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Socioeconomic inequalities in a 16-year longitudinal measurement of successful ageing
  1. Almar A L Kok1,2,
  2. Marja J Aartsen3,
  3. Dorly J H Deeg1,
  4. Martijn Huisman1,2
  1. 1Department of Epidemiology & Biostatistics, Medical Faculty F-Wing, VU University Medical Center, Amsterdam, The Netherlands
  2. 2VU University Amsterdam, Faculty of Social Sciences, Department of Sociology, Amsterdam, The Netherlands
  3. 3Norwegian Social Research—NOVA, Centre for Welfare and Labour Research, Oslo, Norway
  1. Correspondence to Almar A L Kok, Department of Epidemiology & Biostatistics, Medical Faculty F-Wing, VU University Medical Center, De Boelelaan 1089a, Amsterdam 1081 HV, The Netherlands; a.kok1{at}


Background This study examines to what extent education, occupation and income are associated with the multidimensional process of successful ageing, encompassing trajectories of physical, mental and social functioning in old age.

Methods We employed 16-year longitudinal data from 2095 participants aged 55–85 years at baseline in the Dutch, nationally representative Longitudinal Aging Study Amsterdam. For 9 indicators of successful ageing, separate Latent Class Growth models were used to identify subgroups of older adults with a ‘successful’ trajectory. A ‘Successful Aging Index’ expressed the number of indicators for which individual respondents had a successful trajectory (range 0–9). Using multivariate regression models, we investigated associations between socioeconomic position and the Successful Ageing Index, and with separate indicators of successful ageing.

Results Higher education, occupational skill level and income were independently associated with higher numbers of successful trajectories. Education (β=0.09) was a slightly stronger correlate of successful ageing than income (β=0.08). Analyses of separate indicators of successful ageing showed that cognitive functioning, functional limitations and emotional support given were associated with all three components of socioeconomic position, while other indicators were associated with only one (eg, life satisfaction) or none (eg, social loneliness). For some indicators of successful ageing, socioeconomic inequalities were present at baseline, and also increased or decreased during follow-up.

Conclusions Education, occupation and income represent distinct socioeconomic life course factors, each of which contribute in a specific way to inequalities in successful ageing. Physical and cognitive functioning were associated more strongly with socioeconomic position than social and emotional functioning.

  • Epidemiology of ageing
  • Health inequalities
  • Social and life-course epidemiology

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  • Contributors AALK was responsible for writing all versions of the manuscript and for carrying out the statistical analyses. MH conceived the idea of the study, as well as rewrote and provided substantial feedback on sections of the manuscript, and assisted with carrying out the statistical analyses. MJA and DJHD provided substantial feedback on the textual suggestions for all versions of the manuscript.

  • Funding This work was supported by the ‘Longitudinal Aging Study Amsterdam’ (LASA;, largely funded by the Netherlands Ministry of Health, Welfare and Sports, Directorate of Long-Term Care; and by a VIDI-fellowship from the Netherlands Organisation for Scientific Research (Grant number 452-11-017, to MH).

  • Competing interests None declared.

  • Ethics approval VU University Medical Center Medical Ethics Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Researchers interested in the data from the LASA study are requested to fill in a data request form, which can be obtained via