A Life Course Approach to Healthy Ageing

Healthy aging has long been a neglected area of epidemiological research as the traditional focus has been on specific chronic diseases of older life. There is a growing consensus from scientists, research funders and policy makers that ageing itself needs to be studied from an interdisciplinary and life course perspective, to inform strategies for reducing the societal and individual costs of an aging population.

A Life Course Approach to Healthy Ageing is a synthesis of life course perspectives in epidemiology and interdisciplinary perspectives in aging research. It brings together expert investigators of maturing birth cohort and aging studies, cross-cutting methodologists, and authorities in aging research and knowledge transfer from across the world in one wide-ranging volume.

Contributors discuss how aspects of healthy aging are conceptualised, defined and measured; relate to each other; change across life; and are influenced by biological, psychological and social factors operating from early life onwards. They identify research gaps, and suggest how evidence from observational studies can be strengthened through improved study design and longitudinal analysis, thereby increasing the research contribution to practice or policy change.

The book considers how we might delay or slow down the progressive, generalised impairment of function that occurs at the individual, body system and cellular levels, as people grow older. It also considers the determinants of wellbeing in older people, including personal fulfilment, positive emotions and social relationships.

Broad in scope, discussing topics from genetics to psychological and social wellbeing, A Life Course Approach to Healthy Ageing is a key resource for epidemiologists, social scientists, clinicians, public health physicians, policy makers and practitioners with a research interest in healthy aging.

Diana Kuh, Director, MRC National Survey of Health and Development and MRC Unit of Lifelong Health and Ageing, University College London, UK,Rachel Cooper, Programme Leader Track, MRC Unit for Lifelong Health and Ageing, University College London, UK,Rebecca Hardy, Programme Leader, MRC Unit for Lifelong Health and Ageing, University College London, UK,Marcus Richards, Programme Leader, MRC Unit for Lifelong Health and Ageing, University College London, UK,Yoav Ben-Shlomo, Professor of Clinical Epidemiology, School of Social and Community Medicine, University of Bristol, UK

Diana Kuh, Professor of Life Course Epidemiology at University College London, is the director of the MRC Unit for Lifelong Health and Ageing, and the MRC National Survey of Health and Development, the oldest of the British birth cohort studies that has followed up over 5000 individuals since their birth in March 1946. Diana is also the principal investigator of the Healthy Ageing across the Life Course (HALCyon) network and co-Director of an NIH programme on the Integrative Analysis of Longitudinal Studies of Ageing (IALSA) that brings together cohort studies to investigate lifetime influences on ageing.


Rachel Cooper is a Programme Leader Track at the MRC Unit for Lifelong Health and Ageing, University College London. Rachel has a BA in Human Sciences from the University of Oxford, an MSc in Epidemiology from the London School of Hygiene and Tropical Medicine and a PhD in Epidemiology from University College London. Rachel has experience of using data from a range of longitudinal studies to address research questions which have a life course perspective and has worked on the MRC National Survey of Health and Development since 2003. Since 2007 Rachel's primary focus has been on the unit's physical capability and musculoskeletal ageing programme and she has been heavily involved in the study of these measures across cohorts as part of the New Dynamics of Ageing Collaborative Research Programme - Healthy Ageing across the Life Course (HALCyon). Rachel is interested in all aspects of life course epidemiology and in applying this approach to the study of healthy ageing.

Rebecca Hardy is Professor of Epidemiology and Medical Statistics and is a Programme Leader in the MRC Unit for Lifelong Health and Ageing. She leads a research programme investigating the biological and social life course influences on cardiovascular ageing and the development of cardiovascular disease using data from the MRC National Survey of Health and Development and other cohort studies. She also has an interest in the methodology for the analysis of life course data and for cross-cohort comparisons.

Professor Marcus Richards is a Programme Leader at the MRC Unit for Lifelong Health and Ageing, and a Professor of Psychology in Epidemiology at the Faculty of Population Health Sciences, University College London. Marcus read Experimental Psychology at Oxford University, and obtained a PhD at London University in the physiology of human learning. He has held appointments at Columbia University in New York and King's College London Institute of Psychiatry to conduct research into neurodegenerative diseases of ageing, and was one of the first recipients of an Alzheimer's Society Research Fellowship. He joined the MRC National Survey of Health and Development team in 1996, where his work is primarily focused on developing a life course approach to mental ageing and its integration with physical health and function.


Professor Ben-Shlomo is a clinical epidemiologist and has been at the forefront of a life course approach to epidemiology both a theoretical and empirical level. He is involved with several cohort studies and has interests in ageing, neurodegenerative disorders, endocrine influences on health and equity of access to health care.

Part I. The life course perspective on healthy ageing
1. Life course epidemiology, ageing research and maturing cohort studies: a dynamic combination for understanding healthy ageing, Diana Kuh, Rebecca Hardy, Rachel Cooper, Marcus Richards and Yoav Ben-Shlomo
2. A life course approach to physical capability, Rachel Cooper, Rebecca Hardy, Avan Aihie Sayer and Diana Kuh
3. A life course approach to cognitive capability, Marcus Richards and Ian J Deary
4. A life course approach to psychological and social wellbeing, Catharine R Gale, Ian J Deary and Mai Stafford
Part II. Methods for studying ageing from a life course and interdisciplinary perspective
5. Design of life course studies of healthy ageing, Rebecca Hardy, Graciela Muniz-Terrera and Scott Hofer
6. Longitudinal data analysis in studies of healthy ageing, Graciela Muniz-Terrera and Rebecca Hardy
7. Modelling repeat exposures: some examples from life course epidemiology Supplementary web material, Andrew Wills and Kate Tilling
8. Propensity score matching and longitudinal research designs: counterfactual analysis using life course data in a longitudinal context, Sean Clouston
9. Understanding healthy ageing using a qualitative approach: the value of narratives and individual biographies, JD Carpentieri and Jane Elliot
Part III. Healthy ageing in body systems, organs and cells
10. A life course approach to neuroendocrine systems: the example of the HPA axis, Yoav Ben-Shlomo, Michael Gardner and Stafford Lightman
11. A life course approach to metabolic and vascular function Supplementary web material, Debbie A. Lawlor and Rebecca Hardy
12. A life course approach to healthy musculoskeletal ageing, Kate A Ward, Judith E Adams, Ann Prentice, Avan Aihie Sayer and Cyrus Cooper
13. A life course approach to biomarkers of ageing, Carmen Martin-Ruiz and Thomas von Zglinicki
14. Genetic aspects of ageing, Teri-Louise Davies, Tamuno Alfred and Ian Day
15. Life course epigenetics and healthy ageing, Paul Haggarty and Anne Ferguson Smith
Part IV. The way we live
16. Lifetime lifestyles I: diet, the life course and ageing, Gita Mishra, Marcus Richards, Seema Mihrshahi and Alison Stephen
17. Lifetime lifestyles II: physical activity, the life course and ageing, Ulf Ekelund
18. Lifetime lifestyles III: where we live, the life course and ageing, Emily Murray and Mai Stafford
19. Conclusions, Diana Kuh, Rachel Cooper, Rebecca Hardy, James Goodwin, Marcus Richards and Yoav Ben-Shlomo