Why ageing doesn’t have to mean years of poor health

One of the more depressing prospects of old age is years of poor health towards the end. The familiar story is that, while people are living longer, our healthspans haven’t risen to the same extent, meaning those who reach old age experience more years of illness.

It is heartening, then, that a new way of assessing our later years reveals a different picture, shifting the focus from chronic disease diagnoses to whether a person is able to live their life in a way they value – described as “intrinsic capacity”. When looked at this way, people born in the 1950s in wealthy nations seem set to live the longest and healthiest lives of any generation yet.

We don’t yet know, however, if people born after this will enjoy a similar trend, as rises in obesity, pollution and sedentary lifestyles could reverse past gains.

It is estimated that in 2023, more than three quarters of the US population had at least one chronic condition and over half of all middle-aged adults had two or more. But when thinking in terms of intrinsic capacity, being diagnosed with an illness need not mark the end of good health, provided there are ways to manage the condition.

It is unfortunate, then, that the idea of a chronic disease epidemic is cited as the motivation behind the Make America Healthy Again campaign, fronted by Robert F. Kennedy Jr, the US health secretary, who last week cut research funding for mRNA vaccine technology. That funding could have helped lengthen lives and lessen the impact of disease.

However, there are still reasons for optimism. GLP-1 drugs, for example, have provided a powerful new way to manage obesity and, as we reported last week, are now being investigated as a way to slow ageing. This week, preliminary findings in mice suggest a new approach for lessening the impact of Alzheimer’s disease.

Such advances should remind politicians that if spending more years in better health is our goal, biomedical research is our ally, not our enemy.