Policies and strategies on active and healthy ageing: a scoping review of the recommendations of European and international agencies.

Abstract

Over the past six decades, life expectancy has significantly increased, with a concurrent decline in fertility rates, leading to unprecedented demographic shifts. These changes have deeply changed population structures and presented challenges for welfare systems, particularly regarding sustainability and intergenerational equity. This study aimed to review recommendations from major international organizations [e.g., the World Health Organisation (WHO), Organisation for Economic Co-operation and Development (OECD), European Union (EU)] to promote active and healthy ageing (AHA). A scoping review was conducted to identify policy-relevant documents published between 2008 and 2023 by major international and European organizations. The search strategy, carried out via Google using targeted search strings and snowballing methods, identified 33 reports to be included. Inclusion criteria required that documents be targeted to policymakers and present recommendations for promoting AHA. Documents focused solely on treatment, frailty, or child/youth interventions were excluded. Data extraction was carried out independently by two reviewers. The elaboration of the 33 included policy-oriented reports published between 2008 and 2023 yielded 554 actions. These were classified across 19 policy sectors and grouped into 14 cross-sectoral strategies to support healthy ageing. The most represented sectors were health (37.5% of actions), labor, social welfare, and civil rights. Strategies included enhancing access to quality services, reducing non-communicable diseases, supporting prolonged working lives, enabling ageing in place, tackling socio-economic divides, and fostering better laws. Specific interventions ranged from tax incentives for a healthy diet to flexible retirement policies, caregiver support, and urban planning for inclusive environments. There is a need for a multi-sectoral approach to policymaking, as healthy ageing promotion cannot rely solely on health policy. Focusing on preventive rather than disease-oriented actions, AHA policies must be grounded in equity, sustainability, and long-term planning. Despite limited rigorous evidence-often based on expert consensus-the study offers a practical classification system to guide national and local policy development. It provides a comprehensive framework to help governments shift from reactive healthcare to proactive, integrated approaches that promote lifelong wellbeing and support the sustainability of welfare systems amid demographic and epidemiological transitions.