Is Health Deterioration Unidirectional? Evidence from Monastic Populations in Austria and Germany (2012–2022)

Paola Di Giulio , Vienna Institute of Demography of the Austrian Academy of Sciences
Marc Luy, Vienna Institute of Demography

A central assumption in demographic health research is that health declines progressively with age. Many analyses model the relationship between age and health as linear or unidirectional, assuming a constant rate of deterioration over time. Yet, recent studies have suggested that health trajectories may be more complex, with transitions not only toward poorer health but also toward recovery. Empirical tests of the pattern of age-related health changes, particularly those integrating expected or perceived changes in health, remain rare. This study examines whether the perceived trajectories of health change with age follow a unidirectional trend. We use data from the Cloister Study, a longitudinal survey of monastic populations in Austria and Germany, selecting the waves conducted in 2012, 2017 and 2022. By studying monastic populations, characterised by uniform living conditions, cohesive communities, and limited socio-economic heterogeneity, this research provides a quasi-experimental setting to explore the ageing process. Specifically, we analyse how respondents evaluate past changes in their health based on a unique question that asks them to select from nine pictures of health trajectories. These trajectories represent different possible paths of health change, which may be linear, unidirectional, or non-monotonic. Our findings contribute to understanding whether health deterioration follows a steady, unidirectional course with age or whether it takes more variable forms—such as temporary declines, recoveries, or alternating improvements and setbacks. The results also provide new insights into the accuracy and predictive validity of subjective health perceptions, enriching the interpretation of self-rated health measures in demographic surveys.

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 Presented in Session 33. Aging, Frailty and the Dynamics of Later-Life Health