Supplementary Material for: The Modified Healthy Ageing Index Is Associated with Mortality and Disability: The Rugao Longevity and Ageing Study

<b><i>Introduction:</i></b> The Healthy Ageing Index (HAI) has been shown not only to have wider applicability and predictive ability but also to adequately predict mortality in Western populations. There is still a lack of studies validating the applicability of the HAI in China. <b><i>Objective:</i></b> To evaluate the applicability of the HAI and validate whether the HAI is suitable for monitoring ageing in the elderly population in China. <b><i>Methods:</i></b> Data were obtained from the Rugao Longevity and Ageing Study. The modified HAI was constructed based on systolic blood pressure, chronic pulmonary diseases, cognitive function, fasting glucose, and kidney function. It was calculated in 1719 individuals aged 70–84 years at baseline. The adverse outcomes were mortality and disability. Demographic, physiologic, and clinical data were collected. Cox proportional hazards and logistic regression models were used to analyze the relationship between the modified HAI and adverse outcomes. <b><i>Results:</i></b> A total of 1,719 older adults were analyzed in our study. A total of 793 (46.13%) males were recruited. The mean age was 75.69 ± 3.93 years. At the 5-year follow-up, there were 266 deaths and 275 individuals with disabilities. In the multivariable models, the modified HAI was associated with mortality (hazard ratio = 1.11, 95% confidence interval [CI]: 1.03–1.20) and disability (odds ratio = 1.11, 95% CI: 1.05–1.18). In the sensitivity analyses, similar associations remained after imputing missing data using multiple imputation and excluding participants with major cardiovascular disease at baseline. <b><i>Conclusion:</i></b> The modified HAI was a robust and independent predictor of adverse outcomes. It is a valid and feasible tool for monitoring ageing in older adults.

<b><i>引言:</i></b> 健康衰老指数（Healthy Ageing Index, HAI）已被证实具备更广泛的适用性与预测能力，且可有效预测西方人群的死亡风险。目前仍缺乏验证HAI在中国人群中适用性的相关研究。<b><i>研究目的:</i></b> 评估健康衰老指数的适用性，验证其是否适用于中国老年人群的衰老状态监测。<b><i>研究方法:</i></b> 本研究数据源自如皋长寿与衰老研究（Rugao Longevity and Ageing Study）。基于收缩压、慢性肺部疾病、认知功能、空腹血糖及肾功能构建改良版健康衰老指数，对基线时1719名年龄在70~84岁的受试者进行计算。不良结局定义为死亡与残疾。收集受试者的人口学、生理学及临床数据，采用Cox比例风险回归与逻辑回归模型分析改良版HAI与不良结局间的关联。<b><i>研究结果:</i></b> 本研究共纳入1719名老年受试者进行分析，其中男性793名，占比46.13%，平均年龄为75.69±3.93岁。经过5年随访，共发生266例死亡事件，275名受试者出现残疾。多变量模型分析显示，改良版HAI与死亡风险显著相关（风险比=1.11，95%置信区间[CI]: 1.03~1.20），同时与残疾风险亦存在显著关联（优势比=1.11，95%置信区间[CI]: 1.05~1.18）。敏感性分析结果一致：通过多重插补法填补缺失数据，以及排除基线时合并重大心血管疾病的受试者后，上述关联依然成立。<b><i>研究结论:</i></b> 改良版健康衰老指数是不良结局的可靠且独立预测因子，可作为老年人群衰老状态监测的有效且可行工具。