Association Between Successful Aging and Mortality: Evidence from the Chinese Longitudinal Healthy Longevity Survey (2011–2018)

Successful aging is essential for health, particularly as the global population of older adults rises. It assesses whether older adults maintain a healthy lifestyle and enjoy quality in their later years. This study explores the relationship between successful aging and mortality, focusing on how its components relate to mortality across different genders. We conducted a longitudinal analysis of 9633 older adults (aged 65+) from the Chinese Longitudinal Healthy Longevity Survey (2011-2018). This study used two definitions of successful aging: SA I includes five dimensions (the absence of major diseases, no subthreshold depression, freedom from disability, high cognitive function, and active social participation); SA II consists of four dimensions and excludes the absence of major diseases. Both genders exhibited lower mortality rates among those achieving successful aging (males: hazard ratio [HR] = 0.62 for SA I, HR = 0.65 for SA II; females: HR = 0.57 for SA I, HR = 0.58 for SA II). All successful aging dimensions correlated with reduced death risk, except for subthreshold depression in females. In males, significant reductions in mortality were linked to freedom from disability (HR = 0.49) and active social participation (HR = 0.60). In females, these were notable for freedom from disability (HR = 0.46) and high cognitive function (HR = 0.47). SA I, which includes the absence of major diseases, is more relevant for Chinese younger old. The influence of successful aging components on mortality risk varies by gender, emphasizing the importance of addressing functional daily living challenges to enhance the health of older adults in China.