Women over 50 prioritise quality of life over living longer, ELSA study finds

New research using data from the English Longitudinal Study of Ageing shows that women aged over 50 are more likely than men to prioritise quality of life over living longer. The findings also reveal that health care preferences differ widely between individuals, highlighting the importance of personalised conversations between patients and healthcare professionals.

Women aged over 50 are more likely than men to value quality of life over simply living longer, according to new research using data from the English Longitudinal Study of Ageing (ELSA).

The study, published in PLOS One, examined the healthcare preferences of more than 6,000 adults aged 50 and over living in England. Researchers found important differences in how people think about healthcare decisions, risk, and ageing, while also showing that there is no single set of preferences shared by all older adults.

Participants were asked about six aspects of healthcare decision making, including whether they preferred quality of life or length of life, attitudes to risk and experimental treatments, whether body function mattered more than appearance, and how much they wished doctors to make treatment decisions on their behalf. These questions were developed specifically for ELSA to understand how older adults approach healthcare choices.

The researchers found clear differences between women and men. Women were more likely to prioritise quality of life over longevity, were less willing to try experimental treatments, were more cautious about taking risks, and preferred to play a more active role in healthcare decisions rather than leaving those decisions entirely to doctors. Men, by comparison, were more likely to prioritise living longer and to leave treatment decisions to healthcare professionals.

Age also influenced healthcare preferences. Participants aged 75 and over were more likely than those in their 50s and early 60s to avoid risks, decline experimental treatments and prefer doctors to make treatment decisions. Older participants also placed greater importance on how well their bodies functioned rather than how they looked.

Despite these broad patterns, the researchers found considerable variation in responses across every aspect of healthcare they examined. Preferences differed markedly between individuals, suggesting that age, sex and education can offer useful context but should never replace conversations with individual patients about what matters most to them.

Professor Paola Zaninotto, Professor of Statistics and Epidemiology at UCL and Deputy Director of ELSA, said:

"One of the clearest messages from this study is that there is no such thing as a 'typical' older person when it comes to healthcare preferences. While we found some broad differences by age, sex and education, people's views varied enormously. That is why it is so important for healthcare professionals to have conversations with patients about what matters most to them, rather than making assumptions."

The study also found that people with fewer educational opportunities were more likely to prefer leaving treatment decisions to their doctor, suggesting that ensuring everyone can take part in shared decision making remains an important challenge.

The authors say their findings could help clinicians have more effective conversations with patients, particularly during short consultations where understanding an individual's priorities can be difficult. While demographic characteristics may provide useful clues, they emphasise that every patient's preferences remain unique and should be discussed directly.

Steel N, Zaninotto P, Enwo OO, Banks J (2026) General healthcare preferences for people aged 50 and over in England: English longitudinal study of ageing. PLoS One 21(7): e0341994. https://doi.org/10.1371/journal.pone.0341994

Photo by Centre for Ageing Better