Aging health dynamics cross a tipping point near age 75.

Aging includes both continuous gradual decline from microscopic mechanisms together with major deficit onset events such as morbidity, disability and ultimately death. These deficit events are stochastic, obscuring the connection between aging mechanisms and overall health. We propose a framework for modelling both the gradual effects of aging together with health deficit onset events, as reflected in the frailty index (FI) - a quantitative measure of overall age-related health. We model damage and repair dynamics of the FI from individual health transitions within two large longitudinal studies of aging health, the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), which together included N=47592 individuals. We find that both damage resistance (robustness) and damage recovery (resilience) rates decline smoothly with both increasing age and with increasing FI, for both sexes. This leads to two distinct dynamical states: a robust and resilient young state of stable good health (low FI) and an older state that drifts towards poor health (high FI). These two health states are separated by a sharp transition near age 75. Since FI accumulation risk accelerates dramatically across this tipping point, ages 70-80 are crucial for understanding and managing late-life decline in health.