Diverging trends in health at older ages in England, 2004-2024: evidence from the English Longitudinal Study of Ageing

BackgroundGiven uncertainty about whether later-life health at similar ages is improving over time, we examined trends across multiple health domains. MethodsWe analysed data from community-dwelling adults aged 50 and older in the English Longitudinal Study of Ageing in 2004/05, 2012/13, and 2023/24 (main survey: N=8389, 8549, and 6090, respectively). Outcomes included self-rated health, limiting long-standing illness, pain, mobility limitations, cardiometabolic and chronic conditions, obesity, inflammation, mental health, quality of life, and memory. Weighted pooled modified Poisson and linear regressions compared outcomes over time, overall, and by age group and education, with additional adjustment for sex and wealth. ResultsAdjusted estimates showed divergent trends. Fair/poor self-rated health increased from 27% to 34%, and any pain from 37% to 47%, whereas mobility impairments declined from 58% to 52%. Self-reported high cholesterol increased from 19% to 39%, while biomarker-defined high cholesterol declined from 78% to 54%; diabetes increased on both measures. Psychiatric problems increased from 6% to 10%, quality of life declined, and memory improved. However, trends differed by age and education, particularly for limiting long-standing illness, mobility limitations, cholesterol biomarkers, and mental health, indicating that aggregate trends masked unevenly distributed changes. ConclusionLater-life health in England has not improved uniformly. Gains in functioning, biomarkers, and cognition coexist with rising pain and poorer mental health. Trends were also socially and age patterned, producing increasingly multidimensional and socially patterned health outcomes. Multidomain health monitoring is essential for interpreting population health trends and planning healthy ageing, prevention, long-term care, and work policies. Key pointsO_LIHealth at older ages in England changed in divergent rather than uniformly favourable directions between 2004/05 and 2023/24. C_LIO_LIImprovements in mobility, selected biomarkers and memory coexisted with rising pain, diabetes, poorer mental health and lower quality of life. C_LIO_LISelf-reported and biomarker-defined cardiometabolic trends diverged, highlighting the importance of how health is measured. C_LIO_LITrends differed by age and education, showing that population averages can conceal persistent or worsening disadvantage. C_LIO_LIMonitoring and planning for ageing populations should use multidomain health measures rather than chronological age or single indicators alone. C_LI