McKinsey Health Institute

Age is just a number: How older adults view healthy aging

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When someone contemplates growing older, it’s likely with a wish for physical and financial independence, joyful and engaging activities, and closeness with loved ones. Whether by playing pickleball or mah-jongg, working a part-time job, or running after grandchildren (or all of the above), the big question is how every older adult, no matter their country or socioeconomic status, can manifest what matters to them.

A new McKinsey Health Institute (MHI) survey of more than 21,000 older adults (defined as those aged 55 and older) across 21 countries finds that respondents largely agree about the importance of having purpose, managing stress, enjoying meaningful connections with others, and preserving independence.1 Consistent with external literature, and building on MHI’s previous work in this area, the analysis examined the intersection of many of those factors with respondents’ subjective, or perceived, health and well-being across the dimensions of mental, physical, social, and spiritual health (see sidebar “Methodology”).2Living longer in better health: Six shifts needed for healthy aging,” McKinsey Health Institute, November 11, 2022; Angus Deaton, Andrew Steptoe, and Arthur A. Stone, “Subjective wellbeing, health, and ageing,” Lancet, February 2015, Volume 385, Number 9,968. The analysis approach is meant to provide a comprehensive picture of how older adults perceive their health, how their perceptions compare with objective measures of health, and what behaviors are most closely associated with their perceptions.

Among the results, unsurprisingly, is that older adults who have financial stability—no matter their country—are more likely than their peers to be able to adhere to healthy habits, including those that boost cognitive health.3 And contrary to the perception that older adults are tech laggards compared with their younger peers, the results find widespread technology adoption, especially in smartphone use, among the older adult population.

But on other topics, including how respondents perceive their health across the four dimensions, how they want to engage in society, and how they view the best ways to stay healthy, responses vary widely. In particular, respondents in high-income economies (HIEs) aren’t necessarily thriving more than their counterparts in upper-middle-income economies (UMIEs) and in low- and middle-income economies (LMIEs) are. For example, almost 20 percent of respondents in HIEs say they would like to work in their old age but aren’t currently doing so. Respondents living in HIEs also describe substantially lower levels of societal participation4 compared with their counterparts in other countries.

In the insights that follow, we share findings around mental, physical, social, and spiritual health and what a healthy lifespan can mean in a world that is growing older. They build on MHI’s previous work on six shifts needed for healthy aging, with the goal of reenvisioning perceptions of aging around capacity rather than chronological age.5Living longer in better health,” November 11, 2022. They also support MHI’s assertion that empowering individuals in optimizing health doesn’t undermine the roles of systems, institutions, countries, or cities.6The secret to great health? Escaping the healthcare matrix,” McKinsey Health Institute, December 20, 2022. It’s our hope that every stakeholder, from employers to local governments to healthcare providers, can see what older adults want, evaluate what’s possible, and feel motivated to be a part of wide-scale aging transformation.

A dozen factors emerge as most closely associated with perceived health

Having purpose, managing stress, physical activity, lifelong learning, and interacting with others matter most to overall health.

Mental and spiritual health are the most favorably rated dimensions

Living longer may not mean better perceived health

There is dissonance between perceived health and healthy life expectancy.

The factors with the greatest uplift broadly align with those identified as most important

Older adults in high-income economies are active but less engaged than their peers

Older adults are socially active, and many want to do even more.

Greatest perceived-health benefit is seen with volunteering and employment

Societal participation aligns with better perceived health.

Many older adults who wish to work are unable to find a job

Challenges with finding a job and attractive opportunities

Difficulty landing a job and lack of attractive opportunities are greatest barriers to employment.

Debunking the myth about older adults and technology

Overcoming the knowledge gap is the key to greater technology adoption.

Economic inequality poses challenges to health

Economic inequality aligns with poorer adherence to healthy brain habits.

Older adults want to stay in their homes, but that’s not always possible

Eighty percent of older adults want to live in their own home, but not all are able.

The desire to remain independent can be a barrier to accessing care

Aging well isn’t only possible: it’s attainable. But to make this a reality for a rapidly aging population, global stakeholders should consider not only how to boost the number of years in a life but also how to enable healthy life in those years.

Some of this starts with reexamining assumptions. MHI’s previous research found that many older adults report good overall health as they age, even as their physical health declines.7In sickness and in health: How health is perceived around the world,” McKinsey Health Institute, July 21, 2022. The current survey results support that research. Even among those facing the greatest disease burden, up to 46 percent report good overall health (exhibit).

Respondents with chronic conditions do not necessarily see themselves as being in poor health.

And when surveyed older adults cite lower physical-health scores, it’s notable that the rates of the other dimensions (mental, social, and spiritual) decline less rapidly—or even rise, in some countries—with older age. For example, in Japan, those aged 65 to 79 report the highest mental-, physical-, social-, and spiritual-health scores. One explanation for this could be that the other dimensions act as a buffer, protecting or mitigating the decline of people’s perception of their overall health despite a decline in their physical capabilities.

The extent to which other aspects of health could compensate for the decline in physical health, and balance people’s view of their overall health, is a topic for further research. As we consider actions to add life to years, part of any solution will need to focus on what drives people to take action to stay in good health. Purpose and meaningful connections with others are critical contributors to good health, as our research indicates.

And the underlying reasons for creating those connections and the definition of purpose vary. For example, our research on societal participation highlights the point that many older adults engage in activities for a variety of reasons, from staying healthy to being connected to their communities and, for some, pursuing financial gain. The motivations are multifaceted, but providing opportunities to fulfil those motivations must be a critical priority for societies.

Too often, society and individuals accept health declines as inevitable—the passing of time leading to physical deterioration. An important objective for many societies could be to ask “What would it take for more than half of people aged 80 and older to report good health over the next decade? What would it take to expand what it means to be in good health at ages 60, 70, 80, 90, and beyond?” For example, in forthcoming work, MHI will explore how a healthy city framework ties into older adults’ abilities to stay active, access care, and keep connected.

Healthy aging also starts with individual actions, such as a person following behaviors proven to improve health, supported by an environment that makes them accessible to all. It’s a lifelong journey, and it’s never too late to set out on the path to becoming well aged.

If you would like to learn more about the McKinsey Health Institute 2023 Global Healthy Aging Survey and the additional data and insights MHI has from the survey, please submit an inquiry via the MHI “contact us” form. The McKinsey Health Institute, as a non-profit-generating entity of McKinsey, is creating avenues for further research that can catalyze action.

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