An examination of healthy aging across a conceptual continuum: prevalence estimates, demographic patterns, and validity

Sara J McLaughlin, Alan M Jette, Cathleen M Connell, Sara J McLaughlin, Alan M Jette, Cathleen M Connell

Abstract

Background: Although the notion of healthy aging has gained wide acceptance in gerontology, measuring the phenomenon is challenging. Guided by a prominent conceptualization of healthy aging, we examined how shifting from a more to less stringent definition of healthy aging influences prevalence estimates, demographic patterns, and validity.

Methods: Data are from adults aged 65 years and older who participated in the Health and Retirement Study. We examined four operational definitions of healthy aging. For each, we calculated prevalence estimates and examined the odds of healthy aging by age, education, gender, and race-ethnicity in 2006. We also examined the association between healthy aging and both self-rated health and death.

Results: Across definitions, the prevalence of healthy aging ranged from 3.3% to 35.5%. For all definitions, those classified as experiencing healthy aging had lower odds of fair or poor self-rated health and death over an 8-year period. The odds of being classified as "healthy" were lower among those of advanced age, those with less education, and women than for their corresponding counterparts across all definitions.

Conclusions: Moving across the conceptual continuum--from a more to less rigid definition of healthy aging--markedly increases the measured prevalence of healthy aging. Importantly, results suggest that all examined definitions identified a subgroup of older adults who had substantially lower odds of reporting fair or poor health and dying over an 8-year period, providing evidence of the validity of our definitions. Conceptualizations that emphasize symptomatic disease and functional health may be particularly useful for public health purposes.

References

    1. Depp CA, Jeste DV. Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies. Am J Geriatr Psychiatry. 2006;14(1):6–20.
    1. Rowe JW, Kahn RL. Human aging: usual and successful. Science. 1987;237(4811):143–149.
    1. ISI Web of Knowledge. Web of science®. Accessed August 3, 2011.
    1. Rowe JW, Kahn RL. Successful aging. Gerontologist. 1997;37(4):433–440.
    1. Masoro EJ. “Successful aging”—useful or misleading concept? Gerontologist. 2001;41(3):415–418.
    1. McLaughlin SJ, Connell CM, Heeringa SG, Li LW, Roberts JS. Successful aging in the United States: prevalence estimates from a national sample of older adults. J Gerontol B Psychol Sci Soc Sci. 2010;65B(2):216–226.
    1. Institute for Social Research. Health and Retirement Study: sample evolution: 1992–1998. Accessed September 20, 2010.
    1. Heeringa SG, Connor JH. Technical Description of the Health and Retirement Survey Sample Design. Ann Arbor, MI: Institute for Social Research; 1995. . Accessed September 26, 2010.
    1. James BD, Boyle PA, Buchman AS, Bennett DA. Relation of late-life social activity with incident disability among community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2011;66(4):467–473.
    1. Morrow-Howell N, Hinterlong J, Rozario PA, Tang F. Effects of volunteering on the well-being of older adults. J Gerontol B Psychol Sci Soc Sci. 2003;58(3):S137–S145.
    1. Pruchno RA, Wilson-Genderson M, Cartwright F. A two-factor model of successful aging. J Gerontol B Psychol Sci Soc Sci. 2010;65(6):671–679.
    1. Fonda S, Herzog AR. Documentation of Physical Functioning Measures in the Health and Retirement Study and the Asset and Health Dynamics Among the Oldest Old Study. Ann Arbor, MI: Institute for Social Research; 2004. . Accessed September 23, 2010.
    1. Brandt J, Spencer M, Folstein M. The Telephone Interview for Cognitive Status. Neuropsychiatry Neuropsychol Behav Neurol. 1988;1(2):111–117.
    1. Herzog AR, Wallace RB. Measures of cognitive functioning in the AHEAD study. J Gerontol B Psychol Sci Soc Sci. 1997;52B(Special Issue):37–48.
    1. Langa KM, Larson EB, Karlawish JH, et al. Trends in the prevalence and mortality of cognitive impairment in the United States: Is there evidence of a compression of cognitive morbidity? Alzheimers Dement. 2008;4(2):134–144.
    1. Raghunathan TE, Solenberger PW, Van Hoewyk J. IVEware: Imputation and Variance Estimation Software. Ann Arbor, MI: The Regents of the University of Michigan; 2002. . Accessed June 23, 2011.
    1. Fisher GG, Hassan H, Rodgers WL, Weir DR. Health and Retirement Study imputation of cognitive functioning measures: 1992–2006. . Accessed June 20, 2011.
    1. Wolff JL, Starfield B, Anderson G. Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med. 2002;162(20):2269–2276.
    1. Louie GH, Ward MM. Socioeconomic and ethnic differences in disease burden and disparities in physical function in older adults. Am J Public Health. 2011;101(7):1322–1329.
    1. Gregory PC, Szanton SL, Xue QL, Tian J, Thorpe RJ, Fried LP. Education predicts incidence of preclinical mobility disability in initially high-functioning older women. The Women's Health and Aging Study II. J Gerontol A Biol Sci Med Sci. 2011;66(5):577–581.
    1. Crimmins EM, Kim JK, Sole-Auro A. Gender differences in health: results from SHARE, ELSA and HRS. Eur J Public Health. 2011;21(1):81–91.
    1. Ostchega Y, Dillon CF, Hughes JP, Carroll M, Yoon S. Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: data from the National Health and Nutrition Examination Survey 1988 to 2004. J Am Geriatr Soc. 2007;55(7):1056–1065.
    1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303(3):235–241.
    1. Britton A, Shipley M, Singh-Manoux A, Marmot MG. Successful aging: the contribution of early-life and midlife risk factors. J Am Geriatr Soc. 2008;56(6):1098–1105.
    1. Chaves ML, Camozzato AL, Eizirik CL, Kaye J. Predictors of normal and successful aging among urban-dwelling elderly Brazilians. J Gerontol B Psychol Sci Soc Sci. 2009;64(5):597–602.
    1. Kaplan MS, Huguet N, Orpana H, Feeny D, McFarland BH, Ross N. Prevalence and factors associated with thriving in older adulthood: a 10-year population-based study. J Gerontol A Biol Sci Med Sci. 2008;63(10):1097–1104.
    1. Strawbridge WJ, Wallhagen MI, Cohen RD. Successful aging and well-being: self-rated compared with Rowe and Kahn. Gerontologist. 2002;42(6):727–733.

Source: PubMed

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