Although the notion of healthy aging has gained wide acceptance in gerontology,
measuring the phenomenon is challenging. Guided by a prominent conceptualization of
healthy aging, we examined how shifting from a more to less stringent definition of
healthy aging influences prevalence estimates, demographic patterns, and validity.
Data are from adults aged 65 years and older who participated in the Health and
Retirement Study. We examined four operational definitions of healthy aging. For each,
we calculated prevalence estimates and examined the odds of healthy aging by age,
education, gender, and race-ethnicity in 2006. We also examined the association between
healthy aging and both self-rated health and death.
Across definitions, the prevalence of healthy aging ranged from 3.3% to 35.5%. For all
definitions, those classified as experiencing healthy aging had lower odds of fair or
poor self-rated health and death over an 8-year period. The odds of being classified as
“healthy” were lower among those of advanced age, those with less education,
and women than for their corresponding counterparts across all definitions.
Moving across the conceptual continuum—from a more to less rigid definition of
healthy aging—markedly increases the measured prevalence of healthy aging.
Importantly, results suggest that all examined definitions identified a subgroup of
older adults who had substantially lower odds of reporting fair or poor health and dying
over an 8-year period, providing evidence of the validity of our definitions.
Conceptualizations that emphasize symptomatic disease and functional health may be
particularly useful for public health purposes.