Multifaceted changes and mortality in older people: A longitudinal study in Taiwan.
OBJECTIVE
Human life expectancy has increased steadily over the past two centuries. In the context of aging, resilience appears to be central to improving quality of life and preserving independence in later years. The present study investigated multifaceted changes and their association with mortality in older people in Taiwan.


METHODS
The present study used older participants aged 60 years or older from the first and second waves (1989 and 1993) of the longitudinal Survey of Health and Living Status of the Elderly in Taiwan. Multifaceted changes comprised chronic conditions, self-rated health, activities of daily living, depression, life satisfaction, social engagement and religious activity. "Positive change" was defined as stable or improving indicator scores from 1989 to 1993. Logistic regressions and Cox proportional hazard models were used to examine associations of positive changes with sociodemographic characteristics and with mortality.


RESULTS
The percentages of positive changes in indicators of respondents ranged from 47% for activities of daily living to 78% for religious activity. The probability of positive changes for chronic conditions, life satisfaction, social engagement, and religious activity were lower in men, singles, less educated and the oldest respondents than in their counterparts. Lower mortality rates were observed in respondents with positive changes of self-rated health (HR = 0.72), activities of daily living (HR = 0.67), life satisfaction (HR = 0.85) and religious activity (HR = 0.79).


CONCLUSIONS
Various changes were valid predictors of mortality in old age. None of the multifaceted aspects of change should be overlooked when designing policies for aging well and active aging in later life. Geriatr Gerontol Int 2017; 17: 959-966.
Department of Social Welfare, National Chung Cheng University, Chia-Yi, Taiwan.|Department of Preventive Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan.
Huei-Jia
HJ
Tzeng
Department of Social Welfare, National Chung Cheng University, Chia-Yi, Taiwan.
Miaw-Chwen
MC
Lee
D000203:Activities of Daily Living; D000368:Aged; D044466:Asian People; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D010549:Personal Satisfaction; D011788:Quality of Life; D055500:Resilience, Psychological; D012959:Socioeconomic Factors; D013624:Taiwan
Taiwan; active aging; mortality; resilience