Daisy fancourt the sense that one is living a meaningful life is associated with positive health outcomes, but less is known about the role of changes in sense of meaning. this outcome-wide analysis investigated bidirectional associations between changes in ratings of doing worthwhile things in life and 32 factors in 6 domains of human function in 5,694 men and women (M = 66.65 years) from the English Longitudinal Study of Ageing. participants rated the extent they felt that the things they did in life were worthwhile in 2012 and 2014. Analyses were adjusted for age, gender, education and social class, and were weighted for non-response. We found that health (e.g. few chronic diseases, no chronic pain), emotional wellbeing (e.g. few depressive symptoms, good sleep), greater physical activity, social factors (e.g. close relationships, friends, organizational membership, volunteering, cultural engagement), and economic factors (wealth, income), at baseline were associated with 2 year increases in worthwhile ratings. Conversely, increases in worthwhile ratings over 2 years were related to more favourable health, emotional, behavioural, and social changes between 2012 and 2016 independently of baseline levels. these bidirectional relationships highlight the importance of maintaining worthwhile activities at older ages.A sense of meaning and purpose in life are core components of eudaimonic wellbeing and contribute to healthier aging 1 . Several longitudinal cohort studies have demonstrated that greater purpose in life is associated with longevity 2-4 , reduced risk of disability and functional impairment 5,6 , fewer sleep problems 7 and more consistent use of preventive health services 8 . The sense that life has purpose is also associated with social integration, economic success and more resilient personal relationships at older ages 9 . Enhancement of purpose in life is an important component of many psychosocial interventions in people with serious physical illness 10 .Meaning in life is a complex construct, and three aspects have been distinguished: coherence (the feeling that life makes sense), purpose (having goals and a direction in life), and significance (the sense that one's life has inherent value and is worth living) 11,12 . Purpose has been measured using Ryff 's Psychological Well-Being Scales in many studies 13 , but simpler ratings are feasible in population studies. Research in this field lends itself to an outcome-wide approach in which the impact of a single exposure on multiple outcomes is assessed, as opposed to more traditional methods that investigate multiple determinants of a single outcome 14,15 . The outcome-wide strategy reduces the problems of mediation and collider stratification bias 16 , since it is less concerned with the conditioning of exposure estimates on outcomes depending on downstream exposures to potential mediators. A recent analysis of the English Longitudinal Study of Ageing (ELSA) showed that stronger beliefs that the things we do in life are worthwhile were associated wi...