Living longer in good health

Unfortunately, health does not generally improve with age. Life expectancy is increasing around the world, which is undoubtedly positive. However, it would be far better if healthy life expectancy, the years we spend in good health as we grow older, increased at the same pace [1]. Professor Carol Jagger, AXA Professor of Epidemiology of Ageing at Newcastle University in the UK, has devoted her research to understanding the factors that could help us live both longer and healthier lives [2][3].

She is a leading authority on ageing, with a particular focus on extending the years people can live in good health, a concept central to public health planning in ageing societies. Her work highlights both the potential and the challenges of ensuring that increased longevity is accompanied by better quality of life, rather than simply more years lived with illness or disability [4]. Jagger’s research draws extensively on data from the Cognitive Function and Ageing Studies (CFAS) project, which followed people aged 65 years or above in three centres across England, Cambridgeshire, Newcastle, and Nottingham, between 1991 and 2011 [3].

Key Concept: Increasing Longevity and Healthy Life Expectancy

Professor Jagger’s research emphasises that while people are living longer due to advances in healthcare, public health, and technology, healthy life expectancy has not always increased at the same rate [3]. This discrepancy raises significant concerns, as the additional years gained are often marked by chronic conditions such as cardiovascular disease, arthritis, and cognitive decline, including dementia [4].

One of Jagger’s key messages is that simply increasing life expectancy is not enough. The goal should be to compress morbidity, that is, to reduce the proportion of life spent living with illness and disability, particularly at the end of life [5]. In her studies, she demonstrates that while life expectancy at age 65 has increased, the additional years are frequently accompanied by disability and disease, placing greater burdens on healthcare systems and caregivers [3].

The Importance of Early and Lifelong Prevention

According to Jagger, addressing this imbalance requires a shift in focus from merely treating diseases in older adults to adopting preventative measures much earlier in life. Public health initiatives must encourage healthier lifestyles from a younger age, such as regular exercise, balanced nutrition, and the avoidance of smoking and excessive alcohol consumption, since habits established in early and mid-life have profound effects on health in later years [6].

She underscores the need for health systems to prioritise preventing multimorbidity, the coexistence of multiple chronic conditions, which is increasingly common in older populations [7]. Jagger has also pointed out that multimorbidity tends to appear earlier in life among more disadvantaged socio-economic groups [7]. This finding supports her call for policies that address health inequalities and ensure that everyone has the opportunity to age well [8].

Focus on Cognitive Health and Dementia

A significant aspect of Professor Jagger’s work is cognitive ageing and dementia. She has stressed that while physical health often dominates the conversation around ageing, maintaining cognitive health is equally important for preserving quality of life in later years [9]. Jagger’s studies suggest that although the prevalence of dementia has not risen in line with life expectancy, the absolute number of people living with dementia is increasing simply because more people are surviving into older age [9].

To address this challenge, Jagger promotes both research into the causes and prevention of dementia, as well as practical interventions that may delay its onset. She supports efforts to improve mental stimulation, social engagement, and physical activity throughout life as key strategies for protecting cognitive health [10]. Evidence suggests that these factors, together with effective management of vascular risk factors such as hypertension and diabetes, can significantly reduce the risk of cognitive decline [11].

Adapting Healthcare Systems and Societal Structures

In addition to lifestyle interventions, Jagger calls for a transformation in the way healthcare systems are organised. Current systems, she argues, are largely designed to treat acute conditions, yet they are often ill-equipped to manage the complex and chronic health needs of an ageing population [12].

She advocates for healthcare that is more integrated and person-centred, with a focus on managing multiple conditions simultaneously rather than treating each in isolation [12]. Moreover, Jagger has emphasised the role of technology and innovation in supporting older adults to live independently for longer. Assistive technologies, such as wearable health monitors, telehealth systems, and home-based care platforms, can help individuals manage their health and maintain autonomy, potentially reducing strain on healthcare services and caregivers [13].

Healthy Ageing for All: Reducing Health Inequalities

A consistent theme in Jagger’s work is the need to address the social determinants of health that shape how different populations age. She has shown that individuals from lower socio-economic backgrounds are more likely to experience poorer health and earlier onset of chronic diseases [8].

This inequity means that strategies for healthy ageing must consider broader socio-economic policies, including improved access to healthcare, education, and healthier living environments [8]. Without addressing these structural factors, gains in longevity may continue to be distributed unevenly across society.

Conclusion

Carol Jagger’s work offers a nuanced perspective on the challenges and opportunities associated with longer life spans, one that aligns closely with many of the ideas explored in our Frailomic and MID-Frail projects into ageing. Her research highlights the need for a multi-faceted approach to healthy ageing: one that integrates early prevention, addresses inequalities, and adapts healthcare systems to the realities of ageing populations.

Ultimately, her message is one of optimism tempered with realism: living longer in good health is possible, but it requires concerted effort from individuals, healthcare providers, researchers, and policymakers alike.

References

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