Development of a Healthy Aging Score in the Population-Based Rotterdam Study: Evaluating Age and Sex Differences

Loes Jaspers, Josje D. Schoufour, Nicole S. Erler, Sirwan K.L. Darweesh, Marileen L.P. Portegies, Sanaz Sedaghat, Lies Lahousse, Guy G. Brusselle, Bruno H. Stricker, Henning Tiemeier, M. Arfan Ikram, Joop S.E. Laven, Oscar H. Franco, Maryam Kavousi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Objectives 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. Design Prospective population-based cohort. Setting Inhabitants of Ommoord, Rotterdam, The Netherlands. Participants A total of 1405 men and 2122 women, mean (standard deviation) age 75.9 (6.4) years. Main measures 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.

Original languageEnglish (US)
Pages (from-to)276.e1-276.e7
JournalJournal of the American Medical Directors Association
Issue number3
StatePublished - Mar 1 2017


  • Healthy aging
  • age differences
  • epidemiology
  • longevity
  • mortality
  • sex differences

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Health Policy
  • General Nursing


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