The Profiles of Health Aging in Older Ethiopian Adults within the WHO Healthy Aging Framework

Abstract The World Health Organisation’s (WHO) Healthy Aging framework describes healthy aging as the maintenance of functional capacity in older adults. However, aging is a heterogeneous process influenced by genetics, lifestyle, and environmental factors, leading to variations in experiences of functional capacity among adults. In this study, Latent Class Analysis (LCA) classified groups of individuals based on their health and functional capacities. Adults from Northwest Ethiopia (n = 845) aged ≥ 60 years old, were interviewed about their cognition, mental health, social support, independence, and sensory functioning. LCA identified three groups, reflecting “high-“ (47.5%); "moderate-" (37.3%); and "low-functioning" (15.2%) participants. Compared to low-functioning individuals, high-functioning individuals were less likely to be aged 80+ (RR = 0.61; 95% CI: 0.46, 0.80), lonely (RR = 2.34; 95% CI: 1.72, 3.18), but more likely to report normal nutritional status (RR = 2.05; 95% CI: 1.47, 2.86), no multimorbidity (RR = 1.18; 95% CI: 1.06, 1.32), living in an urban area (RR = 1.12; 95% CI: 1.03, 1.22), and financially independent (RR = 1.24; 95% CI: 1.03, 1.49). Notably, almost half of the sample was classified as high functioning, comparable to findings from other developing countries. Those individuals in the high-functioning group who did not meet the WHO criteria for functional capacity across all domains did not differ from those individuals who did meet all the WHO criteria. This positively demonstrates that older adults do not need to be functional across all dimensions to experience healthy aging.