BACKGROUND Our population is ageing and in 2050 more than one out of five people will be 60 years or older; 80% of whom will be living in a low-and-middle income country. Living longer does not entail living healthier; however, there is not a widely accepted measure of healthy ageing hampering policy and research. The World Health Organization defines healthy ageing as the process of developing and maintaining functional ability that will enable well-being in older age. We aimed to create a healthy ageing index (HAI) in a subset of six low-and-middle income countries, part of the 10/66 study, by using items of functional ability and intrinsic capacity. METHODS The study sample included residents 65-years old and over (n = 12,865) from catchment area sites in Cuba, Dominican Republic, Peru, Venezuela, Mexico and Puerto Rico. Items were collected by interviewing participants or key informants between 2003 and 2010. Two-stage factor analysis was employed and we compared one-factor, second-order and bifactor models. The psychometric properties of the index, including reliability, replicability, unidimensionality and concurrent convergent validity as well as measurement invariance per ethnic group and gender were further examined in the best fit model. RESULTS The bifactor model displayed superior model fit statistics supporting that a general factor underlies the various items but other subdomain factors are also needed. The HAI indicated excellent reliability (ω = 0.96, ωΗ = 0.84), replicability (H = 0.96), some support for unidimensionality (Explained Common Variance = 0.65) and some concurrent convergent validity with self-rated health. Scalar measurement invariance per ethnic group and gender was supported. CONCLUSIONS A HAI with excellent psychometric properties was created by using items of functional ability and intrinsic capacity in a subset of six low-and-middle income countries. Further research is needed to explore sub-population differences and to validate this index to other cultural settings.

中文翻译：

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拉丁美洲国家健康老龄化指数的制定 - 一项 10/66 痴呆症研究小组基于人口的研究。


背景 我们的人口正在老龄化，到 2050 年，超过五分之一的人将达到 60 岁或以上；其中80%将生活在中低收入国家。长寿并不意味着生活得更健康；然而，目前还没有一个广泛接受的健康老龄化衡量标准，阻碍了政策和研究。世界卫生组织将健康老龄化定义为发展和维持功能能力的过程，以实现老年福祉。我们的目标是通过使用功能能力和内在能力项目，在六个中低收入国家的子集中创建一个健康老龄化指数 (HAI)，这是 10/66 研究的一部分。方法 研究样本包括来自古巴、多米尼加共和国、秘鲁、委内瑞拉、墨西哥和波多黎各流域的 65 岁及以上居民 (n = 12,865)。项目是通过2003年至2010年间采访参与者或关键知情人收集的。采用两阶段因素分析，我们比较了单因素、二阶和双因素模型。在最佳拟合模型中进一步检验了该指数的心理测量特性，包括可靠性、可复制性、一维性和并发收敛有效性以及每个种族和性别的测量不变性。结果双因素模型显示出卓越的模型拟合统计数据，支持各种项目背后的一般因素，但还需要其他子域因素。 HAI 表现出出色的可靠性（ω = 0.96，ωHP = 0.84）、可复制性（H = 0.96）、对一维性的一些支持（解释的共同方差 = 0.65）以及一些与自评健康状况同时收敛的有效性。支持每个种族和性别的标量测量不变性。 结论 通过使用六个中低收入国家子集的功能能力和内在能力项目，创建了具有出色心理测量特性的 HAI。需要进一步研究来探索亚人群差异并验证该指数在其他文化环境中的有效性。