Article by Larisa Dina who is a researcher finishing her PhD at King’s College London. Larisa is writing exclusively for the Purposeful Group companies of which we are a part, (formerly Finitor) and is an expert on digital health.
By 2050, the world will count 1.5 billion people aged 65 and over*1 (1 in 6 people), despite that the gap between life expectancy and healthy life expectancy continues to widen - a gap with implications not only for health systems, but for individuals planning their financial futures. This means that the focus has now shifted from merely extending our lifespan to planning for our longer life.
The healthspan-lifespan gap
A 2024 study in JAMA Network Open*2, covering 183 WHO member states, shows how sharply this gap has grown. Between 2000 and 2021, life expectancy increased by 6.5 years. Nonetheless, healthy life expectancy increased by just 5.4, and the gap is widest in wealthy nations: 12.4 years in the United States, followed by Australia, New Zealand and the UK in fourth place with an 11.3 year-gap.
The latest State of Health and Care of Older People in England 2025 report*3 echoes this pattern. Healthy life expectancy has stalled or declined, particularly in deprived areas where older adults spend more than half their later years living with disability. The fastest-growing age group, the 85+, is placing mounting pressure on hospitals through rising admissions for frailty, dementia, falls and complex multimorbidity. Across the board, there are resounding signals that we live longer, but many of those extra years are lived in precarious health.
What drives healthy aging?
Thankfully, we now have several long-running cohort studies spanning decades to provide answers.
Relationships
The Harvard Study of Adult Development*4; which started in 1938 and has followed participants for more than 85 years, finds that the strongest predictor of health and wellbeing in later life is the quality of close relationships. Men most satisfied with their relationships at midlife were, at 80, the healthiest and happiest in the cohort. Social connection appears to buffer stress, protect cardiovascular health, and slow cognitive decline. If you read last month’s article, you might remember that connection is also a protective factor against dementia.
Lifestyle choices
Lifestyle choices exert a substantial and often independent effect, even in advanced age. A 2023 study in The Lancet Healthy Longevity*5, tracking 36,164 Chinese adults over two decades, found that those with high genetic risk for early mortality gained an additional 4.35 years of life expectancy by adopting healthy lifestyle behaviours. Benefits remained even when comparing siblings and twins, suggesting lifestyle has a causal influence beyond genes and early environment. Notably, beginning healthier habits at age 70 still produced meaningful improvements.
Diet plays a similar role. A 2023 Nature Food study*6 of nearly half a million UK Biobank participants estimated that shifting from a typical Western diet to a longevity-oriented pattern could add more than 10 years of life for a 40-year-old and around 5 years for someone aged 70. Even following the Eatwell Guide*7 captured the majority of the benefits, suggesting that reasonable changes such as making sure we get our 5-a-day, eating a variety of foods across different food groups and limiting processed foods is enough.
Financial stability
Financial wellbeing is an under-recognised predictor of long-term health. A 2021 JAMA Health Forum study*8 following 5,414 U.S. adults over 24 years found that higher net worth in midlife was linked with lower mortality. This finding held even after comparing siblings and twins who share early-life advantages. In addition, a 2023 JAMA Network Open study*9 of 8,082 older adults showed that sudden wealth loss, defined as losing 75% of assets within two years, increased dementia risk by 27% and accelerated cognitive decline. Financial shocks, in other words, are not only economically destabilising, but appear harmful for our health and wellbeing too.
Purpose
A growing body of research highlights a fourth determinant of healthy ageing: a sense of purpose, which is typically defined as a long-term, self-organising life aim that guides goals and behaviour. For instance, a large-scale prospective study in JAMA Network Open*10 from 2019 used data from 6,985 U.S. adults 50+ and found that those with the lowest life purpose had more than double the mortality risk compared with those with the highest. These findings were independent of demographics, health factors, depression and anxiety. This was supported by a 2014 Psychological Science study*11. It turns out that purposeful individuals lived longer across adulthood, regardless of age or employment status. In other words, purpose appears to help regulate stress and shape healthier behaviours.
Crucially, purpose also has financial implications: a stable financial foundation enables the mental space and the time to pursue meaningful activities, rather than directing all our attentional resources toward managing uncertainty.
The longevity strategy, in short
Taken together, the evidence above points to four pillars of longevity:
- Social capital: strong relationships that buffer stress and protect cognitive and cardiovascular health.
- Lifestyle behaviours: diet, movement, sleep and substance use.
- Financial planning: stable finances that protect against stress and the health consequences of economic shocks, plus allow us to maintain a healthier lifestyle and engage in activities that bring us a sense of purpose.
- Purpose: having a life aim promotes healthier choices and buffers psychological stress.
Why longevity matters for financial planning
With people living longer, our thinking around financial planning should also be adjusted. Many assume retirement spending falls sharply. In practice, the opposite is true. The early retirement years are often the most active, often filled with travel, hobbies and family, and spending tends to rise before it eventually tapers off. Any effective retirement plan must therefore fund more years of an active lifestyle, not just basic living costs.
This makes the science of longevity directly relevant to financial planning. The forces that determine whether those later years are lived well - think about the pillars of relationships, lifestyle, finances and purpose - also determine future care needs and costs. At the same time, structural pressures are shifting responsibility onto individuals. Public provision is strained, inflation remains high and the traditional “school-work-retire” model has given way to a more active, purpose-driven older age.
In practice, this shows that financial and health planning converge, and that good life investments are needed so that we can stay well enough to enjoy the life we’ve planned.
1 ohchr.org, 2 JAMA Network Open. 2024, 3 AGE UK, 4 Harvard, 5 The Lancet Healthy Longevity, 6 Nature Food, 7 NHS, 8 JAMA Network. 2021, 9 JAMA Network. 2023, 10 JAMA Network Open. 2019, 11 Psychological Science. 2014
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