Determinants and indicators of successful ageing associated with mortality: a 4-year population-based study

Successful aging may be a solution to the major challenges that population aging poses to healthcare systems, financial security, and labor force supply. Hence, we studied the value of factors discovered by exploratory factor analysis in predicting four main indicators of successful aging, and their association with mortality. We followed-up a nationally representative sample of 1284 older adults for a median of 50 months. Successful aging was defined by fast walking, independence, emotional vitality, and self-rated health. Exploratory factor analysis revealed five determinants: physical activity, life satisfaction and financial status, health status, stress, and cognitive function. Physical activity and health status were significant factors in living independently. Life satisfaction and financial status were associated with walking speed. Stress was solely associated with emotional vitality. Life satisfaction and financial status, and health status, were important predictors of self-rated health. Compared to people without any successful aging indicators, those with one, two, three, or four showed dose-dependent lessening of mortality risk, with respective hazard ratios of 0.39 (95% CI 0.25-0.59), 0.29 (95% CI 0.17-0.50), 0.23 (95% CI 0.11-0.51), and 0.09 (95% CI 0.01-0.66). These associations were stronger in males, older adults, smokers, and drinkers, than in their counterparts.