Profiles of Successful Aging and Their Association with All-Cause Mortality Risk among the Oldest-Old Chinese in Singapore

Introduction: Although successful aging (SA) studies have examined objective indicators such as disease and disability, physical and cognitive function, and social and productive engagement, as well as subjective indicators such as self-rated health, function, and well-being, the interplay among these indicators is rarely studied. We studied SA profiles that captured this interplay and evaluated the association of these profiles with mortality in the oldest-old. Methods: Respondents were 1,000 Chinese Singaporeans aged ≥85 years during interview visits from 2017 to 2018. Latent class analysis examined 12 objective and subjective indicators to identify SA profiles. Multivariable Cox regression assessed the relationship between these profiles and all-cause mortality risk through 2020. Results: Four distinct SA profiles were identified: “frail and dejected” (poor performance in nearly all objective and subjective indicators), “frail but resilient” (poor in objective but good in subjective indicators), “fairly fit and neutral” (good in about half of the indicators), and “fit and positive” (good in nearly all indicators). Compared with “frail and dejected,” the adjusted hazard ratio (95% confidence interval) for mortality risk was 0.63 (0.40–0.97) in “frail but resilient,” 0.56 (0.34–0.93) in “fairly fit and neutral,” and 0.31 (0.19–0.49) in “fit and positive.” Discussion: SA in the oldest-old could take different profiles based on objective and subjective indicators, and these profiles have implications for mortality risk. Individuals with good subjective indicators have advantage in survival despite poor objective indicators.