This chapter concentrates on health and well-being, drawing on 11 New Dynamics of Ageing (NDA) projects covering the whole range, from basic biology to the arts and humanities. Our main purpose is to employ the findings from our projects to examine the barriers to healthy ageing and how to overcome them. By way of introduction to this discussion of healthy ageing we first consider some key concepts in this field: ageing and ill health, older age, quality of life and subjective well-being. We begin with an overview of the main demographic changes that underline the importance of research on healthy ageing.

Key concepts for healthy ageing

Demographic changes

Major demographic shifts are currently under way in countries of the developed world such as the UK. In the 25-year period from 1985 to 2010 the number of adults aged over 65 in the UK increased by 1.7 million, and the number of those aged over 85 almost doubled to 1.4 million (ONS, 2011a). This is partly due to improvements in mortality leading to higher numbers in old age. Life expectancy is increasing at a rate of two years per decade in developed societies. However, there are sharply divergent views about how trends in life expectancy may develop during this century. For example, Christensen et al (2009, p 1196) pointed out, ‘if the pace of increase in life expectancy in developed countries over the past two centuries continues through the 21st century, most babies born since 2000 … [in] countries with long life expectancies will celebrate their 100th birthdays … research suggests that ageing processes are modifiable and that people are living longer without severe disability.’ On the other hand, Olshansky et al (2005, p 1142) stated, ‘as a result of the substantial rise in the prevalence of obesity and its life-shortening complications such as diabetes, life expectancy at birth and at older ages could level off or even decline within the first half of this century’.

The magnitude and implications of population ageing depend heavily on the magnitude of mortality improvement in decades to come. At present, overall age-standardised mortality rates (both sexes combined) are improving at about 2.5 per cent per annum in the UK (based on ONS, 2012a), but current trends are heavily influenced by patterns at ages where deaths are concentrated.