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Cross-cultural comparison between academic and lay views of healthy ageing: a literature review

  • LI-WEN HUNG (a1) (a2), G. I. J. M. KEMPEN (a1) (a3) and N. K. DE VRIES (a1) (a2) (a4)


The aim of this study is to specify the concept of ‘healthy ageing’ from both western and non-western cultural perspectives, and to compare the views of academics and lay older people. Thirty-four published peer-reviewed full papers in English and Chinese (traditional characters) were identified using electronic database searches. The key components of their definitions of healthy ageing were extracted and categorised into 12 domains. The results show that, in general, lay definitions (as described in 11 studies) included more domains (independency, family, adaptation, financial security, personal growth, and spirituality) and more diversity in the healthy ageing concept than academic views (which tend to focus more on physical and mental health and social functioning in later life). Certain domains were valued differently across cultures. As shown in previous studies, the findings affirm that healthy ageing is a multi-dimensional and complex concept and that there are substantial differences in different cultures. Moreover, we found that there are pronounced variations in the conceptualisation of healthy ageing as between academic and older lay people. Generally, older lay people perceive healthy ageing more broadly than the maintenance of physical, mental and social functioning. We suggest that academic researchers should integrate the more holistic perspectives of older lay people and cultural diversity into the classical ‘physical–mental–social’ healthy ageing concept.


Corresponding author

Address for correspondence: Li-Wen Hung, Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Science, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands E-mail: or


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Almeida, O. P., Norman, P., Hankey, G., Jamrozik, K. and Flicker, L. 2006. Successful mental health aging: results from a longitudinal study of older Australian men. American Journal of Geriatric Psychiatry, 14, 1, 2735.
Avlund, K., Holstein, B. E., Mortensen, E. L. and Schroll, M. 1999. Active life in old age: combining measures of functional ability and social participation. Danish Medical Bulletin, 46, 4, 345–9.
Baltes, P. B. and Baltes, M. M. 1990. Psychological perspectives on successful aging: the model of selective optimization with compensation. In Baltes, P. B. and Baltes, M. M. (eds), Successful Aging: Perspectives from the Behavioral Sciences. Cambridge University Press, New York, 134.
Berkman, L. F., Seeman, T. E., Albert, M., Blazer, D., Kahn, R., Mohs, R., Finch, C., Schneider, E., Cotman, C., McClearn, G., Nesselroade, J., Featherman, D., Garmezy, N., McKhann, G., Brim, G., Prager, D. and Rowe, J. 1993. High, usual and impaired functioning in community-dwelling older men and women: findings from the Macarthur Foundation Research Network on successful aging. Journal of Clinical Epidemiology, 46, 10, 1129–40.
Bowling, A. 1993. The concepts of successful and positive aging. Family Practice, 10, 449–53.
Bowling, A. 2006. Lay perceptions of successful ageing: findings from a national survey of middle aged and older adults in Britain. European Journal of Ageing, 3, 3, 123–36.
Bowling, A. 2007. Aspirations for older age in the 21st century: what is successful aging? International Journal Aging and Human Development, 64, 3, 263–97
Bowling, A. 2008. Enhancing later life: how older people perceive active ageing? Aging and Mental Health, 12, 3, 293301.
Bowling, A. and Dieppe, P. 2005. What is successful ageing and who should define it? British Medical Journal, 331, 7531, 1548–51.
Bowling, A. and Iliffe, S. 2006. Which model of successful ageing should be used? Baseline findings from a British longitudinal survey of ageing. Age and Ageing, 35, 6, 607–14.
Burke, G. L., Arnold, A. M., Bild, D. E., Cushman, M., Fried, L. P., Newman, A. B., Nunn, C. and Robbins, J. 2001. Factors associated with healthy aging: the Cardiovascular Health Study. Journal of the American Geriatrics Society, 49, 3, 254–62.
Chong, A. M.-L., Ng, S.-H., Woo, J. and Kwan, A. Y.-H. 2006. Positive ageing: the views of middle-aged and older adults in Hong Kong. Ageing & Society, 26, 2, 243–65.
Chou, K. L. and Chi, I. 2002. Successful aging among the young-old, old-old, and oldest-old Chinese. International Journal of Aging and Human Development, 54, 1, 114.
Depp, C. A., Glatt, S. J. and Jeste, D. V. 2007. Recent advances in research on successful or healthy aging. Current Psychiatry Reports, 9, 1, 713.
Depp, C. A. and Jeste, D. V. 2006. Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies. American Journal of Geriatric Psychiatry, 14, 1, 620.
Fernández-Ballesteros, R., García, L. F., Abarca, D., Blanc, L., Efklides, A., Kornfeld, R., Lerma, A. J., Mendoza-Nuñez, V. M., Mendoza-Ruvalcaba, N. M., Orosa, T., Paúl, C. and Patricia, S. 2008. Lay concept of aging well: cross-cultural comparisons. Journal of the American Geriatrics Society, 56, 5, 950–2.
Fernández-Ballesteros, R., García, L. F., Abarca, D., Blanc, E., Efklides, A., Moraitou, D., Kornfeld, R., Lerma, A. J., Mendoza-Núñes, V. M., Mendoza-Ruvalcaba, N. M., Fraíz, T. O., Paúl, C. and Patricia, S. 2010. The concept of ‘ageing well’ in Latin American and European countries. Ageing & Society, 30, 1, 3940.
Ford, A. B., Haug, M. R., Stange, K. C., Gaines, A. D., Noelker, L. S. and Jones, P. K. 2000. Sustained personal autonomy: a measure of successful aging. Journal of Aging and Health, 12, 4, 470–89.
Fried, L. P., Ettinger, W. H., Lind, B., Newman, A. B. and Gardin, J. 1994. Physical disability in older adults: a physiological approach. Journal of Clinical Epidemiology, 47, 7, 747–60.
Garfein, A. J. and Herzog, R. 1995. Robust aging among the young-old, old-old, and oldest-old. Journal of Gerontology, 50B, 2, S77–87.
Garroutte, E. V. N. S., Arguelles, L., Goldberg, J. and Buchwald, B. 2006. Cultural identities and perceptions of health among health care providers and older American Indians. Journal of General Internal Medicine, 21, 2, 111–16.
Glass, T. A. 2003. Assessing the success of successful aging. Annals of Internal Medicine, 139, 5, 383–84.
Guralnik, J. M. and Kaplan, G. A. 1989. Predictors of healthy aging: prospective evidence from the Alameda county study. American Journal of Public Health, 79, 6, 703–08.
Hansen-Kyle, L. 2005. A concept analysis of healthy aging. Nurse Forum, 40, 2, 4547.
Hsu, H. C. 2007. Exploring elderly people's perspective on successful ageing in Taiwan. Ageing & Society, 27, 1, 87102.
Hsu, H. C. and Chang, M. C. 2004. Successful aging and active aging in Taiwan: a multi-level analysis. Taiwan Journal of Social Welfare, 3, 2, 136. (In Chinese traditional characters)
Kendig, H. and Browning, C. 1997. Positive ageing: facts and opportunities. Medical Journal of Australia, 167, 409–10.
Kickbusch, I. 2005. Action on global health: addressing global health governance challenges. Public Health, 119, 11, 949–51.
Knight, T. and Ricciardelli, L. 2003. Successful aging: perceptions of adults aged between 70 and 101 years. International Journal of Aging and Human Development, 56, 3, 223–45.
Lamb, V. L. and Myers, G. C. 1999. A comparative study of successful aging in three Asian countries. Population Research and Policy Review, 18, 5, 443–9.
Lee, L. Y. K. and Fan, R. Y. K. 2008. An exploratory study on the perceptions of healthy ageing among Chinese adults in Hong Kong. Journal of Clinical Nursing, 170, 10, 1392–4.
Li, C., Wu, W., Jin, H., Zhang, X., Xue, H., He, Y., Xiao, S., Jeste, D. V. and Zhang, M. 2006. Successful aging in Shanghai, China: definition, distribution and related factors. International Psychogeriatrics, 18, 3, 551–63.
Lin, L. H. 2006. A study of successful aging of the elder learners in institutions in Taiwan. Journal of Population Studies, 33, 133–70. (In Chinese traditional characters)
Matsubayashi, K., Ishine, M., Wada, T. and Okumiya, K. 2006. Older adults' views of ‘successful aging’: comparison of older Japanese and Americans. Journal of the American Geriatrics Society, 54, 1, 184–7.
Menec, V. H. 2003. The relation between everyday activities and successful aging: a 6-year longitudinal study. Journal of Gerontology: Social Science, 58B, 2, S74–82.
Moberg, D. O. 2005. Research in spirituality, religion and aging. Journal of Gerontological Social Work, 45, 1/2, 1140.
Montross, L., Depp, C., Daly, J., Reichstadt, J., Golshan, S., Moore, D., Sitzer, D. and Jeste, D. V. 2006. Correlates of self-rated successful aging among community-dwelling older adults. American Journal of Geriatric Psychiatry, 14, 1, 4351.
Newman, A. B., Arnold, A. M., Naydeck, B. L., Fried, L. P., Burke, G. L., Enright, P., Gottdiener, J., Hirsch, C., O'Leary, D. and Tracy, R. 2003. ‘Successful aging’: effect of subclinical cardiovascular disease. Archives of Internal Medicine, 163, 19, 2315–22.
Palmore, E. 1979. Predictors of successful aging. The Gerontologist, 19, 5, 427–31.
Peel, N. 2004. Healthy ageing: how is it defined and measured? Australasian Journal on Ageing, 23, 3, 115–9.
Phelan, E. A., Anderson, L. A., Lacroix, A. Z. and Larson, E. B. 2004. Older adults' views of ‘Successful aging’ and how do they compare with researchers' definitions? Journal of the American Geriatrics Society, 52, 2, 211–6.
Phelan, E. A. and Larson, E. B. 2002. ‘Successful aging’ and where next? Journal of the American Geriatrics Society, 50, 7, 1306–8.
Reed, D. M., Foley, D. J., White, L. R., Heimovitz, H., Burchfiel, C. M. and Masaki, K. 1998. Predictors of healthy aging in men with high life expectancies. American Journal of Public Health, 88, 10, 1463–8.
Roos, N. P. and Havens, B. 1991. Predictors of successful aging: a twelve-year study of Manitoba elderly. American Journal of Public Health, 81, 1, 6368.
Rowe, J. W. and Kahn, R. L. 1987. Human aging: usual and successful. Science, 237, 4811, 143–9.
Rowe, J. W. and Kahn, R. L. 1997. Successful aging. The Gerontologist, 37, 4, 433–40.
Schulz, R. and Heckhausen, J. 1996. A life span model of successful aging. American Psychologist, 51, 7, 702–14.
Strawbridge, W. J., Cohen, R. D., Shema, S. J. and Kaplan, G. A. 1996. Successful aging: predictors and associated activities. American Journal of Epidemiology, 144, 2, 135–41.
Strawbridge, W. J., Wallhagen, M. I. and Cohen, R. D. 2002. Successful aging and well-being: self-rated compared with Rowe and Kahn. The Gerontologist, 42, 6, 727–33.
Tate, R. B., Lah, L. and Cuddy, T. E. 2003. Definition of successful aging by elderly Canadian males: the Manitoba follow-up study. The Gerontologist, 43, 5, 735–44.
Tyas, S. L., Snowdon, D. A., Desrosiers, M. F., Riley, K. P. and Markesbery, W. R. 2007. Healthy ageing in the nun study: definition and neuropathologic correlates. Age and Ageing, 36, 6, 650–5.
Uotinen, V., Suutama, T. and Ruoppila, I. 2003. Age identification in the framework of successful aging: a study of older Finnish people. International Journal of Aging and Human Development, 53, 3, 173–95.
Vaillant, G. E. and Western, R. J. 2001. Healthy aging among inner-city men. International Psychogeriatrics, 13, 4, 425–37.
von Faber, M., Bootsma-van der Wiel, A., van Exel, E., Gussekloo, J., Lagaay, A. M., van Dongen, E., Knook, D. L., van der Geest, S. and Westendorp, R. G. J. 2001. Successful aging in the oldest old: who can be characterized as successfully aged? Archives of Internal Medicine, 161, 22, 2694–700.
World Health Organization (WHO) 1948. Preamble to the Constitution of the World Health Organization. Entered into force 7 April 1948, WHO, Geneva. Available online at [Accessed 18 May 2010].
World Health Organization (WHO) 2008. World Health Statistics 2008. WHO, Geneva.



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