Supplementary Material for: Profiles of Successful Aging and Their Association with All-Cause Mortality Risk among the Oldest-Old Chinese in Singapore

<b><i>Introduction:</i></b> Although successful aging (SA) studies have examined objective indicators such as disease and disability, physical and cognitive function, and social and productive engagement, as well as subjective indicators such as self-rated health, function, and well-being, the interplay among these indicators is rarely studied. We studied SA profiles that captured this interplay and evaluated the association of these profiles with mortality in the oldest-old. <b><i>Methods:</i></b> Respondents were 1,000 Chinese Singaporeans aged ≥85 years during interview visits from 2017 to 2018. Latent class analysis examined 12 objective and subjective indicators to identify SA profiles. Multivariable Cox regression assessed the relationship between these profiles and all-cause mortality risk through 2020. <b><i>Results:</i></b> Four distinct SA profiles were identified: “frail and dejected” (poor performance in nearly all objective and subjective indicators), “frail but resilient” (poor in objective but good in subjective indicators), “fairly fit and neutral” (good in about half of the indicators), and “fit and positive” (good in nearly all indicators). Compared with “frail and dejected,” the adjusted hazard ratio (95% confidence interval) for mortality risk was 0.63 (0.40–0.97) in “frail but resilient,” 0.56 (0.34–0.93) in “fairly fit and neutral,” and 0.31 (0.19–0.49) in “fit and positive.” <b><i>Discussion:</i></b> SA in the oldest-old could take different profiles based on objective and subjective indicators, and these profiles have implications for mortality risk. Individuals with good subjective indicators have advantage in survival despite poor objective indicators.

<b><i>引言：</i></b> 尽管成功老龄化（successful aging, SA）相关研究已考察了疾病与残疾、躯体与认知功能、社会参与及生产性活动等客观指标，以及自评健康、自评功能与主观幸福感等主观指标，但此类指标间的交互作用却极少被探讨。本研究聚焦能够体现此类交互作用的成功老龄化亚型，并评估了高龄老人的此类亚型与死亡率的关联。<b><i>方法：</i></b> 研究对象为2017至2018年接受访谈的1000名年龄≥85岁的新加坡华人。本研究采用潜类别分析（latent class analysis）对12项客观与主观指标进行分析，以识别成功老龄化亚型；并通过多变量Cox回归分析，评估了截至2020年此类亚型与全因死亡风险的关联。<b><i>结果：</i></b> 本研究共识别出4种明确的成功老龄化亚型："衰弱且情绪低落型"（几乎所有客观与主观指标均表现较差）、"衰弱但心理弹性型"（客观指标较差但主观指标良好）、"状态尚可且态度中立型"（约半数指标表现良好）以及"健康状况良好且积极型"（几乎所有指标均表现良好）。以"衰弱且情绪低落型"为参照，校正后的死亡风险比（95%置信区间）分别为："衰弱但心理弹性型" 0.63（95%CI：0.40~0.97）、"状态尚可且态度中立型" 0.56（95%CI：0.34~0.93）、"健康状况良好且积极型" 0.31（95%CI：0.19~0.49）。<b><i>讨论：</i></b> 高龄老人的成功老龄化可依据客观与主观指标划分为不同亚型，此类亚型与死亡风险存在显著关联。即便客观健康指标较差，主观健康指标良好的个体仍具备生存优势。