An integrative framework for healthy aging: Advancing conceptual clarity and practical guidance

Abstract

To synthesize evidence on healthy aging in older adults, identify key determinants across interacting domains, and develop an integrative conceptual framework to inform practice, policy, and research. A scoping review was conducted following the Arksey and O’Malley framework and reported in accordance with PRISMA ScR guidelines. Peer reviewed and gray literature published between January 2019 and June 2025 were systematically searched. Studies on healthy aging among community dwelling older adults were included. Findings were synthesized across six integrative domains: physical health, cognitive capacity, psychological resources, social connections, spiritual orientation, and environmental supports. Fifty one articles were included. Healthy aging emerged as a multidimensional and adaptive process shaped by interactions across domains. Cognitive capacity was supported by education and cognitively stimulating lifestyles and reinforced by physical activity and social engagement. Psychological resources, particularly resilience and self efficacy, functioned as key adaptive mechanisms. Physical health remained foundational but was consistently influenced by psychosocial factors. Social connections, supportive environments, and economic capacity and resources enhanced participation, functional ability, and quality of life. Healthy aging results from interdependent individual and contextual resources rather than isolated determinants. This integrative framework supports holistic assessment, culturally responsive care, and policies that strengthen social and environmental supports in later life.

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