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Healthy aging: how does a multidimensional construct of functional ability predict objective and subjective outcomes?

Antoine Gbessemehlan1, Cécile Proust-Lima2, Luc Letenneur2

  • 1Univ. Bordeaux, INSERM UMR 1219, Bordeaux Population Health Research Center, Bordeaux, France. sgbessemehlan@yahoo.fr.

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Low functional ability (FA) in older adults significantly increases risks for mortality, disability, and poor well-being. A multidimensional approach considering intrinsic capacity and environment is crucial for healthy aging research.

Keywords:
DisabilityHealthy agingLife satisfactionMortalitySubjective health

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Area of Science:

  • Gerontology
  • Public Health
  • Epidemiology

Background:

  • The World Health Organization (WHO) proposes a comprehensive framework for measuring Functional Ability (FA) in healthy aging.
  • Research integrating intrinsic capacity (IC) and environmental factors within the WHO FA framework is limited.
  • This study addresses the gap by defining a multidimensional FA construct and examining its health outcomes.

Purpose of the Study:

  • To define a multidimensional construct of Functional Ability (FA) based on the WHO framework.
  • To investigate the association between FA and objective outcomes (mortality, IADL-disability).
  • To explore the association between FA and subjective outcomes (life satisfaction, perceived health).

Main Methods:

  • Utilized Structural Equation Models to define eight FA subdomains (five IC, three environment) from 30 variables.
  • Included 587 participants from the Aging Multidisciplinary Investigation (AMI) cohort.
  • Employed Cox regression models to assess FA's association with adverse outcomes.

Main Results:

  • Participants were categorized into four FA levels: very high (34%), high (16%), medium (22%), and low (28%).
  • Low FA was significantly linked to increased risks of mortality (HR=2.19) and IADL-disability (HR=3.13).
  • Low FA also correlated with higher likelihoods of poor life satisfaction (HR=1.87) and poor perceived health (HR=3.97).

Conclusions:

  • Low Functional Ability (FA) is a strong predictor of adverse objective and subjective health outcomes in older adults.
  • Simultaneously assessing intrinsic capacity (IC) and environmental factors is essential for a comprehensive understanding of FA in healthy aging.
  • Findings underscore the importance of a holistic approach to FA for promoting healthy aging and well-being.