Skip to main content Accessibility help

Factors associated with active aging in Finland, Poland, and Spain

  • Jaime Perales (a1), Steven Martin (a2), Jose Luis Ayuso-Mateos (a3), Somnath Chatterji (a4), Noe Garin (a1), Seppo Koskinen (a5), Matilde Leonardi (a6), Marta Miret (a7) (a8), Victoria Moneta (a1), Beatriz Olaya (a1), Beata Tobiasz-Adamczyk (a9) and Josep Maria Haro (a1) (a7)...

Continuous population aging has raised international policy interest in promoting active aging (AA). AA theoretical models have been defined from a biomedical or a psychosocial perspective. These models may be expanded including components suggested by lay individuals. This paper aims to study the correlates of AA in three European countries, namely, Spain, Poland, and Finland using four different definitions of AA.


The EU COURAGE in Europe project was a cross-sectional general adult population survey conducted in a representative sample of the noninstitutionalized population of Finland, Poland, and Spain. Participants (10,800) lived in the community. This analysis focuses on individuals aged 50 years old and over (7,987). Four definitions (two biomedical, one psychosocial, and a complete definition including biomedical, psychosocial, and external variables) of AA were analyzed.


Differences in AA were found for country, age, education, and occupation. Finland scored consistently the highest in AA followed by Spain and Poland. Younger age was associated with higher AA. Higher education and occupation was associated with AA. Being married or cohabiting was associated with better AA compared to being widowed or separated in most definitions. Gender and urbanicity were not associated with AA, with few exceptions. Men scored higher in AA only in Spain, whereas there was no gender association in the other two countries. Being widowed was only associated with lower AA in Poland and not being married was associated with lower AA in Poland and Finland but not Spain.


Associations with education, marital status, and occupation suggest that these factors are the most important components of AA. These association patterns, however, seem to vary across the three countries. Actions to promote AA in these countries may be addressed at reducing inequalities in occupation and education or directly tackling the components of AA lacking in each country.

Corresponding author
Correspondence should be addressed to: Josep Maria Haro, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain. Phone: +34 93 600 26 85. Email:
Hide All
Armstrong, T. and Bull, F. (2006). Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). Journal of Public Health, 14, 6670.
Berkman, L. F. and Kawachi, I. (2000). Social Epidemiology, Social Science. Oxford: Oxford University Press.
Bøen, H., Dalgard, O. S. and Bjertness, E. (2012). The importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home: a cross sectional study. BMC Geriatrics, 12, 27.
Bowling, A. (1993). The concepts of successful and positive ageing. Family Practice, 10, 449453.
Bowling, A. and Dieppe, P. (2005). What is successful ageing and who should define it? BMJ, 331, 2431.
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, 607–14.
Carstensen, L. L. (2006). The influence of a sense of time on human development. Science, 312, 19131915.
Cosco, T. D., Prina, A. M., Perales, J., Stephan, B. C. M. and Brayne, C. (2013). Lay perspectives of successful ageing: a systematic review and meta-ethnography. BMJ Open, 3, e002710.
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, 620.
Diari Oficial de la Comunitat Valenciana. (2011). Decret 104/2011. Available at:; last accessed 21 March 2014.
Diari Oficial de la Comunitat Valenciana. (2012). Decret 110/2012. Available at:; last accessed 21 March 2014.
Eikemo, T. a, Huisman, M., Bambra, C. and Kunst, A. E. (2008). Health inequalities according to educational level in different welfare regimes: a comparison of 23 European countries. Sociology of Health and Illness, 30, 565582.
European Commission. (2009). Commission recommendation of 29 October 2009 on the use of the International Standard Classification of Occupations (ISCO-08). Official Journal of the Eurean Union, 292, 3147.
European Union. (2012). European Year for Active Ageing and Solidarity between Generations. [WWW Document]. Available at:; last accessed 9 March 2013.
Fernández-Ballesteros, R. (2008). Lay concept of aging well: Cross-cultural comparisons. Journal of the American Geriatrics Society, 56, 950952.
Fernández-Ballesteros, R., Molina-Martínez, M. A., Schettini-del-Moral, R. and Santacreu, M. (2013). The semantic network of aging well. In Robine, J. M., Jagger, C. and Crimmins, E. (eds.), Annual Review of Gerontology and Geriatrics: Healthy Longevity. (pp. 79107). New York: Springer.
Fries, J. F. (2012). The theory and practice of active aging. Current Gerontoly and Geriatrics Research, 2012, 420637.
Hank, K. (2011). How “successful” do older Europeans age? Findings from SHARE. Journal of Gerontology: Social Sciences, 66B, 230236.
He, W., Muenchrath, M. N. and Kowal, P. (2012). Shades of Gray: A Cross-Country Study of Health and Well-Being of the Older Populations in SAGE Countries, 2007–2010. Washington, DC: US Census Bureau.
Helmuth, L. (2003). The wisdom of the wizened. Science, 299, 13001302.
Ibrahim, F., Cohen, C. and Ramirez, P. (2010). Successful aging in older adults with schizophrenia: prevalence and associated factors. American Journal of Geriatric Psychiatry, 18, 879886.
Jeste, D. V. et al. (2013). Association between older age and more successful aging: critical role of resilience and depression. American Journal of Psychiatry, 170, 188196.
Kenkel, D. S. (1991). Health behavior, health knowledge, and schooling. Journal of Political Economy, 99, 287305
Kerschner, H. and Pegues, J. A. (1998). Productive aging: a quality of life agenda. Journal of the American Dietetic Association, 98, 14451448.
Kessler, R. C. and Ustün, T. B. (2004). The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13, 93121.
Lupien, S. J. and Wan, N. (2004). Successful ageing: from cell to self. Philosophical transactions of the Royal Society of London. Series B, Biological Sciences, 359, 14131426.
Lynch, J. (2000). Income inequality and health: expanding the debate. Social Science & Medicine, 51, 10011005.
Malaspina, L. et al. (2011). Successful cognitive aging in persons living with HIV infection. Journal of Neurovirology, 17, 110119.
Presupuestos Generales del Estado. (2011). Ley 39/2010. Available at:; last accessed 21 March 2014.
Presupuestos Generales del Estado. (2013). Ley 17/2012. Available at:; last accessed 21 March 2014.
Rowe, J. W. and Kahn, R. L. (1997). Successful aging. Gerontologist, 37, 433440.
StataCorp. (2009). Stata: Release 11. Stata Software. Available at:; last accessed 21 March 2014.
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, 135141.
Ustun, T., Chatterji, S., Mechbal, A., Murray, C. and WHS Collaborating Groups. (2005). Quality assurance in surveys: standards, guidelines and procedures. In Department of Economic and Social Affairs Statistics Division of the United Nations (ed.). Household Sample Surveys in Developing and Transition Countries. New York: United Nations.
Walker, A. (2009). Commentary: the emergence and application of active aging in Europe. Journal of Aging & Social Policy, 21, 7593.
Wilkinson, R. G. (2000). Inequality and the social environment: a reply to Lynch et al . Journal of Epidemiology and Community Health 54, 411–3.
World Health Organization. (1990). World Health Annual Statistics. Geneva: World health Organization.
World Health Organization. (1992). ICD-10 Classification of mental and behavioural disorders. Geneva: World health Organization.
World Health Organization. (2001). International Classification of Functioning, Disability and Health (ICF). Geneva: World health Organization.
World Health Organization. (2012). The World Health Organization Disability Assessment Schedule II (WHODAS II) [WWW Document].; last accessed 15 March 2013.
World Health Organization. (2013a). Ageing and life course: What is “active ageing” [WWW Document].; last accessed 15 March 2013.
World Health Organization. (2013b). World Health Organization Translation Guidelines [WWW Document].; last accessed 15 March 2013.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary materials

Perales Supplementary Material
Supplementary Material

 Word (74 KB)
74 KB


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed