TProtective Factors for Sustaining Robustness in Older Adults: An 8-Year Multinational Longitudinal Study Using SHARE...

Frailty is a widely recognized clinical syndrome of ageing. While most studies emphasize risk factors for frailty, little is known about the protective mechanisms that sustain robustness in later life. This study addresses this gap by identifying longitudinal predictors of robustness among older adults.

We analyzed eight years of longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE; Waves 4-8, 2011-2020) across 27 countries, including 7,865 adults aged 65-84, stratified into younger-old (65-74) and older-old (75-84) groups. Logistic regression models estimated odds ratios for maintaining robustness, incorporating sociodemographic, health, lifestyle, functional factors.

Robustness declined steadily over time, with 52% of younger-old adults and 26% of older-old adults remaining robust after eight years. Across all models, better self-rated health (OR ≈ 0.72, p < 0.001), fewer chronic conditions (OR ≈ 0.89, p < 0.001), and greater financial security (OR ≈ 1.11, p = 0.018) were the strongest and most consistent predictors of sustained robustness. Engagement in moderate physical activity and participation in social and cognitive activities further contributed to resilience, though their effects were stronger among younger-old adults compared with the older-old.

This study contributes to ageing research by examining sustained robustness, rather than frailty progression alone, as a longitudinal outcome in a large multinational cohort. By highlighting behavioral, psychosocial, and functional determinants of resilience, it frames robustness as a measurable and actionable outcome in ageing research and practice. These findings promote a more balanced and positive conceptualization of ageing-one that emphasizes not only preventing frailty, but actively maintaining robustness as a core scientific and clinical objective.