Who thrives in older adulthood? Results from the National Population Health Survey 1994-2004

Rapid increase in life expectancy, coupled with declining fertility rates during the last century has accelerated the growth rate of the elderly population. Interest in the prevalence and determinants of “successful aging” is growing. The concept “successful aging” remains ill defined and its appropriate measurement is hotly contested. Furthermore, a majority of the studies focused exclusively on the absence of disability or physical performance as a primary outcome. The present study extends this body of research by using the Health Utilities Index Mark3 (HUI3), a multidimensional measure of health, to assess exceptionally good health with data from the Canadian longitudinal National Population Health Survey (1994-2004). A total of 2599 individuals aged 65 and older met the inclusion criteria for this study. Of these participants, 191 (7%) were classified as having maintained exceptionally good health (HUI3 score =/> 0.89 over 10 years; termed thrivers), 1092 (42%) were “non-thrivers,” and 1316 (51%) had died or were institutionalized during the decade-long study. A multinomial logistic regression analysis was performed to assess whether there were differences between the three groups on the independent variables after controlling for the potential confounding effects of age and gender. SUDAAN was used to adjust for the complex sampling design. The results show that exceptionally healthy aging was related to a number of social (education and income), psychosocial (mastery and sense of coherence) and behavioral factors (never smoked, used alcohol in moderation, and were physically active). Some of the findings are particularly important because they reflect modifiable risk factors.