SUCCESSFUL AGING

“How old would be if you didn’t know how old you was?”Satchel Paige

Successful Aging: What Is It?

• “…our concept of success connotes more than a happy outcome; it implies achievement rather than mere good luck”. Rowe & Kahn (p.37)

• Successful aging:

– Is dependent upon individual choices and behaviors

– Can be attained through individual choice and effort

• Successful and Unsuccessful Aging:

– The difference between sickness and health?

– Focus of “traditional gerontology”

– Absence of disease is not enough.

Rowe & Kahn’s Definition

• …Successful aging…the ability to maintain three key behaviors or characteristics:– Low risk of disease & Disease-related disability

– High mental & physical function

– Active engagement with life

• Pictorial representation on p. 39

What do “successful agers” do?

• “Just keep on going!”

Avoiding Disease & Disability

• “Modern medicine..an applied science of repair rather than prevention”. (p. 40)

• “The very word ‘patient’…implies passivity rather than responsibility for our own health”. (p. 40)

• “many illnesses & disabilities, especially the chronic diseases of old age, are preceded by signs of future problems. And too often, we--and our doctors--ignore those signs.”

• e.g.: systolic BP, abdominal fat, blood sugar; decreases in lung, kidney & immune fx; decreases in bone density & muscle mass--what we often call “USUAL AGING”

An Alternative? A Preventive Orientation

• BP as an example:– Periodic monitoring and action, initially through diet &

exercise, in responses to modes increases in BP--even the range usually considered “normal”

– “…prevention does not supplant surgical & medical remedies of disability & illness”. E.g. hip replacements for OA’s w/ arthritis

Maintaining Mental & Physical Functioning

• INDEPENDENCE

• The principal goal of many OA’s

• “…few issues strike greater fear than the prospect of depending on other for the most basic daily needs”. (p. 42)

BUT--Much of the MacArthur Research Demonstrated:

• Fears about functional loss in old age are exaggerated

• Much functional loss can be prevented

• Many functional losses can be regained

More About: Exaggerated Fears

• Alzheimer’s disease & Nursing Homes are the Biggies

– AD: Over 90% DON’T have it– It’s not an all-or-nothing phenomenon– (Srs. Bernadette & Rose in the Nun Study--pp. 97-

100 in Snowdon)

• Nursing Homes– <5% of OA over 65 are in nursing homes– The % has been falling for at least 10 years

– Of those living in the community at large, <5% need help with basic ADL’s

Research--The Bottom Line on Age-related Declined in Cognitive Fx:

• Declines rarely affect all kinds of cognitive performance

• Most of the losses come late in life

• Many OA’s are NOT significantly affected by even minor losses of mental ability

Continuing Engagement With Life

• “MacArthur research shows clearly that our ‘happy activities’ are essential to successful aging. But this is a relatively novel idea”. ( p. 45)

• ‘60’s--Disengagement Theory. Neugarten & Havighurst (Sociologists, not Gerontologists)– “The final act of relinquishment was letting go ot life

itself”. (p. 46)

• Relating to Others:

• “Being part of a social network of friends and family is one of the most effective predictors of longevity. Men & women, perhaps especially men, who do not have close fiends of family are more likely to become Ill and less likely to live long lives”. (p. 46)

• Continuing Productive Activity

– “Most people, when they think of being productive, thing about earning money”.

– “…we count as productive allactivities, paid or untain, that create goods or services of value”. (p. 47)

Research HX Context of the MacArthur Study

• References go back >50 years

• Problems with definitions:– tended to define successful aging in a narrow

fashion rather than making a coherent theory of human development

– treated success as no more than the absence of explicit failure

Research Context: cont’d

• Neglected positive aspects of aging and possible gains in old age, as if successful aging were merely aging as little as possible

• failed to acknowledge the unavoidable place of values in defining what is good or bad, successful or unsuccessful

How Did the MacArthur Study Differ?

• “By proposing a research-based model of successful aging, by going beyond absence of disease and disability, and by describing the ways in which personal relationships and productive behavior change as people move through the life course:. (p. 52)