I'm good at all of these. Quality of life is great even with a useless left arm and hand.
The new signs of aging well: mental sharpness, independence, and emotional peace
Fact checked by Nick Blackmer
- A new survey from HEALTH found that most Americans value quality of life over simply living longer.
- Respondents said emotional well-being, independence, and staying mentally active are key parts of aging well.
- Experts say healthy habits can help support these goals and improve quality of life as you age.
This article is part of HEALTH’s Longevity Insights Report.
Longevity is a major focus in wellness culture, with some people turning to strategies like peptide stacking and intensive health tracking to help them live longer.
But HEALTH’s new survey suggests that Americans aren’t just chasing longer lifespans—they also want to live well. For many respondents, that means staying sharp, independent, happy, and energized.
That emphasis on quality of life tracks with what Florence Comite, MD, an endocrinologist and attending physician at Lenox Hill and Northwell Hospitals in New York City, also sees in her practice.
“Like a lot of the respondents in this survey, my patients are less engaged in the idea of ‘hacking death’ or living forever,” she said. “They want to continue to have a big impact in the world. They still have so much to do.”
What Aging Well Means to Americans
Americans don’t just want to live well—they value it more than having a longer life. In HEALTH’s Longevity Insights Report, conducted this spring among 1,000 adults and representative of the broader U.S. population, 73% said they would rather focus on living better, however long that is, than on living longer.
Related video: Scientists can predict how well you'll age - years before it happens (TED) When asked what “doing well” means, 89% of respondents pointed to being free of serious illness or disease—but many also singled out factors that are more related to living well. The same percentage said being mentally sharp and clear is a sign of good aging, followed by financial stability, emotional well-being, living independently, having the energy to do enjoyable things, and being mobile and active.As one 25-year-old survey respondent put it: “I just want to live a happy and fulfilling life.”
To experts who treat and study aging populations, the idea that people want their later years to be meaningful—not simply longer—makes a lot of sense. “Some people fear death, but most of us fear suffering more,” said Erin Emery-Tiburcio, PhD, a professor of psychiatry and behavioral sciences at Rush University and co-director of the Rush Center for Excellence in Aging. “Who wants to live longer just to suffer? Not many people.”
In a separate question, roughly half of survey respondents said that they’d prefer a shorter life if it meant maintaining a high quality of life and vitality throughout.
Zachary Bittinger, MD, a clinical assistant professor of family and community medicine at The Ohio State University Wexner Medical Center, said this kind of thinking reflects a recent broader cultural shift in conversations around aging—from simply extending lifespan to improving “healthspan” and quality of life.
It’s a change that Bittinger said more accurately reflects reality, and one that Emery-Tiburcio welcomes. “This idea that we can beat aging suggests that aging is bad, which means that older people are bad, which has serious negative health consequences,” she said.
Why Mental Sharpness Matters So Much
Respondents overwhelmingly singled out mental sharpness, or the speed and clarity with which your brain operates, as an indicator of healthy aging.
That’s not surprising to Comite, who said that, in her experience, people often fear conditions like dementia more than cancer.
“There is something deeply unsettling about the idea of our brain turning against us, that we will lose our memories, and not even recognize the people we know and love, including partners and children,” she added. “It’s a fear of no longer being you, while still being here.”
Of course, some degree of decline in memory, processing speed, and executive function is a natural part of aging, according to Emery-Tiburcio. But genetics can predispose someone to a disease like Alzheimer’s, and lifestyle factors like poor sleep, obesity, hearing loss, poor nutrition, stress and anxiety, and a sedentary lifestyle can also raise the risk of more serious cognitive impairment.
“The great news is that these are all under your control,” said Comite.
In addition to concentrating on healthy habits, there are other ways to support brain health as you age. Just think of your brain like a muscle: “If you use it regularly and strenuously, it will develop and strengthen,” said Bittinger.
Puzzles, challenging tasks or games, and learning new skills can all help keep the brain engaged.
The Overlooked Role of Emotional Well-Being
Another key sign of “doing well” for respondents was being “emotionally at peace,” and 92% said mental, emotional, or social health was their top focus area when it came to aging.
The results highlight the reality that emotional well-being can affect day-to-day life just as much as physical health, as well as a growing willingness to recognize its importance. “It’s no longer taboo to talk about one’s therapist at the dinner table or on TV,” Emery-Tiburcio said. “Emotional health has always been important, it’s just increasingly okay to talk about it now.”
Beyond the habits we already know support mental health, like getting enough sleep, managing stress, spending time with loved ones, and connecting with loved ones and your community, Bittinger’s advice for building emotional resilience is straightforward: know when and how to ask for help.
“Life is filled with stressors, grief, and fear,” he said. “Leaning into what we can handle builds up resilience, but only to a point. Having a doctor you trust is vital to start a discussion for when you might need a referral to a counselor, or perhaps start a safe medication to preserve your mental and cognitive wellbeing.”
Independence and Energy Are End Goals
Overwhelmingly, respondents said that living independently, having the energy to do enjoyable things, and staying mobile and active were key indicators of healthy aging.
“I’d love walking through Akhiabara in Tokyo when I’m 70, still playing Cyberpunk 2077, and being present for my kids and grandkids without my body falling apart,” said one 44-year-old male respondent.
A 59-year-old woman described her ideal vision of aging in a similar way: “I imagine being 90 years of age & walking on a hiking trail on a sunny day—in other words, healthy, mobile, & active.”
Having energy, in particular, is a barometer for overall health. “The number one reason people come to see me is a lack of energy,” said Comite. “It’s the output of so many things: Your nutrition, your sleep, your exercise, your stress level, your overall health, whether you are depressed.”
Unfortunately, when it comes to energy, “we’re all being robbed of it,” said Bittinger, noting that modern stressors like screens, social media, and the nonstop news cycle “will wear us all down eventually.”
However, getting enough exercise, sleep, and in-person social connection can help counter many of the factors that drain energy. “Treating our bodies well maintains our capacity for the day’s demands,” he added.
Disparities Play a Role
Still, experts noted that people aren’t on an even playing field when it comes to the resources that support healthy aging. Wealth inequality and other social barriers mean that access to these tools—and even the time to put healthy habits into practice—can vary quite drastically. In fact, 42% of survey respondents said cost was a major barrier to healthy routines, while 16% said their environment or circumstances make it hard.
While you can’t control your genetics and or every aspect of your circumstances, you can choose where to focus your time and energy. Comite pointed out that many habits associated with healthy aging are simple, inexpensive, and can be practiced every day. “Keep learning, keep laughing, keep friends and family close,” she said. “It’s all good for your brain.”
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