Successful Aging And Its Associated Factors Among The Community-dwelling Elderly In Liaoning Province

Objective: The proportion of the ageing population has been increased year by year in the world.It has been estimated that the number of the people aged 60 years old and over will exceed the number of the teenagers aged 15 years old and below.Owing to the heavy burden caused by aged population,population ageing has become a serious issue for the society.With the largest population of the world,China is and will continue to be the nation with the largest aged population in the world.According to the sixth population census,the total number of the elderly aged 65 years and over had exceeded 0.12 billion and the aging speed would accelerated in future.Moreover,aging in China has been characterized as faster than getting rich,inversed between urban and rural areas,and imbalanced in areas.Therefore,how to solve the problem caused by aging,improve the quality of life of the elderly,and lessen the heavy endowment burden has become one of the most urgent issue in China.In 2001,WHO has proposed the conception of successful aging(SA).With researching and exploring for several decades,SA has become the crucial strategy to cope with aging society in recent years.This study is designed to assess the level of SA among the community-dwelling elderly in Liaoning province and to explore its associated factors with the purpose to provide evidence for coping with population aging and improving the quality of life of the elderly.Methods: Random cluster sampling method was performed in this study.Four districts from urban areas of Shenyang and Anshan cities in Liaoning Province were thereby randomly selected.One subdistrict was randomly sampled from each selected district and one community of each subdistrict was randomly sampled.All people who were≥65 years old,had lived in community for≥5 years,had no dementia and had the willing to participant in this survey composed our study population,a total of 4701 individuals.We received 4057 effective interviews and the effective response rate was 86.3%.After screening for cognitive function by using the mini-mental state examination(MMSE),3558 elderly without cognitive defect became our subjects.The criteria which was made by Li Chunbo et.al and verified to be suitable for the elderly in China was chosen to assess the level of SA in the present study.This criteria mainly included four aspects:(1)cognitive status was evaluated by MMSE scale,(2)daily living ability was assessed by ADL scale,(3)emotional status was judged through a question and interview,and(4)physical disability was judged during interview.In the meantime,the risk factors identified in this study included demographic characteristics(age,gender,race,marital status,pension,and health insurance),health status(chronic disease,visual ability,hearing ability,and sleeping quality),behavioral factors(smoking history,alcohol consumption,taking a walk,and regular diet)and social-psychological factors(participating in leisure activities,watching television often,and filial piety).The data analysis was performed by SPSS 20.0 and SAS 9.2.The distribution of SA among demographic characteristics,health status,behavioral factors,and social-psychological factors was examined by chi-square test and logistic regression analysis was used to identify the factors associated with SA with P<0.05.Results: Among 3558 individuals,1656 elderly were male and 1902 elderly were female.The prevalence of SA in total population is 28.2%.Furthermore,29.2% of male elderly achieved SA,which was significantly higher than the level in female elderly(27.4%)(P<0.01).SA distribution in age was also found to be significant.The prevalence of SA among the elderly aged 65-74 years was much higher than that among the elderly aged≥ 75 years(P<0.01).Univariate analysis showed that the items significantly correlated with SA in male elderly were marital status,pension,chronic disease,visual ability,hearing ability,sleep quality,smoking history,taking a walk,participating in leisure activities,watching TV often and filial piety.As for the female elderly,the items significantly correlated with SA were race,marital status,pension,chronic disease,visual ability,hearing ability,sleep quality,smoking history,taking a walk,regular diet,participating in activities,watching TV often and filial piety.The logistic regression analysis showed that,visual ability has the most significant association with SA for both male and female elderly after adjusting the age in the model(male: OR=3.46,P<0.01;female: OR=4.78,P<0.01).In addition,SA was significantly associated with,in the OR value sequence,having no chronic disease,married or cohabited,good hearing ability,filial piety,watching TV often,good sleep quality,participating in leisure activities and taking a walk frequently in male elderly;whereas with filial piety,having no chronic disease,watching TV often,the Han nationality,good hearing ability,taking a walk frequently and good sleep quality in female elderly.Conclusion: This study is the first attempt to assess successful aging status and identify its associated factors among the community-dwelling elderly in urban areas in Liaoning Province.The criteria assessing SA was proposed by Chunbo Li et.al and had been evaluated as the most suitable measurement method for Chinese elderly.It included 4 dimensions such as cognitive function,daily living ability,perceived psychological/mood status and physical disability.Our findings indicated that the SA level of the elderly in urban areas of Liaoning province was at a lower level.Visual ability was found to have the strongest association with SA in both male and female elderly.In addition,preventing chronic disease,getting married or cohabited,maintaining hearing ability would be able to contribute SA for the male elderly.Whereas,proposing filial piety,preventing chronic disease and watching TV often were revealed to be important for SA among female elderly.