Singapore Institute of Technology
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The Healthy Ageing Questionnaire Index: Validation in the Singapore Longitudinal Ageing Study

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posted on 2023-11-22, 02:29 authored by Tze Pin Ng, Xinyi Gwee, Denise Q.L. Chua, Shiou Liang WeeShiou Liang Wee, Chin Yee Cheong, Philip Lin Kiat Yap, Keng Bee Yap

Healthy ageing (HA) indices typically use full questionnaire, performance or blood-based assessment of functional ability which are time-consuming and resource-intensive. We developed and validated a simple and brief Healthy Ageing Questionnaire (HAQ) index with comparable measurement accuracy. Study Design and Setting: The 15-item HAQ (scored 0-100) was developed using data of 500 participants in the Singapore Study of Successful Ageing (SSOSA) a sub-cohort of the Singapore Longitudinal Ageing Study (SLAS2). Its construct, concurrent and predictive validity was evaluated in 2161 participants in the SLAS2 who were non-participants of the SSOSA. Results: The HAQ index (mean=64.0, SD=11.8) showed a coherent 3-factor structure (Cronbach’s alpha=0.735). HAQ scores were higher among participants who were female, highly educated, not living alone, non-smoking, non-alcohol drinkers, not at risk of malnutrition, were robust or pre-frail, not disabled, had no or <5 medical conditions, and no recent fall or hospitalization. It was positively correlated with MMSE and life satisfaction, and negatively correlated with age, logMAR vision, 5 times sit-and-stand, and timed-up-and-go. The HAQ index was significantly correlated but showed modest concordance with the Rowe-Kahn SA index. Increasing HAQ index quintiles were associated with increased mortality risks from 40.6 to 9.7 deaths per 1,000 p-y; covariate-adjusted hazard ratio for the highest Q5 levels (HAQ score >70) was 0.44 (95%CI=0.28-0.67). Using ROC analysis of predictive accuracy for survival, the AUC of HAQ was 0.675, and Rowe-Kahn SA index was 0.660 (p=0.361). Conclusion: The HAQ is a brief and accurate HA index that is potentially useful across diverse settings and purposes in research, healthcare and policy-making.


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