AccScience Publishing / IJPS / Volume 1 / Issue 1 / DOI: 10.18063/IJPS.2015.01.003
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RESEARCH ARTICLE

Concordance and discordance between objectively and subjectively measured successful aging and their linkages with mortality

Danan Gu1*
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1 1 Population Division, Department of Economic and Social Affairs, United Nations, New York, US
© Invalid date by the Authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Successful aging has extended from the biomedical-oriented model to the biomedi-cal-and-psychosocial mixed model. However, few studies have investigated the subtypes of the joint classification between subjective (psychosocial-oriented) (SSA) and objective (biomedi-cal-oriented) (OSA) measures to identify and distinguish different risk groups. This study aims to examine how concordance and discordance between SSA and OSA are associated with sub-sequent mortality based on five waves of a nationwide longitudinal survey in China from 2000 to 2011 with 30,948 sampled persons aged 65 and older. SSA was measured by absence of poor life satisfaction, poor self-rated health, and psychological distress, while OSA was measured by absence of disability, cognitive impairment, and chronic diseases. We then defined a variable with four subtypes of concordance and discordance from these two dichotomous variables: Type I (not-OSA & not-SSA), Type II (not-OSA & SSA), Type III (OSA & not-SSA) and Type IV (OSA & SSA). Types I and IV are concordance types, while Types II and III are discordance types. The results showed that a negative association between Type IV (SSA & OSA) and risk of mortality was universal over age groups and sexes. Compared to Type I (not-SSA & not-OSA), Type IV (SSA & OSA) has a 25–71% lower risk of mortality, depending on age group and sex, after controlling for a rich set of confounders. Concordance and discordance between OSA and SSA provide added power in predicting subsequent mortality. Public health programs should target those more vulnerable subtypes to promote successful aging.

Keywords
successful aging
subjective successful aging
objective successful aging
concor-dance
discordance
mortality
China
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International Journal of Population Studies, Electronic ISSN: 2424-8606 Print ISSN: 2424-8150, Published by AccScience Publishing