Factors that Predict Healthy Aging

“We are bombarded by contradictory information about what it means to grow old,” is how psychiatrist and Harvard Medical School professor George Vaillant begins his landmark book, Aging Well. He goes on to give us the facts, drawing from three separate longevity studies that tracked the lives of 824 individuals for more than 50 years, beginning in their teens. (The subjects included male Harvard graduates from the 1940s, a group of women from diverse backgrounds who were identified as “gifted” as children, and a group of inner-city male dropouts.)

In his reporting about healthy aging, Vaillant looked at the participants in later life and categorized them as happy-wellsad-sick or prematurely dead. He excluded  participants when it was not clear whether they were in the happy-well or sad-sick category. Vaillant found seven factors that distinguished the happy-well participants from the other two categories.

7 Factors That Predict Healthy Aging

  1. Not smoking or stopping when young –the single most important predictive factor in the study was “not being a heavy smoker before age 50.” In those who stopped smoking by about age 45, the effects could no longer be discerned at age 70 or 80.
  2. Adaptive coping style – our ability to turn lemons into lemonade. Vaillant called these “mature defenses.” This was found to be the second most powerful predictor of healthy aging across all three groups.
  3. Absence of alcohol abuse – this third major factor influences both physical as well as psychological health.
  4. Healthy weight – obesity, like smoking was found to be linked to bad physical health only.
  5. Stable marriage – a good, stable marriage was linked to both physical and psychological health.
  6. Some exercise – like good marriages, exercise was linked to both physical and psychological health.
  7. Years of education – this final factor, appear to be linked to self-care and perseverance. Vaillant theorizes that education promotes a sense of greater self-control and determination over one’s life, and facilitates physical and psychological health by fostering an “appreciation of the causal connections between personal behaviors and their consequences.”

The great news is that things we can control – our coping style, maintaining healthy weight, a sustained loving relationship (marital in most cases), avoiding tobacco and alcohol abuse, and even years of education –  are among the factors that foster positive physical and psychological aging. Also good news, Vaillant discovered that factors outside our control such as ancestral longevity, parental characteristics, and childhood temperament were among those ruled out.

Six Factors That Don’t

Vaillant also outline six factors that didn’t necessarily predict healthy aging. They are:

How long your parents and grandparents lived – we should be careful to point out that he makes a distinction between healthy aging and longevity. On one hand, ancestral longevity was shorter among those participants who had died young, but by age 70 to 75 there was no difference in ancestral longevity between the happy-well and the sad-sick groups.

  1. Cholesterol – Vaillant carefully points out the risk of cholesterol in earlier life, and especially in those who formerly had a heart attack; the study found that cholesterol levels “at age 50 did not distinguish the happy-well from the sad-sick or even from the prematurely dead.”
  2. Stress levels in earlier life – one might expect that stress earlier in life would influence health and old age, but the study found that the physical as well as psychosomatic symptoms associated with stress before age 50 did not correlate with physical health at age 75.
  3. Parental characteristics – characteristics about our parents and childhood family, variables that are important to younger adulthood, no longer hold sway among older adults.
  4. Childhood temperament – temperament is one of the many factors that might make a big difference in your quality of life as a young adult, but not so during later years. “After age 70 childhood temperament did not distinguish the happy-well from the sad-sick.”
  5. Vital affect and social ease – while these characteristics may lead to good psychosocial adjustment in young adulthood, the studies did not find a correlation between these psychological characteristics and healthy aging.

One more factor: Religion and spirituality

Many other studies have suggested a positive relationship between religion and overall well-being. Participation in religious and spiritual practices has shown to have an overwhelmingly positive effect on the physical and mental health of practitioners. However, Aging Wellpaints a different picture. As Vaillant points out, “a surprise of the study of adult development was that the presence or absence of either spirituality or religious adherence had little association with successful aging. It was hope and love rather than faith that seemed most clearly associated with maturity of defenses, with successful aging, and with generativity… neither religion nor spirituality was any more salient in old age than it had been in midlife.”

Vaillant points out a few factors that might explain the disparity between other studies about religion and the Aging Well subjects. Those who seek religion later in life, after a lifetime of not practicing, often do so because they face a significant difficulty – problems with health, and loneliness are among the most common. This isn’t to discount the value that religion can bring to your life. But, if you haven’t felt yourself becoming more religious or more spiritual with age, it doesn’t mean that you are outside the mainstream.


So, what does the Aging Well study mean for your future? Vaillant suggests that rather than looking at risk factors in one’s life, we should count up the number of positive factors outlined earlier, which he refers to as “protective factors.” He also suggests that there are four personal qualities that shape the future: (1) the ability to plan, anticipate and hope; (2) the capacity for forgiveness and gratitude (seeing the glass half-full, not half-empty); (3) love and ability to hold others empathetically; and (4) “the desire to do things with people, not do things to people, or ruminate that they will do things to us.” He points out that, in aging as in war, the best way to traverse the minefield is to follow carefully in the footsteps of others who have made it safely across. The message of the Aging Well study is not about pointlessly trying to stave off the inevitable, but not inviting it in prematurely, and enjoying the highest quality and most vital and satisfying life along the way.


Vaillant, G. E. (2002). Aging well: Surprising guideposts to a happier life from the landmark study of adult development. Boston, Little, Brown and Company.

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