Domains and determinants of a person-centered index of aging well in Canada: a mixed-methods study

Objectives The objectives of this study were to explore the perspectives of older adults about the most important domains of aging well and to identify the social determinants of a person-centered index capturing these domains. Methods We conducted a mixed-methods study of 40 semi-structured interviews and epidemiological data from 670 older adults participating in the International Mobility in Aging Study (IMIAS) in Saint-Hyacinthe and Kingston. A composite index capturing the domains of aging well was constructed on the basis of findings from qualitative content analysis. Bivariate and multivariate regressions were carried out to examine the determinants of aging well, including economic determinants, health behaviours, health services, and the social environment. Results The qualitative results confirm the importance of symptomatic health conditions and psychosocial components. The index was computed as a continuous score (0 to 100) containing health components (ADL disability, mobility disability, pain, self-rated health, and cognitive function), and psychosocial components (mood, productive activities, social relations, life satisfaction, and self-mastery). Mean scores were 81 among Canadian older adults, and 83 and 79 for men and women respectively. Being male, having sufficient income, doing leisure physical activity, and feeling safe in one’s neighbourhood were all significantly associated with a higher score on the aging well index. Conclusion The composite index highlights important aspects of health and psychosocial well-being that could be augmented according to older adults themselves. Modifiable social determinants of aging well could guide social and health policies to maximize well-being in this population.