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1、 Age is just a number:How older adults view healthy agingThe results of a survey from the McKinsey Health Institute shed light on the health perceptions and priorities of people aged 55 and older.This article is a collaborative effort by Hemant Ahlawat,Anthony Darcovich,Martin Dewhurst,Ellen Feehan,

2、Viktor Hediger,and Madeline Maud,representing views from the McKinsey Health Institute.May 2023When someone contemplates growing older,its likely with a wish for physical and financial independence,joyful and engaging activities,and closeness with loved ones.Whether by playing pickleball or mah-jong

3、g,working a part-time job,or running after grandchildren(or all of the above),the big question is how every older adult,no matter their country or socioeconomic status,can manifest what matters to them.A new McKinsey Health Institute(MHI)survey of more than 21,000 older adults(defined as those aged

4、55 and older)across 21 countries finds that respondents largely agree about the importance of having purpose,managing stress,enjoying meaningful connections with others,and preserving independence.1 Consistent with external literature,and building on MHIs previous work in this area,the analysis exam

5、ined the intersection of many of those factors with respondents subjective,or perceived,health and well-being across the dimensions of mental,physical,social,and spiritual health(see sidebar“Methodology”).2Among the results,unsurprisingly,is that older adults who have financial stabilityno matter th

6、eir countryare more likely than their peers to be able to adhere to healthy habits,including those that boost cognitive health.3 And contrary to the perception that older adults are tech laggards compared with their younger peers,the results find widespread technology adoption,especially in smartpho

7、ne use,among the older adult population.But on other topics,including how respondents perceive their health across the four dimensions,how they want to engage in society,and how they view the best ways to stay healthy,responses vary widely.1 The online survey was in the field from late December 2022

8、 to February 2023 and garnered responses from more than 21,000 participants aged 55 and older across 21 countries.2 Martin Dewhurst,Katherine Linzer,Madeline Maud,and Christoph Sandler,“Living longer in better health:Six shifts needed for healthy aging,”McKinsey Health Institute,November 11,2022;Ang

9、us Deaton,Andrew Steptoe,and Arthur A.Stone,“Subjective wellbeing,health,and ageing,”Lancet,February 2015,Volume 385,Number 9,968.The analysis approach is meant to provide a comprehensive picture of how older adults perceive their health,how their perceptions compare with objective measures of healt

10、h,and what behaviors are most closely associated with their perceptions.3 Bishwajit Ghose,Rui Huang,and Shangfeng Tang,“Effect of financial stress on self-rereported health and quality of life among older adults in five developing countries:A cross sectional analysis of WHO-SAGE survey,”BMC Geriatri

11、cs,August 2020,Volume 20,Number 1.Age is just a number:How older adults view healthy aging2Respondents largely agree about the importance of having purpose,managing stress,enjoying meaningful connections with others,and preserving independence.MethodologyTo gain a better understanding of the health

12、perceptions,preferences,and activities of older adults(those aged 55 and older)around the world,the McKinsey Health Institute conducted an internet-based survey between late December 2022 and February 2023,collecting information on about 1,000 older adults per country.For the participants unable to

13、fill out the survey because of medical conditions or lack of internet access,we collected responses from a spouse,child,or child-in-law.Within each country,we applied quotas and respondent weights to ensure that the final sample was representative for the entire country with respect to age,gender,an

14、d proportions of urban and rural location and tertiary education.We also used weights within each country to balance the sample,as much as possible,on respondents self-reported health status.This design was to ensure that results in one country on some measures dont look better than those from anoth

15、er solely because a higher proportion of their respondents report health substantially above the average for their age cohort.3Age is just a number:How older adults view healthy agingIn particular,respondents in high-income economies(HIEs)arent necessarily thriving more than their counterparts in up

16、per-middle-income economies(UMIEs)and in low-and middle-income economies(LMIEs)are.For example,almost 20 percent of respondents in HIEs say they would like to work in their old age but arent currently doing so.Respondents living in HIEs also describe substantially lower levels of societal participat

17、ion4 compared with their counterparts in other countries.In the insights that follow,we share findings around mental,physical,social,and spiritual health and what a healthy lifespan can mean in a world that is growing older.They build on MHIs previous work on six shifts needed for healthy aging,with

18、 the goal of reenvisioning perceptions of aging around capacity rather than chronological age.5 They also support MHIs assertion that empowering individuals in optimizing health doesnt undermine the roles of systems,institutions,countries,or cities.6 Its our hope that every stakeholder,from employer

19、s to local governments to healthcare providers,can see what older adults want,evaluate whats possible,and feel motivated to be a part of wide-scale aging transformation.Methodology(continued)Considerations for cross-generational surveysWe asked about each participants attitudes and behaviors only at

20、 the time of the survey.Therefore,when differences in average answers between age cohorts exist,we cant determine how much they result from different generations thinking differently versus people getting older and their preferences changing.Its possible that younger cohorts will eventually think an

21、d behave like older cohorts once they reach the same age.Considerations for surveys conducted onlineThe survey was conducted online.Without proper guardrails,the survey would have been affected by substantial nonresponse bias,because individuals without reliable internet access couldnt have been par

22、t of the sample.This is why we asked spouses,children,and children-in-law to answer on behalf of participants without reliable internet access.We used the best information available to decide on the proportions of responses to come directly from participants and from somebody answering on behalf of

23、an older adult.It is possible,however,that we have slightly under-or overcorrected.Considerations for cross-country surveysSubstantial cultural differences are known to exist across countries,and they can affect how respondents interpret survey questions and answers,how they use the scales,how likel

24、y they are to agree with survey questions,and how likely they are to answer truthfully.For example,past McKinsey analysis has shown that,in general,survey respondents in India have a higher propensity to agree and to agree strongly with survey statements than respondents in most other countries do.A

25、lthough we relied on cultural experts to safeguard equivalence of meaning during translation across languages,some observed differences across countries may still be induced in the process.Country differences were computed as differences among country averages.Unless specified,we analyzed by taking

26、a simple average across countries within a country income archetype and then took the simple average across archetypes in order to get an overall average.4 Based on extensive literature review,we define“societal participation”as participating in at least one of the following activities:working,volun

27、teering,pursuing education,and being active in community programs.5 For more,see“Living longer in better health,”November 11,2022.6 For more,see Lars Hartenstein and Tom Latkovic,“The secret to great health?Escaping the healthcare matrix,”McKinsey Health Institute,December 20,2022.4Age is just a num

28、ber:How older adults view healthy agingTop factors of individual health(out of 53 factors tested),relative importance index 1Questions:When considering the entire course of your life,how much do you agree with the following statements?Today and moving forward,how much do you agree with the following

29、 statements?To understand the importance of individual factors of health,we calculated the correlations of each factor with each of the four health dimensions across countries in aggregate.We grouped these correlations in magnitude levels based on quartiles.Each factor was then assigned an index val

30、ue,and these values were summed across dimensions to arrive at an overall relative importance index.Source:McKinsey Global Healthy Aging Survey,2023Having purpose,managing stress,physical activity,lifelong learning,andinteracting with others matter most to overall health.McKinsey&CompanyWeb Exhibit

31、of AverageimportanceAbove-averageimportanceSpends time in natureHas had a healthy and nutritious dietPractices meditation or prayerCares for younger family/community membersCan aford desired lifestyleParticipates in community organizations/activitiesFeels a respected part of the communityFeels that

32、perspective as an older adult is valued Has felt confdent/informed in making fnancial decisionsIs able to get a good nights sleepEngages in regular moderate to vigorous exerciseHas had a mentally stimulating lifestyleHas meaningful connections with friendsVolunteers when ableHas opportunities to lea

33、rn new skillsParticipates in formal learning/continuing educationHas been conscious of physical posture/movementHas balanced stress levelHas purpose in lifeA dozen factors emerge as most closely associated with perceived healthMHI asked survey participants about 53 factors,ranging from societal part

34、icipation to exercise,to assess what matters most to older adults and how those individual factors may affect health.The analysis reveals that purpose,stress,physical activity,lifelong learning,meaningful connections with others,and financial security are the factors most strongly associated with re

35、spondents overall perceived health.While there are nuanced differences by country,overall,respondents in HIEs and UMIEs emphasize stress and financial decisions,while those in LMIEs highlight the importance of exercise and sleep.These factors often tie into how respondents perceive their mental,phys

36、ical,social,and spiritual health.5Age is just a number:How older adults view healthy agingMental and spiritual health are the most favorably rated dimensionsOverall,survey respondents perceived health across all four dimensions declines with age.Physical health has the sharpest drop38percentwhen loo

37、king at the average response,across all countries,between the youngest and oldest cohorts.For those aged 55 to 64,mental health tends to be the most positively rated dimension.For those aged 65and older,spiritual health becomes the most positively rated dimension.When examining economies and whether

38、 they affect health,the picture is mixed.On average,respondents in LMIEs report better average health than those in HIEs did.Yet respondents in HIEs report an increase in health across all dimensions from about age 55 to about age 79,which may be correlated to retirement.Of the countries represented

39、 in the survey,Australia and Japan were the only two where perceived mental,social,and spiritual health increased with age,with scores among those aged 80 and older higher than those of their counterparts aged between 55 and 64.Respondents in China report the smallest declines in physical health,whi

40、le those in Sweden report the smallest declines in mental and social health.Respondents in Egypt,Nigeria,and South Africathe African countries represented in the surveyreport the smallest declines in spiritual health.Yet perceptions of health dont always connect to life expectancy.Web Exhibit of Per

41、ceived good or very good health,by dimension of health,%of respondents(n=22,661)Note:At the overall level,diferences greater than 2%are statistically signifcant at a 95%confdence level.At the country-income-archetype level,diferences greater than 5%are statistically signifcant at a 95%confdence leve

42、l.Source:McKinsey Health Institute Global Aging Survey(2023)Overall,perceived physical and mental health drops the most by age 80.McKinsey&CompanyPhysical5564657980+Mental5564657980+Social5564657980+Spiritual5564657980+503734059524619percentagepoints1916136Age is just a number:How older a

43、dults view healthy agingLiving longer may not mean better perceived healthOn average,older people can expect to have an additional 20 years of life expectancy compared with those in 1960.7 But survey respondents living in countries with higher healthy life expectancy in old age(as measured by the WH

44、O8)dont necessarily report better perceived health.Whats more,those with chronic conditions dont necessarily report poor health.The report rates of perceived overall positive health status of respondents with the greatest disease burden are 27percent,40 percent,and 53 percent by those in HIEs,UMIEs,

45、and LMIEs,respectively.This reaffirms that health is much more than the absence or presence of disease and consists of multiple dimensions.Across the 21 countries represented in the survey,Japan has the highest healthy life expectancy for those in old age,but the share of Japanese respondents report

46、ing very good or good perceived health is among the lowest.In general,a lower share of HIE respondents reports very good or good perceived health compared with other economies.The exception is in Saudi Arabia and the United Arab Emirates,where respondents have relatively high perceptions of their he

47、alth.Perceived health and healthy life expectancy of older adults aged 6579,by country,(n=21,022)Note:To create comparable sample across countries,analysis was conducted on the 6579 age cohort that was most likely no longer working and also of sufcient sample size(80+sample size varied widely across

48、 countries).1Question:How would you/older adult rate your/their health across each of the dimensions below?Very good/good health is the average of those self-reporting“very good”and“good”health across each of the four dimensions of health.Source:2021 population estimates(55+and all ages),United Nati

49、ons Department of Economic and Social Afairs,Population Division(2022);World Population Prospects 2022;McKinsey Global Healthy Aging Survey,2023There is dissonance between perceived health and healthy life expectancy.McKinsey&CompanyWeb Exhibit of 2023040506070SingaporeJapanAustraliaUSMex

50、icoMalaysiaIndonesiaSaudi ArabiaSouthAfricaBrazilNigeriaUnited Arab EmiratesEgyptIndiaChinaSwedenGermanyFranceItalySouthKoreaUKVery goodor goodperceived health,%Estimated healthy life expectancy in old age(HALE-60)Respondents living in countries with higher healthy life expectancy in old age did not

51、 necessarily report better perceptions of their health022100Area shownHigh-incomeeconomies Upper-middle-incomeeconomies Lower-middle-incomeeconomies7 World Bank Open Data,World Bank,accessed on May 10,2023.For more,see“Living longer in better health,”November 11,2022.8 Measurement of“the average num

52、ber of years in full health a person(usually at age 60)can expect to live based on current rates of ill-health and mortality.”Global Health Observatory,WHO,updated on December 4,2020.7Age is just a number:How older adults view healthy agingThe factors with the greatest uplift broadly align with thos

53、e identified as most importantIn addition to looking at the factors that respondents report as most important to their health,our analysis looked at the factors with the greatest uplift.9 We examined what would happen if everyone could achieve the same level of perceived health as those with the bes

54、t reports of a specific factor.For example,managing stress has meaningful potential uplift.Among respondents aged 65 to 79,those who agree or strongly agree that they“manage their stress levels”have a 17-percentage-point uplift,on average,in their perceived overall health.Feeling respected by ones c

55、ommunity and feeling that ones perspective as an older adult is valued also result in substantial uplifts,with the greatest effect seen in respondents in HIEsso much so that the difference between perceived health and life expectancy almost completely disappears.This supports the idea that reframing

56、 aging has the potential to alter how older adults perceive their own health.At first glance,there appears to be less potential uplift for respondents in LMIEs,but the picture is more complicated.Such respondents give a higher baseline rating across most factors at the onset compared with their peer

57、s.For example,among respondents in LMIEs,a sense of purpose is largely ubiquitous.So selecting for the population subset that rates purpose most favorably invariably includes almost the entire sample,leading to little room for uplift.Has made education a priorityHas access to engaging art/musicHas s

58、table employmentHas meaningful connections with friendsHas purpose in lifeSpends time in natureFeels that perspective as an older adult is valuedPractices meditation or prayerCares for younger family/community memberFeels like a respected part of the communityHas access to buildings/recreational pub

59、lic spacesHas been conscious about posture/movementIs able to get a good nights sleepHas felt confdent/informed to make fnancial-planning decisionsHas enjoyed fnancial securityHas had a healthy and nutritious dietHas had a mentally stimulating lifestyleHas access to community organizations/activitie

60、sHas opportunities to learn new skillsCan aford desired lifestyleVolunteers when ableParticipates in formal learning/continuing educationEngages in regular moderate to vigorous exerciseParticipates in community organizations/activitiesHas balanced stress level17.216.215.915.714.214.113.913.313.212.7

61、12.412.312.012.011.911.411.111.111.110.810.79.910.110.310.3Highlightedin analysisNot highlightedin analysisAddressing factors of health individually can have outsize impact on overall perceived health.Average uplift in perceived health,by factor of health,percentage-point uplift in very good/good he

62、alth from baselineNote:Uplift is calculated as the average of those self-reporting“very good”and“good”health across each of the four dimensions of health.To create comparable sample across countries,analysis was conducted on the 6579 age cohort that was most likely no longer working and also of sufc

63、ient sample size(80+sample size varied widely across countries).Question:How would you/older adult rate your/their health across each of the dimensions below?All uplifts are statistically signifcant at a 95%confdence level.Diferences between uplifts greater than 4%are statistically signifcant at the

64、 95%confdence level.Source:McKinsey Global Healthy Aging Survey,2023 9“Uplift”is defined as the net-positive impact on overall health status when including only the survey participants who respond that they agree or strongly agree with the statement related to the specific factor compared with the a

65、verage of all respondents.Uplifts are based on correlation,not causation.The factors that are deemed important and also result in substantive uplift are shown.Factors with insufficient sample size in numerous countries are excluded from this analysis.8Age is just a number:How older adults view healt

66、hy agingOlder adults in high-income economies are active but less engaged than their peersAcross countries and incomes,employment is the most frequently reported societal-participation activity,followed by formal volunteering by respondents in LMIEs and community activities by respondents in HIEs an

67、d UMIEs.Most surprising:fewer than 60percent of the respondents in HIEs report engaging in any type of societal participation.While reasons may vary,our research finds a meaningful opportunity around increasing societal participation,with up to 44 percent of older adults expressing a desire to engag

68、e in a new type of activity.Not participating in any activities,%of respondentsEngagement in and desire to engage in societal-participation activities,%of respondents(n=20,677)Note:The total share that“wants to do an activity”plus the total share that“does not want to do an activity”(not shown)will

69、equal 100%.Questions:Which of the following activities are you currently engaged in?Which of the following activities are you not currently engaged in?Source:McKinsey Global Healthy Aging Survey,2023Older adults are socially active,and many want to do even more.High-income economies(HIEs)Upper-middl

70、e-income economies(UMIEs)Lower-middle-income economies(LMIEs)McKinsey&CompanyWeb Exhibit of Not doingbut wants to(unmet demand)Currently doingand wants toEmploymentFormal volunteeringEducationCommunity programsLMIEsUMIEsHIEsLMIEsUMIEsHIEsLMIEsUMIEsHIEsLMIEsUMIEsHIEs38253437282582841214483

71、68286644364342HIEsUMIEsLMIEs1531419Age is just a number:How older adults view healthy agingGreatest perceived-health benefit is seen with volunteering and employmentParticipating pays off.Reports of overall health are better for survey respondents who engage in working,voluntee

72、ring,education,and community activities than for those who dont.The greatest gain is seen with volunteering(eight percentage points,on average).When looking at country and country income archetypes,results vary,but in one example,the perceived benefit of volunteering correlates to increased wealth.D

73、eclining health can be a barrier to overall societal participation but isnt a deal-breaker.Our data show that there is strong demand in this area even for those in less-than-ideal health.More than one-fifth of respondents in poor health report working,and the rates rise to 32 percent and 44 percent

74、for respondents in average and good health,respectively.There is an opportunity to both boost older adults participation in society and benefit society overall.While its intuitive to connect more economic impact with employment,this analysis also indicates that older adults who volunteer,participate

75、 in community activities,or further their education are potentially more likely to report better health,reducing their healthcare costs in turn(see sidebar“Isolation is complex”).Perceived health,by involvement and interest in societal participation,%of respondents reporting good or very good health

76、(n=20,677)1Questions:Which of the following activities are you currently engaged in?Which of the following activities are you not currently engaged in?How would you/older adult rate your/their health across each of the dimensions below?Simple average of self-reported health across each dimension.Exc

77、ludes participants with low health.Diferences greater than 3.5%are statistically signifcant at a 95%confdence level.Unmet demand.Source:McKinsey Global Healthy Aging Survey,2023Societal participation aligns with better perceived health.McKinsey&CompanyWeb Exhibit of Not doing but wants to Currently

78、doing and wants toEmploymentFormalvolunteeringEducation727465667669101628+7+8 percentage points+7Communityprograms187167+410Age is just a number:How older adults view healthy agingMany older adults who wish to work are unable to find a jobWhile the desire to work tends to decline with ageto 38 perce

79、nt for respondents aged 80 and older,from more than two-thirds of those aged 55 to 64a sizeable share of older adults report wanting to work.When evaluating the associated economic implications,there is the potential for$5 trillion in incremental annual GDP in HIEs.Across economies,19 to 25percent o

80、f survey respondents want to work but arent doing so.They most often cite a lack of attractive opportunities and difficulty in landing jobs as their primary barriers.534Not workingWorkingDoesnt wantto workWantsto work3072538Lack of attractive opportunitiesDifculty landing a jobSocietal ba

81、rriers(eg,mandatory retirement policies,cultural norms)Personal fulfllmentFinancial reasonsHealth reasonsTop 3 motivations cited among those wanting to work and doing soTop 3 barriers cited among those not working but wanting toOlder adults work and want to work in large numbers for reasons beyond j

82、ust fnancial.Employment preferences and status across lower-middle-income economies,%of respondents(n=3,927)Not workingWorkingDoesnt wantto workWantsto workDifculty landing a jobLack of attractive opportunitiesSocietal barriers(eg,mandatory retirement policies,cultural norms)Financial reasonsPersona

83、l fulfllmentHealth reasonsTop 3 motivations cited among those wanting to work and doing soTop 3 barriers cited among those not working but wanting toEmployment preferences and status across upper-middle-income economies,%of respondents(n=5,003)Not workingWorkingDoesnt wantto workWantsto workDifculty

84、 landing a jobLack of attractive opportunitiesSkills arent in demandFinancial reasonsPersonal fulfllmentHealth reasonsTop 3 motivations cited among those wanting to work and doing soTop 3 barriers cited among those not working but wanting toEmployment preferences and status across high-income econom

85、ies,%of respondents(n=11,747)Note:Diferences greater than 3%are signifcant at a 90%confdence level.Diferences greater than 3.6%are statistically signifcant at a 95%confdence level.1Question:Which of the following activities are you currently engaged in?Source:McKinsey Global Healthy Aging Survey,202

86、311Age is just a number:How older adults view healthy agingChallenges with finding a job and attractive opportunitiesRoughly three in ten respondents in LMIEs and HIEs cite“difficulty getting a job”as their top barrier to employment.10 Within countries,the range of respondents citing this as the top

87、 challenge is 25(in Malaysia)to 55 percent(in Mexico).Many respondents across economies name a“lack of opportunities”as a barrier to working.However,more respondents in LMIEs than in other economies also say“not knowing where to look for jobs”is a barrier.11 Could technology help with that challenge

88、?Barriers to employment,by country income archetype,%of respondentsNote:Diferences greater than 4.5%are signifcant at a 90%confdence level.1Question:Which of the following options describe the barriers you encounter to fnd work?Percentage of respondents intending to become employed in the next year

89、reporting as top barrier to employment.Source:McKinsey Global Healthy Aging Survey,2023Difculty landing a job and lack of attractive opportunities are greatest barriers to employment.McKinsey&CompanyI dont know whereto look for jobsMy skills arenot in demandSocietalbarriersLack of attractiveopportun

90、itiesDifcultylanding a jobHigh-income economies(n=1,274)Upper-middle-income economies(n=828)Lower-middle-income economies(n=589)27273029564010 For more,see Achieving equitable healthy aging in low-and middle-income countries:The Aging Readiness&Competitiveness Report 4.0,a joint report fr

91、om AARP and Economic Impact,2022.11 A further examination on the barriers and opportunities to societal participation will be published in summer 2023.12Age is just a number:How older adults view healthy agingDebunking the myth about older adults and technologyThe vast majority of survey respondents

92、 aged 55 to 64 use a smartphone;the percentage drops almost in half for residents aged 80 and older.When looking at countries,usage also varies widely.Three-fourths of those aged 80 and older in China have a smartphone,compared with less than one-third of that cohort in France.While more than 40 per

93、cent of those oldest respondents say they want to use a smartphone,and 25 percent say they want to use a laptop or tablet,there is a share uninterested in using technology.Roughly one in five respondents aged 80 and over are saying no to all technology products in their life.Within countries,that sh

94、are ranges from more than 40 percent(in Brazil and France)to under 10 percent in China,India,Nigeria,Saudi Arabia,and Sweden.These differences reflect a variety of factors,from access to interest to lifelong use.Respondents say the biggest barriers to technology adoption are around cost and a lack o

95、f knowledge,with the former more important for younger cohorts and the latter more important for older cohorts.Other barriers include lack of availability,lack of trust,and poor internet.To address these issues,its possible that lower costs and more education could help the oldest respondents.But gi

96、ven how the youngest cohort of older adults is invested in technology,there will be a naturally higher penetration of use among older adults over time.In other words,stakeholders are wise to start dismantling the idea that elderly people dont want,know how to use,or have a smartphone.Most desired te

97、chnology products,by age,%of respondents(n=21,022)Barriers to use of technology,by age,%of respondentsNote:Diferences between uplifts greater than 2.5%are statistically signifcant at a 95%confdence level.1Question:Which tools and devices would you want to use in your life?Only includes technology pr

98、oducts where at least 20%of respondents within one age cohort expressed a desire for specifc type of technology product.All uplifts are statistically signifcant at a 95%confdence level.Question:What are the barriers to using these tools and devices in your life?Source:McKinsey Global Healthy Aging S

99、urvey,2023Overcoming the knowledge gap is the key to greater technology adoption.McKinsey&CompanyExhibit of 80+65795564Dislike oftechnologyPoor internetcapabilityLack of trustAvailabilityTechnologicalknowledge gapCostNONEFitness watchOnline toolsSmart-home deviceLaptop or tabletSmartphone70614938324

100、04724208493525274Age is just a number:How older adults view healthy agingEconomic inequality poses challenges to healthMHI also tested older-adult adherence to behaviors shown to affect either the development or the progression of dementia.12 Our research

101、indicates that older adults need more support to follow healthy behaviors.Managing stress is the only behavior in which a majority of respondents across financial-situation cohorts report surpassing the minimum generally acceptable benchmark.Respondents least adhere to the behavior of“taking care of

102、 ones physical health.”Some of this could be attributed to financial situation;those who report living comfortably,with discretionary spending,are 73 percent more likely than their peers to eat healthy foods and subscribe to a balanced diet.Yet even for those who are financially stable,many are stil

103、l avoiding best health practices.Behavior dissonance isnt a problem unique to older adults;there are fathomless actions that individuals know are good for them yet dont do.However,the survey results are worrisome when contemplating the rising rate of cognitive decline.This ties into the need to addr

104、ess global povertys impact on healthy habits.Participation in healthy brain habits,by fnancial-situation cohort,%of respondents(n=21,022)Note:Diferences greater than 2%are statistically signifcant at a 90%confdence level.Diferences greater than 2.5%are statistically signifcant at a 95%confdence leve

105、l.Benchmarks based on best practice matching from academic-literature search to standardized scale used in survey:I keep stress at a manageable level(at least weekly);I take care of my physical health;I keep my mind active with meaningful activities;I eat healthy foods and subscribe to a balanced di

106、et;I make an efort to have good sleep hygiene(at least a few times per week).1Question:To what extent do you/does this person follow the below lifestyle behaviors?Source:McKinsey Global Healthy Aging Survey,2023Economic inequality aligns with poorer adherence to healthy brain habits.McKinsey&Company

107、Web Exhibit of 59636675465458635354423192232Well-managed stressSleephygienePhysicalhealthMind-activeactivitiesBalanceddiet Facing serious hardshipGetting by with current resourcesLiving comfortably with no discretionary spendingLiving comfortably with discretionary spendingMORE WEALTHYLES

108、S WEALTHY12 This was based on adjusted selections from the“Dementia prevention,intervention,and care”report by the Lancet Commission.14Age is just a number:How older adults view healthy agingOlder adults want to stay in their homes,but thats not always possibleNot surprisingly,most survey respondent

109、s want to stay in their homes as they age.However,living at home isnt without challenges for older adults.For example,those living alone may be at risk of having a sudden medical emergency without the ability to access help or a potentially life-threatening household problem(such as forgetting to tu

110、rn off the stove).Employing external supports(for example,a laundry service),using technology(such as remote monitoring),and embarking on home renovations(such as a ground-floor bedroom and ramps)could potentially let older adults stay in their homes longer.13 The discussions about how to plan for a

111、ging should start early,preferably in midlife(see sidebar“Living intergenerationally might benefit ones health”).Living situation and preferences,share of respondents(n=21,022)1Questions:Where do you currently live?What is your most preferred living situation as you age?Includes respondents living i

112、n a friends or relatives home/apartment,in a minimum-support unit/room,in a residential aged-care or memory care facility,or all other living situations not enumerated.Source:McKinsey Global Healthy Aging Survey,2023Eighty percent of older adults want to live in their own home,but not all are able.M

113、cKinsey&CompanyWeb Exhibit of 41 out of every 100 people living in their own home or apartment wish to remain there39 out of every 100 people living outside of their own home or apartment wish they were in a place of their own4 out of every 100 people live in their own home and dont want to16 out of

114、 every 100 people live outside of their own home or apartment and are happy where they areof those living in their own home or apartment wish toremain there91%of those not living in their own home or apartment wish they could71%13 For more,see Michele Lerner,“More older people are opting to age in t

115、heir homes.Heres how theyre doing it,”Washingtonian,March 13,2023.15Age is just a number:How older adults view healthy agingThe desire to remain independent can be a barrier to accessing careAll respondents report at least one unmet care need.Participants in UMIEs and HIEs report the desire to remai

116、n independent as the main barrier to accessing care.While thats also a concern for those in LMIEs,they report access to care and affordability as more pressing.These trends persist across gender and age cohorts.As populations age and dependency ratios increase,health stakeholders will need to ensure

117、 not only access to care and its quality but also responsiveness of available care to older adults desire to remain independent.This could include increasing the focus on in-home services and other community-based types of care.In this area,Norway is a lighthouse for its use of technology,such as ca

118、re coordination platforms and digital-key systems,and Singapore is a notable example of intergenerational care tied to health.14In upper-middle-income and high-income economies,the desire for independence trumps having care needs met.Barriers to the delivery of care and population reporting unmet ca

119、reneeds,by age and country income archetype,%of respondents(n=9,193)Desire for independenceLimited accessAfordabilityAt least one unmet care need5564High-incomeeconomiesUpper-middle-incomeeconomiesLower-middle-incomeeconomiesNote:Diferences greater than 4%are statistically signifcant at a 90%confden

120、ce level.Diferences greater than 5%are statistically signifcant at a 95%confdence level.1Question:What are the biggest challenges you face in getting support or assistance?Please select all that apply.Self-assessed challenges reported by those already receiving at least one type of care.Question:Whi

121、ch of the following areas would you like to receive support or assistance with but do not currently?Please select all that apply.Source:McKinsey Global Healthy Aging Survey,20233836431286852Desire for independenceLimited accessAfordabilityAt least one unmet care need6579High-incomeeconomi

122、esUpper-middle-incomeeconomiesLower-middle-incomeeconomies655233273929363475402521Desire for independenceLimited accessAfordabilityAt least one unmet care need80+High-incomeeconomiesUpper-middle-incomeeconomiesLower-middle-incomeeconomies302437273643535969171848McKinsey&Company14 For more,see The gl

123、obal roadmap for healthy longevity,National Academy of Medicine,June 3,2022.Age is just a number:How older adults view healthy agingAging well isnt only possible:its attainable.But to make this a reality for a rapidly aging population,global stakeholders should consider not only how to boost the num

124、ber of years in a life but also how to enable healthy life in those years.Some of this starts with reexamining assumptions.MHIs previous research found that many older adults report good overall health as they age,even as their physical health declines.15 The current survey results support that rese

125、arch.Even among those facing the greatest disease burden,up to 46 percent report good overall health.And when surveyed older adults cite lower physical-health scores,its notable that the rates of the other dimensions(mental,social,and spiritual)decline less rapidlyor even rise,in some countrieswith

126、older age.For example,in Japan,those aged 65 to 79 report the highest mental-,physical-,social-,and spiritual-health scores.One explanation for this could be that the other dimensions act as a buffer,protecting or mitigating the decline of peoples perception of their overall health despite a decline

127、 in their physical capabilities.The extent to which other aspects of health could compensate for the decline in physical health,and balance peoples view of their overall health,is a topic for further research.As we consider actions to add life to years,part of any solution will need to focus on what

128、 drives people to take action to stay in good health.Purpose and meaningful connections with others are critical contributors to good health,as our research indicates.And the underlying reasons for creating those connections and the definition of purpose vary.For example,our research on societal par

129、ticipation highlights the point that many older adults engage in activities for a variety of reasons,from staying healthy to being 16Perceived very good or good health,by age,%of respondents by number of chronichealth conditions(n=22,661)1Arthritis,cancer,cardiovascular diseases(heart disease);cogni

130、tive diseases(dementia,Alzheimers),diabetes and kidney diseases;high cholesterol;hypertension;chronic mental illness(eg,depression).Source:McKinsey Global Healthy Aging Survey,2023Respondents with chronic conditions do not necessarily see themselves as being in poor health.McKinsey&Company0Noconditi

131、ons(n=7,673)Onecondition(n=7,334)Twoconditions(n=4,198)Three or moreconditions(n=3,456)07080+657955-6415 Clment Desmouceaux,Martin Dewhurst,Daphn Maurel,and Lorenzo Pautasso,“In sickness and in health:How health is perceived around the world,”McKinsey Health Institute,July 21,2022.17Age i

132、s just a number:How older adults view healthy agingconnected to their communities and,for some,pursuing financial gain.The motivations are multifaceted,but providing opportunities to fulfil those motivations must be a critical priority for societies.Too often,society and individuals accept health de

133、clines as inevitablethe passing of time leading to physical deterioration.An important objective for many societies could be to ask“What would it take for more than half of people aged 80 and older to report good health over the next decade?What would it take to expand what it means to be in good he

134、alth at ages 60,70,80,90,and beyond?”For example,in forthcoming work,MHI will explore how a healthy city framework ties into older adults abilities to stay active,access care,and keep connected.Healthy aging also starts with individual actions,such as a person following behaviors proven to improve h

135、ealth,supported by an environment that makes them accessible to all.Its a lifelong journey,and its never too late to set out on the path to becoming well aged.If you would like to learn more about the McKinsey Health Institute 2023 Global Healthy Aging Survey and the additional data and insights MHI

136、 has from the survey,please submit an inquiry via the MHI“contact us”form.The McKinsey Health Institute,as a non-profit-generating entity of McKinsey,is creating avenues for further research that can catalyze action.Many older adults engage in activities for a variety of reasons,from staying healthy

137、 to being connected to their communities and,for some,pursuing financial gain.18Age is just a number:How older adults view healthy agingIsolation is complexNo one wants to feel alone.Consistent with existing research on social isolations harm,1 our analysis of responses from older adults finds that

138、isolation is a wide-ranging problem.Globally,10 to 20 percent of respondents report feeling isolated.Additionally,we find that more income doesnt necessarily help in this area.While an average of 12 percent of respondents in low-and middle-income economies report isolation,the share jumps to 19 perc

139、ent in high-income economies.What potentially helps is when older adults can participate in society.In the survey,higher societal-participation2 rates correlate to decreased isolation rates:by one-third in upper-middle-income economies and up to one-half in low-and middle-income economies.How much a

140、dults benefit from the activities varies by country,potentially reflecting different structures for societal participation and perceptions of what isolation means to an individual(exhibit).In two countries represented in the survey,India and the United States,jumping into societal activities seems t

141、o have a particularly large impact.The reported isolation rate is 8 percent for respondents in India participating in two or more activities,increasing to 33 percent for those who dont participate in any activities.In the United States,the increase is from 9 to 25 percent.Comparatively,respondents i

142、n the United Kingdom appear to benefit less from societal participation.For UK respondents reporting no participation in social activities,the isolation rate is 19 percent,which drops minimally for those who report participation in two or more activities.3Self-reported isolation,by societ

143、al-participation levels,%of respondents(n=20,677)1Saudi Arabia and United Arab Emirates excluded from HIEs in this analysis,as they show patterns closer to UMIEs and LMIEs in the topics considered,likely due to largely expatriate and migrant worker populations.Source:McKinsey Global Healthy Aging Su

144、rvey,2023Participation in societal activities aligns with lower self-reported isolation.McKinsey&CompanyTwo or more activitiesOne activityNo activities201010High-income economies(HIEs)Upper-middle-income economies(UMIEs)Lower-middle-income economies(LMIEs)Exhibit1 John T.Cacioppo and Stephanie Cacio

145、ppo,“Older adults reporting social isolation or loneliness show poorer cognitive function 4 years later,”Evidence-Based Nursing,April 2014,Volume 17,Number 2.2 Based on extensive literature review,we define“societal participation”as participating in at least one of the following activities:working,v

146、olunteering,pursuing education,and being active in community programs.19Age is just a number:How older adults view healthy agingLiving intergenerationally might benefit ones healthGood news for those planning to move in with their children:as noted in previous research,older adults often benefit whe

147、n they can live in intergenerational households.1 As part of our research in healthy aging,we looked at survey results for older people living intergenerationally(defined in our study as those living with their adult children).Respondents in that cohort who are retired and have low levels of care ne

148、eds tend to report being in better or much better than average health across dimensions compared with those not living with their children or spouse and children.This trend varies across economy archetypes,with the greatest benefits,especially related to physical and social health,in respondents in

149、low-and middle-income economies(exhibit).Moderate benefit is seen across all four health dimensions(mental,physical,social,and spiritual)by respondents in upper-middle-income economies.For respondents in high-income economies,those living intergenerationally report very little benefit from intergene

150、rational living.In some countries(such as the United States),stigma against intergenerational living may contribute to an observed decline in mental health.This research adds to an important body of evidence pointing toward the benefits of older people living with family,especially after retirement.

151、Coupled with the trend away from extended-or nuclear-family living,this evidence suggests an opportunity to create intentional,age-inclusive communities where older adults can interact with younger generationswhether family or otherwisein their daily lives.Perceived health of older adults living int

152、ergenerationally,percentage-point increase1Questions:Which of the following areas do you receive assistance with currently?Which of the following areas would you like to receive assistance with but do not currently?(Respondents who indicated they receive/desire to receive care in neither clinical su

153、pport nor personal support rated“low”;either clinical or personal support rated“medium”;both clinical and personal support rated“high.”)This analysis includes only those who have low-intensity care,defned as living with either their children only or with their spouse and children.Intergenerational(n

154、=170),nonintergenerational(n=191).Intergenerational(n=333),nonintergenerational(n=566).Intergenerational(n=479),nonintergenerational(n=2,407).*Statistically signifcant at a 95%confdence level.*Statistically signifcant at a 90%confdence level.*Statistically signifcant at an 80%confdence level.Source:

155、McKinsey Global Healthy Aging Survey,2023In lower-middle-income economies and upper-middle-income economies,older adults living with their adult children report better health.McKinsey&CompanyPhysical Mental Social SpiritualPhysical Mental Social SpiritualPhysical Mental Social SpiritualLower-middle-

156、income economies Upper-middle-income economies High-income economies+19*+5*+4*+3+2+3+2+3+5*+5+10*0Exhibit1 Faizan Bhatia and Raiya Suleman,“Intergenerational housing as a model for improving older-adult health,”BC Medical Journal,May 2021,Volume 63,Number 4.Designed by McKinsey Global PublishingCopy

157、right 2021 McKinsey&Company.All rights reserved.Hemant Ahlawat is a global leader of the McKinsey Health Institute(MHI)and a senior partner in McKinseys Zurich office,Anthony Darcovich is a consultant in the New York office,Martin Dewhurst is a senior partner emeritus in the London office,Ellen Feeh

158、an is a partner in the New Jersey office,Viktor Hediger is a senior partner in the Dubai office,and Madeline Maud is a coleader,healthy aging,at MHI and an associate partner in the Brisbane office.Designed by McKinsey Global PublishingCopyright 2023 McKinsey&Company.All rights reserved.Scan Download PersonalizeFind more content like this on the McKinsey Insights App