Increased life and disability free life expectancy are among the motors transforming later life. However, such changes have not made old age less feared or unwelcome. Utilising the framework of the social imaginary of the fourth age to examine this apparent paradox this paper will suggest that later life is often overshadowed by fears of frailty, dementia and suffering. Recognising the power of this social imaginary is critical to understanding how ageing is negotiated and how it shapes tensions and expectations among older people. This paper argues that what is now becoming regarded as ‘real’ old age sets new challenges for ageing populations that go beyond ‘unsuccessful’ ageing or the focus on financing social and health care. Instead there needs to be an acceptance that such fears of old age are of real anticipated futures and these should be addressed.