{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:39:03Z","timestamp":1791218343579,"version":"4.1.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>This study aimed to reveal urban-rural disparities in successful aging among Chinese older adults and the impact of gender and age on aging outcomes. We utilized the Successful Aging Index (SAI), a multidimensional measure encompassing social, economic, bio-clinical, psychological, and lifestyle factors. Scores on the SAI range from 0 to 10, with higher scores signifying better aging. Data was sourced from the 2018 Chinese Longitudinal Healthy Longevity Survey, comprising 7,315 participants. Urban older adults (OU) had significantly higher SAI scores than rural older adults (OR), with averages of 4.32 \u00b1\u2009 1.44 and 3.85 \u00b1\u2009 1.24, respectively (p\u2009&lt;\u20090.001). Men showed more successful aging than women, regardless of their residence (p\u2009&lt;\u20090.001). OU had better financial and educational status and higher social activity scores, except for friend interaction (p\u2009&lt;\u20090.001). They were more physically active (p\u2009&lt;\u20090.001), more adherent to the Mediterranean diet (p\u2009&lt;\u20090.001), and less likely to smoke (p\u2009=\u20090.018). However, OU had a higher prevalence of cardiovascular disease risk factors compared to OR (p\u2009&lt;\u20090.001). Notably, depression scores were similar between OU and OR (p\u2009=\u20090.129). In summary, significant urban-rural differences in successful aging are evident among Chinese older adults, with urban-dwelling older adults aging more successfully than their rural peers. Men, irrespective of their place of residence, experience more successful aging outcomes than women.<\/jats:p>","DOI":"10.1371\/journal.pone.0319105","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T21:15:45Z","timestamp":1742505345000},"page":"e0319105","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Urban-rural differences in the successful aging among older adults in China"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2584-1458","authenticated-orcid":true,"given":"Keying","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiedan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijian","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"pone.0319105.ref001","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.maturitas.2020.05.018","article-title":"The World Health Organization (WHO) approach to healthy ageing","volume":"139","author":"E Rudnicka","year":"2020","journal-title":"Maturitas"},{"key":"pone.0319105.ref002","volume-title":"Major figures on 2020 population census of China. Beijing: China Statistical Publishing Press","author":"Office of the Leading Group for the Seventh National Population Census of the State Council","year":"2021"},{"key":"pone.0319105.ref003","volume-title":"Bulletin of main figures of the fifth national population census of China in 2000 [EB\/OL]. [2001-03-28]","author":"National Bureau of Statistics"},{"issue":"7531","key":"pone.0319105.ref004","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1136\/bmj.331.7531.1548","article-title":"What is successful ageing and who should define it?","volume":"331","author":"A Bowling","year":"2005","journal-title":"BMJ"},{"issue":"1","key":"pone.0319105.ref005","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.exger.2014.09.010","article-title":"Successful aging, dietary habits and health status of old adults individuals: a k-dimensional approach within the multi-national MEDIS study","volume":"60","author":"S Tyrovolas","year":"2014","journal-title":"Experimental gerontology"},{"issue":"4811","key":"pone.0319105.ref006","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1126\/science.3299702","article-title":"Human aging: usual and successful","volume":"237","author":"J Rowe","year":"1987","journal-title":"Science"},{"issue":"4","key":"pone.0319105.ref007","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/geront\/37.4.433","article-title":"Successful aging","volume":"37","author":"J Rowe","year":"1997","journal-title":"The gerontologist"},{"issue":"6","key":"pone.0319105.ref008","doi-asserted-by":"crossref","first-page":"e002710","DOI":"10.1136\/bmjopen-2013-002710","article-title":"Lay perspectives of successful ageing: a systematic review and meta-ethnography","volume":"3","author":"TD Cosco","year":"2013","journal-title":"BMJ Open"},{"key":"pone.0319105.ref009","unstructured":"Cho J. Successful aging and developmental adaptation of oldest-old adults: Graduate theses and dissertations [Paper 12049]. 2011."},{"issue":"4","key":"pone.0319105.ref010","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1080\/07317110802677302","article-title":"Successful aging: Definitions and subjective assessment according to older adults","volume":"29","author":"C Ferri","year":"2009","journal-title":"Clinical Gerontology"},{"issue":"6","key":"pone.0319105.ref011","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.eurger.2014.09.005","article-title":"Factors associated with successful aging in persons aged 65 to 75 years","volume":"5","author":"M Dahany","year":"2014","journal-title":"Eur Geriatr Med"},{"key":"pone.0319105.ref012","first-page":"695854","article-title":"The older they are, the less successful they become? Findings from the georgia centenarian study","author":"J Cho","year":"2012","journal-title":"J Aging Res"},{"issue":"2","key":"pone.0319105.ref013","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1093\/oxfordjournals.aje.a008900","article-title":"Successful aging: Predictors and associated activities","volume":"144","author":"R Cohen","year":"1996","journal-title":"American Journal of Epidemiology"},{"issue":"2","key":"pone.0319105.ref014","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.gerinurse.2021.01.009","article-title":"Factors associated with successful aging in Brazilian community-dwelling older adults: When physical health is not enough","volume":"42","author":"LC Salamene","year":"2021","journal-title":"Geriatr Nurs"},{"issue":"7","key":"pone.0319105.ref015","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/JGP.0b013e3181e040bb","article-title":"Older adults\u2019 perspectives on successful aging: qualitative interviews","volume":"18","author":"J Reichstadt","year":"2010","journal-title":"Am J Geriatr Psychiatry"},{"issue":"2","key":"pone.0319105.ref016","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1017\/S0029665112003023","article-title":"Nutrition and ageing: knowledge, gaps and research priorities","volume":"72","author":"JC Mathers","year":"2013","journal-title":"Proc Nutr Soc"},{"key":"pone.0319105.ref017","volume-title":"Understanding the psychology of diversity. 2nd ed. SAGE Publications Inc","author":"BE Blaine","year":"2013"},{"issue":"11","key":"pone.0319105.ref018","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1111\/j.1532-5415.2011.03665.x","article-title":"Successful aging: development and testing of a multidimensional model using data from a large sample of older Australians","volume":"59","author":"RA Parslow","year":"2011","journal-title":"J Am Geriatr Soc"},{"issue":"6","key":"pone.0319105.ref019","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1093\/ageing\/afl100","article-title":"Which model of successful ageing should be used? Baseline findings from a British longitudinal survey of ageing","volume":"35","author":"A Bowling","year":"2006","journal-title":"Age and Ageing"},{"issue":"3","key":"pone.0319105.ref020","doi-asserted-by":"crossref","first-page":"e59858","DOI":"10.1371\/journal.pone.0059858","article-title":"The onset of widespread musculoskeletal pain is associated with a decrease in healthy ageing in older people: a population-based prospective study","volume":"8","author":"R Wilkie","year":"2013","journal-title":"PLoS One"},{"issue":"10079","key":"pone.0319105.ref021","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1016\/S0140-6736(17)30548-2","article-title":"Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study","volume":"389","author":"Y Zeng","year":"2017","journal-title":"Lancet"},{"issue":"3","key":"pone.0319105.ref022","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1080\/01639366.2010.499096","article-title":"Repeatability and validation of a short, semi-quantitative food frequency questionnaire designed for older adults living in Mediterranean areas: the MEDIS-FFQ","volume":"29","author":"S Tyrovolas","year":"2010","journal-title":"Journal of Nutrition for the Elderly"},{"issue":"8","key":"pone.0319105.ref023","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.numecd.2005.08.006","article-title":"Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk","volume":"16","author":"DB Panagiotakos","year":"2006","journal-title":"Nutr Metab Cardiovasc Dis"},{"issue":"5","key":"pone.0319105.ref024","first-page":"399","article-title":"Leisure-time physical activity and sedentary behaviors among Chinese adults in 2010","volume":"46","author":"X Chen","year":"2012","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"issue":"3","key":"pone.0319105.ref025","first-page":"3","article-title":"Analysis of the differences in physical exercise participation between urban and rural residents in China","volume":"46","author":"Y Zhang","year":"2010","journal-title":"China Sports Technology"},{"issue":"5","key":"pone.0319105.ref026","first-page":"72","article-title":"A comparative study on physical activity and physical fitness status of older adults aged 60 to 69 in different urban and rural areas of Shanghai","volume":"28","author":"J Dai","year":"2014","journal-title":"J Nanjing Inst Phys Educ (Soc Sci Ed)"},{"issue":"10","key":"pone.0319105.ref027","first-page":"32","article-title":"Does physical exercise have an impact on the subjective well-being of older adults: an empirical study on Chinese older adults leisure sports participants","volume":"55","author":"Y Zheng","year":"2019","journal-title":"China Sports Technology"},{"key":"pone.0319105.ref028","first-page":"67","article-title":"Relationship between physical exercise and life satisfaction: The mediation effects of self-efficacy, social support and self-esteem","volume":"35","author":"Q Dai","year":"2012","journal-title":"J Beijing Sport Univ"},{"issue":"10","key":"pone.0319105.ref029","first-page":"77","article-title":"A study on the correlation between sports lifestyle and health-related quality of life among urban older adults","volume":"37","author":"H Xiao","year":"2011","journal-title":"J Chengdu Inst Phys Educ"},{"issue":"1","key":"pone.0319105.ref030","first-page":"28","article-title":"Progress and trends in research on the relationship between sports and quality of life","volume":"31","author":"C Ma","year":"2011","journal-title":"J Guangzhou Inst Phys Educ"},{"issue":"4","key":"pone.0319105.ref031","first-page":"804","article-title":"The impact of physical exercise on the health literacy level and executive function of older adults","volume":"40","author":"D Zhao","year":"2020","journal-title":"Chin J Gerontol"},{"issue":"1","key":"pone.0319105.ref032","first-page":"51","article-title":"Expert consensus on the dose-effect relationship of physical exercise delaying cognitive decline in the older adults","volume":"45","author":"C Zhidong","year":"2021","journal-title":"Journal of Shanghai University of Sport"},{"issue":"12","key":"pone.0319105.ref033","first-page":"104-114,129","article-title":"Meta-analysis of exercise delaying cognitive decline in the older adults","volume":"43","author":"L Gao","year":"2020","journal-title":"J Beijing Sport Univ"},{"issue":"4","key":"pone.0319105.ref034","first-page":"807","article-title":"The role of moderate physical exercise in reducing the incidence of falls and improving cognitive function in older adults","volume":"40","author":"B Song","year":"2020","journal-title":"Chin J Gerontol"},{"issue":"4","key":"pone.0319105.ref035","first-page":"177","article-title":"The impact of physical exercise programs on the mental health of urban empty nest older adults","volume":"16","author":"Y He","year":"2013","journal-title":"J Hunan Univ Sci Technol (Soc Sci Ed)"},{"issue":"11","key":"pone.0319105.ref036","first-page":"963","article-title":"Analysis of the level of health literacy and its influencing factors among older adults aged 60-69 from 2012 to 2017","volume":"35","author":"M Shi","year":"2019","journal-title":"China Health Educ"},{"issue":"31","key":"pone.0319105.ref037","first-page":"2856","article-title":"A survey and analysis of hypertension and dietary habits among urban and rural residents","volume":"24","author":"M Bai","year":"2010","journal-title":"Nursing Research"},{"issue":"1","key":"pone.0319105.ref038","doi-asserted-by":"crossref","first-page":"104523","DOI":"10.1016\/j.archger.2021.104523","article-title":"Successful aging and lifestyle comparison of Greeks living in Greece and abroad: the epidemiological Mediterranean Islands Study (MEDIS)","volume":"97","author":"A Papadimitriou","year":"2021","journal-title":"Archives of Gerontology and Geriatrics"},{"issue":"11","key":"pone.0319105.ref039","first-page":"2021-2024,2034","article-title":"Analysis of the current situation and influencing factors of successful aging of older people in different regions of China: an empirical study based on CHARLS data","volume":"47","author":"Y You","year":"2020","journal-title":"Mod Prev Med"},{"issue":"6","key":"pone.0319105.ref040","first-page":"583","article-title":"Report on cardiovascular health and diseases in China 2022: an updated summary","volume":"38","author":"China Writing Committee of the Report on Cardiovascular Health and Diseases in","year":"2023","journal-title":"Chinese Circulation Journal"},{"issue":"1","key":"pone.0319105.ref041","doi-asserted-by":"crossref","first-page":"e12","DOI":"10.1016\/S2542-5196(17)30181-X","article-title":"Ambient carbon monoxide and cardiovascular mortality: a nationwide time-series analysis in 272 cities in China","volume":"2","author":"C Liu","year":"2018","journal-title":"Lancet Planet Health"},{"issue":"11","key":"pone.0319105.ref042","doi-asserted-by":"crossref","first-page":"117006","DOI":"10.1289\/EHP1849","article-title":"Ambient Ozone Pollution and Daily Mortality: A Nationwide Study in 272 Chinese Cities","volume":"125","author":"P Yin","year":"2017","journal-title":"Environ Health Perspect"},{"key":"pone.0319105.ref043","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.envint.2018.04.019","article-title":"Associations between short-term exposure to ambient sulfur dioxide and increased cause-specific mortality in 272 Chinese cities","volume":"117","author":"L Wang","year":"2018","journal-title":"Environ Int"},{"issue":"1","key":"pone.0319105.ref044","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1164\/rccm.201609-1862OC","article-title":"Fine particulate air pollution and daily mortality: A nationwide analysis in 272 Chinese cities","volume":"196","author":"R Chen","year":"2017","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"issue":"32","key":"pone.0319105.ref045","first-page":"48","article-title":"Research on the epidemic trend of diabetes and patients\u2019 self-management behavior in China","volume":"18","author":"Z Liu","year":"2018","journal-title":"World Latest Med Inf"},{"issue":"7","key":"pone.0319105.ref046","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1111\/jch.14306","article-title":"Trends in the prevalence of hypertension according to severity and phenotype in Chinese adults over two decades (1991\u20102015)","volume":"23","author":"Q Yi","year":"2021","journal-title":"J of Clinical Hypertension"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0319105","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T21:17:13Z","timestamp":1742505433000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0319105"}},"subtitle":[],"editor":[{"given":"Thal\u00eda","family":"Fern\u00e1ndez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,3,20]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,20]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0319105","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,20]]}}}