![]() ![]() Similarly, two reviewers screened full texts, and reasons for exclusion were noted. The full text was retrieved for all included articles available online and by contacting authors. When consensus could not be reached, a third independent reviewer was consulted. Two reviewers independently screened the articles by title and abstract. ![]() Results were exported into EndnoteX8 for screening. When original papers of newly identified models from the reviews could not be found or were published in books, we included the earliest reference we could access that allowed the extraction of the model and noted this as a forward search paper. We also conducted backward search of the reference lists of included papers and a forward citation search for full-text review to identify other eligible articles not identified in our initial search. No limit on publication year or language was added. Lifespan development and psychology theories that tackle ageing outside the context of HA were excluded. We excluded empirical models from qualitative and quantitative studies, operational definitions and validations, studies on HA determinants and risk factors, and animal/experimental studies on mechanisms of ageing. We included published peer-reviewed original conceptual articles, concept analyses, and reviews only when these proposed new theoretical definitions or models with a normative description of ageing. ![]() The full search strategy per database is available in ( Supplement 1). The main search terms were healthy, successful, active, robust, positive, optimal, well, and productive ageing combined with definition, construct, model, theory, concept, and dimension. We aim to systematically review the literature on HA, analyze the theoretical models and definitions, explore the related normative terms and concepts, and produce a comprehensive thematic overview of what constitutes HA's dimensions, attributes, antecedents, and consequences.Ī search strategy was developed with the help of experts, adapted and completed across, Medline (Ovid), Cochrane CENTRAL, CINAHL, PsycINFO, and Web of Science until August 17, 2022. There is an ensuing need for a homogenized approach in understanding the use of terms referring to HA as well as mapping the characteristics of this concept. To the best of our knowledge, none of the available reviews takes on the basic task of rethinking the foundations of HA theoretical models and aim to set a clear basis for future studies by combining systematic review and conceptual analysis methods. older adult definitions and questions around the feasibility and desirability of HA. In contrast, more recent reviews are focused on critiques of existing models, exploring researcher vs. reflects on six frameworks of ageing well to construct a narrative around self-development that accompany life changes. Several researchers have taken on the task of reviewing and analyzing theoretical models of HA and its associated terms. 16, 17 This clarification has not proved to be simple. Understanding the theoretical grounds underpinning the operationalizations of HA is a requirement for two reasons: to advance empirical research on clear conceptual dimensions and outcomes across various populations and contexts and to consequently enable the implementation of evidence-based strategies targeting biological, demographic, social, psychological, and behavioural determinants of HA in these settings. ![]() 8, 9, 10, 11, 12, 13, 14, 15 Aligning concepts constitutes a priority action toward shaping policies and optimizing HA with targets set by WHO for 2030. 3, 4, 5, 6, 7 Perhaps the difficulty in achieving conceptual clarity in these terms lies in the complexities of the network of biological mechanisms underlying the ageing process, the different meanings of HA for different populations and contexts, and the ongoing debate on the concept of health. Past efforts in exploring HA show an explosion of normative terms, including active, resilient, and successful ageing, among many others, and a great heterogeneity in operationalizing conceptual models and definitions. However, many other definitions also exist. The WHO defines HA as maintaining a functional ability that enables individuals to meet their needs and contribute to society within their environment. 2 This raises the question of how to promote healthy ageing (HA) in the population. 1 This is of particular concern as this increase in life expectancy is often accompanied by increased years spent in ill health. The increase in life expectancy at birth and global demographic shift into an older age present unprecedented social and economic challenges to the modern world. ![]()
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