Data_Sheet_4_Development and Validation of a Multidimensional Population-Based Healthy Aging Scale: Results From the China Health and Retirement Longitudinal Study.pdf

BackgroundThe World Health Organization proposed a multidimensional concept of healthy aging in 2015; there was limited evidence about how the concept was constructed and measured. The current study aims to develop a health aging scale (HAS) following the WHO framework and validate it using data from the China Health and Retirement Longitudinal Study (CHARLS).
MethodsA total of 13,233 adults aged ≥ 45 years old from the CHARLS included in current study. Based on the WHO framework, 37 self-reported indicators were used to determine healthy aging. Exploratory factor analysis and second-order and bi-factor modeling, as well as psychometric coefficients, were used to examine the structure of healthy aging. To assess concurrent validity of the HAS, regression analyses were used to examine the associations of HAS and its subscales with sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction in Wave 1. The predictive validity of HAS and subscales was assessed by their associations with mortality in Wave 2 follow-up using Cox regressions.
ResultsThe general HAS and its five subscales were generated according to bi-factor modeling [CFI = 0.949; TLI = 0.942; SRMSR = 0.030; and RMSEA = 0.033 (95% CI, 0.032–0.034)] and psychometric coefficients (ω = 0.903; ωH = 0.692; ECV = 0.459). The general HAS presented solid evidence of concurrent validity with various sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction; and predictive validity with mortality.
ConclusionsThe population-based multidimensional healthy aging scale and its subscales can be used to monitor the trajectories of general healthy aging and its subdomains to support the development of healthy aging policies and interventions.

背景 世界卫生组织（World Health Organization, WHO）于2015年提出了健康老龄化的多维概念，但目前针对该概念的构建与测量方式的相关研究证据较为有限。本研究旨在遵循世界卫生组织的框架开发健康老龄化量表（Healthy Aging Scale, HAS），并利用中国健康与养老追踪调查（China Health and Retirement Longitudinal Study, CHARLS）的数据对其进行效度验证。
方法 本研究共纳入中国健康与养老追踪调查中13233名年龄≥45岁的成年受试者。基于世界卫生组织的框架，本研究采用37项自我报告指标来界定健康老龄化。通过探索性因素分析、二阶与双因素建模以及心理测量学系数，对健康老龄化的结构进行检验。为评估健康老龄化量表的同时效度，本研究采用回归分析，考察了第一波调查中健康老龄化量表及其各子量表与社会人口学特征、健康状况、医疗服务利用情况以及生活满意度的关联。为评估健康老龄化量表及其子量表的预测效度，本研究通过Cox回归分析，考察了第二波追踪调查中其与死亡率的关联。
结果 本研究通过双因素建模得到了通用健康老龄化量表及其5个子量表，各项模型拟合指标为CFI = 0.949; TLI = 0.942; SRMSR = 0.030; RMSEA = 0.033 (95% CI, 0.032–0.034)，心理测量学系数为ω = 0.903; ωH = 0.692; ECV = 0.459。通用健康老龄化量表展现出可靠的同时效度证据，可与各类社会人口学特征、健康状况、医疗服务利用情况以及生活满意度建立显著关联；同时也展现出对死亡率的良好预测效度。
结论 本研究开发的基于人群的多维健康老龄化量表及其子量表，可用于监测通用健康老龄化及其各亚领域的发展轨迹，从而为健康老龄化政策与干预措施的制定提供科学支撑。