Authors (including presenting author) :
To TF(1), Ng HT(1), To KY(1), Sin J(1), Chui CCJ(1)
Affiliation :
Saint Francis University
Keyword 1: :
active aging
Keyword 2: :
older adults
Keyword 4: :
scale validation
Introduction :
Hong Kong faces rapid population ageing, with the proportion of adults aged 65 or above projected to continue rising, creating pressures on healthcare expenditure and long-term care services. Active aging is recognised as a key concept for maintaining quality of life and sustaining the viability of the healthcare system, yet most existing measures focus on societal-level indicators rather than individual-level behaviours and capacities. The University of Jyväskylä Active Aging Scale (UJACAS) is a multidimensional questionnaire that assesses active aging at the individual level across goals, functional ability, opportunities and activity, and has been validated in several European languages but not previously adapted for Chinese-speaking older adults in Hong Kong. Given the policy shift towards ageing in place and community-based care, a culturally adapted, psychometrically sound tool is needed to quantify active aging and support clinical decision making, research, and policy development.
Objectives :
This study aimed to translate and culturally adapt the University of Jyväskylä Active Aging Scale into traditional Chinese (UJACAS‑C) for use among community-dwelling older adults in Hong Kong. The primary objective was to evaluate the reliability of UJACAS‑C, including internal consistency and test–retest reliability, in a Chinese-speaking elderly population. Secondary objectives were to examine the concurrent validity of UJACAS‑C by exploring its associations with physical activity and inactivity, measured by the Chinese version of the International Physical Activity Questionnaire (IPAQ), and health-related quality of life, measured by the Chinese version of the 36‑item Short Form Health Survey (SF‑36). The overarching goal was to establish UJACAS‑C as a quantitative, culturally relevant tool to assess individual active aging in Hong Kong and to facilitate future cross-cultural comparisons with existing UJACAS versions.
Methodology :
A quantitative test–retest study design was adopted. UJACAS was translated into traditional Chinese using a standard forward–backward translation procedure, followed by expert review by a translation specialist and a physiotherapist and pilot testing with 10 Chinese-speaking older adults to confirm clarity and cultural appropriateness. Community-dwelling older adults aged 60–94 years who could communicate in Chinese were recruited via convenience sampling from a university physiotherapy clinic and a community health centre; individuals with significant language or cognitive impairments were excluded. At baseline (T1), participants self-completed UJACAS‑C, the Chinese IPAQ short form, SF‑36, and a sociodemographic and health questionnaire; at follow-up (T2), approximately three weeks later, UJACAS‑C was re-administered. Internal consistency was assessed using Cronbach’s alpha for the total and subscale scores, and test–retest reliability was evaluated using intraclass correlation coefficients (ICC, two-way mixed, mean-rating, absolute-agreement) and Bland–Altman analysis. Concurrent validity was examined using Spearman’s rank correlation coefficients between UJACAS‑C scores and measures of physical activity, inactivity, and SF‑36 component scores, with significance set at p< 0.05.
Result & Outcome :
Seventy-five older adults (mean age 71.1 years, SD 7.5; 78.9% women) completed T1, and 57 participants completed both T1 and T2 (24% dropout). Participants generally reported moderate to high socioeconomic status, high prevalence of multimorbidity (80.7% with more than one chronic condition), and notable mobility limitations, while the prevalence of falls was low. UJACAS‑C demonstrated excellent internal consistency, with Cronbach’s alpha of 0.951 for the total score and 0.871, 0.887, 0.889, and 0.819 for the goal, ability, opportunity, and activity subscales, respectively. Test–retest reliability was moderate, with ICC of 0.728 for the total score and 0.566–0.698 across subscales, and Bland–Altman plots indicated good agreement, narrow limits of agreement, and no systematic bias or ceiling effects. For concurrent validity, the UJACAS‑C total score showed a moderate positive correlation with physical activity (Spearman’s rho 0.437, p< 0.001), while the ability subscale correlated moderately with physical activity (rho 0.529, p< 0.001) and weakly with SF‑36 physical health; correlations with inactivity and mental health components were weak or non-significant. UJACAS‑C exhibited excellent internal consistency and moderate test–retest reliability, supporting its use as a reliable instrument to assess individual active aging among community-dwelling, Chinese-speaking older adults in Hong Kong. Its moderate association with physical activity suggests that UJACAS‑C is particularly sensitive to the physical dimension of active aging, although its limited correlations with mental health and environmental aspects indicate that complementary measures may be required for a comprehensive evaluation. UJACAS‑C can serve as a practical quantitative tool in clinical and research settings to monitor active aging and to benchmark Hong Kong’s older population against international data, while future work should consider refining mental and environmental content and standardising administration procedures to further strengthen validity and reliability.
