How Do Older Adults Define Successful Aging? A Scoping Review

Picturing the dance: intersections of gender, sexuality, and age in older women queer square dancers

A dearth of research has focused on the diverse experiences of aging sexual minority populations and, in particular, older sexual minority women. Studies that have disaggregated the population of lesbian, gay, bisexual, transgender, questioning, queer, intersex and two-spirit (LGBTQIS+) older adults reveal that due to minority stress and a lifetime of disadvantage. Lesbians experience higher rates of chronic health conditions and mental health problems (including loneliness) than heterosexual women and greater financial inequalities compared to gay men or heterosexual women. Despite this, limited inquiry has explored the everyday lives of older queer women and fewer still draws upon women's commentary on their own lived experiences or centers older women as authoritative agents and experts on their own lives. In response to this knowledge deficit, this research traverses the aging experiences of female-identified members of a gay square dance (GSD) club in Toronto, Canada. We apply queer theory to explicate the unique ways in which a GSD club queers the aging process for 14 older women dancers. Findings of the inquiry highlight the ways in which these dancers confront and reject heteronormativity, while illuminating pathways to successful aging for older sexual diverse women. The older women dancers in this study perform gender in ways that challenged heteronormativity and gender binaries, enhanced belongingness and acceptance, embodied joy, and fostered wellness. These concepts have been identified as critical factors in successful aging and highlight what queering aging might look like for this resilient population who have overcome a lifetime of disadvantage.

Successful Aging of Korean Older Adults Engaging in Sports Regularly: Health Beliefs, Exercise Adherence Intention, and Health Promotion Behavior

The population of older adults is increasing more rapidly in Korea than in any other country, making successful aging a salient need in Korean society. For successful aging, older adults must engage in sports activities regularly. This study determined the relationships among health beliefs, exercise adherence intention, health promotion behavior, and successful aging among older adults who engage in sports activities regularly. The participants were 287 adults aged 65 years or older who live in Korea and exercise regularly. Data were collected through a survey and analyzed using descriptive statistics, correlation analysis, and structural equation modeling. The integrated model lacked explanatory power in terms of goodness of fit, but the alternative model had sufficient explanatory power. The alternative model showed that health beliefs, exercise adherence intention, and health promotion behavior are significantly related and that health promotion behavior positively predicts successful aging. It also showed that health beliefs affect successful aging through the mediation of exercise adherence intention and health promotion behavior. This study is meaningful because it verifies the structural and theoretical relationships among health beliefs, exercise adherence intention, health promotion behavior, and successful aging. As a result, it provides information that can improve the welfare of older adults in Korean society.

Exploring Characteristics of Self-Defining Memories in Older Adults

The aim of this descriptive study was to investigate the Self-Defining Memories (SDMs) in a large sample of 181 older adults (65-90 years; mean age = 73.0 years) and to target the relationships between their different dimensions. The sampling method was nonprobabilistic, based on voluntary participation. Participants were asked to recall three SDMs. They also completed the Mini-Mental State Examination, the Hospital Anxiety and Depression Scale, and a Self-esteem Scale. Almost half of the SDMs were specific and more than a quarter were integrated. Specificity, tension, redemption, contamination sequences, and affective response varied regarding thematic content. Specificity was positively correlated to tension whereas autobiographical reasoning was positively correlated to redemption and negatively linked to emotional response and depression. This research highlighted that identity is constituted by the main types of events that make up a life: interpersonal relationships, life-threatening events, achievement, and leisure.

Negotiating Experiences of Belonging Alongside Age-Related Life Transitions

Belonging is a pervasive human need that is vital to our well-being as we age. Ageist attitudes, stereotyping, and life transitions tend to jeopardise older adults' experiences of belonging. Although community involvement can lead to the development of social relationships that support belonging in older adulthood, little is known about how belonging is perceived and experienced by older adults. The purpose of this article is to share findings from research conducted with members of a community centre for people 50 years of age and older who shared their perceptions and experiences of belonging. Findings highlight the ways that age-related life transitions affect experiences of belonging. Findings also reveal that features of a belonging experience include feeling worthwhile, being welcomed and accepted, having opportunities for connection, and seeking to belong. We draw from these findings to suggest ways to enhance belonging for older adults.

Active and productive ageing in India: evidence from the time use pattern of ageing adults

BACKGROUND

With the increasing proportion of older adults in India, it becomes essential to get an insight into the various influencing factors of successful ageing. However, the literature on successful ageing is minuscule in the Indian context. The present study attempted to understand successful ageing in terms of active and productive ageing by exploring their determining factors.

METHODS

The data were extracted from the Longitudinal Ageing Study in India (LASI) Wave-1 (2017-2018). We utilized self-reported time use information from the experimental module of the LASI. A total of 7837 ageing adults were included in the study. We employed descriptive statistics, bivariate analysis and a multinominal logistic regression model to examine the prevalence and the determinants of active and productive ageing.

RESULTS

The prevalence of inactive ageing was higher among the Indian ageing population (57.47%), followed by active ageing (29.59%) and productive ageing (12.94%). Poor sleep quality and the prevalence of morbidity and disability limited the ageing population from attaining active and productive ageing. Engagement in physical activity was significantly associated with active and productive ageing (β = 0.83, 99% CI: -0.72-0.94 and β = 0.82, 99% CI: 0.66-0.98), respectively. Rural ageing adults were more likely to attain active ageing and less likely to attain productive ageing.

CONCLUSION

Engagement in physical activities among the ageing population shall be promoted to attain active and productive ageing. Since the rural ageing population were less likely to attain productive ageing than their urban counterparts, opportunities to participate in more formal economic activities in rural areas could be promoted for the wellbeing of the second demographic dividend.

Positive Aging and Death or Dying: A Scoping Review

BACKGROUND AND OBJECTIVES

This scoping review aims to examine the extent and the manner in which research that utilizes successful, active, productive, and healthy aging framework(s) includes death or dying.

RESEARCH DESIGN AND METHODS

An examination of peer-reviewed academic journal articles was conducted following Joanna Briggs Institute's methodological standards for scoping reviews and conforming to Arskey and O'Malley's 5-stage framework. The initial search resulted in 1,759 articles for review, and following the rigorous screening, 35 studies were included for the final review. A qualitative thematic analysis was used to identify how research utilizes the concepts of death and dying in the context of 4 positive aging models.

RESULTS

The core themes identified include (a) the absence of death and dying dimensions in positive aging models; (b) older adults' outlooks on death and dying while aging well; (c) religious and spiritual dimensions of aging well; (d) negative consequences of positive aging models without death and dying dimensions; and (e) the future of death and dying in positive aging models.

DISCUSSION AND IMPLICATIONS

The review delivers a critique by researchers on the noticeable absence of death and dying processes within the framework of successful, active, productive, and healthy aging models. These findings represent a rich opportunity for future research on these concepts.

Age, Individual Resources, and Perceived Expectations for Active Aging: General and Domain-Specific Effects

Exposure to expectations for active aging may be modulated by age and individual resources (socioeconomic status, social integration, and health) via multiple pathways. Using a cross-sectional, nationally representative sample of adults aged 17 to 94 (N = 2,007), we investigated the relations between age, individual resources, and perceived expectations for active aging (PEAA) in three domains (physical health, mental health, and social engagement). Across domains, young adults and individuals aged 70+ reported slightly lower PEAA than emerging adults did; no other age differences emerged. Multiple regression showed that a higher subjective socioeconomic status, better perceived general health, and partnership (in older adults) predicted higher PEAA (almost) across domains, whereas church attendance, employment status, and occupational prestige yielded domain- and age-specific effects, which were not always positive. We conclude that the effects of individual resources on PEAA are limited in general but vary depending on life domain and age.

Impact of Using Smartphone While Walking or Standing: A Study Focused on Age and Cognition

BACKGROUND

Using smartphones during a task that requires upright posture is suggested to be detrimental for the overall motor performance. The aim of this study was to determine the role of age and specific aspects of cognitive function on walking and standing tasks in the presence of smartphone use.

METHODS

51 older (36 women) and 50 young (35 women), mean age: 66.5 ± 6.3 and 22.3 ± 1.7 years, respectively, were enrolled in this study. The impact of using a smartphone was assessed during a dynamic (timed up and go, TUG) and a static balance test (performed on a force platform). Multivariate analyses of variance were applied to verify main effects of age, task, estimates of cognitive function and interactions.

RESULTS

Compared to young, older individuals exhibited a poorer performance on the dynamic and on the static test (age effect: p = 0.001 for both variables). Dual-tasking with a smartphone had a negative impact on both groups (task effect: p = 0.001 for both variables). The negative impact, however, was greater in the older group (age × task effect: p = 0.001 for both variables). Executive function and verbal fluency partially explained results of the dynamic and static tests, respectively.

CONCLUSIONS

The negative impact of using a smartphone while performing tasks similar to daily activities is higher in older compared to young people. Subclinical deficits in distinct aspects of cognitive function partially explain the decreased performance when dual-tasking.

Happiness and mental health of older adults: multiple mediation analysis

Introduction

This study aims to explore the influence mechanism of older adult mental health. As the aging population grows, the mental health of older adults becomes a significant public health and social issue, with happiness serving as a key dimension of mental health.

Methods

This study utilizes public data from CGSS to investigate the relationship between happiness and mental health, with Process V4.1 used for mediating effects analysis.

Results

The findings suggest a positive predictive effect of happiness on mental health, with three mediating paths identified: independent mediating effect paths of income satisfaction and health, as well as a multiple mediating effects path through income satisfaction and health.

Discussion

The study suggests that improving the multi-subject mental health support service system for older adults and creating public values for mental health risk coping mechanisms. This helps to understand the complex relationship between aging on individual and social levels. These results provide empirical support for healthy aging among older adults and future policymaking.

The Impact of Caregiving on Successful Ageing of Informal Carers: A Qualitative Study among Respiratory Patients' Caregivers

Providing intensive informal caregiving can cause caregivers' overburden, possibly impacting successful ageing factors such as physical and mental health and social life. This article aimed to investigate how informal caregivers experience the impact of providing care for chronic respiratory patients on the process of caregiver ageing. A qualitative exploratory study was performed using semi-structured interviews. The sample comprised 15 informal caregivers who provided intensive care for patients with chronic respiratory failure for more than six months. They were recruited while accompanying the patients on their examination for chronic respiratory failure in Special Hospital for Pulmonary Disease in Zagreb between January 2020 and November 2020. Semi-structured interviews were used with informal caregivers, and interview transcripts were analysed by the inductive thematic analysis method. Similar codes were organised into categories, and categories were grouped into themes. Two themes were identified in the domain of physical health relating to informal caregiving activities and inadequate treatment of their difficulties, three themes were in the domain of mental health relating to satisfaction with the recipient of care and feelings, and two themes were in the domain of social life, relating to social isolation and social support. Informal caregivers of patients with chronic respiratory failure experience a negative impact on the factors that contribute to the successful ageing of informal caregivers. The results of our research suggest that caregivers need support in maintaining their own health and social inclusion.

Longevity is not an ingredient of successful aging as self-reported by community-dwelling older adults: a scoping review

OBJECTIVES

There has been a long-standing debate in gerontology about what constitutes successful aging (SA). This scoping review investigated older adults' perspectives on longevity as part of SA to promote developing a standardized conceptual model.

METHOD

The current review followed the JBI methodological guidelines and used Rowe & Kahn's SA framework and Baltes' selection, optimization, and compensation model as the foundational theoretical framework. Five electronic databases (PubMed, Scopus, PsycInfo, CINAHL, and Web of Science) were searched using specific inclusion criteria (participants, concept, and context) to identify original studies that evaluated SA.

RESULTS

Eighteen studies, including 9,360 individuals (aged 60 years and older), were selected. Main indicators involved six primary domains: Psychological, physical, social, environmental, spiritual, and behavioral. Physical activity, basic aspects of wellbeing, positive outlook, satisfaction with life, interpersonal relationship, participation in meaningful activities, and financial security emerged as the most important factors. The findings suggest that older adults do not consider longevity a primary component of SA.

CONCLUSION

We identified multidimensional self-reported SA components without longevity being emphasized, guiding further improvement of older adults' wellbeing. The study outlines an updated conceptual framework that can be applied to real-life scenarios to test how older adults can best adapt to the challenges of aging.

Valuing the individual - evaluating the Dignity Care Intervention

BACKGROUND

Palliative care needs in older persons can endanger their dignity. To provide dignity-conserving care to older persons, the Swedish Dignity Care Intervention (DCI-SWE) can be used. The DCI-SWE is built on Chochinov's dignity model and the original version, developed and tested in UK and Scotland.

AIM

To describe older persons' and their relatives' experiences of dignity and dignity-conserving care when using the DCI-SWE in municipal health care.

RESEARCH DESIGN

A mixed method study with convergent parallel design.

PARTICIPANTS AND RESEARCH CONTEXT

The DCI-SWE was used and evaluated in a Swedish municipality health care context. Older persons' (n=17) dignity-related distress and quality of life were assessed after the intervention. Interviews with older persons (n=10) and their relatives (n=8) were analysed using thematic analysis.

ETHICAL CONSIDERATIONS

The study followed the World Medical Association Declaration of Helsinki. Ethical approval was obtained from the Regional Ethical Review Board in Uppsala, Sweden (Reg No. 2014/312) and the National Swedish Ethical Review Authority (Reg. No. Ö 10-2019). Informed consent was collected from older persons and their relatives.

FINDINGS

The older persons' dignity-related distress did not significantly change over time (p = 0.44) neither was their overall quality of life (p = .64). Only psychological quality of life was decreased significantly (p = 0.01). The older persons and their relatives emphasized the importance of valuing the individual.

CONCLUSIONS

The DCI-SWE provides a forum to talk about dignity issues, but relevant competence, continuity and resources are needed. Psychological care actions and health care professionals' communication skills training are important. To fully evaluate, the DCI-SWE a larger sample and validated instruments are necessary.

The interagency care team: A new model to integrate social and medical care for older adults in primary care

To integrate management of social drivers of health with complex clinical needs of older adults, we connected patients aged 60 and above from primary care practices with a nurse practitioner (NP) led Interagency Care Team (ICT) of geriatrics providers and community partners via electronic consult. The NP conducted a geriatric assessment via telephone, then the team met to determine recommendations. Thirteen primary care practices referred 123 patients (median age = 76) who had high rates of emergency department use and hospitalization (28.9% and 17.4% respectively). Issues commonly identified included medication management (84%), personal safety (72%), disease management (69%), food insecurity (63%), and cognitive decline (53%). Referring providers expressed heightened awareness of older adults' social needs and high satisfaction with the program. The ICT is a scalable model of care that connects older adults with complex care needs to geriatrics expertise and community services through partnerships with primary care providers.

Association between bidirectional intergenerational support and successful aging in China: Evidence from CHARLS 2018

Aging has gradually accelerated in China, and achieving successful aging of older adults has become a public health concern. Intergenerational support is crucial for Chinese older adults in later life due to the culture of filial piety. However, the association between successful aging and intergenerational support remains poorly understood in China. This study aimed to examine the association between patterns of intergenerational support and successful aging of older adults in China. The present study is a secondary analysis of data obtained from the follow-up survey of the China Health and Retirement Longitudinal Study 2018. Data were analyzed using descriptive statistics and logistic regressions. Bidirectional intergenerational support was associated with successful aging in the participants. In addition, there was an association between different intergenerational financial, caring, and emotional support patterns and elements of successful aging.

Alaska native successful ageing in Northwest Alaska: how family impacts how one ages in a good way

aged well, yet today they experience high rates of illness and lower access to care because of colonisation. Aand this research explores successful ageing from an AN perspective or what it means to achieve "Eldership" in the rural Northwest Alaska. A community-based participatory research approach was used to engage participants at every stage of the research process. Semi-structured interviews were conducted with 16 AN men and 25 women and the interviews were professionally transcribed. Kleinman's explanatory model served as the foundation of the questionnaire to gain a sense of the beliefs about ageing and guide the thematic analysis to establish an AN understanding of successful ageing. The foundation of the Norton Sound southern sub-region Model of Successful Ageing is the reciprocal relationship between Elders and family which enables Elders to access meaningful activities, including Native ways of life, physical health, spirituality, and emotional well-being. Community-based interventions should foster opportunities for Elders to share their Native way of life alongside family and community members, which will enable them to remain physically active, maintain healthy emotional well-being, continue engaging in spiritual practices, and contribute to the health and well-being of families.

Promoting Resilience and Flourishing Among Older Adult Residents in Community Living: A Feasibility Study

BACKGROUND AND OBJECTIVES

The Stress Management and Relaxation Training-Relaxation Response Resiliency Program (SMART-3RP) is a mind-body group intervention that integrates relaxation training with cognitive behavioral and positive psychology techniques. This study assessed SMART-3RP feasibility, acceptability, and preliminary efficacy for enhancing resilience and flourishing among older adults in continuing care retirement communities (CCRCs).

RESEARCH DESIGN AND METHODS

We conducted a prospective single-arm study of SMART-3RP groups delivered by clinicians at 4 CCRCs (n = 80). Eligible residents lived in community apartments. Participants completed pre- and postintervention surveys. We evaluated attendance (hypothesis: ≥60% attend ≥6 of 9 sessions), enrollment, and retention. Mixed methods were used to explore acceptability. Paired samples t-tests were conducted to explore changes in resilience, flourishing, and key intervention targets.

RESULTS

From March to June 2021, we screened 89 residents with 87 (98%) consenting to participate and 80 (90%) enrolling in the study. Among 80 participants (85% female; 98% non-Hispanic White; M age = 80 years [SD = 6]), 88% attended ≥6 sessions, and 89% completed the postintervention survey. Participants found meaning in participation and practiced skills in the context of challenges such as caregiving burden or bereavement. Survey results, showing increases in resilience, flourishing, and several intervention targets, aligned with participants' perceived intervention value.

DISCUSSION AND IMPLICATIONS

SMART-3RP was feasible and acceptable for CCRC residents; participants perceived value in practicing mind-body strategies in a group-based setting. Preliminary evidence suggested a pattern of improvements in resilience, flourishing, and intervention targets. Findings provide insights for mind-body interventions and recommendations for adaptations to late-in-life concerns and community settings.

CLINICAL TRIALS REGISTRATION NUMBER

NCT04720014.

Current and Future Needs of Gerontological Social Work Practice in Alberta: Findings from the World Café at the Gerontological Symposium in Edmonton, Canada

The growing aging population in Canada has multi-faceted psycho-social needs. Social workers are well-positioned to address these needs, despite many challenges. This paper reports findings from the World Café at the Gerontology Symposium in Alberta, Canada, held in 2018. The goal was to learn from social work practitioners, researchers, and educators (N = 49) about current and future needs of gerontological social work in Alberta. There were two research questions: 1) What strategies do social workers need on the micro, mezzo, and macro levels to help better serve the growing older adult population in Alberta? (R1) 2) How can social workers promote the value and contribution of gerontological social work within the interprofessional community? (R2) The data were analyzed using qualitative content analysis. Ten R1-related themes emerged: personal traits of a social worker; professional skills; bio-psycho-social needs of older adults; community connections; access to benefits; gerontological social work education; integrated healthcare; aging policy; ageism; and advocacy to strengthen the voice of older adults. The three R2-related themes include strengthening the status of the social work profession; building trust through demonstrated skills; and interprofessional education and practice.

Successful Aging among Immigrant and Canadian-Born Older Adults: Findings from the Canadian Longitudinal Study on Aging (CLSA)

BACKGROUND

Few studies in Canada have focused on the relationship between immigrant status and successful aging. The concept of successful aging used in this study includes the ability to accomplish both activities of daily living (ADLs) and instrumental activities of daily living (IADLs), freedom from mental illness, memory problems and disabling chronic pain, adequate social support and older adults' self-reported happiness and subjective perception of their physical health, mental health and aging process as good.

METHODS

The present study analyzed the first two waves of data from the comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA). The sample includes 7651 respondents aged 60+ at time 2, of whom 1446 respondents were immigrants. Bivariate and multivariable binary logistic regression analyses were conducted.

RESULTS

Canadian-born older adults had a slightly higher prevalence and age-sex adjusted odds of achieving successful aging than their immigrant counterparts (aOR = 1.18, 95% CI: 1.04, 1.34, p < 0.001). After adjusting for 18 additional factors, immigrant status remained statistically significant (aOR = 1.24, 95% CI: 1.09, 1.41, p < 0.001). Significant baseline factors associated with successful aging among immigrants included being younger, having higher income, being married, not being obese, never smoking, engaging in moderate or strenuous physical activities, not having sleeping problems and being free of heart disease or arthritis.

CONCLUSIONS

Immigrant older adults had a lower prevalence of successful aging than their Canadian-born peers. Further research could investigate whether policies and interventions supporting older immigrants and promoting a healthy lifestyle enhance older adults achieve successful aging in later life.

Multidimensional Factors Affecting Successful Aging among Empty-Nesters in China Based on Social-Ecological System Theory

BACKGROUND

This study aims to identify the status of successful aging and the factors influencing empty-nest elderly in China based on the social-ecological system theory.

METHODS

The data came from the follow-up survey (2018) of the China Health and Retirement Longitudinal Study and 3074 empty-nesters aged 60 and over are included. Chi-squared tests and logistic regressions were used to identify factors associated with successful aging.

RESULTS

The successful aging rate of empty-nesters in China was 5.9%. The results of the multifactor analysis showed that younger age, higher education level, good self-rated health, good hearing, high life satisfaction, availability of financial resources at the microsystem level, higher frequency of contact with children at the mesosystem level, and medical insurance at the macrosystem level were the contributing influencing factors for successful aging of empty-nesters in China.

CONCLUSION

This study is an important attempt to explore the successful aging of empty-nesters in China. Because this study is based on social-ecological system theory, it confirms the important role of individual characteristics of older adults and their surrounding environment in achieving successful aging. Therefore, we should pay attention not only to the individual characteristics of the elderly, but also to the role of the surrounding environment on the health of the elderly, so that we can develop intervention measures to promote their successful aging.

Optimism and subjective well-being in nursing home older adults: The mediating roles of gratitude and social support

OBJECTIVES

To examine the level of subjective well-being (SWB) and the mediating roles of gratitude and social support in the relationship between optimism and SWB amongst older Chinese people in nursing homes.

METHODS

A total of 354 older adults in Chinese nursing homes completed the World Health Organization's well-being index, Life Orientation Test-Revised, Gratitude Questionnaire-Six-Item Form, and Multidimensional Scale of Perceived Social Support. Structural equation modeling was used to evaluate the relationships between optimism, gratitude, social support and SWB.

RESULTS

The mean SWB score of the older people was (63.14 ±15.31), with 21.0% of subjects reporting low SWB. Gratitude and social support in serial partially mediated the relationship of optimism with SWB (total indirect effect: Standardized β = 0.157, 95% CI [0.109,0.216], p<0.001).

CONCLUSION

These findings provide good evidence for the inter-relationship mechanism amongst the protective factors of SWB, suggesting the need to prioritize positive psychological nursing interventions to promote SWB in older people in residential care.

“It is Easy to do Nothing and Easy to Sit Down”: Perceptions of Physical Activity and Sedentary Behaviors During Pre-retirement

This study explored the insights of old age pre-retirement employees towards physical activity and sedentary behavior. A quota sampling of 20 participants from within the Civil Service in Malta were invited to an interview. Participants who were included met the statutory requirement for retirement within the subsequent 6 months to 1 year. Semi-structured interviews were conducted using a narrative approach. Structural narrative analysis and reflective thematic analysis were used. The story structure highlighted the significance of the individual experiences on the perceptions towards future physical activity during retirement. Two themes were identified using the thematic analysis, influencers, and perceptions. Triangulation identified that sedentary behavior was not part of the narration. The transition from work to retirement is a unique and personal experience and therefore when promoting an active lifestyle, the individual experience and past behaviors must be actively considered.

Factors that influence the emotional impact of memory problems in older adults: A qualitative descriptive study

BACKGROUND

Associations among psychological health and memory concerns in older adults are well-established, but much of this research is quantitative.

OBJECTIVES

This study examined how memory problems influence emotional well-being in older adults without dementia, and whether this differs by cognitive status and current depressive or anxiety symptoms.

METHODS

A qualitative descriptive design was used to examine our research questions. Community-dwelling older adults without dementia (n = 49, M_age  = 74.5[10.1], 63% women) completed a cognitive assessment, questionnaires and two semi-structured interviews. Content analysis was used to code and categorise the transcribed interview data, then identify themes within and across participant groups.

RESULTS

Five themes described the influence of memory problems on emotional well-being: Evoking Emotions, Fearing Future, Undermining Self, Normalising Problems and Adjusting Thinking. Memory problems' impact on emotional well-being varied by current anxiety symptoms, characteristics of the problem and personal experience with dementia.

CONCLUSION

The emotional impact of memory problems tended to differ by affective symptoms, not cognitive status. Older adults who report memory concerns without objective evidence of impairment may be at risk for negative impacts to mental health and well-being.

IMPLICATIONS FOR PRACTICE

Cognitive screening guidelines should consider best practices for responding to memory concerns when cognitive testing results are normal.

High Sensory Responsiveness in Older Adults is Associated with Walking Outside but Not Inside: Proof of Concept Study

Background and Purpose

Reduced mobility and a higher risk of falls among older adults are related to aging-associated sensory alteration. Sensory responsiveness (SR) has been found to be strongly correlated with postural control in studies on young adults in stimulating environments; however, SR has not been studied in the context of mobility among older adults, despite its potential to enhance fall risks. The aim of the current study is to characterize the associations between SR and gait under single and dual-task (ST, DT) conditions inside and outside the laboratory.

Methods

Twenty-six community-dwelling older adults (age 70.3 ± 4.6 years, 65.4% women) participated in this cross-sectional study. Gait variables were measured using the APDM system under single and dual task conditions, in a quiet corridor inside and in an ecological (outside) environment. SR was evaluated using the SR questionnaire and cognition was assessed with the Trail-Making Test and the Montreal Cognitive Assessment.

Results

SR was negatively associated with gait speed during ST (r_s = −0.491, p < 0.05) and DT (r_s = −0.528, p < 0.01) outside and with ST gait speed inside (r_s = −0.528, p < 0.01). SR was positively associated with gait variability under DT (r_s = 0.41, p < 0.05) and with DT cost (r_s = 0.44, p < 0.05) only outside.

Conclusion

SR may play an important role in understanding mobility deterioration throughout the aging process, especially outside, illuminating the importance of SR evaluation among older adults during mobility assessment. Therefore, accounting for SR in gait research may contribute to a better understanding of mobility decline throughout the aging process.

The perspectives of successful ageing among older adults aged 75+: a systematic review with a narrative synthesis of mixed studies

Older adults 75 and above are a fast-growing segment of the population. However, few studies have investigated what it means to age successfully from their perspective. This group of older adults face challenges that might characteristically differ from younger older adults. Therefore, the aim of this study was to conduct a systematic review of the perspectives of older adults aged 75 and above regarding what it means to age successfully and to summarise the findings through a narrative synthesis. We also aimed to provide a snapshot of inhibitors and facilitators to achieve successful ageing. A systematic review of the 75+ older adults’ perspectives was conducted across PubMed, CINAHL, Scopus, Web of Science and PsycINFO. Qualitative, quantitative and mixed-methods original peer-reviewed studies were included. After reviewing 4,661 articles, 15 articles met the inclusion criteria and 15 themes were identified. They ranged from biomedical components such as physical functioning to psychosocial components such as relationships, reflections on life and past experiences, preparations for death and environmental factors. The findings revealed that as people age, their definition of successful ageing changes, expanding the current conceptualisation of successful ageing by including additional factors that can act as facilitators and/or inhibitors, such as death and environmental factors. The findings also highlight the need for further research on theory development by considering age-related differences and the perspectives of under-studied populations.

Temporality and the aging self. How subjective time is folding over its linear progression

We were interested in how the retirement transition shapes the structure of time and how these changes, in turn, affect the way people see themselves. Conceptualized as a relation between subjective time and self-concept, we theorized that it can shed more light on the heterogeneity of aging processes at the individual level. We used the narrative method to collect 14 life stories among elders with different retirement tenure. Three distinct time-structuring modes occurring as a response to the retirement transition were identified using the constructivist grounded theory methodology. However, these temporal positions tended to shift in more senior cases, mostly as a response to the contingencies of later life guided by inner functions of reflexivity. Those changes were usually not sudden, eliciting interesting problems of blended temporalities and temporal persistence, which we argue accounts for the duration of these shifts. In conclusion, we develop a conceptual understanding of self-concept in relation to the folding of subjective time and its linear progression in the individual aging process.

Finding the Silver Lining: Aging Well Amongst Older Brazilian Women in the Post-Migration Context

STUDY BACKGROUND

The aging population in Canada has been increasing steadily over the past 40 years, however, there is limited information about the meaning of aging well amongst older Brazilian women in Canada.

METHODS

A Heideggerian interpretive phenomenology study was conducted to understand the meaning of aging well amongst older Brazilian women in the post-migration context living in the Greater Toronto Area (GTA) in Ontario, Canada.

RESULTS

Eight older Brazilian women residing in the GTA were recruited through purposive and snowball sampling and participated in individual face-to-face interviews. Through data analysis and the incorporation of Heidegger's four existentials of human existence, the themes that emerged were (a) Embracing being part of a mosaic, (b) Aging with grace, (c) Chasing your dreams and (d) Being a bridge and not a fence. The overarching theme was: Finding the silver lining: Aging well.

CONCLUSION

This study informs nursing practice, research and policy development to advance the health of older immigrant adults in Canada.

Association Between Successful Aging Activities and Perceived Health Among Older Adults With Hearing and/or Vision Impairments

Due to the high prevalence of age-related sensory impairment (SI), this study examined the relative strength of the association between successful aging activities and perceived health among older adults with SI. A sample of adults aged 65 and older who experienced SI in vision and/or hearing was drawn from the 2015–2017 National Survey on Drug Use and Health ( N = 2,084). Two aspects of successful aging were considered: employment status and religious participation. Of the total sample, 1,370 (65.7%) reported hearing impairment; 440 (21.1%), vision impairment; and 274 (13.1%) dual sensory impairment. Among the covariates, female gender, higher educational attainment, non-Hispanic White race, fewer chronic diseases, alcohol use, non-hospitalization, non-cigarette use, and no mobility challenges were associated with greater perceived health status. Working older adults with SI are more likely to perceive their health status as good compared with their unemployed counterparts (odds ratio [OR] = 2.43, p < .01). Religious participants with SI also perceive greater health (OR = 1.58, p < .01). For older adults with SI, ensuring that they participate in productive activities, such as employment or religious activities, may be important for their perceived health status and may lead to better overall health outcomes.

Active Ageing across the Life Course: Towards a Comprehensive Approach to Prevention

"Active ageing" has become the leading scientific and policy conceptualization of a later life over the past two decades in the European Union (EU). It has been used as a key strategy for responding to demographic ageing. In the United States, in contrast, discourses around successful ageing have been more prevalent. This review article charts the development of active ageing responses to demographic change, showing how the concept compares with the notion of successful ageing and other terms associated with "ageing well." It identifies how, in practice, active ageing has been dominated by a narrow economic or productivist interpretation that prioritizes the extension of working life (to reduce the "burden" of population ageing). Such interpretations of active ageing undermine its value and emphasize the need for a more comprehensive approach which is set out. The development of the Active Ageing Index in 2012 provided a new analytical tool to promote evidence-based strategies towards population ageing. However, in practice, we show how it has not yet engaged fully with a comprehensive approach to active ageing or with the critical role of the life course in shaping the experience of old age. Nonetheless, this review article shows that the concept of active ageing still has an important role to play in our understanding of and responses to population ageing.

Testing a Proactive Model of Successful Aging Among Older Adults in Costa Rica and Spain

The purpose of this study is to examine successful aging among Spanish-speaking older adults in Costa Rica and in Spain using the proactive framework proposed by Kahana et al. (2014). More specifically, we hypothesized that older adults' life satisfaction would be positively associated with the frequency and perceived level of social support, spirituality/having purpose in life, and the use of proactive physical, cognitive, and social self-care behaviors. Our results confirmed these hypotheses, not only for the overall group of participants, but also separately for older adults in Costa Rica and in Spain. The present study contributes to the literature of successful aging among older adults, by examining the protective factors associated with life satisfaction among Spanish speaking older adults in Costa Rica and in Spain. It identifies specific protective factors (spirituality/purpose in life, social support, and self-care) associated with the values and preferences held by participants in the study.

Psychosocial Resources for Hedonic Balance, Life Satisfaction and Happiness in the Elderly: A Path Analysis

We explored possible paths from physical and mental health-related quality of life, self-efficacy, optimism, and social support to happiness in older adults, considering hedonic balance and life satisfaction as mediators. A total of 154 Spanish male and female (50%) older adults (65–96 years old, M = 77.44, SD = 8.03; 64% noninstitutionalized elderly) voluntarily participated in this correlational, cross-sectional study. The participants completed self-reports on their perceived health status, self-efficacy, social support, optimism, and global subjective well-being (SWB) as well as its dimensions. Path analysis was used to examine direct and indirect relationships. The final model had an excellent fit with the data (χ2(10) = 11.837, p = 0.296, χ2/df = 1.184; SRMR = 0.050, CFI = 0.994, RMSEA = 0.035), revealing the unique causal effects of all the included predictors on happiness. With the exception of self-efficacy, the psychosocial resources predicted older adults’ current happiness, and this relationship was fully mediated by hedonic balance and life satisfaction, which were found to be putative intermediary factors for SWB. Self-efficacy in turn predicted the remaining psychosocial resources. Our findings extend the existing evidence on the influences of health-related quality of life, self-efficacy, optimism, and social support on SWB. Furthermore, they support the proposal of hedonic balance and life satisfaction as dimensions of SWB, thus supporting the tripartite hierarchical model of happiness. These results may inform future interventions seeking to improve happiness in late adulthood.

What attributes of successful aging are important to older adults? The development of a multidimensional definition of successful aging

Older adults' experiences and perspectives have been missing in the quest to develop a unified definition of successful aging. Through an online survey using convenience sampling, respondents (N = 477) were asked to report how important 25 specific attributes of successful aging, originating from published literature that examined successful aging from the perspective of older adults, were to them as they age. Over 90% of respondents reported 11 attributes as important or very important to them as they age, which included "remaining free of chronic diseases" and "feeling good about myself." A factor analysis (N = 462) resulted in four dimensions explaining 57.06% of the variance: Adaptation and Coping; Being Healthy; Self-Determination; and Social Relationships and Interactions. The findings revealed older adults' definition of what is important to them as they age is multidimensional, with having access to affordable health care and remaining alert and mentally active as critical elements followed by elements of self-determination, coping, and physical and social health. Future research should replicate the study with diverse populations to continue to refine a definition of successful aging that could influence program development and intervention approaches in health and social services.