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

Introduction: 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. Objective: To evaluate the applicability of the HAI and validate whether the HAI is suitable for monitoring ageing in the elderly population in China. Methods: 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. Results: 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. Conclusion: 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.

引言：健康衰老指数（Healthy Ageing Index, HAI）不仅被证实具备更广泛的适用性与预测能力，还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。
研究目的：评估健康衰老指数的适用性，验证该指数是否适用于中国老年人群的衰老监测。
研究方法：数据来源于如皋长寿与衰老研究（Rugao Longevity and Ageing Study）。本研究基于收缩压、慢性肺部疾病、认知功能、空腹血糖及肾功能构建了改良版健康衰老指数，并在基线时年龄为70~84岁的1719名受试者中计算该指数。本研究的不良结局为死亡与残疾，同时收集了受试者的人口学、生理学及临床数据，采用Cox比例风险回归与logistic回归模型分析改良版HAI与不良结局之间的关联。
研究结果：本研究共纳入1719名老年人进行分析，其中男性受试者793名，占比46.13%，平均年龄为75.69±3.93岁。在5年随访期间，共发生266例死亡事件，275名受试者出现残疾。多变量模型分析结果显示，改良版HAI与死亡风险显著相关（风险比=1.11，95%置信区间（confidence interval, CI）：1.03~1.20），同时与残疾风险亦存在显著关联（比值比=1.11，95%置信区间（confidence interval, CI）：1.05~1.18）。敏感性分析结果表明，在采用多重插补法处理缺失数据以及排除基线时患有主要心血管疾病的受试者后，上述关联依然保持稳定。
研究结论：改良版健康衰老指数是不良结局的可靠且独立的预测因子，可作为中国老年人群衰老监测的有效且可行的工具。