Trajectories of health in the 1921-26 cohort of the Australian longitudinal study on women's health

The world’s population is ageing, and the oldest age group is the fastest growing segment of the population in developed countries. This thesis aimed to investigate whether the last years of life, which for more and more people are occurring at a greater age, are spent in good or poor health. Specifically, the work in this thesis investigated heterogeneity in the ageing experience of older Australian women, by estimating trajectories of physical functioning, mental health, and sleep, in late life. Baseline predictors for the maintenance of good health, and change in health, were explored. We found that the ageing experience is highly varied, with some older women experiencing excellent physical health, mental health, and sleep. However, we also found sub-groups of women who did not age well. Factors associated with ageing well included entering old age in good health, at a healthy weight, participating in regular physical activity, fewer chronic diseases, higher education, and having no financial difficulty. These findings regarding the diversity of the ageing experience have implications for public policy. Public policy largely focuses on the physical care needs of older persons, and lacks programs tailored towards preventing poor health and maintaining good health. This reactive approach, dealing largely with the needs of older people who are already in poor health, misses a valuable opportunity to maximise the potential of others to remain in good health, and to capitalise upon them as a valuable resource. While current policy providing care and support for those in poor health should be maintained, also required are a greater number of preventative policies to ensure more people reach old age in good health, as well as policies aimed at maintaining good health throughout later life.