Population priorities for successful aging: a randomized vignette experiment

Objectives: Ageing populations have led to increasing interest in “successful ageing” but there is no consensus as to what this entails. We aimed to understand the relative importance to the general population of six commonly-used successful ageing dimensions (disease, disability, physical functioning, cognitive functioning, interpersonal engagement, productive engagement). Method: 2,010 British men and women were shown vignettes describing an older person with randomly determined favourable/unfavourable outcomes for each dimension and asked to score (0-10) how successfully the person was ageing. Results: Vignettes with favourable successful ageing dimensions were given higher mean scores than those with unfavourable dimensions. The dimensions given greatest importance were cognitive function (difference (95% CI) in mean scores: 1.20 (1.11, 1.30)) and disability (1.18 (1.08, 1.27)), while disease (0.73 (0.64, 0.82)) and productive engagement (0.58 (0.49, 0.66)) were given the least importance. Older respondents gave increasingly greater relative importance to physical function, cognitive function, and productive engagement. Discussion: Successful ageing definitions that focus on disease do not reflect the views of the population in general and older people in particular. Practitioners and policy makers should be aware of older people’s priorities for ageing and understand how these differ from their own