Development of a Healthy Aging Index and Analysis of Healthy Aging Trajectories Over a 6-Year Period Using the Korean Frailty and Aging Cohort Study

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ID: 317835
2026
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Abstract
Abstract Background and Objectives Measurements and data on older adults are instrumental in our understanding of healthy aging (HA). No universally agreed-upon definition and heterogeneity in the operationalization of HA have necessitated the development of better HA measures. This study aimed to develop a Healthy Aging Index (HAI) based on a multidimensional item response theory (MIRT) framework and explore patterns of HA trajectories over a six-year period with adverse health outcomes as distal outcomes. Research Design and Methods Using longitudinal data (baseline to Wave 4, n = 2,986) from the Korean Frailty and Aging Cohort Study, factor analyses and a bifactor MIRT model were used to evaluate the psychometric properties. Heterogeneity in HA trajectories, with mortality and frailty as distal outcomes, was investigated using a growth-mixture model. Results The 25-item multidimensional HAI demonstrated an excellent model fit (RMSEA = 0.023, TLI = 0.979, CFI = 0.983). We identified four subgroups that exhibited similar HA trajectory patterns. Notably, compared with those in the high-stable group (57.6%), the moderate-stable (29.7%) and low-declining (4%) groups were associated with an increased risk of mortality (Odds Ratios [OR] = 2.60 and 4.55) and frailty (OR = 6.41 and 40.00) at Wave 4. The high decliners (8.7%) were more likely to be frail and exhibit worse physical function than the high-stable group over the six-year follow-up period. Discussion and Implications A multidimensional measure of HA may help identify older adults who are at risk of early mortality and frailty.
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Authors Eunsaem Kim, Yunhwan Lee, Jinhee Kim, Miji Kim, Younyoung Choi, Jimin Han
Journal the gerontologist
Year 2026
DOI
10.1093/geront/gnag142
URL
https://doi.org/10.1093/geront/gnag142
Keywords Keywords not found

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