A model of successful ageing in British populations

Background: European populations are ageing rapidly yet, although, it is widely recognized that some individuals age more successfully than others, an agreed concept of successful ageing remains elusive. We sought to develop a model of successful ageing in a British population, which combines the subjective and objective elements of successful ageing that have previously been proposed. Methods: Structural equation modelling was used to provide a model of successful ageing, defined in subjective and objective terms. The data comprised 15 000 subjects aged epsilon 50 years in England, recruited to the Health and Lifestyle Surveys (HALS) (followed up > 7 years) and the English Longitudinal Survey of Ageing (ELSA) (followed up > 2 years). A model was developed using a 50% random sample from HALS and tested in the other 50% and in ELSA. We examined the association of risk of disease, functioning and engagement with society at baseline with confidence and continued engagement at follow-up. Results: The model developed in the 50% sample of HALS was strong and reproducible in the other data sets. Low risk and good function at baseline are associated with confidence and continued engagement at follow-up, with engagement at baseline independently associated with engagement at follow-up. Conclusions: This model provides reproducible insights on the nature of ageing well, confirming the importance of personal resilience and continued involvement in physical and social activities. Far from retiring, engagement with life and society should be the norm for ageing populations.