Abstract
Successful ageing is often defined as a later life with less disease and disease-related disability, high level of cognitive and physical functions, and an active life style. Few studies have compared successful ageing across different societies in a non-Western social context. This study aims to compare prevalence and correlates of successful ageing between China and South Korea. The data come from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and the Korean Longitudinal Study of Ageing (KLoSA). A total of 19,346 community-dwelling elders over 65 years were included, 15,191 from China and 4,155 from Korea. A multidimensional construct of successful ageing was used, with the criteria of no major comorbidity, being free of disability, good mental health, engaging in social or productive activity, and satisfaction on life. Correlates of successful ageing included demographics (gender, age, and rural/urban residence), socioeconomic features (financial status, education, and spouse accompany), and health behaviours (smoking, alcohol-drinking, and exercising). The results showed that 18.6 % of the older adults in China was successful agers, which was less than 25.2 % in Korea. When gender and age were adjusted, older adults were 51 % less likely to be successful agers in China than Korea (p < 0.001). The association patterns between successful ageing and its correlates are similar between China and Korea. However, before the socioeconomic variables are under control, rural residence was negatively related to successful ageing in China, whereas this is not the case in Korea. And the gender gap of successful ageing was mostly explained by socioeconomic features and health behaviours in Korea, but not in China. In both countries, good financial condition was highly associated with successful ageing. The study suggests that advancement of public health system could better control progression of non-communicable diseases among old people and thus promote successful ageing.
Similar content being viewed by others
References
Andrews G, Clark M, Luszcz M (2002) Successful aging in the Australian longitudinal study of aging: applying the MacArthur model cross nationally. J Soc Issues 58:749–765
Berkman LF, Seeman TE, Albert M, Blazer D, Kahn R, Mohs R, Finch C, Schneider E, Cotman C, Mcclearn G, Nesselroade J, Featherman D, Garmezy N, Mckhann G, Brim G, Prager D, Rowe J (1993) High, usual and impairment functioning in community-dwelling older men and women: findings from the Macarthur Foundation Research Network on successful ageing. J Clin Epidemiol 46(10):1129–1140
Blazer DG (2006) Successful ageing. J Geriatr Psychiatry 14(1):2–5
Bowling A, Dieppe P (2005) What is successful ageing and who should define it? BMJ 331:1548–1551
Bowling A, Iliffe S (2006) Which model of successful ageing should be used? Baseline findings from a British longitudinal survey of ageing. Age Ageing 35(6):607–614
Brandt M, Deindl C, Hank K (2012) Tracing the origins of successful aging: the role of childhood conditions and social inequality in explaining later life health. Soc Sci Med 74(9):1418–1425
Carr D, Komp K (2011) Gerontology in the era of the third age. Springer, New York
Chaves ML, Camozzato AL, Eizirik CL, Kaye J (2009) Predictors of normal and successful ageing among urban-dwelling elderly Brazilians. J Gen Physiol Sci 64(5):597–602
Chodzko-Zajko W, Schwingel A, Park CH (2009) Successful ageing: the role of physical activity. Am J Lifestyle Med 3(1):20–28
CLHLS Research Team (2000) Weighting method. http://www.geri.duke.edu/china_study/Weighting%20method.pdf. Accessed 20 June 2010
Cook IG, Bummer TJB (2004) Changing health in China: re-evaluating the epidemiological transition model. Health Policy 67(3):329–343
Depp CA, Jeste DV (2006) Definitions and predictors of successful ageing: a comprehensive review of larger quantitative studies. Am J Geriat Psychiatry 14(1):6–20
Diener E, Inglehart R, Tay L (2013) Theory and validity of life satisfaction scales. Soc Indic Res 112(3):497–527
Dong Z, Phillips MR (2008) Evolution of China’s health care system. Lancet 372(9651):1715–1716
Feng Q, Helen HM, Gu D, Zeng Y, Purser JL (2010) Impact of new disability subtypes on 3-year mortality in Chinese older adults. J Am Geriatr Soc 58(10):1952–1958
Flaherty JH, Liu ML, Ding L, Dong B, Ding Q, Li X, Xiao S (2007) China: the ageing giant. J Am Geriatr Soc 55(8):1295–1300
Fries JF (1980) Aging, natural death, and the compression of morbidity. N Engl J Med 303:130–135
Fries JF (2002) Successful ageing: an emerging paradigm of gerontology. Clin Geriatr Med 18(3):371–382
Gaudreau P, Jose AM, Bryna S, Katherine GD, Abdel K et al (2007) Nutrition as a determinant of successful ageing: description of the Quebec longitudinal study Nuage and results from cross-sectional pilot studies. Rejuvenation Res 10(3):377–386
Glass TA (2003) Assessing the success of successful aging. Ann Intern Med 139:382–383
Glatt SJ, Chayavichitsilp P, Depp C, Schork NJ, Jeste DV (2007) Successful ageing: from phenotype to genotype. Biol Psychiatry 62(4):282–293
Gruenberg EM (1977) The failures of success. Milbank Q 83(4):779–800
Gu D (2008) General data assessment of the Chinese Longitudinal Healthy Longevity Survey. In: Zeng Y, Poston DL, Vlosky DA, Gu D (eds) Healthy longevity in China: demographic, socioeconomic, and psychological dimensions. Springer, The Netherlands, pp 39–59
Gu D, Feng Q, Sautter J (2008) Social network types, intimacy and healthy longevity among the Chinese elderly. In: Garner JB, Christiansen TC (eds) Social sciences in health care and medicine. Nova Science Publishers, New York, pp 11–49
Hank K (2011) How “successful” do older Europeans age? Findings from SHARE. J Gerontol Soc Sci 66(2):230–236
He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, Wang J, Chen CS, Chen J, Wildman RP, Klag MJ, Whelton PK (2005) Major causes of death among men and women in China. N Engl J Med 353:1124–1134
Holstein MB, Minkler M (2003) Self, society, and the “new gerontology”. Gerontologist 43(6):787–796
Howe N, Jackson R, Nakashima K (2007) The ageing of Korea: demographics and retirement policy in the land of the morning calm. Metlife. http://csis.org/files/media/csis/pubs/070321_gai_ageingkorea_eng.pdf. Accessed 20 June 2010
Hsu HC (2005) Gender disparity of successful ageing in Taiwan. Woman Health 42(1):1–21
Hsu HC, Jone BL (2012) Multiple trajectories of successful aging of older and younger cohorts. Gerontologist 52(6):843–856
Inglehart R (1990) Culture shift in advanced industrial society. Princeton University Press, Princeton
Jang SN, Choi YJ, Kim DH (2009) Association of socioeconomic status with successful ageing: differences in the components of successful ageing. J Biosoc Sci 41(2):207–219
Jeste DV, Depp CA, Vahia IV (2010) Successful cognitive and emotional aging. World Psychiatry 9(2):78–84
Kahana E, Kahana B (2012) Interventions to promote successful aging. http://healthyandsuccessfulaging.wordpress.com/2012/11/12/paper-5-interventions-to-promote-successful-aging/. Accessed 25 June 2014
Kapteyn A, Smith JP, Van Soest A (2009) Life satisfaction. IZA, Bonn (discussion paper no 4015)
Keith J, Fry CL, Glascock AP (1994) The ageing experience diversity and communality across cultures. Sage, London
Khang YH, Lynch JW, Kaplan GA (2004) Health inequalities in Korea: age- and sex-specific educational differences in the 10 leading causes of death. Int J Epidemiol 33(2):299–308
Kim D (2006) The increasing tendency of the elderly population and its structural features. Statistics (Korean Statistical Association) 32:44–59
Kim S, Kim DH, Kim WS (2010) Long-term care needs of the elderly in Korea and elderly long-term care insurance. Soc Work Public Health 25(2):176–184
Koh EK, Koh CK (2008) Caring for older adults: the parables in Confucian texts. Nurs Sci Q 21(4):365–368
Kwon S (2003) Payment system reform for health care providers in Korea. Health Policy Plan 18(1):84–92
Lamb VL, Myers GC (1999) A comparative study of successful ageing in three Asian countries. Popul Res Policy Rev 18(5):433–449
Lewis JP (2010) Successful aging through the eyes of Alaska natives: exploring generational differences among Alaska natives. J Cross Cult Gerontol 25:385–396
Liang J, Luo B (2012) Toward a discourse shift in social gerontology: from successful aging to harmonious aging. J Aging Stud 26:327–334
Manton KG (1982) Changing concepts of morbidity and mortality in the elderly population. Milbank Fund Q 60:183–244
McLaughlin SJ, Connell CM, Heeringa SG, Li LW, Roberts JS (2010) Successful ageing in the United States: prevalence estimates from a national sample of older adults. J Gerontol Soc Sci 65(2):216–226
Menec VH (2003) The relation between everyday activities and successful aging: a 6-year longitudinal study. J Gerontol B Psychol Sci Soc Sci 58(2):S74–82
Meeks S, Murrell SA (2001) Contribution of education to health and life satisfaction in older adults mediated by negative affect. J Aging Health 13(1):92–119
Minkler M, Fadem P (2002) “Successful aging”: a disability perspective. J Disabil Policy Stud 12(4):229–235
Morrow-Howell N, Hinterlong J, Sherraden M (2001) Productive aging: concepts and challenges. The John Hopkins University Press, Baltimore
Myers GC, Lamb VL (1993) Theoretical perspectives on healthy life expectancy. In: Robine J-M, Mathers CD, Bone MR, Romieu I (eds) Calculation of health expectancies. John Libbey, Montrouge, pp 109–119
Myers GC, Lamb VL, Agree EM (2003) Patterns of disability change associated with the epidemiologic transition. In: Robine JM, Jagger C, Materhs CD, Crimmins EM, Suzman RM (eds) Determining health expectancies. Wiley, West Sussex, pp 59–74
Ng TP, Broekman BFP, Niti M, Gwee X, Kua EH (2009) Determinants of successful ageing using a multidimensional definition among Chinese elderly in Singapore. Am J Geriatr Psychiatry 17(5):407–416
Olshansky SJ, Ault AB (1986) The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases. Milbank Q 64:355–391
Ouwehand C, de Ridder DTD, Bensing JM (2007) A review of successful ageing models: proposing proactive coping as an important additional strategy. Clin Psychol Rev 27(8):873–884
Phelan EA, Larson EB (2002) Successful aging—where next? J Am Geriatr Soc 50(7):1306–1308
Phelan EA, Anderson LA, LaCroix AZ, Larson EB (2004) Older adults’ views of “successful aging”—How do they compare with researchers’ definitions? J Am Geriatr Soc 52:211–216
Pruchno RA, Wilson-Genderson M, Rose M, Cartwright F (2010) Successful aging: early influences and contemporary characteristics. Gerontologist 50(6):821–833
Raudenbush S, Bryke A, Cheong YF, Congdon R, Du Toit M (2004) HLM: hierarchical linear and nonlinear modeling. Scientific Software International Inc., Linvolneoof
Robin JM, Michel JP (2004) Looking forward to a general theory on population ageing. J Gerontol 59(6):590–597
Rowe JW, Kahn RL (1987) Human ageing: usual and success. Science 237(4811):143–149
Rowe JW, Kahn RL (1997) Successful ageing. Gerontologist 37(4):433–440
Rowe JW, Kahn RL (1999) Successful ageing. Dell Publishing, New York
Steca P, Alessandri G, Caprara GV (2010) The utility of a well-known personality typology in studying successful ageing: resilients, undercontrollers, and overcontrollers in old age. Personal Individ Differ 48:442–446
Strawbridge WJ, Wallhagen MI, Cohen RD (2002) Successful ageing and well-being: self-rated compared with Rowe and Kahn. Gerontologist 42(6):727–733
Suh I (2001) Cardiovascular mortality in Korea: a country experiencing epidemiologic transition. Acta Cardiol 56(2):75–81
Tang F (2014) Successful aging: multiple trajectories and population heterogeneity. Int J Soc Sci Stud 2(3):12–22
Tate RB, Lah L, Cuddy TE (2003) Definition of successful aging by elderly Canadian males: the Manitoba follow-up study. Gerontologist 43(5):735–744
KLI KLoSA Team (2007) KLoSA Wave 1 User Guide. http://www.kli.re.kr/klosa/en/about/introduce.jsp. Accessed 20 July 2014
Tella RD, MacCulloch RJ, Oswald AJ (2003) The macroeconomics of happiness. Rev Econ Stat 85(4):809–827
Thoits PA (2010) Stress and health: major findings and policy implications. J Health Soc Behav 51(1):41–53
Torres S (1999) A culturally-relevant theoretical framework for the study of successful ageing. Ageing Soc 19(1):33–51
United Nations Population Division (2009) World population prospects: the 2008 revision population database. http://esa.un.org/unpp. Accessed 20 June 2010
United Nations Population Fund (2007) State of world population 2007: unleashing the potential of urban growth. http://www.unfpa.org/swp/2007/english/introduction.html. Accessed 20 June 2010
Uotinen V, Suutama T, Ruoppila I (2003) Age identification in the framework of successful ageing: a study of older Finnish people. Int J Aging Hum Dev 56(3):173–195
Von Faber M, der Bootsma-van Wiel A, van Exel E, Gussekloo J, Lagaay AM, van Dongen E, Knook DL, van der Geest S, Westendorp RGJ (2001) Successful ageing in the oldest old: who can be characterized as successfully aged? Arch Intern Med 161(22):2694–2700
Winship C, Radbill L (1994) Sampling weights and regression analysis. Sociol Method Res 23(2):230–257
World Bank Group (2010) World data bank. http://databank.worldbank.org/ddp/home.do#ranking. Accessed 20 June 2010
World Health Organization (2002) Active ageing: a policy framework. World Health Organization, Geneva
Yang GH, Kong LZ, Zhao WH, Wan X, Zhai Y, Chen LC, Koplan JP (2008) Emergence of chronic non-communicable diseases in China. Lancet 372(9650):1697–1705
Yeung W, Xu Z (2011) Economic stress, quality of life, and mortality for the oldest-old in China. Soc Indic Res 4:1–22
Young Y, Fan MY, Parrish JM, Frick KD (2009) Validation of a novel successful ageing construct. J Am Med Dir Assoc 10(5):314–322
Zeng Y, Liu Y, George L (2003) Gender differentials of the oldest old in China. Res Aging 25:65–80
Zeng Y, Poston DL, Vlosky DA, Gu D (2008) Healthy longevity in China: demographic, socioeconomic, and psychological dimensions. Springer, The Netherlands
Zeng Y, Cheng L, Zhao L, Tan Q, Feng Q, Chen H, Shen K, Li J, Zhang F, Cao H et al (2013) Interactions between social/behavioral factors and ADRB2 genotypes may be associated with health at advanced ages in China. BMC Geriatr 13:91
Zhang D, Unschuld PU (2008) China’s barefoot doctor: past, present, and future. Lancet 372(9653):1865–1867
Acknowledgments
This study is supported by the Grants from National Natural Science Foundation of China (71110107025; 71233001) (YZ) and NIA/NIH (R01 AG023627) (YZ).
Author information
Authors and Affiliations
Corresponding author
Additional information
Responsible Editor: H.-W. Wahl.
Rights and permissions
About this article
Cite this article
Feng, Q., Son, J. & Zeng, Y. Prevalence and correlates of successful ageing: a comparative study between China and South Korea. Eur J Ageing 12, 83–94 (2015). https://doi.org/10.1007/s10433-014-0329-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10433-014-0329-5