More people are living longer than ever before. Which makes the process of ageing more important than it’s ever been before. But one of the fundamentals of human existence—having purpose, a reason for living—is often completely overlooked as a key driver of both physical and mental health in later life. Here, we explore why the longevity burden is growing, how purpose shapes healthy longevity, and critique the “retire and rest” model whilst offering myriad ideas to effectively cultivate a sense of purpose in older adults.

In the UK alone, over 11 million people, nearly one in five, are now aged 65 or older, with that figure expected to reach a quarter by 2050. The United States shows the same pattern, with older adults projected to rise from 58 million to 82 million over the same period. Globally, this shift is even more striking, with the number of people aged 65+ expected to double to around 1.6 billion by mid-century.

But longer life does not mean better life. The reality of this growing longevity burden is that for many, these extra years are lived in poor health, often involving polypharmacy. Around 80% of adults over 65 now live with at least one chronic condition, and most manage multiple illnesses (multi-morbidity) along with the growing drug burden. On average, up to one-fifth of later life is spent in ill health, too often shaped by cardiovascular disease, dementia, diabetes and other long-term conditions.