Development of a composite healthy ageing score: evidence from middle-to-older aged Australians

Conceptualisation and measurement of healthy ageing: Insights from a systematic literature review

This paper enhances the understanding and measurement of Healthy Ageing (HA) through a systematic review of its multidimensional operationalisation. Despite progress in HA research, no consensus exists on its constitutive elements, and current frameworks often do not capture its full complexity. Building on the World Health Organization (WHO) HA definition, we organise empirical evidence under three dimensions: intrinsic capacity (IC), functional ability (FA) and the environment (ENV). To identify conceptual, empirical and methodological gaps, we provide a structured synthesis of concepts, measures and instruments used in HA research, evaluating methodological advancement and standardisation in HA measurement. Following PRISMA guidelines, we extract data from 55 quantitative, qualitative and mixed-methods studies with a multidimensional HA focus. We arrange evidence into three primary domains (IC, FA and ENV; first order), 15 sub-domains (second order) and 84 themes (third order). We identify operational categories via thematic analysis and inductively determine the final categorisation, moving from third to first order based on conceptual and measurement considerations. Given the lack of systematic knowledge on ENV, we generate a more nuanced categorisation capturing different levels of analysis and contexts. We compute a mean usage ratio to assess differences in the application of validated tools across HA aspects. The review revealed substantial variability in HA conceptualisation and measurement. IC and FA are the most extensively studied domains, with well-established measurement approaches and widespread use. Common themes include locomotion, cognitive capacities and functional status. ENV remains significantly underexplored and lacks standardised measurement, as mainstream assessments still prioritise deficit-based approaches over enabling environments. This analysis calls for a standardised, multidimensional HA model integrating individual and contextual factors, recognising the role of structural environmental supports in shaping ageing trajectories. Future research should prioritise comprehensive HA measurement and pursue an interdisciplinary approach bridging conceptual and methodological gaps to inform HA policies effectively.

Perceptual-vision training as a strategy for healthy aging in adults with intellectual disability: a study protocol

Aging leads to changes in motor-cognitive performance. Despite the importance of physical activity for healthy aging and the need for health promotion interventions in individuals with intellectual disability (ID), there is a lack of empirically strategies for promoting health in adults with ID. Therefore, we are conducting a clinical trial (NCT06628999 on clinicaltrials.gov) to investigate a strategy for promoting healthy aging by targeting physical and cognitive domains in ID individuals. The present work aims to provide a detailed account of the study protocol of the proposed trial to promote transparency and dissemination of the ongoing research. Specifically, this project will study the effect of a vision training program on cognitive performance and physical fitness in adults with ID. A secondary aim is to examine the association between mental and physical performance outcomes. Participants will be randomly allocated into a vision training group (VT, n = 28), a vision training-detraining group (VTD, n = 28), and a control group (C, n = 28). During the first 8 weeks, the VT and VTD groups will follow the same training protocol (based on vision oculomotor exercises combined with postural control exercises). From weeks 9 to 16, the VT group will continue the training protocol, whereas the VTD group will abstain from training (detraining). Cognitive performance and physical fitness will be assessed at baseline, mid- and post-training intervention. Overall, a vision training program can positively impact various aspects of life for individuals with ID promoting autonomy, and social integration to counteract the aging process.

Re-Engagement in Physical Activity Slows the Decline in Older Adults' Well-Being - A Longitudinal Study

Physical activity is recommended for older adults; however, the benefits of previous active engagement in physical activity that can be sustained after one becomes inactive remain to be determined. This study investigated the longitudinal associations between physical activity engagement patterns and older adults' well-being. This population-based cohort study used data from the China Health and Retirement Longitudinal Study between 2015 and 2020. People aged 60 years and above were included, and they were categorized as active engagers if they reported engaging in at least 10 min of moderate and/or vigorous exercise consecutively per week in each survey year. Older adults' well-being was evaluated using the healthy aging score, and geographical variations were visualized. The generalized estimating equations model was adopted to examine the differences between various physical activity engagement patterns and older adults' well-being. Among the 3300 older adults (50.5% men; age 66.9 ± 5.7 years) during the five years of follow-up, engagement in physical activity increased from 31.7% to 59.6%. However, their well-being decreased gradually, especially among those who were inactive engagers (beta = -0.20 to -0.21). Physical activity engagement patterns appeared to slow decline in well-being. Geographical variations were noted, with more favorable healthy aging scores observed in northern China than in southern China. As older adults age, well-being deteriorates, and disengagement of physical activity accelerates the rate of decline. Re-engagement in physical activity can slow the rate of decline in well-being. Early identification of and intervention in inactive engagement in physical activity reduce the detrimental effects on older adult's well-being. A national health initiative is an effective strategy to create a supportive environment for older adults to continue and engage in physical activity. The participation of healthcare professionals and community parties is important to encourage and engage older adults in physical activity.

The effect of alexithymia on self-perceived aging among community-dwelling older adults with multiple chronic conditions: the mediating role of maladaptive cognitive emotion regulation strategies

Objectives

This study investigated the mediating role of maladaptive cognitive emotion regulation strategies in the relationship between alexithymia and self-perceived aging among older adults.

Methods

We surveyed 478 Chinese community-dwelling older adults from November 2022 to May 2023. The Toronto Alexithymia Scale (TAS-20), Cognitive Emotion Regulation Questionnaire (CERQ), and Brief Aging Perceptions Questionnaire (B-APQ) were used. Correlation analyses, multiple linear regression analysis, and structural equation modeling were performed.

Results

The average age of participants was 71.52 ± 7.80 years, and the number of chronic diseases was distributed as follows: 270 (56.49%) had 2 disease conditions, 156 (32.64%) had 3 disease conditions, and 52 (10.88%) had 4 disease conditions or more. Scores for alexithymia 57.83 ± 10.19; maladaptive cognitive emotion regulation strategies 49.63 ± 10.65; and self-perceived aging 58.74 ± 10.23. Alexithymia and maladaptive cognitive emotion regulation strategies were positively correlated with negative self-perceived aging (r=0.665 and r=0.673, respectively), explaining 51.8% of the variance in self-perceived aging. Structural equation modeling results showed that alexithymia had a direct effect (of 0.368) on self-perceived aging, accounting for 44.1% of the total effect. Maladaptive cognitive emotion regulation strategies partially mediated the relationship, with a mediation effect of 0.386, accounting for 51.8% of the total effect.

Conclusion

These findings suggest that addressing maladaptive cognitive emotion regulation strategies can help reduce negative self-perceived aging in elderly individuals with multiple chronic conditions, particularly among those with alexithymia.

Seven knowledge gaps in modern biogerontology

About a year ago, members of the editorial board of Biogerontology were requested to respond to a query by the editor-in-chief of the journal as to what one question within their field of ageing research still needs to be asked and answered. This editorial is inspired by the wide range and variety of questions, ideas, comments and suggestions received in response to that query. The seven knowledge gaps identified in this article are arranged into three main categories: evolutionary aspects of longevity, biological survival and death aspects, and heterogeneity in the progression and phenotype of ageing. This is not an exhaustive and exclusive list, and may be modified and expanded. Implications of these knowledge gaps, especially in the context of ongoing attempts to develop effective interventions in ageing and longevity are also discussed.