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. 2021 Jul 9;50(3):880-892.
doi: 10.1093/ije/dyaa236.

Development of a common scale for measuring healthy ageing across the world: results from the ATHLOS consortium

Albert Sanchez-Niubo  1   2 , Carlos G Forero  3 , Yu-Tzu Wu  4 , Iago Giné-Vázquez  1   2 , Matthew Prina  4   5 , Javier De La Fuente  6   7 , Christina Daskalopoulou  4 , Elena Critselis  8 , Alejandro De La Torre-Luque  2   6   7 , Demosthenes Panagiotakos  8 , Holger Arndt  9 , José Luis Ayuso-Mateos  2   6   7 , Ivet Bayes-Marin  1   2 , Jerome Bickenbach  10   11 , Martin Bobak  12 , Francisco Félix Caballero  13   14 , Somnath Chatterji  15 , Laia Egea-Cortés  1 , Esther García-Esquinas  13   14 , Matilde Leonardi  16 , Seppo Koskinen  17 , Ilona Koupil  18   19 , Blanca Mellor-Marsá  1   20 , Beatriz Olaya  1   2 , Andrzej Pająk  21 , Martin Prince  5   22 , Alberto Raggi  16 , Fernando Rodríguez-Artalejo  13   14 , Warren Sanderson  23   24 , Sergei Scherbov  23   25   26 , Abdonas Tamosiunas  27 , Beata Tobias-Adamczyk  28   29 , Stefanos Tyrovolas  1   2 , Josep Maria Haro  1   2 ; ATHLOS Consortium
Affiliations

Development of a common scale for measuring healthy ageing across the world: results from the ATHLOS consortium

Albert Sanchez-Niubo et al. Int J Epidemiol. .

Abstract

Background: Research efforts to measure the concept of healthy ageing have been diverse and limited to specific populations. This diversity limits the potential to compare healthy ageing across countries and/or populations. In this study, we developed a novel measurement scale of healthy ageing using worldwide cohorts.

Methods: In the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) project, data from 16 international cohorts were harmonized. Using ATHLOS data, an item response theory (IRT) model was used to develop a scale with 41 items related to health and functioning. Measurement heterogeneity due to intra-dataset specificities was detected, applying differential item functioning via a logistic regression framework. The model accounted for specificities in model parameters by introducing cohort-specific parameters that rescaled scores to the main scale, using an equating procedure. Final scores were estimated for all individuals and converted to T-scores with a mean of 50 and a standard deviation of 10.

Results: A common scale was created for 343 915 individuals above 18 years of age from 16 studies. The scale showed solid evidence of concurrent validity regarding various sociodemographic, life and health factors, and convergent validity with healthy life expectancy (r = 0.81) and gross domestic product (r = 0.58). Survival curves showed that the scale could also be predictive of mortality.

Conclusions: The ATHLOS scale, due to its reliability and global representativeness, has the potential to contribute to worldwide research on healthy ageing.

Keywords: Healthy ageing; data integration; functional ability; intrinsic capacity; item response theory; scale.

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Figures

Figure 1
Figure 1
Trends of healthy ageing T-scores by age groups in each study
Figure 2
Figure 2
Kaplan-Meier curves of healthy ageing T-scores categorized into four groups (<40, 40–49, 50–59, >60) and time from participant assessment to death
Figure 3
Figure 3
Distributions of healthy ageing T-scores by country
Figure 4
Figure 4
Healthy ageing T-score means by country compared with the indicators ‘healthy life expectancy’ and ‘gross domestic product’, respectively
See this image and copyright information in PMC

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