Survival expectations alter health habits asymmetrically
In 10,878 older adults, regular exercise dropped only when survival expectations fell, whereas paid health checkups increased only when expectations rose.
The Journals of Gerontology, Series B
In a study of 10,878 South Korean adults aged 45 and older, researchers examined how changes in subjective survival probability relate to health-promoting behaviors. Using ten waves of the Korean Longitudinal Study of Ageing from 2006 to 2024, the team analyzed 65,069 person-wave observations using individual fixed-effects models.
A standard symmetric model showed that a one-unit increase in subjective survival probability on a 0-to-10 scale was associated with a 0.69 percentage-point rise in regular exercise, after adjusting for self-rated health, chronic diseases, functional limitations, and socioeconomic traits. However, decomposing changes into increases and decreases revealed asymmetric responses. Regular exercise responded exclusively to losses in survival expectations, reflecting behavioral disengagement. In contrast, paid health checkups responded only to gains in survival expectations. Statistical tests confirmed that the absolute effects differed significantly between expectation gains and losses.
Why it matters
Perceptions of remaining lifespan influence whether older individuals engage in preventative care or maintain lifestyle habits. Recognizing these domain-specific asymmetries may help clinicians design targeted interventions to sustain physical activity and health investments in aging populations.
Caveats
The study is observational and relies on self-reported survival probabilities within a South Korean population, so the results may not generalize to other healthcare settings or prove causality.
The paper
Korea Institute for Health and Social Affairs · Korea University
The Journals of Gerontology, Series B · 1 Oct 2026