Later generations of Europeans over 50 had more physical and mental capacity, with ever smaller gains

Whether today’s 60-year-olds are in better shape than their parents were at the same age is more than a dinner-table argument. Pension ages, retirement savings and care budgets are all planned around the answer. Two years ago, long-running surveys in England and China gave a yes. In England, researchers found that a 68-year-old born in 1950 had higher capacity than a 62-year-old born ten years earlier.

A study published on October 1 in The Lancet Healthy Longevity has now run the same test across continental Europe, on 80,105 adults aged 50 or older in 10 countries who were interviewed repeatedly between 2004 and 2022. People born in later decades had more physical and mental capacity when they entered the survey than earlier generations had, according to the researchers’ model, and they lost it more slowly over the following decade. Two results temper that good news. The improvement got smaller with each newer generation, and it went disproportionately to people higher up the social ladder.

The work was led by John Beard of Columbia University with Meimei Chen and Yuanyuan Gu from Macquarie University and Katja Hanewald of the University of New South Wales in Sydney, the same group behind the English study. Their English and Chinese work had pointed to improving health in later life. What nobody knew, they wrote in setting up the new analysis, was whether the same held “in other countries, in adults younger than 60 years, or across socioeconomic groups”. The European data let them test all three.

What intrinsic capacity measures

The measure at the center of the study comes from the World Health Organization. In 2015 its first world report on aging redefined healthy aging around functional ability, which it described as the combination of the intrinsic capacity of the individual with the places they live and how the two interact. Intrinsic capacity is the person’s half of that equation, the composite of all the physical and mental capacities an individual has, whether or not their surroundings help.

Researchers usually break it into five parts, and this study followed that pattern. Together the parts cover a person’s ability to move, think, see, hear and remember, along with mood and vitality, the physical reserves that show up as strength and steady weight. In the European survey the team drew on, interviewers tested immediate and delayed memory, word fluency and arithmetic in person, timed people standing up from a chair and measured their grip, while participants answered questions about their mood, hearing, eyesight, sleep and weight.

Rolling them into one score lets researchers follow people who are still well. Counts of severe disability, as the team has argued before, say little about the functioning of people who are managing fine at 58, while a capacity score can register a slow slide long before anything goes wrong. It also predicts what comes next. A 2024 meta-analysis pooled 37 studies with 206,693 participants to test the association of intrinsic capacity with functional decline and mortality. People with higher scores were less likely to lose the ability to manage daily tasks, and their risk of death over follow-up was lower by roughly two-fifths. Decline is common, too: a separate review of 15 studies put the share of community-dwelling older adults with some loss of capacity at 67.8%, more than two-thirds.

“It can predict the onset of limitations in daily activities and mortality,” Hanewald, an insurance economist, said of the score in a university profile of the work.

How the SHARE survey compared generations born 40 years apart

The data came from SHARE, a European survey of health, aging and retirement that has interviewed the same people repeatedly since 2004. The team used seven waves from 2004 to 2022 and participants in Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden, and Switzerland. Between them, the 80,105 respondents gave 222,761 interviews. Their average age across those interviews was 67.7, and 54% were women.

Each person’s capacity score was tracked across their repeated interviews, so the analysis could estimate two things separately: how much capacity people had when they first joined the survey, and how fast it fell afterward. The team then asked how both quantities shifted with year of birth and reported model-based predictions for specific birth years: 1920, 1930, 1940, 1950 and 1960.

Nobody was watched across a whole lifetime. Those born in 1920 were already in their 80s when SHARE began, and people born in 1960 did not turn 50 and become eligible until 2010. The oldest generation’s decline was therefore observed in their 80s and 90s, and the youngest one’s in their 50s and early 60s. Comparisons between the earliest and latest birth years rely on the model linking generations whose ages overlap, and so on how well it separates the effect of birth year from the effect of age. In their English study, the same team checked this by making direct comparisons of capacity in participants of different cohorts at the same age, and the improvements were still large.

What changed in intrinsic capacity from one generation to the next

On both counts, later birth years came out ahead. Participants born more recently had higher intrinsic capacity at study entry, and their capacity declined more slowly over the following decade. The same pattern appeared in each of the five parts of the score, from memory to mobility.

The size of the improvement, though, was not constant. The gains in capacity at entry became progressively smaller for the most recent birth years, and the slowing of decline weakened as well. “It looks like we may be reaching some kind of ceiling effect,” Hanewald said. “The latest cohorts are seeing smaller gains, possibly because they are already starting from relatively high levels.”

Countries started in different places and moved by different amounts. Italy, where the 1920 generation had some of the lowest scores, showed larger gains in intrinsic capacity at study entry than Switzerland, which had started higher. By the 1960 birth year the gap between the two at entry had shrunk by roughly three-quarters. The pattern reversed for the rate of decline, where Switzerland improved more. On the model’s estimates, the yearly loss of capacity for the 1960 generation in both countries was a small fraction of what it had been for the 1920 generation, though the two were observed at very different ages.

Women gained more than men, which narrowed a gap that once favored men. “Earlier-born women had lower intrinsic capacity than men. But the gains for more recently born women were larger than for men, progressively narrowing the difference,” Hanewald said.

The socioeconomic story ran the other way. The researchers split participants into four groups by socioeconomic status, and the gains at entry across birth years were larger in higher socioeconomic status groups than in the lowest one. With each generation, then, the gap between the most and least advantaged widened.

The study does not test why any of this happened. In the university profile, Hanewald suggested that better access to education, nutrition, health care and sanitation may have contributed, and that as room for further progress in those areas narrows, so may the gains. In their English and Chinese work, the same researchers listed possible causes including broad societal influences and improvements in medical care, with the example of a person whose arthritic hip, once disabling, can now be replaced.

How European capacity trends compare with England, Denmark and the US

The European results agree with the team’s own earlier work in direction, but not in one telling detail. In England and China, the authors reported that improvements were large, “with the greatest gains being in the most recent cohorts”. In continental Europe the newest generations gained least. Whether that difference reflects the countries, the years covered or the measures used is not something either paper can settle.

Independent research points the same way for the oldest Europeans. A Danish team led by Kaare Christensen compared 2,262 Danes born in 1905 and assessed at 93 with 1,584 born in 1915 and assessed at 95. Despite being two years older at assessment, the 1915 group did better on both the cognitive tests and the activities of daily living score, which the authors took as a sign that more people were living to older ages with better overall functioning.

The United States is a warning that progress is not automatic. Using national health surveys of more than 680,000 adults, Hui Zheng and Paola Echave found that measures of physical wear and tear worsened steadily from Baby Boomers through late-Generation X and Generation Y. Later-born Americans had worse readings at comparable ages on measures such as metabolic syndrome and a urine marker of chronic inflammation. Their measures differ from intrinsic capacity, so the two sets of results are not directly comparable, but they show that generational health can move in either direction.

Where the comparison of generations falls short

It describes averages. The study reports the typical path of each birth year in each group. The team’s earlier paper acknowledged that this approach probably masks significant intracohort heterogeneity, meaning large differences between people born in the same year.

Survivors only. The people born in 1920 who answered SHARE questions in their 80s were the ones who had survived and were well enough to take part. In their English and Chinese study the authors argued that any resulting survivor bias would probably make the positive trends look smaller than they are, because the frailest members of older generations were missing.

Some parts are self-reported. Hearing, eyesight, mood and sleep came from participants’ own answers. The same team has noted that reporting habits, and changes in access to hearing and visual supports such as hearing aids and glasses, may affect trends in those areas, though their steepest improvements in England and China were in parts measured objectively.

Ten western European countries. None of the countries is in eastern Europe, and the results may not transfer to the US, where generational trends look different.

No cause. This was an observational description of change over time. It cannot say whether schooling, medical care, smoking, diet or something else is responsible, or which of those would have to keep improving for the gains to continue.

The work was paid for by an Australian Research Council program for population aging research and Velux Stiftung, a foundation.

What the intrinsic capacity results mean for later life

On average, later-born Europeans in this study reached their 50s and 60s with more in reserve than their grandparents did, and kept it longer. The authors’ conclusion is less celebratory than that sounds: the positive trends, they wrote, are unequally distributed and could be reaching a ceiling, and “Policy makers cannot assume that these trends will continue.” How an individual’s own physical and mental capacity is changing is assessed by their doctor.

Hanewald drew a broader point from the widening gap between socioeconomic groups. “There are a lot of things we can still do as a society to help people maintain capacity in older age. But we can also act earlier across the life course to help younger people maintain a healthy trajectory as they get older,” Hanewald said.

The generation born around 1960 has, on these measures, the most physical and mental capacity of those SHARE has followed, but its lead over the one before is the smallest yet, and it is not shared evenly.