Europe has the highest proportion of persons over 65 years compared with any other continent. While some persons remain relatively healthy with aging, others become vulnerable to stressors and frail. It is therefore important to study which populations are at a higher risk of frailty and other poor health outcomes. The care system is currently often characterized by a reactive, monodisciplinary approach focussed on one disease or condition. However, older persons often may have multiple physical- and social health problems. A preventive approach which is patient-centred instead of disease-centred and coordinated from primary care could provide a solution.

This thesis aimed to study,
1) the variation in indicators of healthy ageing among older persons in Europe, and,
2) the effects and process components of a coordinated preventive health and social care approach aimed at promoting healthy ageing in Europe.

This thesis showed that there appear to be large socioeconomic and ethnic inequalities in frailty among older persons. Further, a coordinated preventive health- and social care approach among older persons in varied European settings was received positively and showed promising results. However, the effects of such a coordinated preventive care approach on the health and quality of life of older persons could be greater when older person’s engagement in the approach is promoted.

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H. Raat (Hein) , A. van Grieken (Amy) , J.A.C. Rietjens (Judith)
Erasmus University Rotterdam
Department of Public Health

Franse, C.B. (2019, April 9). Healthy ageing in Europe : Variation and promotion among older persons. Erasmus University Rotterdam. Retrieved from