Life expectancy has increased significantly - Thanks to advances in health, hygiene and nutrition, the average life expectancy in the US has risen from 47 years in 1900 to over 78 years today.
Lifespan ≠ healthspan - Many people spend the final years of their lives living with chronic illness, cognitive decline or disability.
Healthspan is a key - It’s not just about how many years we live, but how many of those years are spent in good physical, mental and social health.
Lifespan vs Healthspan: What’s the difference?
Lifespan - life expectancy
Lifespan, or life expectancy, refers to the total number of years an individual is expected to live. It’s a biological measure influenced by factors such as healthcare, environment, lifestyle and nutrition. Life expectancy has increased significantly in many developed countries. For example, between 1950 and 2020, global life expectancy increased from around 47 to 73 years. In some countries, such as Japan, it now exceeds 85 years.
This shift is widely regarded as one of the great achievements of modern civilisation. However, it comes with caveats. Many people now reach old age with significant functional limitations or chronic diseases.
Healthspan - healthy life expectancy
Healthspan, or healthy life expectancy, refers to the number of years a person lives without serious illness, disability or cognitive decline. It is the period of life during which an individual is physically and mentally active, self‑sufficient and able to fully participate in social life. From a public health standpoint, healthspan is arguably a more meaningful measure than lifespan alone.
According to WHO estimates, the global average healthspan is about 64 years, compared to a life expectancy of 73. That’s roughly nine years spent living with illness, limitations or a reliance on care.
An example of the difference
Imagine two men who both live to 85. The first remains active until the age of 80 – playing sports, travelling, working – and then develops a serious heart condition, spending his final five years in poor health. The second, however, begins suffering from diabetes, high blood pressure and frequent hospital stays from the age of 60. Although they have the same lifespan (85 years), their healthspans are very different: the first enjoys 80 years of good health, while the second only has 60.
A long life does not necessarily mean a good life
While life expectancy is increasing, the real question is: what is the quality of those extra years? Statistics show that many people spend the later stages of life coping with poor health – chronic pain, reduced mobility, dementia and a loss of independence. For some, this period of ill health can last decades.
Ageing and chronic diseases
Ageing naturally brings physiological changes, but it also increases the risk of developing so‑called "diseases of old age", including:
cardiovascular diseases
type 2 diabetes
dementia and cognitive impairment
chronic obstructive pulmonary disease
cancer
osteoporosis and arthrosis
sarcopenia and frailty syndrome
These conditions can significantly reduce quality of life, causing pain, reduced mobility, loss of independence and a growing reliance on others for daily care. They also place substantial pressure on healthcare and social support systems.
Impact on society and the economy
According to the World Health Organization (WHO), chronic diseases are the leading cause of death and disability worldwide, responsible for more than 70% of all deaths. Furthermore, up to four out of every five years lived with illness are linked to these conditions. From an economic perspective, the burden is enormous. The cost of medications, long‑term care, lost productivity and hospital admissions runs into trillions globally. As the ageing population grows, these costs are expected to rise dramatically.
Factors affecting healthspan
Healthspan – the number of years we live in good health and independence – isn’t simply a matter of luck or genetics. In fact, modern science confirms that we have significant influence over many of the factors that determine how well we age. While we can’t alter our genetic code, our lifestyle and environment play a crucial role in the rate at which we age and the quality of life we experience in later years.
Good health in old age begins in youth
A healthy lifestyle matters at every stage of life – but the earlier we start, the greater the long‑term benefit. From childhood onwards, factors such as diet, physical activity, sleep, stress levels, education and living conditions all shape our future health. Even adopting healthier habits in middle age can have a powerful impact. Research shows that it’s never too late to make meaningful changes that extend our years of wellbeing and independence.
1. Lifestyle
One of the most significant influences on healthy life expectancy is how we live day to day. Long‑term studies such as the EPIC‑Norfolk or FINGER trials highlight lifestyle as one of the most important positive factors:
Movement: Regular physical activity — even moderate activities like walking – reduces the risk of heart disease, type 2 diabetes, dementia and depression.
Nutrition: A Mediterranean‑style diet, rich in fruit, vegetables, whole grains, fish and olive oil, has been shown to lower the risk of chronic disease and slow cognitive decline.
Sleep: Chronic sleep deprivation speeds up inflammatory processes and biological ageing, increasing the risk of obesity and diabetes.
Stress management: Long‑term stress is linked with faster ageing at the cellular level, including telomere shortening.
Avoiding harmful substances: Smoking, excessive alcohol intake and a diet high in processed foods are major risk factors that negatively impact healthspan.
2. Prevention and access to health care
Regular preventive check‑ups allow early detection of risk factors and emerging health problems.
Early treatment of hypertension, type 2 diabetes or high cholesterol can prevent serious complications (e.g., heart attack or stroke).
Education on nutrition, exercise and healthy ageing promotes a proactive approach to one's own health.
3. Mental health and social connections
Loneliness, depression or loss of meaning in life can significantly reduce healthspan. In contrast, people with strong social networks are generally healthier, live longer and report greater happiness.
Meaningful activities, such as volunteering, mentoring, continued learning, or caregiving, boost mental and emotional resilience, even in later years.
4. Genetics and epigenetics
Genetics does play a role, but according to a study from the UK Biobank, genetics account for only around 2% of the risk of developing chronic diseases, whereas lifestyle and environmental factors account for up to 17%.
Epigenetics - the study of how behaviours and environment influence gene expression – suggests that we can, to some extent, override genetic predispositions. Positive lifestyle choices can help ‘switch off’ harmful gene expressions and support healthy ageing.
5. Social and economic factors
Individuals with less education, lower incomes, or poor access to healthcare tend to experience poorer health outcomes and shorter healthspans.
Better living conditions in early childhood, quality education and stable employment in adulthood are long‑term investments for a healthy old age.
How we can actively extend healthspan
Healthy ageing isn’t just a matter of luck or good genes – it’s largely shaped by the daily choices and habits we adopt.Scientific research consistently shows that lifestyle and environment play a major role in determining how many years we live in good health. The good news? Positive changes are beneficial at any age.
Below is a summary of science‑backed strategies that can help extend your healthspan:
1. Regular exercise
Physical activity is one of the most powerful tools for maintaining both physical and mental function. Just 150 minutes of moderate exercise per week (such as brisk walking) can significantly lower the risk of type 2 diabetes, dementia, cardiovascular disease and depression.
Combining aerobic exercise with strength training delivers even greater benefits. Building and preserving muscle mass is key to healthy ageing and maintaining independence.
Why is muscle mass important not only in old age?Muscles aren't just for movement - they have a vital endocrine function. Muscle tissue produces myokines – signalling molecules that influence inflammation, immune response and metabolism. Active muscles help reduce chronic inflammation, supporting overall health.
Muscles are an important organ for glucose uptake from the blood. When muscle mass declines, insulin sensitivity drops, increasing the risk of insulin resistance and type 2 diabetes.
Sarcopenia — the age‑related loss of muscle mass and strength – typically begins after the age of 30 and accelerates with age unless actively addressed. In later life, it can lead to a higher risk of falls, fractures, immobility and loss of independence.
Low muscle strength is associated with higher mortality, lower quality of life and longer hospital stays for illness or injury.
That’s why maintaining muscle mass and strength is one of the cornerstones of healthy ageing. Strength training twice a week – whether using your own body weight, resistance bands or light dumbbells – is a simple and highly effective way to maintain vitality, support metabolism and preserve independence well into later life.
2. Healthy and varied diet
Nutrition plays a vital role in supporting health at every stage of life – but it becomes even more crucial in older age. As we age, changes in metabolism, hormone levels, digestion and appetite mean that a well‑balanced, nutrient‑rich diet can help prevent chronic diseases, preserve muscle mass, maintain energy levels and support functional independence.
Basic nutritional recommendations for prolonging healthspan:Adequate caloric intake: It is important to stay within a healthy body fat range. Both undernutrition and obesity can negatively impact healthy ageing.
Adequate quality protein: Adults are advised to consume 1.2–1.6g of protein per kilogram of body weight per day to preserve muscle mass and strength. Protein also aids recovery, supports immunity and increases satiety, which helps prevent overeating.
Sufficient fibre: Aim for 25–30 grams of dietary fibre per day. Fibre supports gut health, improves digestion, regulates blood sugar and helps lower cholesterol.
A minimum of 500g of fruits and vegetables per day: That’s around five servings a day. Fruits and vegetables are rich in antioxidants, polyphenols, vitamins and minerals – all of which help protect cells, strengthen the immune system and reduce the risk of chronic illness.
Prioritise whole foods: Choose foods that are minimally processed. Whole foods are more filling, provide better nutritional value and help manage calorie intake while supporting long‑term health.
3. Preventing obesity and metabolic disorders
Excess fat – particularly around the abdomen – contributes to chronic inflammation and increases the risk of type 2 diabetes, heart disease, stroke and dementia.
Evidence from a Swedish registry study found that individuals who were obese in middle age had up to 2.5x the risk of developing dementia later in life.
4. Sleep and recovery
Quality sleep is not simply passive rest – it’s an active biological process essential for the recovery of both body and brain. Despite its importance, sleep is often overlooked as a pillar of healthy ageing. Poor sleep doesn’t just affect your energy levels the next day – it can reduce your healthy life expectancy (healthspan) over time.
What does sleep affect?Caloric intake and appetite: hort or interrupted sleep disrupts hormone regulation – increasing ghrelin (the hunger hormone) and reducing leptin (the satiety hormone). This leads to heightened appetite, particularly for sugary and high‑calorie foods, increasing the risk of overeating and obesity.
Physical activity: Lack of sleep reduces energy and motivation to exercise. People with poor sleep tend to move less, leading to lower energy expenditure, increased fat storage and eventual muscle loss.
Brain "detoxification": During deep sleep, the glymphatic system – the brain’s self‑cleaning mechanism – becomes active, clearing out metabolic waste such asbeta‑amyloid, a substance linked to Alzheimer’s disease. Poor‑quality sleep slows this process and increases the risk of cognitive decline.
Insulin sensitivity and metabolism: Sleep deprivation impairs the body’s response to insulin, raising blood sugar levels and increasing the risk of type 2 diabetes. Even one night of reduced sleep has been shown to lower insulin sensitivity in healthy adults.
5. Social connection and meaningful activity
Strong social connections and a sense of belonging are protective factors against cognitive decline and depression.
People who have meaningful goals, hobbies and social involvement age more slowly and live longer.
6. Stress management and mental health care
Mental wellbeing is a crucial – and often underestimated – factor in healthy ageing. Research shows that mental health is not just a result of physical health, but also a predictor of longevity, functional independence and disease risk.
Why is mental wellbeing important?Chronic stress disrupts hormone levels (e.g. byraising cortisol), weakens the immune system and contributes to metabolic disorders such as insulin resistance and inflammation.
Poor mental health – including loneliness, low mood, loss of purpose, or emotional numbness – is associated with faster physical and cognitive decline.
Studies show that higher levels of psychological wellbeingare linked to a lower risk of chronic illnesses, including heart disease, depression, dementia and frailty syndrome.
7. Education and cognitive activity
The brain is like a muscle — the more we use it, the better it works. Studying, reading, playing games, music or learning a language promote neuroplasticity and delay cognitive decline.
8. Combining as many protective factors as possible
No single intervention is as powerful as combining several healthy lifestyle strategies. For instance, the FINGER study – one of the most comprehensive studies on ageing – found that in older adults at risk of dementia, combining a nutritious diet, regular physical activity, cognitive training and proactive management of health risks significantly slowed cognitive decline.
What to take from this
It’s not just about living longer – it’s about living well. A long life spent battling illness, dependency or isolation is not the goal.
Genes are not destiny. While genetics play a role, lifestyle, environment and daily choices have a much greater influence on how healthily we age.
Healthy exercise, quality diet, adequate sleep and mental well‑being form the foundation for a long and healthy life. Each of these pillars can be strengthened even in advanced age.
Muscle health is for everyone, not just athletes. Building and maintaining muscle mass supports metabolism, independence and protection against falls and chronic disease.
Healthy ageing is an investment. Every step toward better habits today can mean more years in health tomorrow.
