Development of a common scale for measuring healthy ageing across the world: Results from the ATHLOS consortium

Albert Sanchez-Niubo, Carlos G. Forero, Yu Tzu Wu, Iago Giné-Vázquez, Matthew Prina, Javier De La Fuente, Christina Daskalopoulou, Elena Critselis, Alejandro De La Torre-Luque, Demosthenes Panagiotakos, Holger Arndt, José Luis Ayuso-Mateos, Ivet Bayes-Marin, Jerome Bickenbach, Martin Bobak, Francisco Félix Caballero, Somnath Chatterji, Laia Egea-Cortés, Esther García-Esquinas, Matilde LeonardiSeppo Koskinen, Ilona Koupil, Blanca Mellor-Marsá, Beatriz Olaya, Andrzej PajCrossed D Sign k, Martin Prince, Alberto Raggi, Fernando Rodríguez-Artalejo, Warren Sanderson, Sergei Scherbov, Abdonas Tamosiunas, Beata Tobias-Adamczyk, Stefanos Tyrovolas, Josep Maria Haro

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)
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Background: Research efforts to measure the concept of healthy ageing have been diverse and limited to specific populations. This diversity limits the potential to compare healthy ageing across countries and/or populations. In this study, we developed a novel measurement scale of healthy ageing using worldwide cohorts. Methods: In the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) project, data from 16 international cohorts were harmonized. Using ATHLOS data, an item response theory (IRT) model was used to develop a scale with 41 items related to health and functioning. Measurement heterogeneity due to intra-dataset specificities was detected, applying differential item functioning via a logistic regression framework. The model accounted for specificities in model parameters by introducing cohort-specific parameters that rescaled scores to the main scale, using an equating procedure. Final scores were estimated for all individuals and converted to T-scores with a mean of 50 and a standard deviation of 10. Results: A common scale was created for 343 915 individuals above 18 years of age from 16 studies. The scale showed solid evidence of concurrent validity regarding various sociodemographic, life and health factors, and convergent validity with healthy life expectancy (r = 0.81) and gross domestic product (r = 0.58). Survival curves showed that the scale could also be predictive of mortality. Conclusions: The ATHLOS scale, due to its reliability and global representativeness, has the potential to contribute to worldwide research on healthy ageing.

Original languageEnglish
Pages (from-to)880-892
Number of pages13
JournalInternational Journal of Epidemiology
Issue number3
Publication statusPublished - 1 Jun 2021
Externally publishedYes


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