Usual Ageing vs Successful Ageing
Have you ever been surprised to learn someone is much older chronologically than they look? You thought Fred was 60 years of age, and later found out he was over 80.
Conversely, you may have observed someone we will call Joe who moved and looked like he was 80, and you were shocked to discover he was only 60.
There can be many reasons why Joe has aged to the extent that he has. He may have been a smoker, a heavy drinker, may have had cancer or another disease, or been exposed to a range of behavioural and biomedical risk factors.
In contrast, Fred may have pursued a healthy lifestyle, engaged in daily vigorous activity, and consumed a healthy diet.
(I have used male examples here, as you do not talk about a woman’s age – unless you are referring to the late Queen or my old mum, both of whom were 96 when they passed, and their age was a badge of honour.)
Chronological Age vs Biological Age
An important introductory message is this: you can’t change your chronological age, but you can control your biological ageing.
Your biological age is the age of your mind and body, and it is assessed by measuring several biomarkers. Biological (or physiological) ageing does not need to match chronological ageing.
Disability is not mandatory.
Decrepitude is not inevitable.
In the words of Dr Walter Bortz: Use it or lose it.
If you want to slow down your biological ageing, you need to do something about it. No one ever made a difference by doing the same thing. If you want to improve your health and fitness, you will need to make changes to your lifestyle.
If you think you can, or if you think you can’t, you are probably right.
What is Successful Ageing? Why bother?
In essence, successful ageing is positivity and maintaining a good quality of life until you pass.
In the literature, successful ageing is described as:
Avoiding disease
Maintaining high cognitive and physical function
Remaining actively engaged with life
My research goes further, suggesting that having a purpose for getting out of bed in the morning and being able to assist others are also critical components.
I am often asked why people need to bother with successful ageing. If you already have a good diet and pursue regular exercise, you may be doing some of this already.
However, in the words of the late George Burns, who passed at 100 years of age:
“Too many older people practice playing old. They think themselves into their dotage by adopting what they consider to be the expected mannerisms and lifestyle of the elderly. That lifestyle is long on inactivity and semi-dependence and short on vigorous exercise and self-reliance.”
Where Australia currently sits
The statistics tell an uncomfortable story:
66% of Australians are overweight or obese
Approximately 90% consume insufficient fruit and vegetables
Around 40–50% of people over 55 are physically inactive
These are behavioural and biomedical risk factors that can be avoided.
However, many people are misguided or find it easier to take medication. As a result, a high proportion of people aged 65+ are on multiple forms of medication. While medication may resolve one problem, it often creates another.
In fact, no one can accurately predict the cumulative side effects when multiple medications are consumed by one person.
When you consider our Indigenous population, these issues are even more concerning, although that is beyond the scope of this research.
If you have these, or other risk factors, you are likely following the typical or usual ageing pattern in Australia – a pattern that now represents an increasing proportion of the population.
What is Usual Ageing?
Usual ageing follows the commonly observed course of ageing, characterised by:
Gradual loss of strength
Declining immune function
Increases in blood pressure, body weight and serum cholesterol
Rowe and Kahn (1987) suggested that these age-linked changes, often considered ‘normal,’ are associated with lifestyle patterns that increase the risk of cardiovascular disease and cancer.
Usual ageing may result in reduced function or disease, causing a person to fall below the disability threshold – the point at which they can no longer perform day-to-day activities without assistance.
This diagram adapted from WHO (2002) illustrates this disability threshold.
Early identified components of Successful Ageing
Rowe and Kahn sought to distinguish successful ageing from the usual pattern that results in early disability and morbidity – outcomes they argued do not need to be part of the ageing process.
Their Rowe & Kahn Model (1998) identified three defining characteristics of successful ageing:
Low risk of disease and disease-related disability
High mental and physical function
Active engagement with life
This model challenged the assumption that decline is inevitable and reframed ageing as something shaped largely by lifestyle choices.
Choosing your Ageing Curve
Ageing is something we all do. The question, therefore, is not whether you will age, but how you will age.
You can continue along the usual ageing curve, or you can make deliberate lifestyle choices that shift you toward successful ageing.
Avoid behavioural and biomedical risk factors, and you are already halfway there.
The earlier you start, the better the outcome, but it is never too late to change direction.
Read more about the three potential life curves and the disability threshold here.