to participants who achieved SA in 2016 (N = 393, 71.7%), the number of older adults with SA decreased by 7.8% in 2020. Among older adults preserving SA (SA→SA group, 54%), there were relatively small numbers of older adults who successfully maintained indicators, including chronic diseases (no→no, 9.5%), employment (yes→yes, 12.2%), and volunteer activities (yes→yes, 2.9%). Our findings suggest that interventions to strengthen the physical and psychological function of older adults are needed, and social support needs to be guaranteed to improve social engagement for older adults.

Cognitive trajectories in older adults and the role of depressive symptoms: A 7-year follow-up study

OBJECTIVES

To examine different trajectories of cognitive changes in elderly adults and explore the mediating role of depressive symptoms.

DESIGN

A 7-year, community-based, prospective cohort study.

SETTING

The downtown neighborhood of Shanghai, China.

PARTICIPANTS

A cohort of 394 older adults, with an average age of 71.8 years, was recruited in 2015 and has been reassessed every two years until 2021.

METHODS

Latent Class Growth Analysis was used to model aging trajectories and Linear Mixed-Effect Models for Repeated Measures were used to estimate the least squares mean changes of cognition between subjects with depression (DEP+) and without (DEP-) across all visits.

RESULTS

Three cognitive trajectories were identified: the "successful aging" (SA) trajectory had the best and most consistent performance (n=229, 55.9%); the "normal aging" (NA) trajectory showed lower but stable cognition (n=141, 37.3%); while the "cognitive decline" (CD) trajectory displayed poor and declining cognition (n=24, 6.8%). Depressive symptoms were found to be influential across all trajectories. In the CD trajectory, the MoCA scores of the DEP+ group increased in within-group comparisons and were significantly higher than those of the DEP- group at visits 1 and 3 in between-group comparisons. A similar trend was observed in the NA trajectory, though it did not reach statistical significance.

CONCLUSIONS

Our research suggests that mild and decreasing depressive symptoms can be a reversible factor that might slow down the irreversible cognitive decline in the elderly. Therefore, we suggest that even mild depressive symptoms in the elderly should be monitored and detected.

A biological age model based on physical examination data to predict mortality in a Chinese population

Biological age could be reflective of an individual's health status and aging degree. Limited estimations of biological aging based on physical examination data in the Chinese population have been developed to quantify the rate of aging. We developed and validated a novel aging measure (Balanced-AGE) based on readily available physical health examination data. In this study, a repeated sub-sampling approach was applied to address the data imbalance issue, and this approach significantly improved the performance of biological age (Balanced-AGE) in predicting all-cause mortality with a 10-year time-dependent AUC of 0.908 for all-cause mortality. This mortality prediction tool was found to be effective across different subgroups by age, sex, smoking, and alcohol consumption status. Additionally, this study revealed that individuals who were underweight, smokers, or drinkers had a higher extent of age acceleration. The Balanced-AGE may serve as an effective and generally applicable tool for health assessment and management among the elderly population.

Spatial Analysis of Home and Community-Based Services and Number of Deaths Among Older Adults in Taiwan

This study examined the geographical distribution of home- and community-based services (HCBS) resources in Taiwan's Long-Term Care 2.0 policy and explored its association with the number of deaths among older adults. The main outcome of the study was determination of the number of deaths among older adults in townships (N = 346) in 2021. The results showed that home-based HCBS had a significant positive association with mortality among older adults; moreover, community-based and complementary services, which are highly clustered within a township and among its neighbors, exert a significant protective effect on mortality among older adults. Stratified analyses showed a significantly lower mortality among older adults using adult foster care and transportation services, but a significantly higher mortality among older adults using home-based professional care and respite care services, after considering the sociodemographic characteristics of older adults, urbanization, and the number of long-term care resources in the spatial analysis.

The impact of social support for older adults in nursing homes on successful aging: a moderated mediation model

Objective

To investigate the connection between social support (SS) and successful aging (SA) in older adults residing in nursing homes, examining the mediating role of meaning in life (MIL). Additionally, this study aims to assess whether frailty moderates the mediation model.

Methods

A cross-sectional survey approach was employed to recruit older adults from six nursing homes in Sichuan Province between August 2022 and December 2022. Questionnaires, including the General Information Questionnaire, Social Support Rating Scale (SSRS), Meaning in Life Questionnaire (MLQ), Tilburg Frailty Indicator (TFI), and Successful Aging Inventory (SAI), were administered. Data obtained from the completed questionnaires were analyzed using SPSS and its macro program PROCESS.

Results

SS emerged as a noteworthy positive predictor of SA in older adults of nursing homes. MIL was identified as a partial mediator in the link between SS and SA. Furthermore, frailty attenuated the positive predictive impact of MIL on SA and moderated the latter part of the mediation model, wherein SS influences SA through MIL. The influence of MIL on SA was more pronounced in older adults with lower frailty levels in nursing homes, while it was diminished in those with higher levels of frailty.

Conclusion

Apart from ensuring the availability of essential medical resources in long-term care for older adults, workers in nursing homes should also recognize the significance of "spiritual aging" to cultivate a sense of MIL among older adults. Simultaneously, attention must be directed toward screening for frailty indicators in older adults. Psychological care and physical exercise programs should be intensified for older adults with a high level of frailty, aiming to decelerate the progression of frailty in nursing home residents. This approach leverages the mediating role of MIL and the moderating influence of frailty, ultimately enhancing SA and promoting healthy aging in older adults within nursing home settings.

Nutrition as the foundation for successful aging: a focus on dietary protein and omega-3 polyunsaturated fatty acids

Skeletal muscle plays a critical role throughout the aging process. People living with sarcopenia, a progressive and generalized loss of skeletal muscle mass and function, often experience diminished quality of life, which can be attributed to a long period of decline and disability. Therefore, it is important to identify modifiable factors that preserve skeletal muscle and promote successful aging (SA). In this review, SA was defined as (1) low cardiometabolic risk, (2) preservation of physical function, and (3) positive state of wellbeing, with nutrition as an integral component. Several studies identify nutrition, specifically high-quality protein (eg, containing all essential amino acids), and long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), as positive regulators of SA. Recently, an additive anabolic effect of protein and n-3 PUFAs has been identified in skeletal muscle of older adults. Evidence further suggests that the additive effect of protein and n-3 PUFAs may project beyond skeletal muscle anabolism and promote SA. The key mechanism(s) behind the enhanced effects of intake of protein and n-3 PUFAs needs to be defined. The first objective of this review is to evaluate skeletal muscle as a driver of cardiometabolic health, physical function, and wellbeing to promote SA. The second objective is to examine observational and interventional evidence of protein and n-3 PUFAs on skeletal muscle to promote SA. The final objective is to propose mechanisms by which combined optimal intake of high-quality protein and n-3 PUFAs likely play a key role in SA. Current evidence suggests that increased intake of protein above the Recommended Dietary Allowance and n-3 PUFAs above the Dietary Guidelines for Americans recommendations for late middle-aged and older adults is required to maintain skeletal muscle mass and to promote SA, potentially through the mechanistical target of rapamycin complex 1 (mTORC1).

The Moderating Effect of Personal Assets in the Relationships between Subjective Health, Housing Expense, and Life Satisfaction for Korean Middle and Old-Aged

The proportion of the elderly in Korea has increased. Given the circumstances, this research is intended to explore the characteristics of the elderly. The aim of this research is to explore the antecedents of life satisfaction in the Korean elderly using subjective health. Next, the goal of this research is to appraise the moderating effect of personal assets in the relationship between life satisfaction and housing expenses. The study data consist of 7199 observations from the 2018 and 2020 waves of the Korean Longitudinal Study of Aging (KLOSA). This research uses econometric analysis to test the research hypotheses, which include ordinary least squares, fixed-effects, and random-effects regression analyses. Following ordinary least squares, fixed-effects, and random-effects regression analyses, the results indicate a positive influence of subjective health on older Koreans' life satisfaction. Additionally, personal assets positively moderate the association between housing expense and life satisfaction, the most valuable finding of the study. This research sheds light on the literature by revealing the moderating effect on the relationship between housing expense and life satisfaction. Moreover, the results could be used for better policy design with respect to the middle- and old-aged members Korean society.

Does Active Aging Reduce Mortality Risk Among Older Adults? A Survival Analysis in Malaysia

Active aging is important for promoting the health, wellbeing, and participation of older adults. This study investigated the association between active aging and mortality risk among 2 230 respondents aged 60 and older. Principal component analysis extracted a five-factor structure from 15 indicators of active aging. The mean active aging score was 55.57 and the median was 53.33. The Kaplan-Meier curve showed that individuals with active aging scores of 53.33 and above had significantly longer survival than those below the median. Cox regression analysis indicated the significance of active aging in reducing mortality risk by 2.5% after adjusting for sex, marital status, age, ethnicity, chronic diseases, and risk factors. The active aging approach comprising health, economic, and social factors is crucial in improving survival among older adults. Hence, policies and programs that promote active aging should be encouraged to enhance the health and wellbeing of older adults and their engagement in society.

Individual and environmental factors associated with successful aging among Korean older adults: Multilevel analysis of cross-sectional nationwide survey data

PURPOSE

The importance of environmental influences on successful aging has recently been emphasized. However, existing studies that investigated environmental factors related to successful aging in older adults did not apply multi-level analysis while simultaneously examining individual and environmental factors related to successful aging. Therefore, this study aimed to determine the level of successful aging in older adults and the individual and environmental factors related to successful aging.

MATERIALS AND METHODS

Data from a nationwide survey were used. The study comprised a cross-sectional sample of 73,942 community-dwelling adults aged ≥65 years with individual-level data drawn from the 2019 Korea Community Health Survey. Community-level data of 255 local administrative districts (cities or counties) were extracted from the Community Health Determinant Database from 2017 to 2019. These data were merged and used in multi-level logistic regression analyses.

RESULTS

Generally, 27.1% of the participants achieved successful aging. Individual factors including sex, age, marital status, education level, job, monthly household income, smoking, physical activity, and body mass index were significantly associated with successful aging. Four environmental factors, urban residential area, social network, satisfaction with living environment, and air quality, were positively associated with successful aging at the community level; among them, high satisfaction with living environment (OR = 6.06, 95% CI: 2.43-15.12) was the most strongly associated factor with successful aging.

CONCLUSIONS

The findings suggest that environmental factors are essential for successful aging among older adults in addition to individual factors. Therefore, multiple strategies considering individual and environmental factors are needed to improve successful aging.

The elderly's satisfaction with physical activity programs in senior welfare centers

Introduction

Healthcare for the aging population has become a crucial issue in South Korea to maintain the elderly's quality of life, and physical activity is of primary importance for older adults. This study evaluated the exercise characteristics and satisfaction of the elderly who participated in physical activity programs provided by senior welfare centers in South Korea.

Methods

We surveyed 266 participants to learn the characteristics of the elderly's exercise participation and their satisfaction with instructors, exercise programs, and facilities provided by senior welfare centers. A total of 263 copies were analyzed using the SPSS 23.0 statistical software.

Results and discussion

The top three physical activity programs that the elderly participated in senior welfare centers were dancing (25.3%), gymnastics (24.8%), and table tennis/badminton (13.2%). There were significant differences in respondents' satisfaction according to sex, education level, spouse, family type, and monthly income per household (p < 0.05). The elderly were satisfied with programs (4.183 ± 0.483), facilities (3.881 ± 0.483), and instructors (3.604 ± 0.483) in order. Also, this study shows that user satisfaction differs depending on the demographic characteristics (gender, education, marital status, family type, economic status) and the characteristics of the exercise participation of the elderly (exercise duration, participation period).

Conclusions

In conclusion, we presented the elderly's satisfaction with physical activity programs in senior welfare centers, suggesting that the elderly need physical activity programs according to their demographic and exercise characteristics.

Association between bidirectional intergenerational support and successful aging in China: Evidence from CHARLS 2018

Aging has gradually accelerated in China, and achieving successful aging of older adults has become a public health concern. Intergenerational support is crucial for Chinese older adults in later life due to the culture of filial piety. However, the association between successful aging and intergenerational support remains poorly understood in China. This study aimed to examine the association between patterns of intergenerational support and successful aging of older adults in China. The present study is a secondary analysis of data obtained from the follow-up survey of the China Health and Retirement Longitudinal Study 2018. Data were analyzed using descriptive statistics and logistic regressions. Bidirectional intergenerational support was associated with successful aging in the participants. In addition, there was an association between different intergenerational financial, caring, and emotional support patterns and elements of successful aging.

Value of social activities and prerequisites for continued participation of rural older adults: A qualitative study

AIMS

To explore the value of social activities and the prerequisites for continuous participation among rural older adults based on their experiences.

DESIGN

Qualitative, descriptive design.

METHODS

Individual semi-structured interviews were conducted with 14 older adults from voluntary community salons in a rural area in Japan. Participants were selected through purposeful sampling. Data were analyzed using qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist were used.

RESULTS

Four values of social activities were identified: "Mutual benefit connectedness," "Preventing and coping with aging," "Making life brilliant 'now'," and "Building a safety net." Three prerequisites for activities were identified: "Do not overreach," "Do not infringe on personal territory," and "Do not go against community norms." Social activities provide rural older adults with reciprocity ties, coping with aging, enhanced daily lives, and a social safety net. Continued participation in rural social activities requires adherence to cultural norms and moderation of relationship distances. Community and public health nurses are expected to promote social activities that incorporate these values and adhere to these prerequisites.

Obesity-related measures and successful ageing among community-dwelling older adults in India: a cross-sectional study

Obesity is a chief lifestyle disease globally and causes a significant increase in morbidities. Overweight/ obesity prevalence has been rising faster in India compared to the world average. Therefore, the study examined the association between overweight/ obesity and successful ageing among older population in India. We also explored the gender difference in risks posed by obesity on successful ageing and the different socio-economic correlates associated with successful ageing. This study utilized data from India's first nationally representative longitudinal ageing survey (LASI-2017-18). The effective sample size for the present study was 31,464 older adults with a mean age of 69.2 years (SD: 7.53). Overweight/ obesity was defined as having a body mass index of 25 or above. The study carried out a bivariate analysis to observe the association between dependent and independent variables. Further, multivariable analysis was conducted to examine the associations after controlling for individual socio-demographic, lifestyle and household/community-related factors. The study included 47.5% men and 52.5% women. It was found that the prevalence of obesity/overweight was higher among older women compared to older men (23.2% vs 15.5%). Similarly, high-risk waist circumference (32.7% vs 7.9%) and high-risk waist-hip ratio (69.2% vs 66.5%) were more prevalent among older women than older men. The study found significant gender differences (men-women: 8.7%) in the prevalence rate of successful ageing (p < 0.001). The chances of successful ageing were significantly higher among older adults who were not obese/overweight [AOR: 1.31; CI 1.31-1.55], had no high-risk waist circumference [AOR: 1.41; CI 1.29-1.54], and those who had no high-risk waist-hip ratio [AOR: 1.16; CI 1.09-1.24] compared to their respective counterparts. Interaction results revealed that older women who were not obese/overweight had a lower likelihood of successful ageing compared to the older men who was not obese/overweight [AOR: 0.86; CI 0.80-0.93]. Similarly, older womens who had no high-risk waist circumference [AOR: 0.86; CI 0.80-0.96] and no high risk-hip ratio [AOR: 0.81; CI 0.73-0.89] were less likely to have successful ageing compared to their counterparts, respectively. Being overweight/ obese and having high-risk waist circumference and waist-hip ratio were found to be significant factors associated with less successful ageing among older adults, especially women in this study. The current findings highlight the importance of understanding the modifiable factors, including nutritional awareness and developing targeted strategies for promoting successful ageing.

Multidimensional Factors Affecting Successful Aging among Empty-Nesters in China Based on Social-Ecological System Theory

BACKGROUND

This study aims to identify the status of successful aging and the factors influencing empty-nest elderly in China based on the social-ecological system theory.

METHODS

The data came from the follow-up survey (2018) of the China Health and Retirement Longitudinal Study and 3074 empty-nesters aged 60 and over are included. Chi-squared tests and logistic regressions were used to identify factors associated with successful aging.

RESULTS

The successful aging rate of empty-nesters in China was 5.9%. The results of the multifactor analysis showed that younger age, higher education level, good self-rated health, good hearing, high life satisfaction, availability of financial resources at the microsystem level, higher frequency of contact with children at the mesosystem level, and medical insurance at the macrosystem level were the contributing influencing factors for successful aging of empty-nesters in China.

CONCLUSION

This study is an important attempt to explore the successful aging of empty-nesters in China. Because this study is based on social-ecological system theory, it confirms the important role of individual characteristics of older adults and their surrounding environment in achieving successful aging. Therefore, we should pay attention not only to the individual characteristics of the elderly, but also to the role of the surrounding environment on the health of the elderly, so that we can develop intervention measures to promote their successful aging.

Trajectories of depressive symptoms among community-dwelling Korean older adults: findings from the Korean longitudinal study of aging (2006-2016)

BACKGROUND

Depression among older adults is an important public health concern associated with increased risk of suicide and decreased physical, cognitive, and social functioning. This study identified trajectories of depressive symptoms and investigated predictive variables of group-based trajectory modeling among Korean community-dwelling older adults.

METHODS

Participants comprised 2016 community-dwelling Korean adults over 65 years. Data from the years 2006-2016 of the Korean Longitudinal Study of Aging, a nationally representative panel survey that has been conducted every two years since 2006, were used. We employed a group-based trajectory modeling analysis to identify depressive symptom trajectories. Multinomial logistic regression analysis was conducted to identify predictors of each class of depressive symptoms.

RESULTS

Five depressive symptom trajectory groups were identified: Group 1, "None" (28.9%); Group 2, "Slowly worsening" (24.3%); Group 3, "Rapidly worsening" (17.5%); Group 4 "Improving" (12.4%); and Group 5, "Persistently severe" (16.9%). Older adults followed five distinct depressive symptom trajectories over 10 years. Mini-Mental State Examination scores, number of chronic diseases, educational level, and social activity were predictors associated with increasing depressive symptoms.

CONCLUSIONS

This study showed that many older adults living in the community have depressive symptoms. To prevent and treat depression and aid successful mental health aging among older adults, the development of interventions should be tailored to target specific needs for each symptom trajectory. It is necessary to develop community-based interventions and strategies to identify and prevent depressive symptom trajectories among older adults.

The Mechanism of Bone Remodeling After Bone Aging

Senescence mainly manifests as a series of degenerative changes in the morphological structure and function of the body. Osteoporosis is a systemic bone metabolic disease characterized by destruction of bone microstructure, low bone mineral content, decreased bone strength, and increased brittleness and fracture susceptibility. Osteoblasts, osteoclasts and osteocytes are the main cellular components of bones. However, in the process of aging, due to various self or environmental factors, the body’s function and metabolism are disordered, and osteoporosis will appear in the bones. Here, we summarize the mechanism of aging, and focus on the impact of aging on bone remodeling homeostasis, including the mechanism of ion channels on bone remodeling. Finally, we summarized the current clinical medications, targets and defects for the treatment of osteoporosis.

Frailty index and gender-specific mortality in Korean adults: Findings from the Korean Longitudinal Study of Aging (2006-2018)

AIMS

To examine the predictive ability of the frailty index in estimating gender-specific mortality in a population of Korean adults.

DESIGN

A descriptive and prospective longitudinal design.

METHODS

Data were used from the Korean Longitudinal Study of Aging conducted from 2006 through 2018. A total of 10,254 adults aged 45-98 years at baseline were included. A 41-item deficit accumulation frailty index was measured, based on multi-domain assessment such as self-rating of health, physical condition, mental status, cognitive function, activities of daily living, instrumental activities of daily living and chronic conditions. We categorized the frailty index into robust (≤0.10), prefrail (0.10-0.25) and frail (≥0.25). Cox's proportional hazards regression analysis was employed to determine the association between the frailty index and all-cause mortality.

RESULTS

A total of 4705 individuals (45.9%) were categorized as robust, 4178 (40.7%) as prefrail and 1371 (13.4%) as frail. The frailty index increased with age, and females were found to have a higher frailty index than males. The survival probabilities were significantly lower in older adults (aged ≥65) compared with adults and significantly lower in males compared with females. Compared with the robust group, the risk of mortality in the prefrail and frail groups was 1.37 and 2.57 times higher, respectively. The association between frailty status and all-cause mortality was similar in adults and older adults, while the hazard ratios were higher in frail group of males than that of females.

CONCLUSION

The frailty index had a predictive ability for all-cause mortality with respect to age and sex.

IMPACT

Using a frailty index among community-dwelling adults could be beneficial to support healthcare providers in early detection of individuals with frailty and facilitate the development of more effective interventions for reducing mortality.

Successful ageing in the oldest old: objectively and subjectively measured evidence from a population-based survey in Germany

Despite rapid increase of people aged 80 and over, concepts of successful ageing (SA) are primarily examined for people below that age. Therefore, successful ageing was examined in a population-based representative sample of N = 1863 people aged 80 to 102 (NRW80+) with 11% living in institutionalized settings. In this survey on quality of life and well-being, multiple linear and logistic regression models were used to calculate the distribution of successful agers. According to Rowe and Kahn's objective definition, 9% of the sample aged successfully, but one-third (33%) still met four to five SA criteria. This is in line with the theoretical a priori criterion of 10% in a normal distribution of a sample, while 80% age normally and 10% pathologically. However, averages of life satisfaction, affective well-being, positive ageing experience and valuation of life were high. The majority of the oldest old (65%) are successful agers in their own subjective perception, which is not in line with objective measurements. Moreover, 11% of objectively measured successful agers do not meet subjective criteria. These empirical findings reveal a remarkable discrepancy between objective and subjective criteria of SA. Future research on concepts that define successful ageing for the oldest old should consider more holistic markers of success, e.g., outcomes of productive social engagement.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10433-021-00609-7.

Association between successful aging transitions and depressive symptoms among older Korean adults: findings from the Korean longitudinal study of aging (2006-2018)

Background

The importance of SA (Successful aging) has been emphasized in recent years, with focus shifting towards attaining healthier aging rather than longevity. However, the influence of SA and its changes on mental health such as depression remains a relatively unexplored area in gerontology. Therefore, we investigated the longitudinal association between changes in SA and depressive symptoms in Korean older adults.

Methods

This study comprised a longitudinal sample of older adults aged ≥ 45 years, drawn from the Korean Longitudinal Study of Aging (2006–2018). Changes in SA status was determined using the Rowe and Kahn model over two consecutive years. Using an adjusted generalized estimating equation model, we examined the association between changes in successful aging status, namely SA and NSA (Non-successful aging), and depressive symptoms.

Results

Compared to the SA→SA group, depressive symptom risk in the NSA→NSA and SA→NSA groups were higher in men [(OR, 1.16; 95 % CI, 1.13–1.18), (OR, 1.11; 95 % CI, 1.08–1.13), respectively] and in women [(OR, 1.15; 95 % CI, 1.13–1.18), (OR, 1.11; 95 % CI, 1.09–1.14), respectively]. Subgroup analysis of the dimensions of successful aging revealed that low or worsening criteria of successful aging status in men and women were associated with depressive symptoms.

Conclusions

Korean older adults who continuously failed to attain or maintain successful aging status had the highest risk of depressive symptoms. These results could further assist in establishing policies and interventions that promote successful aging and subsequently protect the mental health of the Korean older adult population.

Healthy aging predicts mortality risks: Results from the Korean longitudinal study of aging (2006-2014)

INTRODUCTION

While there has been some gerontological research on healthy aging, few studies have identified a reasonable health status for the older adults. Guided by the four healthy aging concepts in studies from the US and Spain, this study sought to determine a useful definition for Korean older adults by examining the associations between each of the four healthy aging definitions and mortality.

METHODS

A longitudinal analysis was conducted based on the 2,960 older people (65 years or older) who participated in the Korean Longitudinal Study of Aging (2006-2014). Four healthy aging gradient definitions (Rowe and Kahn, Group Ⅰ, Group II, and Group III) were determined: absence of disease, free of disability, physical and cognitive function, and engagement with life.

RESULTS

The young old who failed to achieve healthy aging were found to have a higher risk of mortality in all four healthy aging gradient definitions in both males (HR range from 4.15 to 5.39) and females (HR range from 4.07 to 9.55). In old old, however, the unhealthy aging mortality risk in Rowe and Kahn's definition was disappeared, but predominant mortality risks were found in Group III for both male (HR = 3.16, 95% CI 1.67 - 5.98) and female (HR = 3.65, 95% CI 1.36 - 9.81) CONCLUSION: To promote healthy aging, we suggest that the definition for the young old includes rigid disease criteria, and old old emphasize functional ability. Age-specific aims for healthy aging may be useful for defining healthy aging.

The Association between Longest-Held Lifetime Occupation and Late-Life Cognitive Impairment: Korean Longitudinal Study of Aging (2006-2016)

The association between longest-held lifetime occupation and late-life cognitive impairment: Korean Longitudinal Study of Aging (2006–2016). Backgrounds: Our study hypothesized that occupation in adulthood may be one of the modifiable factors in cognitive performance. This follow-up study aimed to examine whether there was an association between the longest-held occupation in a lifetime and cognitive impairment. Methods: This study used data from the 2006, 2012, and 2016 waves of the Korean Longitudinal Study of Aging, and a total of 1733 subjects aged over 65 were included. Longest-held occupation in a lifetime was classified into blue-collar, pink-collar, and white-collar. Cognitive function was evaluated using the Korean version of the Mini-Mental State Examination. Results: In males, no significant associations were observed. In females, on the contrary, risk of cognitive impairment in the blue-collar occupation was consistently higher than in the white-collar occupation over the 10-year follow-up (2006, OR = 2.49, 95% CI 1.05–5.88; 2016, OR = 2.17, 95% CI 1.02−4.65). Conclusions: Lifetime occupation should be taken into consideration in the process of screening for cognitive decline in the elderly, especially females. This study needs to be interpreted cautiously in view of inherent data and methodological limitations.

Association between obesity status and successful aging among older people in China: evidence from CHARLS

Background

The paper aimed to examine the association between obesity status and successful aging among elderly adults in China and further find gender differences in the effect of components of successful aging on obesity status.

Methods

The data came from the follow-up survey(2015) of China Health and Retirement Longitudinal Study (CHARLS) and 4019 dwellers age 60 and over are included. Obesity status were defined by the body mass index (BMI) according to Chinese criteria. Successful aging was defined following Rowe and Kahn’s multidimensional model. Multivariable logistic regression was used to estimate the relationship between obesity status and successful aging.

Results

The rate of successful aging in men and women was 18.87 and 9.48% respectively. For BMI, the proportion of population with underweight, overweight and obesity in men was 10.29, 23.04 and 29.63% respectively and that in women was 1.40, 11.69 and 9.47%. Men with obesity (OR = 1.587 95% CI 1.087 ~ 2.316) has an positive relationship with successful aging than normal weight men; Women with underweight (OR = 0.197 95% CI 0.058 ~ 0.824) has an negative relationship with successful aging than normal weight women; Meanwhile, no matter men and women, the relationship between obesity status and successful aging were not significant among oldest adults(≥75 years).

Conclusion

Obesity status was significantly association with successful aging in young older adults (60-74 years), and the components of successful aging differently were related with the obesity status of male and female.

The WHO active ageing pillars and its association with survival: Findings from a population-based study in Spain

BACKGROUND

The World Health Organization's active ageing model is based on the optimisation of four key "pillars": health, lifelong learning, participation and security. It provides older people with a policy framework to develop their potential for well-being, which in turn, may facilitate longevity. We sought to assess the effect of active ageing on longer life expectancy by: i) operationalising the WHO active ageing framework, ii) testing the validity of the factors obtained by analysing the relationships between the pillars, and iii) exploring the impact of active ageing on survival through the health pillar.

METHODS

Based on data from a sample of 801 community-dwelling older adults, we operationalised the active ageing model by taking each pillar as an individual construct using principal component analysis. The interrelationship between components and their association with survival was analysed using multiple regression models.

RESULTS

A three-factor structure was obtained for each pillar, except for lifelong learning with a single component. After adjustment for age, gender and marital status, survival was only significantly associated with the physical component of health (HR = 0.66; 95% CI = 0.47-0.93; p = 0.018). In turn, this component was loaded with representative variables of comorbidity and functionality, cognitive status and lifestyles, and correlated with components of lifelong learning, social activities and institutional support.

CONCLUSION

According to how the variables clustered into the components and how the components intertwined, results suggest that the variables loading on the biomedical component of the health pillar (e.g. cognitive function, health conditions or pain), may play a part on survival chances.

Determinants and indicators of successful ageing associated with mortality: a 4-year population-based study

Successful aging may be a solution to the major challenges that population aging poses to healthcare systems, financial security, and labor force supply. Hence, we studied the value of factors discovered by exploratory factor analysis in predicting four main indicators of successful aging, and their association with mortality. We followed-up a nationally representative sample of 1284 older adults for a median of 50 months. Successful aging was defined by fast walking, independence, emotional vitality, and self-rated health. Exploratory factor analysis revealed five determinants: physical activity, life satisfaction and financial status, health status, stress, and cognitive function. Physical activity and health status were significant factors in living independently. Life satisfaction and financial status were associated with walking speed. Stress was solely associated with emotional vitality. Life satisfaction and financial status, and health status, were important predictors of self-rated health. Compared to people without any successful aging indicators, those with one, two, three, or four showed dose-dependent lessening of mortality risk, with respective hazard ratios of 0.39 (95% CI 0.25-0.59), 0.29 (95% CI 0.17-0.50), 0.23 (95% CI 0.11-0.51), and 0.09 (95% CI 0.01-0.66). These associations were stronger in males, older adults, smokers, and drinkers, than in their counterparts.