A Florida State University researcher is part of a pioneering team that has developed a new measure to understand and support healthy aging, with the potential to change how health care workers, employers and policymakers assist older adults in remaining active and engaged.
Dawn Carr, director of FSU’s Claude Pepper Center and professor of sociology, is part of the multi-institutional research team that includes experts from Tufts University, University of Washington, Urban Institute and University of Michigan. Through their research, the team developed the Index of Aging in Midlife and Beyond (IAM+), a simple and accessible new tool designed to measure and predict healthy aging.
The IAM+ is a multi-domain measure of health that makes it possible to evaluate changes in aging from midlife and beyond, which can inform the design of early interventions that may lead to improved quality of life for adults as they age. Its simplicity and accessibility make it a powerful tool for tracking health and engagement at midlife when early health challenges often go undetected, with potential applications in research, policy and clinical practice.
“The solvency of our future workforce and health care system depends on researchers identifying ways to move the needle in improving the health of our rapidly aging population,” Carr said. “With tools like the IAM+ measure, we are better positioned to identify public health strategies and individual health behaviors that can increase the number of years people can remain actively engaged in meaningful activities.”
Traditional measures of aging often focus on advanced disability or single aspects of health, missing early signs of decline. The IAM+ index fills this gap by providing a multidimensional, accessible and reliable measure of health and functioning starting in midlife before severe disability sets in — and unlike expensive biomarker-based tools, relies on publicly available survey data, making it easy to implement and track over time.
The IAM+ is a 10-item scale that assesses a range of health domains, including self-reported overall health, eyesight, hearing, memory, chronic conditions, depressive symptoms, functional capacity and difficulties with daily activities and is intended to be used alongside contextual information. Scores range from 0.8 to 10, with higher scores indicating worse health and functioning. The index was developed using data from the Health and Retirement Study, a large national survey of Americans aged 51 and older.
“With tools like the IAM+ measure, we are better positioned to identify public health strategies and individual health behaviors that can increase the number of years people can remain actively engaged in meaningful activities.”
– Dawn Carr, director of the FSU Claude Pepper Center
One area of increasing importance is the health and well-being of older workers in the United States. The team’s research showed that people with physically demanding jobs in midlife already have significantly higher IAM+ scores (worse health) and experience accelerated aging as they move into later life. Even after retirement, those who worked in strenuous roles continued to show elevated scores compared to peers in less demanding jobs. This “scarring effect” suggests that workplace exposures can have lasting impacts on health.
Higher IAM+ scores in midlife also predicted reduced engagement in activities a decade later, including early labor force exits, less volunteering and lower exercise levels. Over 20 years, higher scores were linked to increased frailty, higher mortality risk and greater health care needs.
“Among the most robust health-protective behaviors linked to healthy aging are volunteering and exercising,” Carr said. “If early health declines restrict our ability to participate in these kinds of activities, we face further risks that contribute to poorer quality of life as we age.”
The IAM+ index works well for both men and women and shows differences by race and education. The index can provide insight into steps that can be taken to help everyone as they age:
- Early intervention: By identifying health decline in midlife, the IAM+ enables earlier interventions to prevent disability and promote healthy aging.
- Workplace policy: Employers and policymakers can use the IAM+ to design safer, more supportive work environments and retraining programs for older workers.
- Retirement planning: The index highlights the need for flexible retirement policies that account for differences in aging trajectories, especially for those exposed to health-harming work environments.
- Targeted public health tactics: The IAM+ can help identify groups at risk of accelerated aging due to structural inequalities, guiding targeted public health and social support efforts.
“This measure offers an exciting new tool for researchers to use as we work to isolate the most important factors that best help us stave off health problems until the latest stages of life,” Carr said.
Carr is also a faculty affiliate for FSU’s Pepper Institute on Aging and Public Policy, which is housed in FSU’s College of Social Sciences and Public Policy along with the Claude Pepper Center.
For more information about FSU’s Claude Pepper Center, visit claudepeppercenter.fsu.edu.