title: Development of a Healthy Aging Score in the Population-Based Rotterdam Study: Evaluating Age and Sex Differences.
abstract: OBJECTIVE
  To develop a healthy aging score (HAS), to assess age and sex differences in HAS, and to evaluate the association of the HAS with survival.
  
  
  METHODS
  Prospective population-based cohort.
  
  
  METHODS
  Inhabitants of Ommoord, Rotterdam, The Netherlands.
  
  
  METHODS
  A total of 1405 men and 2122 women, mean (standard deviation) age 75.9 (6.4) years.
  
  
  METHODS
  We included 7 domains in the total score of HAS: chronic diseases, mental health, cognitive function, physical function, pain, social support, and quality of life; each scored 0, 1, or 2 in each domain. A total score (range 0-14) was constructed and was assessed continuously and in tertiles (13-14: healthy aging, 11-12: intermediate aging, 0-10: poor aging). Sex-specific change in the mean HAS was computed for the age categories of 65-69, 70-74, 75-79, 80-84, and ≥85 years. The association between HAS and mortality was assessed with Cox proportional hazards models.
  
  
  RESULTS
  Mean follow-up was 8.6 (3.4) years. Men had poorer scores in the chronic disease domain than women. However, women had poorer mental health, worse physical function, more pain, and lower quality of life compared with men. The prevalence of healthy aging was higher in men (n = 396, 28.2%), than in women (n = 526, 24.8%). The mean (standard deviation) HAS was 11.1 (2.2) in men and 10.7 (2.3) in women. Mean HAS was higher in men than in women for all age categories. The β for change in mean HAS across the 5 increasing age categories was -0.55 (-0.65 to -0.45) in men and -0.65 (-0.73 to -0.57) in women. The age-adjusted hazard ratio per unit increase in HAS with mortality was 0.86 (0.83-0.89) in men, and 0.89 (0.87-0.91) in women.
  
  
  CONCLUSIONS
  Levels of HAS were lower in women compared with men, in all age categories. The HAS declined with increasing age for both sexes, albeit slightly steeper in women. The HAS was strongly associated with mortality in both sexes. A better understanding of population healthy aging and sex differences in this regard could aid to implement strategies for sustainable healthcare in aging populations.
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Loes
authors.initials: L
authors.lastname: Jaspers
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Josje D
authors.initials: JD
authors.lastname: Schoufour
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Biostatistics, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Nicole S
authors.initials: NS
authors.lastname: Erler
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Sirwan K L
authors.initials: SK
authors.lastname: Darweesh
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Marileen L P
authors.initials: ML
authors.lastname: Portegies
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Sedaghat
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Lies
authors.initials: L
authors.lastname: Lahousse
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Guy G
authors.initials: GG
authors.lastname: Brusselle
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Joop S E
authors.initials: JS
authors.lastname: Laven
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: m.kavousi@erasmusmc.nl.
authors.forename: Maryam
authors.initials: M
authors.lastname: Kavousi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D000073656:Healthy Aging; D006801:Humans; D008136:Longevity; D008297:Male; D009026:Mortality; D009426:Netherlands; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis
keywords: Healthy aging; age differences; epidemiology; longevity; mortality; sex differences