HEALTHSPAN-LIFESPAN TRADE-OFF UNDER ACCELERATED BIOLOGICAL AGING - Evidence from the Health and Retirement Study

Sep 28, 2026

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Healthy life expectancy has not kept pace with rising life expectancy, leaving a widening HLE–LE gap reflecting years lived in poor health. This study tests whether accelerated biological aging alters transitions across health states and changes the balance between healthspan and lifespan, with emphasis on socially disadvantaged groups. Using longitudinal U.S. Health and Retirement Study data, biological aging is quantified with the Pace of Aging metric and health transitions are modeled via continuous-time Markov multi-state methods.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Abstract

Background: HLE–LE gap

Methods: Pace of Aging and multi-state modeling

Findings: transitions, poor-health duration, group differences

Implications: inequities and intervention targets

1070 Innovation in Aging, 2025, Vol. 9, No. S2 Abstract citation ID: igaf122.3600 HEALTHSPAN-LIFESPAN TRADE-OFF UNDER ACCELERATED BIOLOGICAL AGING: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY Heming Pei1, Arun Balachandran2, Yifan Shi3, and Daniel Belsky4, 1. UNC Gillings School of Global Public Health University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States, 2. Columbia University, New York City, New York, United States, 3. New York University, New York, New York, United States, 4. Columbia University, New York, New York, United States While life expectancy (LE) has increased globally, the rise in healthy life expectancy (HLE) has not kept pace. This widening gap between HLE and LE—years lived in poor health—could be impacted by the pace of physiological deterioration. This study investigates how accelerated biological aging affects transitions between health states and to assess how it contributes to the compression or expansion of healthspan relative to lifespan, and whether this effect is more pronounced in socially disadvantaged groups. Using longitudinal data from the U.S. Health and Retirement Study, we quantified biological aging with the Pace of Aging metric. Health transitions—including chronic disease, functional decline, cognitive impairment, and death—were modeled using a continuous-time Markov multi-state approach to simulate and calculate healthspan and lifespan across different aging profiles. The analysis revealed that individuals with faster pace of aging had increased risk of transitioning from healthy to unhealthy states, more so than the risk of death once already unhealthy. This imbalance led to an extended duration of life spent in poor health. The HLE–LE gap was consistently wider among those aging faster across all outcomes. And this effect was strongest in individuals with lower educational attainment, minority status, or unhealthy behaviors, suggesting systemic inequities amplify the impact of biological aging. Accelerated biological aging predicts shorter healthy life and exacerbates health inequities. Interventions aimed at slowing biological aging may yield dual benefits—improving overall population health and reducing disparities in how long and how well people live.

FAQs

What problem does the study address regarding healthspan and lifespan?

It addresses the growing gap between healthy life expectancy and life expectancy, reflecting more years lived in poor health.

How is accelerated biological aging measured in the study?

Biological aging is quantified using the Pace of Aging metric from longitudinal Health and Retirement Study data.

What modeling approach is used to analyze health transitions?

The study models transitions, including chronic disease, functional decline, cognitive impairment, and death, using a continuous-time Markov multi-state approach.

Sep 28, 2026

Upload by McQueen