Evaluation of perceived importance of components of healthy ageing and their relationship with mortality

Abstract

Healthy ageing (HA) research is hampered by a lack of consensus over how HA should be defined and measured. Little is known about which components of HA are important to different population groups. In addition, how components of HA relate to mortality outcomes is poorly understood. These gaps were addressed through four studies. A systematic literature review identified elements, metrics and operationalisations of HA definitions reported in 60 papers. The outcomes of the literature review were used to design the second study in which a series of card sorting tasks (CSTs) were used to investigate how groups with different academic backgrounds and older people categorised these elements. Ten components of HA created during the CSTs were used as the basis for the third study in which surveys were used to rate and rank the importance of these ten components. The overwhelming result of the surveys was that all aspects of HA were considered important and that academics and older people ranked the components of HA in broadly similar ways. This survey was expanded to investigate age group, ethnic group and gender differences in perceptions of relative importance of the ten components of HA. Again, the main finding was one of similarity between population groups who identified independence, mood and physical function as the top three components of HA. Finally, survival analysis was performed on longitudinal cohort data from the Hertfordshire Ageing Study and Whitehall II cohorts to examine relationships between the components of HA and mortality. Brain function, health problems and physical function, and overall HA score, were associated with mortality. These findings highlight that while a multidimensional definition of HA is important to the populations most frequently involved in HA research, future work on the measurement of HA should focus on those components of HA which can impact healthy life span.