A demographic success story. The past century can be seen as a success story in terms of longevity: The average life expectancy in Switzerland, for example, for a girl born in 2023 was 85.8 years, and 82.2 years for a boy born in the same year. In 1948, the year the public social security and pension system was introduced, it was still 69 (women) and 65 (men) years (Swiss Federal Institute of Statistics, 2025).
Healthier for longer or just longer? As early as the 1980s, there was a debate about the extent to which this increase in years also means an increase in life, according to the motto “add life to years not just years to life”. “It's complicated!”, one might say, because aging is a complex, multifactorial and dynamic process. Not only are we living longer, but we are also living longer in good health, although the increase in lifespan and healthy lifespan occur at different rates. Depending on the exact health conditions and global region, there are signs of both compression as well as expansion of morbidity (e.g.,5,7) – and a need for a separation between objective morbidity and functionally meaningful impairments in the daily lives of people.
Commercialization of longevity – potentially interesting at best. Understandably – and of course desirable on the whole – there are many research efforts, especially in biomedical research that aim to gain a better understanding of aging processes in order to be able to influence them positively for longevity to coincide with added value not only in quantitative but also in qualitative terms. However, much of what is currently being discussed – and in some cases offered at very high prizes – currently must be considered at best as “potentially promising”. Many so-called scientifically based treatments and diagnostics advertised are based on (few) animal studies with sometimes contradictory results, investigate isolated factors rather than the holistic picture, and lack evidence of the transferability to humans and, above all, the human life and health span. This applies to many pharmacological but also behavioral interventions in the area of dietary supplements, cold chambers and other experimental treatments (e.g.,4).
Apart from scarce empirical underpinnings for very costly intervention offers, another critical point is the overtly ageist tone with which many “longevity clinics” operate. Moreover, in most approaches, responsibility for healthy longevity lies exclusively with the individual, without considering the central role of the environment and public infrastructure as an important field of intervention (and investment!) – but make no mistake, we are not living in a vacuum. Not to mention social inequality, which is inherent in many of the very expensive offers by definition, and already an inherent challenge from a public health perspective.
Enjoyment of life is more important than dietary supplements. The recently proposed WHO perspective on healthy aging focuses on functional ability (FA) as a key indicator to reflect aging well.10 In this perspective, FA results from the individual characteristics of a person interacting with their environmental conditions, and is naturally subject to dynamic change, as both the person and the environment are not static variables. Important aspects of functional ability are, for example, mobility and social integration, learning opportunities and social participation. They therefore relate to many of the empirically well-documented lifestyle factors for a long and healthy life. Even if objective physical health parameters lay important foundations for successful mobility and social activity, perceived meaning of life as experienced in terms of having a sense of purpose in life as it is lived is hardly apparent at the cellular level. The feeling of being a welcome and respected member of and contributor to society until old age can hardly be achieved through dietary supplements.
Subjective health despite objective limitations. From a psychological aging perspective, life gains its significance from supporting and facilitating dignity and self-determination for as long as possible and being able to strengthen age-related opportunities and gains over losses. From this perspective, “good” and healthy aging is explicitly possible even when faced with objective health impairments.1 The fact that the gain-loss balance across adulthood is often positive is indicated not least by the high level of life satisfaction (and subjective health) reported by the majority of older adults, especially in the so-called Third Age, despite increasing objective health restrictions.2 Only a few years before death does there appear to be a decline in well-being.6 Dealing with loss is largely achieved by actively shaping one's own life, by skillfully selecting the goals pursued and by flexibly adapting the means to achieve them.3 However, goal disengagement also becomes more important when resources are limited. To support individual action capacity and experience, however, age-friendly opportunities and structures are needed that allow personally meaningful activities to be carried out at any age.
“65+” – a heterogeneous group. Healthy aging, and therefore the experience of longevity, is also a multifaceted phenomenon. Older adults, e.g., from the age of 65, are a very heterogeneous group and live through a very diverse life with different phases.1 Far too often, this diversity is reduced to “65+”, to losses and deficits. Narrow-minded and incapable of learning, slow but wise, friendly, cagey and completely digitally clueless. This type of image of old age characterizes many current efforts to take the edge off aging and death. And yet there is solid evidence of the positive vs. harming and very costly long-term effects on health and longevity of positive and differentiated versus only deficit-oriented views on aging.8,9
Culture of aging. The well-known gerontologist Paul Baltes coined the term “culture of ageing”, referring to the need for an age-positive or resource focused framework of aging, even in the more vulnerable “fourth age”. This does not mean trying to stop or even reverse aging by all means, but rather learning to deal with age-related losses alongside preventative measures that could have a systemic public health effect rather than just a small-scale effect for the affluent few. It seems that we should definitely bring this culture of aging back to the fore in the current discourse on (healthy) longevity.
