Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-10T12:59:42.287Z Has data issue: false hasContentIssue false

Validation of an a priori, index model of successful aging in a population-based cohort study: the successful aging index

Published online by Cambridge University Press:  20 May 2015

Theodore D. Cosco*
Affiliation:
Cambridge Institute of Public Health, Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB20SR, UK
Blossom C. M. Stephan
Affiliation:
Institute of Health and Society, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE24AX, UK
Carol Brayne
Affiliation:
Cambridge Institute of Public Health, Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB20SR, UK
*
Correspondence should be addressed to: Theodore D. Cosco, Forvie Site, Robinson Way, Cambridge, CB20SR, UK. Phone: 07414983921. Email: tdc33@medschl.cam.ac.uk.

Abstract

Background:

Many definitions of successful aging (SA) exist in the absence of an established consensus definition. There are few examples of a priori application of SA models in real world contexts using external validation procedures. The current study aims to establish the predictive validity of an a priori, continuous model of SA with respect to service utilization.

Methods:

Individuals (n = 740; 64.2% female) aged 65 years and over (mean 75.9; SD 6.2), randomly selected from general practitioner registries in five sites across the United Kingdom included in the second and third combined screen and assessment waves of the Medical Research Council Cognitive Function and Aging Study (MRC CFAS; a longitudinal population-based cohort study) comprised the baseline and two-year follow-up in the current study. A Successful Aging Index (SAI) was created using items identified by systematic reviews of operational definitions and lay perspectives of SA, capturing physiological and psychosocial components. Demographic data and SAI components were collected at baseline. Outcome measures, i.e. health service use, informal care use, and functional service, were captured at two years follow-up.

Results:

Logistic regression revealed significant relationships between the SAI and six of eight service use outcomes in models adjusted for age, sex, education, and socio-economic status. Analysis of the area under the receiver operating characteristic (ROC) curve demonstrated sufficient predictive capabilities for all models, (range 0.65–0.86).

Conclusions:

The SAI demonstrated a strong association, and predictive accuracy, with respect to service use, providing preliminary support for the practical utility and usefulness of this measure.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bowling, A. and Iliffe, S. (2006). Which model of successful ageing should be used? Baseline findings from a British longitudinal survey of ageing. Age and Ageing, 35, 607614.CrossRefGoogle ScholarPubMed
Brayne, C. (2006). Incidence of dementia in England and Wales: the MRC cognitive function and ageing study. Alzheimer Disease and Associated Disorders, 20 (Suppl. 2), S47S51.CrossRefGoogle ScholarPubMed
Cluett, C. et al. (2010). Polymorphisms in LMNA and near a SERPINA gene cluster are associated with cognitive function in older people. Neurobiology of Aging, 31, 15631568.CrossRefGoogle Scholar
Cosco, T. D., Prina, A. M., Perales, J., Stephan, B. and Brayne, C. (2013). Lay perspectives of successful ageing: a systematic review and meta-ethnography. BMJ Open, 3, e002710.Google Scholar
Cosco, T. D., Prina, A. M., Perales, J., Stephan, B. and Brayne, C. (2014a). Operational definitions of successful aging: a systematic review. International Psychogeriatrics, 26, 373381.Google Scholar
Cosco, T. D., Prina, A. M., Perales, J., Stephan, B. and Brayne, C. (2014b). Whose “successful ageing”? Lay- and researcher-driven conceptualisations of ageing well. European Journal of Psychiatry, 28, 124130.Google Scholar
Cosco, T. D., Stephan, B. and Brayne, C. (2014c). (Unsuccessful) binary modeling of successful aging in the oldest-old adults: a call for continuum-based measures. Journal of the American Geriatrics Society, 62, 15971598.Google Scholar
Depp, C. and Jeste, D. (2006). Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies. American Journal of Geriatric Psychiatry, 14, 620.Google Scholar
Drubbel, I., de Wit, N., Bleijenberg, N., Eijkemans, R., Schuurmans, M. and Numans, M. (2013). Prediction of adverse health outcomes in older people using a frailty index based on routine primary care data. Journals of Gerontology Series B: Psychological Sciences & Social Sciences, 68, 301308.Google Scholar
Folstein, M., Robins, L. and Helzer, J. (1983). The Mini-Mental State Examination. Archives of General Psychiatry, 40, 812.CrossRefGoogle ScholarPubMed
Havighurst, R. (1961). Successful aging. The Gerontologist, 1, 813.CrossRefGoogle Scholar
Jopp, D., Wozniak, D., Damarin, A., De Feo, M., Jung, S. and Jeswani, S. (2015). How could lay perspectives on successful aging complement scientific theory? Findings from a US and a German life-span sample. The Gerontologist, 55, 91106.Google Scholar
Katz, S., Downs, T. D., Cash, H. R. and Grotz, R. C. (1970). Progress in development of the index of ADL. The Gerontologist, 10, 2030.Google Scholar
Kehusmaa, S., Autti-Ramo, I., Helenius, H., Hinkka, K., Valaste, M. and Rissanen, P. (2012). Factors associated with the utilization and costs of health and social services in frail elderly patients. BMC Health Services Research, 12, 204.Google Scholar
Lawton, M. and Brody, E. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179186.Google Scholar
Pruchno, R., Wilson-Genderson, M. and Cartwright, F. (2010). A two-factor model of successful aging. Journals of Gerontology Series B: Psychological Sciences & Social Sciences, 65, 671679.Google Scholar
Rowe, J. and Kahn, R. (1987). Human aging: usual and successful. Science, 237, 143149.Google Scholar
Searle, S., Mitnitski, A., Gahbauer, E., Gill, T. M. and Rockwood, K. (2008). A standard procedure for creating a frailty index. BMC Geriatrics, 8, 24.Google Scholar
Townsend, E. and Ryan, B. (1991). Assessing independence in community living. Canadian Journal of Public Health, 82, 5257.Google Scholar
Xie, J., Brayne, C. and Matthews, F. E. (2008). Survival times in people with dementia: analysis from population based cohort study with 14 year follow-up. BMJ, 336, 258262.CrossRefGoogle ScholarPubMed
Yip, A. G., Brayne, C., Easton, D. and Rubinsztein, D. C. (2002). Apolipoprotein E4 is only a weak predictor of dementia and cognitive decline in the general population. Journal of medical genetics, 39, 639643.Google Scholar
Young, Y., Fan, M. Y., Parrish, J. M. and Frick, K. D. (2009). Validation of a novel successful aging construct. Journal of the American Medical Directors Association, 10, 314322.Google Scholar
Supplementary material: File

Cosco supplementary material

Appendix 1

Download Cosco supplementary material(File)
File 17.7 KB