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Healthy ageing: Adding good health and life to years

Professor Claire Donnellan

Professor of Nursing Research, Edith Cowan University, Perth, Western Australia
Adjunct Associate Professor, Trinity College Dublin, Ireland

Population ageing was one of the most distinctive demographic events of the 20th century and refers to the process by which older individuals become a proportionally larger share of the total population. Longevity figures globally not only show us that more individuals are surviving to old age but once there, they tend to live longer, meaning there are expected relative gains in life expectancy. We know life expectancy tells us about the status of population health because it captures mortality along the entire life course and the average age of death in a population. This dramatic rise in life expectancy has resulted in increasing interest in promoting healthier ageing and the study of how people actually age successfully. Despite it being proposed as a field of great interest in gerontological research and as a challenge for the design of health and social policy and practice, the concept of healthy ageing still needs to be incorporated into healthcare provision and for healthcare professionals to actively promote it as part of their practice.  

Healthy ageing as a concept is primarily concerned with increasing the quantity and quality of life of older adults. It also implies a focus on the maintenance of health, often through lifestyle choices and preventive measures. Havighurst wrote back in 1963 that it was essential for gerontology to have a theory of successful ageing. He defined this as a statement of the conditions of individual and social life under which the individual person gets a maximum of satisfaction and happiness, and society maintains an appropriate balance among satisfactions for the various groups which make it up—old, middle-aged, and young, men and women. [1]

Rowe and Kahn (1987, 1997) reintroduced the concept and defined successful ageing as multidimensional, encompassing the avoidance of disease and disability, the maintenance of high physical and cognitive function and sustained engagement in social and productive activities. [2, 3] In 2015, WHO’s World report on ageing and health outlined a policy framework for healthy ageing that centres on the notion of functional ability. [4] It refers to healthy ageing as a combination of the intrinsic capacity of the individual, relevant environmental characteristics and the interactions between the individual and these characteristics.

Because many older adults see themselves as active and healthy, (including older Australians aged 65 and older who indicated their health as good, very good or excellent in the 2017-18 National Health Survey [5]), it is important to focus on promoting and maintaining these healthy states in an ageing population. In our research work, we have devised a program of care called REsources And LIfe Strategy Management (REALISM) based on a theory of successful ageing [6-9] that aims to support older adults engage with healthy behaviours.  

Havighurst referred to ‘adding life to the years.’ WHO has reworded this phrase as ‘adding health to the years’ because promoting healthy ageing involves influencing and encouraging older adults to make better decisions related to diet, exercise and managing their overall health and wellbeing while also enjoying all life has to offer.

  1. Havighurst RJ. Successful aging. Gerontologist. 1961;1(1):8-13.
  2. Rowe JW, Kahn RL. Human aging: Usual and successful. Science. 1987;237(4811):143.
  3. Rowe JW, Kahn RL. Successful aging. Gerontologist. 1997;37(4):433-440.
  4. World Health Organization. World report on ageing and health [Internet]. Geneva: WHO; 2015 [cited 2023 Jul 4]. Available from: https://apps.who.int/iris/bitstream/handle/10665/186463/9789240694811_eng.pdf?sequence=1&isAllowed=y  
  5. Australian Bureau of Statistics. National Health Survey: First results. 2017-18. Canberra, ACT: ABS; 2018. 
  6. Baltes PB, Baltes MM. Psychological perspectives on successful aging: The model of selective optimization with compensation. In: Baltes P, Baltes M, editors. Successful aging: Perspectives from the behavioral sciences. Cambridge, UK: Cambridge University Press; 1990. p. 1-34.
  7. Donnellan C. REsources And LIfe Strategy Management (REALISM) trial: Protocol for a stroke rehabilitation intervention using a goal setting and attainment framework. Int J Stroke. 2014;9(S3):221-221.
  8. Donnellan C. The Baltes’ model of successful aging and its considerations for Aging Life Care™ / geriatric care management. Journal of Aging Life Care [Internet]. 2015 [cited 2023 Jul 4]; Fall. Available from: https://geriatriccareconsultants.com/wp-content/uploads/2023/02/ALCA-Journal-Fall-2015-Resilience-2.pdf.
  9. Donnellan C, O’Neill D. Baltes’ SOC model of successful ageing as a potential framework for stroke rehabilitation. Disabil Rehabil. 2014;36(5):424-429.
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*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.