br Acknowledgments This research was funded in part by the

Acknowledgments This research was funded in part by the National Institute of Mental Health (R01MH100298). A previous version of this paper was presented at the 2015 Gerontological Society of America meeting in Orlando, Florida. We thank Yeates Conwell for reviewing an earlier draft of this paper and David Pratt for editorial assistance.
Introduction There has been growth in the volume of scientific studies that explore the connection between religion, spirituality and health. Earlier reviews have established that while associations are not universal, on balance, studies indicate salutary benefits arising from religious and spiritual involvement across a number of health outcomes (Hummer, Ellison, Rogers, Moulton, & Romero, 2004; Koenig, 2009; Koenig, King, & Carson, 2012; Marks, 2005; Seeman, Dubin, & Seeman, 2003). The current article is an essay that examines a selection of literature that derives from several notions: religiosity and spirituality is pervasive globally; health benefits that may stem from religious and spiritual involvement could be important for the future of global caspofungin health, and; this is particularly the case given realities of global population aging. The dialog to follow therefore identifies religiosity and spirituality as key components of health within the context of global aging and expanding life expectancy. The essay covers several topics. It begins by characterizing population aging and increasing longevity. It then defines religiosity and spirituality within a global context. Evidence is provided that links religiosity and spirituality to health of older persons. Potential mechanisms of these links are then discussed. This leads into a dialog on some potential future directions, followed by a concluding statement.
Religiosity and spirituality in the context of global aging and increasing longevity Population aging is a term that refers to increasing numbers and proportion of older persons within populations. Population aging is being experienced throughout the world (UNFPA & HelpAge International, 2012). According to United Nations estimates, the population aged 60 and older in 2015 was about 900 million, representing about 12% of the global population (United Nations, 2015). Given medium level growth projections, this number is expected to pass 2 billion by 2050, which at that time will represent close to 22% of the global population. Related to this is increasing longevity with people in many parts of the world living to much older ages than has ever been the case (Vaupel & Kistowski, 2005). With few exceptions, these changes are happening everywhere, in every global region (Zimmer & McDaniel, 2013). The impacts of population aging, including rising health care costs and formal and informal health care needs, are being shared across societies thousands of miles apart, rich and poor, with different cultures, languages, structures of government, family values, and economic systems. Many of the consequences of population aging are common across human societies in all corners of the world. Given the ubiquity of population aging and increasing longevity, common ways in which good health in old age can be promoted is now of paramount concern to health professionals, researchers and policy makers worldwide (World Health Organization, 2015). While population aging is a recent phenomenon, religiosity, which evidence suggests may be a common factor associated with health, is a long-standing one that similarly extends to all corners of the world (George, Larson, Koenig, & McCullough, 2000; O’Brien, Palmer, & Barrett, 2007). When expanded to include meditative and contemplative activity, the desire to seek a meaning to life or the desire for a transcendent connection, it is clear that expressions of religiosity and spirituality is widespread across individuals living in human societies, across regions with differing ideologies, orientations and practices. To illustrate we provide in Table 1 results from the 2015 release of the World Values Survey (WVS) (data collected between 2010 and 2014) for major countries with different religious traditions and degrees of secularization (World Values Survey Association, 2014). The countries we show are chosen because they are the most populated ones covered by the WVS. Together they represent 60% of the global population. Shown is the percent within each country that respond to questionnaire items by saying they consider themselves to be a religious person (labeled ‘Religious’) and the percent saying that they sometimes or often think about or contemplate upon the meaning of life (labeled ‘Think’). The latter question is not a direct measure of spirituality, but, given common definitions of spirituality (Koenig, 2012) it does suggest reflection upon abstract and intangible things that relate to a purpose of life and therefore reflects a degree of spiritual-like thinking. Moreover, earlier versions of the WVS included additional questions about meditation and prayer, and the item on thinking and contemplating meaning of life correlates highly with these other measures that can also be linked to spiritualness. The first two columns compare these items for the total sample 18 and older. The next four columns show the percentages for those under age 60 and for those age 60 and older. Statistically significant differences across age groups are indicated by an asterisk.