Construction of the active aging index in Bangladesh: challenges and opportunities.

Background: Bangladesh is one of the fastest-growing older populations in the world. However, there has been little initiative in constructing an Active Aging Index (AAI) to monitor the quality of life of senior citizen. Objectives: The objective of the study was to construct an AAI to know the active aging scenario of the population in Bangladesh. Methods: A cross-sectional study was conducted among 518 respondents aged 60 years or older from six villages and six wards. Three villages and three wards from Rangpur district and three villages and three wards from Dhaka district were selected for the collection of data. A semi-structured questionnaire was used to collect data on the eight indicators of the 'health dimension', three indicators of the 'participation dimension', and seven indicators of the 'security dimension' for the AAI using the World Health Organization (WHO) model. The responses for each of the indicators (ranges from 0, 1, 2, or 3) in each dimension were added to create a composite index (CI) for each of the dimensions. Descriptive statistical methods with significance tests were applied to analyze the data. Results: The findings provide opportunities to view the 18 aspects of the quality of life of the older population by sex and place of residence. Among the respondents, the overall AAI score shows that 48.1% of the health, 28.9% of the participation, and 48.5% of the security dimensions score fall in the lower active category. Gender differences were distinct in all three dimensions, where the moderate AAI score for females from both rural (41.5%) and urban areas (62.7%) was lower than for males in rural (73.5 %) and urban areas (76.3%). Conversely, the AAI value for urban older adults was higher in all dimensions in comparison with rural older adults. Overall, 62.7% of the respondents were moderately active (a range within 0.50-0.79), while 34.4% were poorly active (a range within 0.0-0.49) and only 3.9% were highly active (a range within 0.80+). Conclusion: Effective initiatives are needed to improve the individual scores of each of the three dimensions of the AAI. Attention should be given to addressing the gender and residential variations in all three dimensions of the AAI. The incorporation of indicator-specific measures is essential to the existing plan of action and programs to improve the situation of the older population that is poorly and moderately active. This result will help policymakers from concerned ministries to focus on specific dimensions to improve the AAI situation in the country. A nationally representative study is needed regularly to monitor the AAI situation.