We aimed to investigate factors enabling older people with cognitive impairment to age successfully.

We used the 12-item Short Form Health Survey to measure health-related quality of life (HR-QoL) in 2,007 people aged ≥60 in the 2000 British National Psychiatric Morbidity Survey. We tested the hypothesis that affective symptoms and social support mediated the relationship between cognitive functioning and poorer HR-QoL.

The mean age of the participants was 66.2 (66.0–66.4). The majority of people with suspected dementia reported high mental health-related quality of life, suggesting they may not be distressed by, or aware of, cognitive and mental impairment, and the majority are aging “successfully.” The relationship between cognitive impairment and mental HR-QoL was mediated by affective symptoms, but not by social support. After considering mediators and confounders, HR-QoL was no longer associated with cognitive impairment.

The lower quality of life previously reported by people with cognitive impairment is due to the greater physical and mental health problems in this population, rather than to cognitive impairment per se. Active management of mental and physical health may improve the HR-QoL of those with cognitive impairment who are not ageing successfully.