Week 1
Defining successful aging: A tangible or elusive concept
Definition & background:
- “Successful aging” covers aging processes throughout the lifespan
- It implies positive aging but is criticized for being either too limited or too broad
Characteristics of successful aging:
- Life satisfaction
- Longevity
- Freedom from disability
- Mastery and personal growth
- Active engagement with life
- Independence
Alternative terms:
- Also referred as “vital aging”, “active aging”, “productive aging”
- These terms suggest that later life can be period of health, vitality, and societal contribution
Historical perspective:
Emerging patterns:
- Recognition of biological limitation alongside human agency and subjective experiences of aging
- Early theories emphasize the importance of social respect and honor for the elderly, an aspect
less present in modern aging theories
Early definitions in gerontology:
- Early models highlight personality, social roles, health, and legacy-building as key to successful
aging
- Increasing recognition of subjective well-being and the individual’s active role in shaping a
satisfying later life
MacArthur network on successful aging:
- Purpose: address stagnation in gerontology by focusing on “positive” aging factors
- Criteria for successful aging:
- Freedom from disease and disability
- High cognitive and physical functioning
- Active engagement with life
- Rowe and Kahn’s:
- Criticized a focus on “normal aging”, which ignored diversity and unique aging
experiences within age groups
- Proposed a distinction between usual aging and successful aging, emphasizing physical
health and disease avoidance
- Three components of successful aging:
- Low disease/ disability risk, high functional capacity, active life engagement
- Critique:
- Criticized for downplaying genetic factors and promoting a “fortunate elite” perspective,
potentially stigmatizing less healthy aging individuals
,Selective optimization with compensation; Baltes and Baltes’ SOC model:
- Focus: aging involves both losses and gains in physical and psychosocial domains, with an
emphasis on optimizing remaining strengths
- Components: selection, optimization, and compensation (SOC) are key processes for successful
development
- Model structure:
- Antecedents: includes adaptation, resources (internal and external)
- Processes: SOC components guide adaptation
- Outcomes: aims to maximize gains, minimize losses, and promote growth and function
maintenance
- Cultural relevance: recognizes individual and cultural variations in successful aging
- Related definitions of successful aging:
- Medical/ public health: focuses on “compression of morbidity,” aiming to maximize life
expectancy and minimize morbidity concentrated in later years
- Social science perspective: views successful aging as a socially esteemed process
that adapts to cultural standards of mind, body, and community
- Behavioral genetics: emphasizes plasticity and individual differences in aging,
compatible with a genetic and developmental perspective
- Application: Carstensen’s Socioemotional Selectivity Theory:
- Focus: older adults prioritize emotional goals, adjusting social interactions to optimize
positive emotional experiences
- Relation to SOC: aligns with SOC as older adults become selective in relationships to
enhance emotional well-being
Preventive and corrective proactivity:
- Purpose: expands the definition of successful aging to include older adults facing significant
physical, social, and environmental challenges
- Framework: based on stress theory, acknowledging common stressors like chronic illness, social
losses, and inadequate environmental fit
- Key adaptations:
- Preventative proactivity: health promotion, planning, and helping others
- Corrective proactivity: seeking support, role substitution, and modifying environments
- Goal: these proactive behaviors aim to improve quality of life, psychological well-being, personal
goals, meaning, and maintenance of valued activities
- Refinements and applications:
- Expanded to include broader temporal and environmental influences
- Applied to vulnerable groups such as older adults with HIV
- Relation to other models:
- Shares preventive aspects with Rowe and Kahn’s model while also incorporating
corrective adaptations aligned with Baltes and Baltes SOC model
- Defines successful aging as both process and an outcome
Longevity and successful aging:
- Conceptual variability of successful aging:
- Multiple definitions exist without a universally accepted framework, complicating
measurement and research comparability
- Depp & Jeste reviewed existing definitions, finding common components like physical
functioning, yet noted high variability in reported proportions of successful aging
, - Objective vs subjective perspectives:
- Objective definitions based on physical health label only a minority as aging successfully,
while most older adults perceive themselves as successful based on psychosocial factors
- Researchers like Phelan and Larson propose combing objective and subjective aspects,
supporting multidimensional definitions
- Divergent views on measurement:
- Jeste highlighted a disconnect between researcher and lay definitions
- Lay views emphasize adaptation, meaning, and relationships, while researchers
views often focus on physical health
- Glass argued for understanding successful aging through self-perception and cautioned
against equating it solely with disease-free aging
- Cross-cultural differences in successful aging:
- Successful aging is culturally influences, with distinct views in different societies
- Eastern cultures ⇒ aging well often emphasizes family support
- Western cultures value activity and independence
- Universal elements like health, but compensation for function decline (e.g., through
wealth, social roles) varies in importance by culture
Selective Optimization with Compensation (SOC) Model (Baltes & Baltes, 1990)
- Entails: This model focuses on three main processes:
- Selection: Prioritizing goals and activities to focus on what is most important.
- Optimization: Engaging in activities that enhance the ability to achieve selected goals.
- Compensation: Implementing strategies to offset losses in abilities or resources to
maintain functioning.
- It emphasizes the dynamic interplay between these processes to maximize gains and minimize
losses throughout the aging process.
Multidimensional Model of Successful Aging (Depp & Jeste, 2006)
- Entails: This model categorizes successful aging into several components, including:
- Disability/Physical Functioning: The absence of significant physical limitations.
- Cognitive Functioning: Maintaining cognitive abilities.
- Life Satisfaction/Well-Being: Psychological health and contentment with life.
- Social/Productive Engagement: Active participation in social and community activities.
- Presence of Illness: The extent to which illness affects life quality.
- Longevity: The lifespan and health span.
- Self-Rated Health: Individuals’ perceptions of their health.
- Personality: Traits that contribute to successful aging.
- Environment/Finances: The role of supportive environments and financial stability.
- Self-Rated Successful Aging: Individuals’ assessments of their own aging process.
Preventive and Corrective Proactivity Model (Kahana & Kahana, 1996, 2003)
- Entails: This model highlights how older adults can maintain quality of life despite challenges by
leveraging:
- Social and Psychological Resources: Utilizing internal and external support systems.
- Preventive Adaptations: Proactive behaviors aimed at health promotion and planning.
- Corrective Adaptations: Strategies to address challenges, such as seeking social
support or modifying the environment.
- The model underscores the importance of proactive approaches to mitigating the effects
of stressors on well-being.
, Multifactorial Model of Successful Aging (Phelan & Larson, 2002)
- Entails: This model identifies seven major elements that contribute to successful aging:
- Freedom from Disability: The absence of significant physical limitations.
- Independent Functioning: The ability to live autonomously.
- Life Satisfaction: General happiness and fulfillment.
- Active Engagement with Life: Involvement in activities that provide meaning.
- Longevity: Lifespan considerations.
- Positive Adaptation: The ability to adjust positively to changes.
- Mastery/Growth: Continuous personal development and mastery of life tasks.
Three-Factor Model of Successful Aging (Rowe & Kahn, 1997)
- Entails: This influential model posits that successful aging is characterized by:
- Low Probability of Disease and Disease-Related Disability: Minimizing health-related
issues.
- High Cognitive and Physical Functional Capacity: Maintaining strong mental and
physical abilities.
- Active Engagement with Life: Participation in social, productive, and leisure activities.
- The model suggests that all three components overlap to define successful aging and
emphasizes the importance of a holistic approach.
Cognitive and neuropsychological examination of the elderly:
Introduction:
- Early detection of brain changes:
- Neurodegenerative changes in the brain occur years before clinical symptoms of
dementia appear
- Neuroimaging techniques:
- Advanced techniques MRI, PET are utilized for detecting brain changes
- Biomarkers:
- Biomarkers like amyloid fragments (Ab42), tau181, and phosphorylated tau (p-tau) in
cerebrospinal fluid (CSF) or serum are critical for diagnosis
Utility of neuropsychological measurement in pre/clinical dementia:
- Role in dementia evaluation:
- Neuropsychological measurement is crucial for evaluating and managing dementia,
serving multiple functions, including:
1. Acting as a biomarker for disease
2. Predicting the near-term development of cognitive impairment and dementia
3. Capturing dynamic influences on disease progression
4. Measuring functional abilities
5. Identifying intervention targets
- Neuropsychological measures as biomarkers:
- Neuropsychological measures meet NIH criteria for biomarkers, characterized as:
- Objectively measured indicators of biological processes
- Reflective of both normal and pathological processes
- Validated through standardized assessment procedures with strong reliability
