Successful aging among Chinese centenarians in Hong Kong: A multidimensional approach

Abstract

Increasingly, researchers are challenging the validity of successful aging (SA) models which emphasize intact physical and functional capabilities on the growing population of nonagenarians and centenarians who tend to confront inevitable physical and functional losses. In the light of the limited studies examining multidimensional SA on these very old adults, we developed a multi-domain Successful Aging Index (SAI) to examine SA among Hong Kong Chinese near- and centenarians. This study used the cross-sectional data of Hong Kong Centenarian Study with a sample of 153 Hong Kong Chinese elderly aged 95 or above. SAI assessed performance on physical and functional health (PF), psychological well-being and cognition (PC), social engagement and family support (SF), and economic resources (EC), and operationalized SA as a continuum running from fulfilling none to all four of the above dimensions. The correlations among the dimensions were modest (Spearman’s rhos < .24), supporting the multidimensionality of the phenomenon. Only 5.6% of participants achieved SA in all four dimensions. Most participants however achieved SA in one (31.5%) to two dimensions (35.5%). SAI was associated with self-reported happiness. For biomarkers, SAI was related to elevated levels of high-density lipoprotein cholesterol, glycated hemoglobin, and total protein. Male gender, older age, living with family, having more education, possessing fewer diseases and greater handgrip strength, experiencing fewer barriers to social activities, and being more optimistic were found to be associated with a higher score on SAI. In general, our results support the multidimensionality and continuum-based nature of SA among very old adults.