University of Oulu

Aalto, U.L., Knuutila, M., Lehti, T. et al. Being actively engaged in life in old age: determinants, temporal trends, and prognostic value. Aging Clin Exp Res 35, 1557–1563 (2023).

Being actively engaged in life in old age : determinants, temporal trends, and prognostic value

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Author: Aalto, Ulla L.1,2; Knuutila, Mia2,3,4; Lehti, Tuuli2,3,4,5;
Organizations: 1Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
2Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
3Primary Health Care Unit, Helsinki University Hospital, Helsinki, Finland
4Social Services and Health Care, City of Helsinki, Helsinki, Finland
5Oulunkylä Rehabilitation Center, Helsinki, Finland
6The Finnish Association for the Welfare of Older Adults, Helsinki, Finland
7Center for Life Course Health Research, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: Springer Nature, 2023
Publish Date: 2023-08-30


Purpose: Recently, the concept of successful ageing has shifted from healthy ageing to active ageing, the latter emphasising even more the subjective perspective. Active agency is a marker for better functioning. However, the concept of active ageing lacks a clear definition so far. The specific aims of the study were to identify the determinants of being actively engaged in life (BAEL), to explore the changes in BAEL over 3 decades, and to explore the prognostic value of BAEL.

Methods: This is a repeated cross-sectional cohort study of older (≥ 75 years) community-dwelling people in Helsinki in 1989 (N = 552), 1999 (N  = 2396), 2009 (N  = 1492), and 2019 (N  = 1614). The data were gathered by a postal questionnaire at each time point. Being actively engaged in life was defined by two questions “Do you feel needed?” and “Do you have plans for the future?”, which was further converted into BAEL score.

Results: An increasing temporal trend in BAEL score was observed through the study years. Male sex, good physical functioning and subjective health, and meaningful social contacts were determinants for higher BAEL score. Active agency measured by BAEL score predicted lower 15-year mortality.

Conclusions: Older home-dwelling, urban Finnish people have become more actively engaged in recent years. The underlying causes are diverse but improved socioeconomic status observed over the study years was one of them. Social contacts and not feeling lonely were found to be determinants for being actively engaged. Two simple questions describing active engagement in life may help to predict mortality among older people.

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Series: Aging clinical and experimental research
ISSN: 1594-0667
ISSN-E: 1720-8319
ISSN-L: 1594-0667
Volume: 35
Issue: 7
Pages: 1557 - 1563
DOI: 10.1007/s40520-023-02440-9
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Copyright information: © The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit