Lifestyle behaviours and health span in older adults

As populations age, extending health span, or years lived in good health, is a global priority. Most evidence on healthy lifestyles and prolonged health span comes from middle- aged or comorbid populations, leaving it unclear whether benefits apply to healthy older adults. A study evaluated whether combined lifestyle behaviours are associated with disability-free survival in community-dwelling older adults.
The study included 11, 287 Australian participants (median age 74 from the ASPirin in Reducing Events in the Elderly (ASPREE) study, with a median follow- up of 6.6 years. Participants received one point for adherence to each of the following lifestyle factors: Mediterranean diet, moderate physical activity, non- smoking, and moderate alcohol consumption, and were categorised as having low (0-1 factors), moderate (2 factors), or favourable (≥ 3 factors) lifestyle. The primary outcome was a composite endpoint comprising the first occurrence of death, dementia, or persistent physical disability.
Associations of lifestyle categories with the composite endpoint and its individual components were examined, alongside effect modification by key demographic and health variables. Years gained in disability- free survival and compression of morbidity were calculated.
Compared with those with an unfavourable lifestyle, a moderate [HR 0.75 (95% CI 0. 65-0. 87)] and favourable [HR 0.60 (95% CI 0. 52-0. 70)] lifestyle were associated with a lower risk of the composite endpoint. A favourable lifestyle was associated with a 10% gain in years of health span and a moderate compression of morbidity. Associations did not differ across groups by age, sex, education, aspirin treatment, BMI, diabetes, and hypertension.
In healthy older adults, adherence to a healthy lifestyle was associated with a greater likelihood of surviving free from disability and dementia and was prospectively linked with a prolonged health span and a compression of morbidity, highlighting its potential importance in promoting healthy ageing.
Source: Robb, C., Carr, P.R., Ball, J., Pilekhina, G., Clayton-Chubb, D., George, E.S. et al. (2026). Association of combined lifestyle behaviors with healthspan in older adults. Journal of the American Geriatrics Society, 1–12.