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Successful aging: measuring the years lived with functional loss
  1. Wilma J Nusselder1,
  2. Anna Peeters2
  1. 1Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Netherlands
  2. 2Department of Epidemiology and Preventive Medicine, Monash University Central and Eastern Clinical School, Melbourne, Australia
  1. Correspondence to:
 Dr W J Nusselder
 PO Box 2040, 3000 CA Rotterdam, Netherlands; w.nusselder{at}


Current research of risk factors potentially associated with successful aging faces the difficulty of taking into consideration two distinct outcome measures: survival and functioning. Previous studies either used successful aging measures restricted to survivors or presented more than one outcome measure to handle the dual outcome. This article illustrates the utility of health expectancy measures, based on life tables, to integrate the effects of survival and functioning across all ages. It is shown that three hypothetical successful aging strategies, considered equally successful according to the traditional measures restricted to survivors, are associated with vastly different changes in the years lived with and without disability. Furthermore, the intervention considered most successful when considering multiple successful aging measures, was associated with the largest increase in the time lived with disability. It is recommended that research on successful aging should be based on summary measures of population health that reflect both survival and functioning throughout life. These will provide more relevant information than is currently available for individuals and societies to evaluate and choose between successful aging strategies.

  • successful aging
  • disability
  • mortality

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  • Funding: this work was supported by ZON-MW contract 014-91-054 and 904-68-493. AP was partly funded as a VicHealth Research Fellow during this study. These funding organisations did not participate in the design and conduct of the study, collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

  • Competing interests: none.

  • Ethical approval was not required as this was a secondary data analysis.

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