• Chenkai Wu, Anne B Newman, Bi-Rong Dong, and Michelle C Odden.
• Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York.
• J Am Geriatr Soc. 2018 Jul 1; 66 (7): 1303-1310.

ObjectivesTo characterize the distribution of an index of healthy aging-the Chinese Healthy Aging Index (CHAI)-in Chinese adults aged 60 and older according to sociodemographic characteristics and geographic region and to examine the association between the CHAI and mortality, disability, and functional limitation over 4 years.DesignNationally representative cohort study.SettingChina Health and Retirement Longitudinal Study.ParticipantsChinese adults aged 60 and older (N=3,740).MeasurementsSix CHAI components (systolic blood pressure, peak expiratory flow, Telephone Interview for Cognitive Status, estimated glomerular filtration rate, fasting glucose, C-reactive protein) were scored 0 (healthiest), 1, and 2 (unhealthiest) according to sex-specific tertiles or clinically relevant cut-points and summed to construct the CHAI (range 0-12).ResultsMean CHAI score was 5.6; 5.7% had a score of 0 to 2 (healthiest), 23.0% a score of 3 or 4, 37.5% a score of 5 or 6, and 33.8% a score of 7 to 12 (unhealthiest). Participants who were younger, more educated, and married were much more likely to have an ideal CHAI profile (score 0-2). Age-adjusted prevalence of an ideal CHAI profile ranged from 1.7% in the south to 8.1% in the north. After multivariable adjustment, persons with a CHAI score of 3 to 12 had substantially higher odds of mortality, disability, and functional limitation than those with a score of 0 to 2. The CHAI further stratified outcomes for persons with no clinically recognizable comorbidities.ConclusionSubstantial variation exists in the CHAI according to sociodemographic characteristics and geographic regions. The CHAI could identify Chinese elderly adults with low risk of adverse outcomes and provide incremental value for risk prediction beyond clinically diagnosed comorbidities.© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

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