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Background Longevity is increasing in industrialised populations and there is growing interest in what constitutes and determines “successful aging” (SA). Previous work has largely focussed on disease and disability but there is growing awareness that this does not fully reflect the priorities of older people. We have used a broader six-dimensional model of SA and explored how it varies with socioeconomic position (SEP) across the life-course. Methods Analyses are based on two cohorts of 974 and 1,045 men and women living in the West of Scotland and aged around 57 and 76 after five follow-up waves (between 1987/8 and 2007/8). We explored associations between SA (based on absence of disease/disability; good physical/cognitive functioning; and good interpersonal/productive social engagement) and ten different measures of SEP (based on occupation, education, income, housing and financial difficulties) from childhood through to later adulthood. We considered overall SA score (from -1 = died to 6 = alive with all six positive dimensions) and individual SA dimensions, and examined associations with individual and cumulative SEP. Results Preliminary analyses show more successful aging among higher SEP individuals throughout the life-course, e.g. difference (95% CI) in SA score in non-manual vs. manual childhood, baseline and most recent social class = 0.72 (0.54, 0.89), 1.15 (1.00, 1.30) and 1.05 (0.90, 1.20) respectively. SA score and prevalence of positive SA dimensions also increased steadily with cumulative SEP, e.g. difference (95% CI) in SA score for additional favourable SEP measure = 0.22 (0.19, 0.24). The strongest SEP associations with individual SA dimensions were generally for good cognitive functioning and social engagement, particularly interpersonal. Conclusions Using a multi-dimensional SA model we have found that higher SEP individuals age more successfully than those with lower SEP and the impact of SEP is cumulative across the life-course. All individual SA dimensions are socially patterned with social engagement dimensions, which are not widely included in SA models elsewhere, among the most strongly patterned. Future work should explore mechanisms underlying these associations and establish when and what interventions will best address these inequalities. Key messages Successful aging and all its dimensions, most markedly cognitive functioning and social engagement, is strongly socially patterned and the effect is cumulative across the life-course. Evidence on SA associations with different SEP measures at different life stages will help to identify intervention points to reduce social inequalities in health and wellbeing in aging populations.
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