Social Gerontology – Neda Agahi group

Our research is in the field of social gerontology, focusing mainly on various aspects of inequalities in aging and old age. We study the lifestyle, social relations, health, and disabilities of today’s older adults, and how and why they change over time and in connection with different life events.

Research news

Our research

Ongoing projects

Aging in flux: How changing behaviors and lifestyles in the new cohorts are reshaping old age

PI: Neda Agahi

Old age is changing – both the timing of when one is considered to enter “old age” and what the lives of people in “old age” contain. Yet we know little about how these changes in life courses and behaviors come about. What has become apparent during the Covid-19 pandemic is how little is known about the older population and its heterogeneity, which hampers the possibility of addressing the “70+” group in a nuanced way.

This project will generate new knowledge about the behaviors, lifestyles, and inequalities among today’s oldest old (80+) in Sweden, and the trajectories of various behaviors that lead up to the oldest ages. The overarching question is, do today’s older adults age differently with regard to trajectories of behaviors and lifestyles compared to previous birth cohorts of older people? Focus will be on changes in social and leisure activities, physical activity and diet, and alcohol consumption. Gender and socioeconomic inequalities, as well as their interplay, are central throughout the project.

We will follow and compare separate birth cohorts – people born in the 1910s, 1920s, 1930s and 1940s – from pre-retirement to advanced old age, to examine their trajectories of aging. We will use nationally representative longitudinal data (LNU and SWEOLD) covering a period of over 50 years. The project will increase our knowledge of the “new old” and the processes involved in shaping old age behaviors and lifestyles in the new cohorts of older people. Understanding the dynamic nature of aging and behavioral trajectories is important for societal planning and development in order to create age-friendly societies.

Why are some people resilient when faced with adversities in later life and other not (Bounce back)?

PI’s at ARC: Johan Fritzell and Neda Agahi. Overall PI: Tine Rostgaard, Roskilde University and Stockholm University

We follow individuals 60+, after age-typical losses (loss of family member or physical functioning), across subgroups, birth cohorts and in different societal contexts (Sweden, Ireland, Poland, and Spain, in comparison with other European countries), and examine what may explain whether they return to their initial level of mental well-being or see a continuous decline. We argue that it is essential in ageing societies to understand the multi-factorial mechanisms behind the ability to bounce back.

Our approach enables a comprehensive understanding of psychosocial resilience. In the quantitative analyses, we use trajectory modelling to explore the heterogeneity and dynamics of resilience after age-related losses and link these trajectories to factors at micro-, meso- and macro-levels, in order to identify the mechanisms of protective factors.

We use longitudinal survey data with multiple follow-ups: the Swedish Level of Living Survey (LNU) and SWEOLD studies, and for the comparative analysis, the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Irish TILDA study. The high response rates in SWEOLD allow for follow-ups of subgroups into very high ages while SHARE/TILDA data, with biannual follow-ups, allow analyses of cross-country variation and the influence of macro-level factors, such as participation and enabling environments, also using indicators from the Active Ageing Index (AAI).

In the qualitative approach, we investigate individual narratives of resilience in 4 countries which represent different welfare models and placements in the AAI. With analysis of policy context and qualitative interviews in each country, we explore differences and similarities in meanings of resilience, and aspects articulated as being central.

Our multi-national research team has excellent competences in both qualitative and quantitative analyses and we collaborate with senior and civil society organizations in the four countries who are part of implementation and dissemination of findings. The project is funded by the Swedish Research Council for Health, Working Life and Welfare and will run from 2022 until 2025.

Improving population health in the older population: is there a trade-off between efficiency and equity?

PI: Johan Rehnberg

In Sweden, the Netherlands and other modern welfare states population health has improved; life expectancy has increased, and mortality rates decreased in all ages. However, inequalities in health have persisted or even increased. In other words, not everyone in societies with modern welfare states have benefited equally from improvements in population health. This project aims to examine the distribution of several risk factors for ill-health in the older population and examine how improvements in population health potentially leads to increased health inequalities. The results from this project will show whether there is a trade-off between improving health and reducing inequalities in old age. Such information is important for future policies aim to implement population wide preventive measures for risk factors that may or may not have unintended consequences for health inequalities.

Does inequality increase among older persons in Sweden? A multidimensional perspective

The number and proportion of older persons in Sweden is skyrocketing. Already in 2020, the number of people 75 years and above will pass 1 million. To study and analyse living conditions and inequalities among older persons is therefore of utmost importance. We do this from a multidimensional perspective and against a background of worrying trends and differences in incomes at older ages. In contrast to most other EU-countries, Sweden has, according to Eurostat data, experienced increases of relative poverty, and has one of the largest gender gaps in income among older persons.

An overall aim of this project is to study if these trends are also apparent in more detailed and multidimensional analyses of welfare and living conditions among persons aged 75+. We will also use this perspective to advance the Active Ageing Index that was developed during European year of active ageing in 2012. We will incorporate the inequality dimension into the index but also make it more relevant for the oldest old. In one subproject, we will focus specifically on the income gradient in mortality among the older segments of the population. The income-mortality relationship has lately been studied intensely. However, despite the fact that the vast majority of all deaths in rich countries nowadays occur at old age these studies have rarely ever included persons above working-age.

PI: Johan Fritzell

Implications of residential location in midlife disability and cognitive functioning among the poor vs. rich: within the US and cross-country comparisons

PI: HwaJung Choi, co-investigator: Stefan Fors


Inequality dynamics over the life course: Family and policy influences

PI: Johan Fritzell

This research program illuminates how life-long interplay between our socioeconomic conditions; our family situation, including inter-generational exchanges (of material and social support); and the health and social care system of the place we live shapes health and economic inequality later in life. We aim to provide evidence on the extent to which major welfare state institutions influence inequalities and on how to best combat inequalities via broad policy interventions.

The project has four parts. The first, Life-course influences on unequal living conditions, examines how childhood conditions and trajectories of education, employment, and health influence financial and health resources later in life. It also investigates the impact of working life disruptions (e.g., unemployment), family disruptions (e.g., divorce), and retirement on subsequent financial and health resources. The second, Inequality impact of health care and social services, examines whether changes in Sweden’s health and social care system have led to increasing inequalities among older people and their families. The third, Family as an institutional agent – influences within and across generations, studies the roles of gender, social class, and marital status in late-life inequalities. It also examines whether intergenerational transfers of money, time, and social support increase solidarity or inequality. The fourth, Combatting inequality: policy evaluation using comparative and quasi-experimental approaches, examines whether welfare state programs can influence inequality in mortality and health in the older segments of the population. It also investigates whether prolonged compulsory education has reduced a variety of later inequalities, particularly health inequalities related to parental social class.

We will use data from the Swedish Level of Living Survey, the Swedish Panel Study of Living Conditions of the Oldest Old, and multiple other sources, including but not limited to national Swedish registries, interviews with hospital patients, and European databases.


Divergence and convergence: how health inequalities evolve as we age.
Fritzell, J., Rehnberg, J.
In Hoffmann, R. (ed.) Handbook of Health Inequalities Across the Life Course Cheltenham: Edward Elgar Publishing. 2023: 307-326

Impact of the COVID-19 pandemic on Swedish adults aged 77 years and older: Age differences in lifestyle changes.
Augustsson E, Von Saenger I, Agahi N, Kåreholt I, Ericsson M
Scand J Public Health 2023 Jul;51(5):764-768

Why Are Old-Age Disabilities Decreasing in Sweden and Denmark? Evidence on the Contribution of Cognition, Education, and Sensory Functions.
Badache AC, Mäki-Torkko E, Widen S, Fors S
J Gerontol B Psychol Sci Soc Sci 2023 Mar;78(3):483-495

Heavy alcohol consumption before and after negative life events in late mid-life: longitudinal latent trajectory analyses.
Agahi N, Morin L, Virtanen M, Pentti J, Fritzell J, Vahtera J, Stenholm S
J Epidemiol Community Health 2022 Apr;76(4):360-366

Trends in the shape of the income-mortality association in Sweden between 1995 and 2017: a repeated cross-sectional population register study.
Rehnberg J, Östergren O, Fors S, Fritzell J
BMJ Open 2022 Mar;12(3):e054507

Growing Income-Based Inequalities in Old-Age Life Expectancy in Sweden, 2006-2015.
Fors S, Wastesson JW, Morin L
Demography 2021 Dec;58(6):2117-2138

Trends and Inequality in the New Active Ageing and Well-Being Index of the Oldest Old: a Case Study of Sweden. Fritzell, J., Lennartsson, C., Zaidi A.
Journal of Population Ageing 2021 Feb; 14: 5–22

Interdependent pathways between socioeconomic position and health: A Swedish longitudinal register-based study.
Rehnberg J, Östergren O, Esser I, Lundberg O
Soc Sci Med 2021 Jul;280():114038

Do socioeconomic inequalities in pain, psychological distress and oral health increase or decrease over the life course? Evidence from Sweden over 43 years of follow-up.
Celeste RK, Fritzell J
J Epidemiol Community Health 2018 Feb;72(2):160-167


Research support

  • The Swedish Research Council for Health, Working Life and Welfare (Forte)
  • The Swedish Research Council (VR)

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Postal address

Aging Research Center, Department of Neurobiology, Care Sciences and Society
Karolinska Institutet
SE-171 77 Stockholm

Visiting address

Tomtebodavägen 18 A, Widerström Building, floors 9 and 10
SE-171 65 Solna

Map to Widerström building, Tomtebodavägen 18a, Solna

Gerontology, specialising in Medical and Health Sciences (specialising in Social Sciences to be 50999) Public Health, Global Health, Social Medicine and Epidemiology Sociology (excluding Social work, Social Psychology and Social Anthropology)
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