chapter 9: successful aging

Successful Aging

• continue engagement with life

• minimize risk of disease and disability

• maintain physical and cognitive function

why does aging matter

• knowing what predicts successful aging might help us prepare now for later years

• the world is getting older

• longer lifespans

• lower birth rate

• negative stereotypes about aging can interfere with interactions with older adults

some changes with age

• some mental functions show a decline: reaction times, ability to multitask, remember names

• some functions show improvement with age: complex reasoning skills, empathy, inductive reasoning

• middle-aged brain may be less quick but more shrewd

People with negative perceptions of aging have…

• Higher rates of cardiac disease

• A median life expectancy that’s 7.5 years shorter.

• Less chance of recovering from severe disability.

• Poorer memory and cognition.

• Lower quality diet and exercise regimes.

• Less inclination to take medication as instructed.

• Shakier handwriting.

Rowe & Kahn Successful Again

• Distinguished 3 groups

• Older adults with pathology or disease states

• Normal older adults

• Successful agers

• Normal aging associated with modest declines in physical and cognitive functioning (not pathological), and even though modest, do put at risk of problematic outcomes in physical, psychological, economic, and interpersonal difficulties

Rowe & Kahn Criteria

• Basis for MacArthur Studies of Successful Aging

• Typically modified to “minimal decrements” (as opposed to “no decrements”)

• Successful Aging:

  • Low Disease Risk

  • High Physical and Cognitive Functioning

  • Active Engagement in Life, especially with interpersonal relationships and productive activities

Ryff’s Model of Successful Aging

• self-acceptance

• positive relationships

• autonomy

• environmental mastery

• purpose in life

• personal growth

Correlates of Successful Aging

• Successful ager associated with better overall well-being

  • Happiness

  • Depression

  • Relationships

  • Energy

  • Enthusiasm

  • Optimism

  • Perceived control

the macarthur study

• introduced successful aging as a concept

• interdisciplinary team

the harvard study of adult development

• following cohorts of white men for nearly 80 years

• multimodal dataset (questionnaires every 2 years, physical health info every 5 years)

• The Harvard Study of Adult Development identified predictors before age 50 that predicted “healthy and happy” aging after age 65

  • Perseverance (for Harvard grads)

  • Absence of cigarette use and alcohol use disorder

  • Warm marriage

  • Absence of depressive disorder

  • Good physical health

the alameda county study

• demographically diverse

• longitudinal starting with participants at age 65

• health behaviors most strongly related to mortality:

  • sleep 7-8 hrs/night

  • eat breakfast

  • eat regular meals and not eating between meals

  • maintain healthy weight

  • exercise regularly

  • limit alcohol consumption

  • no smoking

Processes of Successful Aging: Selection-Optimization-Compensation

• Doing the best with what you have….looks at behavioral and psychological processes used to adapt to age-related losses (balance developmental losses with gains)

• Selection – focus on important goals in context of developmental stage

  • Elective (choose to move to PT work to spend more time with grandkids)

  • Loss-based (healthy condition limits what can do)

• Optimization – resources and aids to facilitate success in goal pursuit

• Compensation – for losses in order to adapt to changes and create environment for success

  • Walk-in showers, readers, lighter pans, hire lawn care

SOC Related to:

• Satisfaction with age

• Positive emotions

• Absence of loneliness

• Focus on most important goals

• Moderates relationships between financial hardship and life satisfaction (relationship between financial hardship and life satisfaction is weaker at higher levels of SOC)

Socioemotional Selectivity Theory

• focusing on the right goals at the right times

• developmentally appropriate goals matched to perceptions of how much time one has left

• as people age, goals tend to focus more on stability, maintenance and regulation of emotions

• older adults tend to evidence positivity effect

• older adults tend to invest time and emotion into most important people in social networks

blue zones

• people live to be 100 years old more often than would be expected

• identify the optimal lifestyle of longevity

• they are: sardinia, italy; okinawa, japan; ikaria, greece; nicoya. costa rice; lome linda, CA, USA

Lessons from the Blue Zones

• engage in physical activity naturally

• cut caloric intake by about 20%

• higher proportion of plant-based foods

• alcohol in moderation

• strong sense of purpose

• incorporating rest into daily activities

• participation with a spiritual community

• time with family

• maintain social connections

The Hispanic Paradox

• Latinx Americans, especially those born outside of the US, tend to have equal or superior health outcomes despite worse socioeconomic indicators than White Americans

• Some evidence this is also true in terms of a psychological health advantage

• White older adults: living with their children associated with lower life satisfaction

• Latinx older adults: living with their children associated with higher life satisfaction

• Important to consider both nativity and nationality

• Some have suggested this finding may be a result of biased sample selection

age and well-being

• paradox: older adults tend to be less physically healthy, but happier

• U-shaped association between age and emotional well-being

• mid-20s through 40s: well-being decreases

• age 45-54: lowest levels of well-being

• stress has a similar trajectory (but opposite direction)

• most true for high-income, english-speaking countries

• emotional maturity hypothesis

  • with age come better regulation of emotions

  • reappraisal especially positive reappraisal of situations very helpful

Cultivating Resilience in Adults

• APA: factors for the cultivation of resilience

1. make connections w family, friend, or community

2. avoid seeing crises as insurmountable problems

3. accept that change is part of living

4. move toward your goals

5. take decisive action, use problem- and task-focused coping

6. look for opportunities for self-discovery

7. nurture a positive view of yourself

8. keep events in perspective

9. maintain a hopeful outlook

10. take care of yourself, attend to your needs and feelings

Post-Traumatic Growth

• Involves changes in self-understanding and one’s worldview, or meaning-making

• Moving one toward important new goals…must disengage with old activities, strivings, core projects and create new goals that are intrinsically motivating and personally meaningful…authenticity involves action

• Provides a renewed sense of meaning and purpose

• Social support and acceptance are important factors in promoting post-traumatic growth

4 factors leading to post-traumatic growth

• brutally honest optimism

• perception of control over events

• coping style

• strong sense of self

5 domains of Post-traumatic growth

• personal strength

• closer relationships

• greater appreciations for life

• new possibilities

• spiritual development

wisdom

• good judgement and advice in important but uncertain matters of life

• 5 skills that characterize wisdom:

  • factual knowledge

  • strategic knowledge

  • consideration of life’s uncertainties

  • consideration of the contexts in which decisions are made and activities take place

  • consideration values and life goals through a lens of relativism