Lifestyle determinants of health and well-being in middle-aged and older adults: A narrative review
Abstract
The global epidemiological transition from communicable to non-communicable diseases presents an unprecedented challenge to modern healthcare systems, particularly as populations age rapidly. This narrative review synthesizes evidence on the multifaceted lifestyle determinants of health and well-being among middle-aged and older adults. While previous reviews have examined individual risk factors or delivery models in isolation, this review uniquely synthesizes individual lifestyle behaviors with structural care systems under the unifying lens of socioeconomic health poverty. Primary lifestyle factors, including diet and regular physical activity, are essential for maintaining “health stock,” yet their persistence is heavily influenced by socioeconomic status and “time poverty.” Health information signals, such as diagnoses of chronic conditions, can serve as critical “wake-up calls” that prompt healthier behaviors, though their effectiveness varies across income and education levels. This review also focuses on the social and structural dimensions of health, specifically informal caregiving burdens and social isolation. Informal care often leads to health deterioration for caregivers, while living alone is linked to increased long-term care needs. Continuity of care is a vital longitudinal framework for managing chronic diseases like hypertension and diabetes, reinforcing medication adherence and reducing mortality. However, the COVID-19 pandemic introduced substantial disruptions to these healthcare pathways, revealing deep-seated socioeconomic disparities in health outcomes and well-being. By integrating longitudinal survey data and systematic reviews, this review underscores the necessity of integrated, person-centered care models. Effective policy design must prioritize mitigating socioeconomic barriers and addressing “health poverty” to support healthy aging and ensure the sustainability of healthcare systems.