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Why we need to take a life-course approach to healthy aging

Healthy aging outcomes are affected by various life factors, not only things that happen in older age. A life-course approach considers the whole person throughout life and aims to offer the best support at every stage.

“Healthy aging does not start at age 50 or 55 or 60.”

Ritu Sadana, Head of Ageing and Health at the World Health Organization and lead on the WHO’s Baseline Report for the Decade of Healthy Ageing, speaking at RTOERO’s first Future of Aging Summit in May 2024.
Ritu Sadana
Ritu Sadana, Head of Ageing and Health at the World Health Organization at RTOERO’s Future of Aging Summit in May 2024.

This post is part of a series resulting from the Future of Aging Summit and shares key insights from Sadana’s presentation. The 2024 Future of Aging Summit, sponsored by Johnsons Inc., brought together experts and practitioners from various sectors.

What is healthy aging?

Healthy aging is “the process of developing and maintaining the functional ability that enables well-being in older age.” (WHO)

Functional ability includes:

  • meeting our basic needs
  • learning, growth and making decisions
  • maintaining mobility
  • forming relationships
  • contributing to society

Our environment shapes how we develop and maintain functional ability. It includes our home, relationships, and experiences with the broader society, as well as culture and attitudes, opportunities, programs, and policies. Our intrinsic capacity—what we’re born with—is a factor too. Healthy aging doesn’t mean being free from disability or disease—many individuals will live with one or more diseases or conditions.

Facing the global reality of population aging

2020 was a year of major shifts in more ways than one. Amid a pandemic that disproportionately impacted older adults, the global population hit a significant milestone: The percentage of the population over 60 outnumbered the percentage under 5 for the first time. It’s not expected to change back.

Society’s age makeup was previously pyramid-shaped, with a larger younger population and fewer older adults. Over time, the shape of the pyramid has evolved to be more dome-shaped.

However, focusing on the numbers can dehumanize the challenge when this is really about all of our lives. Population makeup is changing at community levels, nationally, and globally, and our way of life needs to change along with it.

“All responses to population aging should not reflect numbers but instead consider a human rights response.”

Ritu Sadana, WHO, speaking at the first Future of Aging Summit in May 2024

Measuring healthy aging

While global life expectancies are increasing, there are disparities in health and quality of life in older age. By comparing data from multiple countries, societies can understand more about those disparities and the value of interventions.

Ritu Sadana led a team to develop the Baseline Report for the Decade of Healthy Ageing by the World Health Organization, which she referenced during her presentation at the Future of Aging Summit.

Cover of Decade of healthy ageing: baseline report

The report includes data from existing nationally representative studies and includes results from 42 countries and over 150,000 older people, providing a first-time baseline for healthy ageing worldwide. Having baselines and a continued commitment to research are important.  

“If we don’t have the evidence, we have to go get it because we don’t want to do things that aren’t helpful. We need to design and assess, and we must experiment. Without experimentation, we won’t discover new methods. We have to keep evaluating rigorously so we can share our findings around the world.”

Ritu Sadana, WHO, at the first Future of Aging Summit in May 2024

Beyond measuring outcomes and the factors influencing them, we must consider what we value in society.

“How we calculate GDP is important to consider. Many of the positive aspects for health, education, human development, and sustainable environments are not counted, while negative aspects in those areas are counted. We need to recalibrate how we value and account for these things.”

Ritu Sadana, WHO, at the Future of Aging Summit in May 2024

Key considerations for a life-course approach to healthy aging

Chronological age doesn’t define capacity

There’s a misconception that all decline is a natural part of aging when, really, there’s a range of how people age. We need to rethink common aging assumptions while exploring the evidence of what influences capacity. 

“We could see that cognitive capacity did decline, but the rate of decline and, very importantly, the starting point around age 60 varied by their highest educational attainment. And that’s something we can change.”

Ritu Sadana, WHO, at the Future of Aging Summit in May 2024

Social determinants sort people into different life course trajectories

A life-course approach recognizes the importance of health equity initiatives across the lifespan. It also recognizes the role of the environment to build up reserves that can delay declines or mitigate them.

“Your social determinants can be a whole range of things; you could say it’s the environment and the social systems. These different determinants can either give you an advantage or a disadvantage.”

Ritu Sadana, WHO, at the Future of Aging Summit in May 2024

“You have a supportive environment, so even if you experience declines in your capacities, you have an environment that compensates for it.”

Ritu Sadana, WHO, at the Future of Aging Summit in May 2024

Societal attitudes and how we talk about topic matters

The language we use to discuss topics related to an aging population is important.    

“I do not like the term “silver tsunami.” Tsunami is not something good.”

Ritu Sadana, WHO, at the Future of Aging Summit in May 2024

We need a “retirement” rethink

Whether we work in later life should be tied to our desire, not age or necessity. The notion of retirement has changed. With longer lives comes the opportunity and, ideally, agency for new experiences, relationships, growth and contribution.

“We want to challenge negative attitudes and stereotypes. We want to improve literacy in older people, including financial and digital literacy. We want to invest in accessible opportunities for lifelong learning and growth, and we want to facilitate choice and control.”

Ritu Sadana, WHO, at the Future of Aging Summit in May 2024

Generations must not be pitted against another

A successful life-course approach would foster intergenerational understanding and connection. Everyone should have access to programs and support to help them overcome challenges and thrive, whether within Canada or those we support abroad.

“We have an opportunity in our aid as well to better balance and ensure that we consider improvements at every life stage so that we have an optimal trajectory. It’s not about pitting infants and children against older persons. That’s why a life course approach to even funding is important.”

Ritu Sadana, WHO, at the Future of Aging Summit in May 2024

Cross-sectoral collaboration is key

A life-course approach isn’t a siloed approach—actions and communication across sectors and ministries are critical to optimize the various factors that ultimately impact healthy aging.

“The importance of a life course approach is that almost all of these aspects are amenable to policy change, but they must be valued, resourced, and supported by communities, political leaders, and financiers. All those upward trends don’t happen by themselves.”

Ritu Sadana, WHO, at the Future of Aging Summit in May 2024

Further reading

Explore the following resources referenced by Sadana during her presentation to learn more about healthy aging and the life course approach.

Decade of healthy ageing: baseline report

World report on ageing and health