Profiles of behavioral, social and psychological well-being in old age and their association with mobility-limitation-free survival

Introduction: Successful aging is a multidimensional construct covering behavioral, social, and psychological domains of well-being. We aimed to identify well-being profiles and their association with mobility-limitation-free survival. Methods: A total of 1488 healthy individuals aged 60+ from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) were followed-up for 15 years. Mobility limitation was defined as a walking speed <0.8m/s and vital status information was obtained from the National Cause of Death Register. Well-being profiles were derived from different behavioral, social and psychological indicators using latent class analysis among men and women. Cox and Laplace regression models were applied to examine the association with the incidence of a composite endpoint of mobility limitation or death. Results: At baseline, three well-being profiles (i.e., worst, intermediate, best) were identified, which followed a clear gradient in all behavioral, social and psychological indicators. Compared to those in the worst profile, men and women in the intermediate profile had 27% (HR 0.73; 95% CI 0.56-0.94) and 23% (HR 0.77; 95% CI 0.59-1.00) lower hazard of developing mobility limitation/death. An even greater protective effect was seen among individuals in the best versus worst profile (HR 0.47; 95% CI 0.31-0.70 in men; HR 0.60; 95% CI 0.46-0.78 in women). Men in the intermediate and best profiles survived 1 and 3 years longer without mobility limitation, respectively; these figures were 2 and 3 years for women. Conclusions: Better profiles of behavioral, social and psychological well-being may prolong mobility-limitation-free survival by at least one year among older adults. Our findings strengthen the evidence-base to achieve successful aging through multi-domain interventions.