Unfortunately, health does not generally improve with age.  Life expectancy is generally increasing around the world, which is good. But, it would be better if “healthy life expectancy” (the years we spend in good health as we get older) increased too. Carol Jagger, AXA Professor of Epidemiology of Ageing at Newcastle University in the UK is studying the factors that could help us live both longer and healthier [1]. She is a leading authority on the subject of ageing, with a particular focus on extending the years people can live in good health, a concept known as healthy life expectancy. Her work highlights both the potential and the challenges of ensuring that increased longevity is accompanied by a better quality of life, rather than just more years lived with illness or disability. Jagger’s research is based on analysing data from the Cognitive Function and Ageing Studies (CFAS) project, which followed people aged 65 years or above in three centres in England (Cambridgeshire, Newcastle and Nottingham) between 1991 and 2011 [2].

Key Concept: Increasing Longevity and Healthy Life Expectancy

Professor Jagger’s research emphasises that while people are living longer due to advancements in healthcare, public health, and technology, healthy life expectancy—the number of years lived in good health—has not always increased at the same rate. 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.

One of Jagger’s key messages is that simply increasing life expectancy is not enough. The goal should be to compress morbidity, which refers to reducing the time an individual spends living with illness towards the end of life. In her studies, she points out 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.

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 need to encourage healthier lifestyles from a younger age—such as regular exercise, a balanced diet, 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.

She underscores the need for health systems to prioritize preventing multimorbidity, which is the coexistence of multiple chronic conditions, often seen in older populations. Jagger has pointed out that multimorbidity tends to appear earlier in life for those in more disadvantaged socio-economic groups. This fact leads her to advocate for policies that address health inequalities, ensuring that everyone has the opportunity to age well.

Focus on Cognitive Health and Dementia

A significant aspect of Professor Jagger’s work is focused on cognitive ageing and dementia. She has stressed that while physical health often dominates the conversation around ageing, maintaining cognitive health is equally important for quality of life in older age. Jagger’s studies suggest that while the overall prevalence of dementia has not risen in line with life expectancy, the absolute number of people living with dementia is increasing simply because there are more older adults.

To address this, Jagger promotes both research into the causes and prevention of dementia as well as practical interventions that can delay its onset. She supports efforts to improve mental stimulation, social engagement, and physical activity throughout life as key strategies for protecting cognitive health. Her findings suggest that these factors, along with medical interventions to manage risk factors like hypertension and diabetes, can contribute significantly to a reduced risk of cognitive decline.

Adapting Healthcare Systems and Societal Structures

In addition to lifestyle interventions, Jagger calls for a transformation in the way healthcare systems are organized. Current systems, she argues, are largely designed to treat acute conditions, but they are ill-equipped to manage the complex and chronic health needs of an ageing population. She advocates for healthcare that is more integrated and person-centered, with a focus on managing multiple conditions simultaneously rather than treating each in isolation.

Moreover, Jagger has emphasized the role of technology and innovation in supporting older adults to live independently for longer. Assistive technologies, such as wearable health monitors or home-based care systems, can help older individuals manage their health and maintain autonomy, potentially reducing the strain on healthcare services and caregivers.

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 influence how different populations age. She has shown that people from lower socio-economic backgrounds are more likely to experience poorer health and earlier onset of chronic diseases. This inequity means that strategies for healthy ageing must consider broader socio-economic policies, such as improving access to healthcare, education, and healthy living environments for all.

Conclusion

Carol Jagger’s work offers a nuanced perspective on the challenges and opportunities associated with longer life spans that, in a way, reflect many of the thoughts we have had around 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, and policymakers alike.

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