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	Healthy Aging Index Construction	Successful Aging Operationalization
Field	Social Gerontology	Social Gerontology
Family	Process / pipeline	Process / pipeline
Year of origin	2014	1997
Originator	Jason L. Sanders, Anne B. Newman, and colleagues (Cardiovascular Health Study; Long Life Family Study)	John W. Rowe and Robert L. Kahn (MacArthur Foundation Research Network on Successful Aging)
Type	Composite physiologic index of multisystem biological aging	Operational framework for defining and classifying successful aging
Seminal source	Sanders, J. L., Minster, R. L., Barmada, M. M., Matteini, A. M., Boudreau, R. M., Christensen, K., Walston, J. D., Newman, A. B. (2014). Heritability of and mortality prediction with a longevity phenotype: the healthy aging index. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 69(4), 479-485.	Rowe, J. W., & Kahn, R. L. (1997). Successful aging. The Gerontologist, 37(4), 433-440.
Aliases	HAI, Healthy Ageing Index, Multisystem Healthy Aging Index, Physiologic Aging Index	Rowe-Kahn Successful Aging Model, Successful Aging Criteria, MacArthur Successful Aging Framework, Three-Component Successful Aging
Related	4	4
Summary	The Healthy Aging Index (HAI) is a simple composite that summarizes the burden of subclinical physiologic decline across several organ systems into a single score. Introduced by Jason Sanders, Anne Newman, and colleagues in 2014 using the Cardiovascular Health Study, it captures the idea that biological aging is a multisystem process rather than the failure of any one organ. The index combines five readily measured markers, one from each of five physiologic systems: systolic blood pressure (vascular), fasting glucose (metabolic), Mini-Mental State Examination score (cognitive), serum creatinine (renal), and forced vital capacity (pulmonary). Each marker is scored 0, 1, or 2 according to which tertile of risk an individual falls into, and the five scores are summed to give a total from 0 to 10, with higher values indicating worse aging. The HAI predicts mortality and was shown to be heritable, supporting its interpretation as a phenotype of biological aging. Its appeal lies in being inexpensive, transparent, and built from routine clinical measurements rather than specialized assays.	The Rowe-Kahn model operationalizes successful aging as a positive, multidimensional state rather than the mere absence of decline. In their landmark 1997 Gerontologist paper, John Rowe and Robert Kahn argued that gerontology had overemphasized average or 'usual' aging and neglected those who age well, and they proposed a concrete three-part definition. An individual is aging successfully when they simultaneously meet three criteria: low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life through productive activity and interpersonal relationships. Crucially, the model treats these as a hierarchy that must be met jointly, so success is defined by the conjunction of all three components rather than excellence on any one. The framework drew on the MacArthur Foundation Research Network's longitudinal studies and reframed aging as something partly within individual and societal control. It became one of the most cited and most debated organizing frameworks in social gerontology, spawning both widespread application and vigorous critique. Its enduring contribution is a clear, testable template for what 'good' aging means and how to classify it.