Successful Aging: Perceptions of Adults Aged between 70 and 101 Years

Autonomy, independence, and participation of nursing home habitants addressed by assistive technology: a scoping review

CONTEXT

Assistive technologies have been identified by researchers and public policies of the Western world to be promising tools to face the challenge of maintaining quality of life of older people, and especially for nursing home habitants. Independence, autonomy, and participation are major determinants of quality of life of nursing homes habitants. Maintaining quality of life is nowadays a priority for public health policies and institutions of the where the population is growing older every year.

METHOD

This PRISMA-ScR review aims to determine which assistive technologies are used to promote autonomy, independence, and social participation of nursing home habitants. An electronic search was conducted for English, French articles to identify research studies using CINAHL, PubMed, Cochrane Library, PsycINFO, and Googlescholar.

RESULTS

12 papers published between 2009 and 2023 described 6 assistive technologies: technologies integrated into the environment, monitoring technologies, surveillance technologies, information and communication technology, social assistance robots, virtual reality. Six types of AT are currently used worldwide to maintain autonomy, independence and participation of people living in nursing homes. Their use is mainly perceived as positive by habitants, care and non-care staff, next of kin, and experts despite some concerns regarding ethical, financial, consideration.

DISCUSSION

Nevertheless, their impact on habitant's autonomy, independence and participation still needs to be measured using suitable tools to understand their real impact on the quality of life of the elderly.

Perceptions of Successful Aging among Asian Americans

The current study explored Asian Americans' lay perceptions of successful aging and examined the differences and similarities between Asian Americans and White/Caucasian Americans. One hundred forty-five Asian American adults and 86 White/Caucasian adults were asked how they view successful aging. Open-ended responses were coded for recurring themes. The theme most often mentioned by Asian Americans was health, followed by quality of life, activities/interests, and social resources. Compared to White/Caucasian participants, Asian Americans' meaning of successful aging in the current study did not differ greatly in terms of major themes mentioned, but Asian Americans were more likely to mention certain themes, such as physical appearance and youthful look. In sum, the findings suggest that Asian Americans have a multifaceted understanding of successful aging, and reinforce the importance of cultural variations of the perceptions of successful aging.

Successful Aging in the Indian Socio-cultural Milieu

There is a growing recognition of the importance of subjective definitions of successful aging from a clinical and policy perspective, and for their social and cultural relevance. However, the voices of older Indians remain largely underrepresented in the emerging body of qualitative literature on successful aging. Given this gap, and India's burgeoning older population, the present study set out to examine their subjective perception of successful aging. Using convenience sampling, data was collected from older men and women (N = 63, M Age = 71.21) living in the community, and in old age homes in Delhi NCR, through face-to-face interviews and focus group discussions. Reflexive thematic analysis resulted in four primary themes and eight sub-themes - Successful Aging as Personal Well-being, Tensions between Agency and Fatalism, comprising three sub-themes viz. the person as an active agent, co-existence of agency and fatalism, and negotiating with the invisible powers; Linked Lives comprising two sub-themes viz. the aging parent and the adult child, and spousal interrelationship; and The Social and Built Environment comprising three sub-themes, viz. complexity of social life: the health interface, social life in the neighborhood, and the good house. These findings provide a culture-specific view of successful aging in the Indian context, and reveals the multifaceted conceptualization of successful aging of older Indians - one that encompasses various biopsychosocial components.

Determinants of healthy ageing: a systematic review of contemporary literature

Background

Healthy ageing frameworks have been highly explored. Our objective was to assess existing frameworks for healthy ageing and to identify commonly described factors that can potentially act as determinants of healthy ageing.

Methods

We carried out a systematic review by searching five electronic databases (EMBASE, MEDLINE, Cochrane, PsychINFO, and CINAHL) from January 2010 to November 2020 to capture contemporary evidence. Eligible studies needed to report a clear framework of healthy ageing in humans, within one or more of three domains (physical, mental/cognitive, social), in English. No restriction was placed on geographical location. Retrospective studies, studies that did not report a framework of healthy ageing, and studies with a focus on diagnostic measures were excluded.

Results

Of 3329 identified records, nine studies met our eligibility criteria and were included. Most of the studies were qualitative or cross sectional, and a majority were carried out in Asia, followed by North America, Australia, and Africa. The ten determinants identified for healthy ageing include physical activity, diet, self-awareness, outlook/attitude, life-long learning, faith, social support, financial security, community engagement, and independence.

Conclusions

We identified ten determinants of healthy ageing proposed by the contemporary evidence base. There appears to be increasing acknowledgement of the instrumental role of social and mental/cognitive well-being as determinants of healthy ageing. The extent to which each determinant contributes to healthy ageing requires further evaluation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40520-021-02049-w.

Active Aging In Long-Term Care Facilities In Korea : Beyond The Lexical Meaning

The discourse of active aging, as introduced by the WHO, aims at optimizing older adults' opportunities for health, participation, and security that could eventually enhance their social integration and quality of life. Considering that even those with frailty could strive for active aging in the given circumstances, we examined the meaning of active aging in long-term care settings and care strategies to promote it based on the WHO's framework. We conducted interviews with a total of 35 participants. The interpretative analyses revealed that the activities taken place in LTCFs have various scopes depending on older adults' physical and cognitive functional ability, and it captures the forms of activities that go beyond its lexical meaning. By defining being "active," the present findings could contribute to an understanding of how the three elements of active aging can be carried out in LTCFs.

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.

How Important Are Choice, Autonomy, and Relationships in Predicting the Quality of Life of Nursing Home Residents?

Older people face major challenges when they move into nursing homes, particularly in relation to independence and their ability to influence their activities of daily living (ADLs). This study evaluated the contribution of resident choice, as well as the staff-resident relationship, to promoting resident quality of life (QoL). A total of 604 residents from 33 nursing homes in Australia completed measures of QoL, perceived levels of choice in various ADLs, and the staff-resident relationship. A hierarchical regression demonstrated that the predictor variables accounted for 25% of the variance in QoL. Two of the four predictor variables (resident choice over socializing and the staff-resident relationship) significantly contributed to resident QoL. These findings reinforce the important contribution of autonomy and social relationships to resident QoL. Nursing home staff have a key role to play in supporting resident autonomy as a means of building residents' chosen social connections, and thereby promoting QoL.

Goals Do Not Buy Well-Being, but They Help

Abstract. Although personal goals give meaning to life and contribute to well-being, achieving goals can become difficult in older adults faced with age-related challenges. A group of 49 older adults aged 65 to 92 years completed a semistructured interview on personal goals, obstacles to goal achievement, and contributors to well-being. Using thematic analysis, we identified several types of goals contributing to well-being and general aspects of well-being. Results revealed that, although older people might say that they no longer have major goals in their lives, they end up mentioning many activities that theoretically are goals. Many of these activities are geared toward maintaining or increasing their general well-being. Of importance, they report few complaints regarding goal achievement, which they explained by (1) reducing the number and breadth of their goals, (2) adjusting and reevaluating these goals, and (3) overcoming difficulties and stabilizing current functioning, thereby maintaining a sense of continuity and satisfactory levels of well-being. This study illustrates the interactions between resources and stressors from the viewpoint of older adults. Taken together, the results advocate for the usefulness of the functional quality of life model and proactive approaches to successful aging, and they provide directions for individualized interventions in the elderly.

Aging Well on the Autism Spectrum: An Examination of the Dominant Model of Successful Aging

There is a gap in our knowledge of aging with autism. The present study examined the applicability of the popular gerontology concept of "aging well" to autistic adults. Using survey data, a model of "aging well" was operationalised and applied to 92 autistic adults and 60 controls. A very small proportion (3.3%) of autistic adults were found to be aging well. Significantly less autistic adults were "maintaining physical and cognitive functioning" and "actively engaging with life" in comparison to controls. Whilst important differences in health and functioning status were found, the current dominant model of "aging well" is limited for examining autistic individuals. Suggested adjustments include development of a broader, more flexible and strengths -based model.

Understanding the association between osteoarthritis and social participation: a CLSA population-based study

OBJECTIVE

The focus on disability in osteoarthritis (OA) has largely been on performing specific activities, neglecting wider implications for social participation (SP). We investigated the association between OA and SP considering activity limitations (AL) and instrumental supports (IS) as intervening variables in the association.

METHODS

Data were from 21,214 respondents aged 45-85 from cycle 1, Canadian Longitudinal Study on Aging. The questionnaire elicited: self-reported doctor-diagnosed OA; difficulty with 14 activities; perceived availability and receipt of IS; and 17 SP activities. Structural equation modeling was used.

PRIMARY OUTCOME

SP; Primary predictor: OA; Intervening variables: AL, received IS, perceived IS. Latent variables were developed for intervening and SP variables. Covariates: age, sex, body mass index, income, education, smoking, comorbidity count.

RESULTS

Mean age was 63 years, 51% were female, and 26.5% reported OA. Two distinct SP indicators were identified, SP-Diversity and SP-Intensity. Without considering intervening variables, minimal/no association was found between OA and SP. When considered, unique pathways linking OA and SP were found. The overall negative association between AL and SP was, in part, direct and, in part, buffered by both receipt and perceived availability of IS. Absent AL, OA was associated with greater SP.

CONCLUSIONS

Enhanced SP in people with OA without AL may reflect proactive steps taken by those with mild OA to maintain activity and social engagement. For those with AL, findings highlight the need for interventions to mitigate limitations and draw particular attention to the importance of both provision and awareness of available IS in maintaining SP.

Beyond Successful Aging 2.0: Inequalities, Ageism, and the Case for Normalizing Old Ages

This paper reviews challenges to Rowe & Kahn's Successful Aging (SA) framework, particularly those that focus on the ways social inequalities, including ageism, stratify age groups and affect possibilities for SA. We then assess the authors' replies to these critiques. We find that SA 2.0 maintains a naturalization of outcomes of age relations, and retains both its focus on personal choice and its indifference to inequalities. We advocate a paradigm shift that recasts the problems of aging in three distinct ways: 1) avoids treating old age as a problem; 2) avoids treating medical and other maladies as results of aging; and 3) treats the problems of old age as results of age relations instead. By focusing on age relations, this paradigm goes beyond calls to examine inequalities over the life course, and seeks to normalize old ages, valuing both different modes of aging and old age itself.

A research on the effects of successful aging on the acceptance and use of technology of the elderly

The aim of the study is to analyze the effects of successful aging on technology acceptance and use behaviors, via developing a model. This study was conducted with 687 participants in five Retirement Rest Homes in Turkey. A model was developed to meet the study's research objectives using the scales of successful aging and the second unified theory of acceptance and use of technology. A path analysis was performed with Partial Least Squares (PLS) structural equation model. Struggle Against Difficulties (SAD) significantly predicted performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic motivation, price value, habit, and behavior intention, even though SAD did not predict USE. HLH significantly predicted performance expectancy, social influence and facilitating conditions; HLH did not predict effort expectancy, hedonic motivation, price 15 value, habit, behavior intention, and USE. It was revealed that successful aging affected the technology acceptance model in general except the use of technology. It is recommended for future studies that successful aging should be evaluated with varied model studies.

"Something to Live for": Experiences, Resources, and Personal Strengths in Late Adulthood

Due to increased life expectancy, the population segment of older adults has grown the fastest. The global phenomenon of population aging raises important questions regarding successful, positive, active, and meaningful aging. Given that aging is often characterized by declines in physical and mental health and increased risk for social isolation and depression, and given that the concept of well-being in old age is both elusive and complex, the present study explored how aging is experienced through a "bottom-up," open-ended approach. Thirty-one in-depth semi-structured personal interviews were conducted with adults aged 60 and above in order to explore the question: what concerns older adults in their day-to-day living, and what are their perceived resources? The findings illuminated three prominent themes: (1) central concerns described by the participants as characterizing their experience at this life stage; (2) strategies employed by the participants to cope with concerns and to live a meaningful life in old age; and (3) resources and character strengths that facilitate coping strategies and enable thriving. Theoretical and practical implications of the findings are discussed.

Proactive Aging Among Holocaust Survivors: Striving for the Best Possible Life

Objectives

To investigate methods that older Holocaust survivors and their age peers use in order to maintain the best possible life and to examine associations between these methods and subjective well-being.

Method

Participants were 481 older Israelis (mean age 77.4 ± 6.7 years): Holocaust survivors (n = 164), postwar immigrants (n = 183), and prewar immigrants (n = 134). Measures included sociodemographics and indicators of health and well-being. Respondents were asked to answer an open-ended question: "What are the methods you use to maintain the best possible life?". Answers were coded into eight categories.

Results

Holocaust survivors were significantly less likely to mention methods coded as "Enjoyment" (32.3%) relative to postwar (43.7%) and prewar (46.2%) immigrants and significantly more likely to mention methods coded as "Maintaining good health" (39.0%) relative to postwar (27.9%) and prewar (21.6%) immigrants. Controlling for sociodemographics and health status, Holocaust survivors still differed from their peers.

Discussion

Aging Holocaust survivors tended to focus on more essential/fundamental needs (e.g., health), whereas their peers tended to focus on a wider range of needs (e.g., enjoyment) in their effort to maintain the best possible life. Our findings may add to the proactivity model of successful aging by suggesting that aging individuals in Israel use both proactive (e.g., health) and cognitive (e.g., accepting the present) adaptation methods, regardless of their reported history during the war.

Determinants of Successful Aging in a Cohort of Filipino Women

This study describes a multidimensional measure of successful aging (SA) and examines the relationship with chronic disease status and self-reported health. Using data from the 2015 Cebu Longitudinal Health and Nutrition Survey of 1568 Filipino women, we created a four domain measure of SA (physiological, mental health, cognitive, sociological). We explored age-stratified associations of each domain and total SA with various health behaviors, chronic disease status, and correlations with self-reported health measures. Both age groups reported aging well, but younger women had higher mean SA scores. Association patterns between domain and total SA and sociodemographic and health behaviors were similar across age groups. Physiological score was associated with hypertension for all ages, and with diabetes in younger women. Total SA was moderately correlated with self-reported health measures. Participants reported aging successfully despite chronic disease status. Future studies should use a multidimensional definition of SA which incorporates elders’ perspective.

Work and the Family in Later Life: The Effects of Role Stressors, Role Enhancement, and Role Conflict on Self-Perceptions on Aging

The growing aging workforce comprises older workers with a concurrent family role. Guided by life span development and role theories, the primary study hypothesis was that rewards and stressors in the family and work domains would impact self-perceptions on aging because of the enhancement and conflict between these domains. The study sample consisted of workers older than 50 years with at least one of four family roles (spouse, parent of adult children, caregiver to an aging parent, and grandparent) from the 2010 and 2012 Health and Retirement Study ( N = 5,628). Results showed that self-perceptions on aging were impacted directly by family and work stressors and indirectly by these stressors through work-family enhancement and conflict . Work and family roles are thus crucial to the identity of adults in later life.

Overview of measurement-based positive psychiatry

BACKGROUND

Psychiatry has traditionally focused on studying psychopathology and treating mental illnesses to relieve symptoms and prevent relapse. Positive psychiatry seeks to expand the scope of psychiatry to broader aspects of mental health and well-being among individuals with or without mental illnesses. Positive psychosocial factors such as well-being, resilience, optimism, wisdom, and social support are central to positive psychiatry.

AIM

To summarize the emerging science of positive psychiatry, emphasizing the use of measures of positive characteristics and outcomes relevant to mental health.

METHODS

Overview of recent research in positive psychiatry, focusing on measurements.

RESULTS

Positive psychosocial factors are associated with better mental and physical health in diverse populations. Among individuals with serious mental illnesses, levels of these factors vary considerably, but positive psychiatry interventions can improve well-being and rates of recovery in at least subsets of the patients. A number of measures of positive factors and outcomes are available; most of them are based on self-reports, which have advantages as well as limitations.

CONCLUSIONS

Positive psychiatry has the potential to improve the health and well-being of individuals with or without mental illnesses. Further research is needed to provide clinicians and investigators with a full tool-box of validated measures for positive psychosocial factors and outcomes. These measures should be subjected to rigorous psychometric evaluation across populations to help clarify mechanisms underlying positive factors, evaluate their longitudinal trajectories, and examine the impact of interventions on health and well-being over the lifespan in different clinical groups.

Adult Children's Relationship to Parent Influences Their Views on Aging and Attitude Toward Own Aging

The goal of this study was to examine how the quality of relationship between parent and adult children influences adult children’s views on aging and attitude toward their own aging and whether the effects of relationship qualities depend on parents’ health and adult children’s perceptions of how well their parents were aging. The sample included 217 adult children aged 18 to 73. Findings revealed that different parent–child relationship quality dimensions (i.e., support, conflict, depth, ambivalence) differentially influenced adult children’s view on aging (positive and negative) and attitude toward own aging, and some of these effects depended on levels of parental health and the way adult children view how successfully their parents were aging. The quality of the relationship to one’s parents has an important role in shaping adults’ views on aging and experience of their own aging, highlighting the importance of incorporating the role of family context to further enhance our understanding of how individuals develop perceptions of aging.

Knowledge and perceptions about aging and frailty: An integrative review of the literature

A growing body of evidence indicates that biological aging or frailty is a determinant of health-related outcomes, however, frailty is likely poorly understood and under-recognized by the public-at-large. Using Whittemore and Knafl's methodology, we aimed to conduct an integrative review of research on public knowledge and perceptions of aging and frailty, and to create a conceptual model of our findings. Twenty-three studies are presented. The conceptual model suggests that culture, knowledge of aging, and stereotypes influence adults' beliefs and perceptions. Adults determine priorities about aging, and then subconsciously or consciously determine which parts of are controllable. If deemed controllable and important, they may participate in health behaviors to mediate aging. If deemed uncontrollable or less important, adults may aim to control their own peace of mind through acceptance. Scant findings suggest that frailty is a more subjective term in which participants often optimistically do not identify themselves as frail.

Successful Aging: Illness and Social Connections

The objective of this study was to examine the role of social determinants of health: gender, income, education, housing, and social connections in successful aging in older adults aging with illness. Participants were 50 adults aged 65⁻90 years, all aging in place in their own home, and reporting at least one illness. This pilot study used non-probability sampling and employed both online and in-person interviews. The majority (82%) were aging "successfully" or "somewhat successfully" as reported on the single item successful aging scale and demonstrated by their scores on the Successful Aging Inventory (SAI). Correlations were not significant between SAI and gender, income, education, or housing. A significant negative correlation was found between SAI and community activity. However, there were significant positive correlations between SAI and religious activity and relationships. The regression model was a linear combination of participants' community and religious activity and relationships. The majority of older adults aging with illness consider themselves to be aging successfully, but their scores are influenced by relationships with others as well as religious and community activity. Frequent community activity had a suppressor effect on successful aging.

Successful aging as a multidimensional concept: An integrative review

Background: Successful aging as an umbrella term with a large amount of literature has emerged with a variety of meanings and dimensions in different studies. This article aims at determining what dimensions contribute to constructing the concept of successful aging. Methods: The method used in this study is an integrative review of published literature related to successful aging. This method includes both qualitative and quantitative studies. Data searching was conducted during November and December 2014 and was then updated in October 2015. First, 2543 articles were identified, and after the screening phase, 76 articles were eligible for inclusion in the integrative review. Results: The results specified 14 subcategories and 5 main categories of successful aging: social well-being, psychological wellbeing, physical health, spirituality and transcendence, and environment and economic security. Conclusion: The present study provides a thorough understanding of successful aging dimensions and proposes the importance of the multidimensional concept of successful aging at the individual, interpersonal, and environmental levels for future studies and policymaking on population aging.

A qualitative description of successful aging through different decades of older adulthood

OBJECTIVE

To qualitatively examine factors that contribute to successful aging during different decades of older adulthood.

METHODS

Fundamental qualitative description was adopted as the methodological framework. Through purposeful sampling, 42 community dwelling older adults (mean age = 79.6 years, age range = 65-97 years; 19 males) were recruited. Focus groups (6) segmented by decade of life were conducted with participants 65-74 (n = 17) and 75-84 (n = 17) years of age. Semi-structured interviews (16) were conducted with four participants from each decade, as well as participants 85 years of age and older (n = 8). Data analyses were conducted independently for each decade of life and included inductive analysis of textual data through continuous comparisons of meaning units.

RESULTS

Three primary themes related to successful aging were identified across all decades of older adulthood: (1) staying healthy (secondary themes: genetics and lifestyle choices), (2) maintaining an active engagement in life (secondary themes: social engagement and cognitive engagement), and (3) keeping a positive outlook on life. Participants in specific decades of older adulthood identified three additional secondary themes related to maintaining an active engagement in life: finances (65-74 and 85+ years), social support (75+ years), and successful marriage (75+ years). Similarly, only adults 65-84 years of age identified a secondary theme for keeping a positive outlook on life: acceptance and adaptation.

CONCLUSION

Primary themes related to successful aging were agreed upon by participants in all decades of older adulthood, while age-based differences existed among secondary themes. Thus, what it means to age successfully may be age-dependent.

Zen and the Art of Living Mindfully: The Health-Enhancing Potential of Zen Aesthetics

Amidst the burgeoning enthusiasm for mindfulness in the West, there is a concern that the largely secular 'de-contextualized' way in which it is being harnessed is denuding it of its potential to improve health and well-being. As such, efforts are underway to 're-contextualize' mindfulness, explicitly drawing on the wider framework of Buddhist ideas and practices in which it was initially developed. This paper aims to contribute to this, doing so by focusing on Zen Buddhism, and in particular on Zen aesthetic principles. The article concentrates on the seven principles identified by Hisamatsu (1971) in his classic text Zen and the Fine Arts: kanso (simplicity); fukinsei (asymmetry); koko (austere sublimity); shizen (naturalness); daisuzoku (freedom from routine); sei-jaku (tranquillity); and yūgen (profound grace). The presence of these principles in works of art is seen as reflecting and communicating insights that are central to Buddhism, such as non-attachment. Moreover, these principles do not only apply to the creation and appreciation of art, but have clear applications for treating health-related issues, and improving quality of life more generally. This paper makes the case that embodying these principles in their lives can help people enhance their psychosomatic well-being, and come to a truer understanding of the essence of mindful living.

The Role of Existential Beliefs Within the Relation of Centenarians' Health and Well-Being

The purpose of this study was to explore the role of existential beliefs in mediating the influence of health on centenarians' well-being. A total of 80 centenarians (mean age 101.1; SD = 1.3; 81.3 % women) with no/minor cognitive impairment were included. The OARS questionnaire for diseases and functional capacity (ADL, IADL), the Satisfaction with Life Scale, and the existential beliefs subscale were used for data collection. The findings suggest that existential resources are a crucial element for mitigating the impact of health constraints in subjective well-being in this population. Appropriate models of intervention for very old age that recognize the importance of religion, spirituality, and meaning of life are to be considered.

Who Is Your Successful Aging Role Model?

Objectives

Having a role model of successful aging may contribute to views on aging. This article investigated the nature and correlates of young, middle-aged, and older adults' successful aging role models.

Method

One hundred and fifty-one individuals aged 18-99 were asked whether they had a role model of successful aging and if so, the reasons for their choice. Open-ended answers were coded for recurring themes. Views on aging and attitudes toward own aging were assessed with questionnaires.

Results

Eighty-five percent of participants indicated at least one role model. Most mentioned role models from their family, including parents and grandparents. Role models were gender matched. Most frequent reasons for model choices were health, activities, and social resources. Participants with family role models had less negative views on aging. Mediation analyses confirmed that family role models were associated with more reasons for role model choice, which in turn was associated with less negative views on aging. Furthermore, the effect of reasons on attitudes toward own aging was mediated by negative views on aging.

Discussion

Young, middle-aged, and older adults have role models for successful aging. Links between role model features and views on aging suggest that role models may be useful in promoting successful aging.

Making meaning around experiences in interventions: identifying meaningfulness in a group-based occupational therapy intervention targeting older people

There is a need to understand the underlying mechanisms at work within health promotion and occupational therapy interventions. The aim of this article was, therefore, to explore and describe how the participants of a group-based occupational therapy intervention with positive health outcomes created meaning of and around their experiences of the intervention. The studied intervention was part of the evaluation of a single-blinded, exploratory randomised controlled trial of three different interventions. A total of 19 participants between 77 and 82 years of age with experiences from the group-based intervention were interviewed, and the transcribed interviews were analysed from a constructivist approach. The results showed five different perspectives of meaning, including enjoyment, usefulness, togetherness, respect for individuality and self-reflection. Based on our findings, we argue that the possibility of getting information, sharing with others and having fun, and the ability to adjust the activities in the intervention so that they met the individual's needs, created meaning for the participants. Moreover, meeting with others supported the participants’ perspectives of themselves. The results are discussed in relation to the pervasive discourse of successful ageing, including how it was present but also challenged within the participants’ accounts of the intervention.

The relationship between sensory-processing patterns and occupational engagement among older persons

BACKGROUND

Meaningful occupational engagement is essential for successful aging. Sensory-processing abilities that are known to deteriorate with age may reduce occupational engagement. However, the relationship between sensory-processing abilities and occupational engagement among older persons in daily life is unknown.

PURPOSE

This study examined the relationship between sensory-processing patterns and occupational engagement among older persons.

METHOD

Participants were 180 people, ages 50 to 73 years, in good health, who lived in their homes. All participants completed the Adolescent/Adult Sensory Profile and the Activity Card Sort.

FINDINGS

Better registration of sensory input and greater sensory seeking were related to greater occupational engagement.

IMPLICATIONS

Sensory-processing abilities among older persons and their relation to occupational engagement in various life settings should receive attention in research and practice. Occupational therapists should encourage older people to seek sensory input and provide them with rich sensory environments for enhancing meaningful engagement in real life.

Personality, Emotional Qualities of Leisure, and Subjective Well-Being in the Elderly

In this study, we examined personality traits of older adults and their emotional experiences associated with engaging in specific leisure activities. Older individuals (17 males, 32 females), ages ranging from 65 to 97 years (mean age 74), completed measures of Big Five personality traits, positive and negative affect, subjective well-being (SWB), independent functioning, and an emotion-activity inventory. As expected, Extraversion, Agreeableness, Conscientiousness, and Openness to experience were related to positive affect, while Neuroticism was related to negative affect. Openness and Agreeableness were related to positive emotions experienced in social and cognitive domains, and Agreeableness was related to greater SWB, greater positive affect, and more positively experienced activities. Neuroticism was related to lower SWB and fewer positively experienced activities. These findings suggest that assessing the fit between personality and emotions experienced during activities should be considered when creating programs tailored to elderly individuals, with the goal of encouraging more active and rewarding lives.

Successful aging: considering non-biomedical constructs

OBJECTIVES

Successful aging continues to be applied in a variety of contexts and is defined using a number of different constructs. Although previous reviews highlight the multidimensionality of successful aging, a few have focused exclusively on non-biomedical factors, as was done here.

METHODS

This scoping review searched Ovid Medline database for peer-reviewed English-language articles published between 2006 and 2015, offering a model of successful aging and involving research with older adults.

RESULTS

Seventy-two articles were reviewed. Thirty-five articles met the inclusion criteria. Common non-biomedical constructs associated with successful aging included engagement, optimism and/or positive attitude, resilience, spirituality and/or religiosity, self-efficacy and/or self-esteem, and gerotranscendence.

DISCUSSION

Successful aging is a complex process best described using a multidimensional model. Given that the majority of elders will experience illness and/or disease during the life course, public health initiatives that promote successful aging need to employ non-biomedical constructs, facilitating the inclusion of elders living with disease and/or disability.

Older Adults' Online Dating Profiles and Successful Aging

This study examined how relevant Rowe and Kahn's three criteria of successful aging were to older adults' self-portrayals in online dating profiles: low probability of disease and disability, high functioning, and active life engagement. In this cross-sectional study, 320 online dating profiles of older adults were randomly selected and coded based on the criteria. Logistic regression analyses determined whether age, gender, and race/ethnicity predicted self-presentation. Few profiles were indicative of successful aging due to the low prevalence of the first two criteria; the third criterion, however, was identified in many profiles. Native Americans were significantly less likely than other ethnic groups to highlight the first two criteria. Younger age predicted presenting the first criterion. Women's presentation of the third criterion remained significantly high with age. The findings suggest that the criteria may be unimportant to older adults when seeking partners, or they may reflect the exclusivity of this construct.

Aspirations for Older Age in the 21st Century: What is Successful Aging?

The literature on successful aging reveals a wide range of definitions, generally reflecting the academic discipline of the investigator. Biomedical models primarily emphasise physical and mental functioning as successful aging; socio-psychological models emphasise social functioning, life satisfaction and psychological resources as successful aging. Several studies also identify these factors as the precursors of successful aging. Moreover, research shows that older people consider themselves to have aged successfully, but classifications based on traditional medical models do not. Fewer studies have explored lay views, and most of these have been exploratory or restricted to specific groups of areas. A model of successful aging needs to be multi-dimensional, incorporate a lay perspective for social significance, use a continuum rather than dichotomous cut-offs for “success” and lack of, and distinguish clearly between predictor and constituent variables.

Correlates of Successful Aging: Are They Universal?

The analysis compared differing correlates of life satisfaction among three diverse population groups in Israel, examining background and health status variables, social environment factors, and activity indicators. Multiple regression analysis revealed that veteran Jewish-Israelis ( n = 2,043) had the largest set of predictors, the strongest of which was health status. Among Arab-Israelis ( n = 609), social visitation served as a significant base for life satisfaction. The predictors among the new immigrant group ( n = 751) reflected the search for social ties beyond the immediate family. The analysis underscores the universal basis of successful aging, especially the contribution of health status. However, it also clarifies that the specific components of some of the general categories of predictors work in different ways among different population groups.

Positive psychiatry: its time has come

Traditionally, psychiatry has been defined and practiced as a branch of medicine focused on the diagnosis and treatment of mental illnesses. Based on growing empirical evidence, we believe that this definition warrants expansion to include the concept of positive psychiatry. In the present article, we provide a critical overview of this emerging field and a select review of relevant scientific literature. Positive psychiatry may be defined as the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions involving positive psychosocial characteristics (PPCs) in people who suffer from or are at high risk of developing mental or physical illnesses. It can also benefit nonclinical populations. Positive psychiatry has 4 main components: (1) positive mental health outcomes (eg, well-being), (2) PPCs that comprise psychological traits (resilience, optimism, personal mastery and coping self-efficacy, social engagement, spirituality and religiosity, and wisdom-including compassion) and environmental factors (family dynamics, social support, and other environmental determinants of overall health), (3) biology of positive psychiatry constructs, and (4) positive psychiatry interventions including preventive ones. There are promising empirical data to suggest that positive traits may be improved through psychosocial and biological interventions. As a branch of medicine rooted in biology, psychiatry, especially with the proposed conceptualization of positive psychiatry, is well poised to provide major contributions to the positive mental health movement, thereby impacting the overall health care of the population.

How could lay perspectives on successful aging complement scientific theory? Findings from a u.s. And a German life-span sample

PURPOSE OF THE STUDY

This article investigates lay perspectives of the concept of successful aging in young, middle-aged, and older adults from 2 cultures, the United States and Germany, to potentially guide the development of scientific theories of successful aging. The empirical findings are embedded in a comprehensive overview of theories of successful aging and life-span development and offer implications for theory development.

DESIGN AND METHODS

Two samples of young, middle-aged, and older adults from the United States (N = 151) and Germany (N = 155) were asked about definitions and determinants of successful aging. Codes were developed to capture common themes among the answers, resulting in 16 categories.

RESULTS

Themes mentioned included resources (health, social), behaviors (activities), and psychological factors (strategies, attitudes/beliefs, well-being, meaning). There were striking similarities across countries, age, and gender. Health and Social Resources were mentioned most frequently, followed by Activities/Interests, Virtues/Attitudes/Beliefs, Well-being, and Life management/Coping. Age differences were limited to Growth/Maturation and Respect/Success, and gender differences were limited to Social Resources and Well-being. Educational and cultural effects were limited to psychological factors and Education/Knowledge, which were more often mentioned by U.S. participants and individuals with more education.

IMPLICATIONS

Young, middle-aged, and older lay persons from the United States and Germany have quite similar concepts of successful aging, which they view in far more multidimensional terms than do established scientific theories (Rowe & Kahn, 1998). Given evidence that factors mentioned by laypeople do promote successful aging, considering them in more comprehensive theoretical models may enhance our understanding.

Critical perspectives on successful aging: does it "appeal more than it illuminates"?

"Successful aging" is one of gerontology's most successful ideas. Applied as a model, a concept, an approach, an experience, and an outcome, it has inspired researchers to create affiliated terms such as "healthy," "positive," "active," "productive," and "effective" aging. Although embraced as an optimistic approach to measuring life satisfaction and as a challenge to ageist traditions based on decline, successful aging as defined by John Rowe and Robert Kahn has also invited considerable critical responses. This article takes a critical gerontological perspective to explore such responses to the Rowe-Kahn successful aging paradigm by summarizing its empirical and methodological limitations, theoretical assumptions around ideas of individual choice and lifestyle, and inattention to intersecting issues of social inequality, health disparities, and age relations. The latter point is elaborated with an examination of income, gender, racial, ethnic, and age differences in the United States. Conclusions raise questions of social exclusion and the future of successful aging research.

Individual and social determinants of self-rated health and well-being in the elderly population of Portugal

This article aims to identify the main determinants of self-rated health and well-being in the elderly Portuguese population, using a set of dimensions including demographic and socioeconomic indicators, characteristics of interpersonal networks and social activities, health, sexual activity, representations of aging, and feeling of happiness. Taking socioeconomic, behavioral, and attitudinal predictors into account to analyze the explanatory value of the interrelated dimensions and weights for each factor, the author argues that social capital, activities associated with active aging, and greater optimism towards aging can contribute greatly to better self-rated health and wellbeing among the elderly, partially offsetting the effect of socioeconomic factors and illness associated with age.

Candidate SNP associations of optimism and resilience in older adults: exploratory study of 935 community-dwelling adults

OBJECTIVE

Optimism and resilience promote health and well-being in older adults, and previous reports suggest that these traits are heritable. We examined the association of selected single-nucleotide polymorphisms (SNPs) with optimism and resilience in older adults.

DESIGN

Candidate gene association study that was a follow-on at the University of California, San Diego, sites of two NIH-funded multi-site longitudinal investigations: Women's Health Initiative (WHI) and SELenium and vitamin E Cancer prevention Trial (SELECT).

PARTICIPANTS

426 women from WHI older than age 50 years, and 509 men older than age 55 years (age 50 years for African American men) from SELECT.

MEASUREMENTS

65 candidate gene SNPs that were judged by consensus, based on a literature review, as being related to predisposition to optimism and resilience, and 31 ancestry informative marker SNPs, genotyped from blood-based DNA samples and self-report scales for trait optimism, resilience, and depressive symptoms.

RESULTS

Using a Bonferroni threshold for significant association (p = 0.00089), there were no significant associations for individual SNPs with optimism or resilience in single-locus analyses. Exploratory multi-locus polygenic analyses with p <0.05 showed an association of optimism with SNPs in MAOA, IL10, and FGG genes, and an association of resilience with a SNP in MAOA gene.

CONCLUSIONS

Correcting for Type I errors, there were no significant associations of optimism and resilience with specific gene SNPs in single-locus analyses. Positive psychological traits are likely to be genetically complex, with many loci having small effects contributing to phenotypic variation. Our exploratory multi-locus polygenic analyses suggest that larger sample sizes and complementary approaches involving methods such as sequence-based association studies, copy number variation analyses, and pathway-based analyses could be useful for better understanding the genetic basis of these positive psychological traits.

Profile and determinants of successful aging in the Ibadan Study of Ageing

OBJECTIVES

To determine the profile and determinants of successful aging in a developing country characterized by low life expectancy and where successful agers may represent a unique group.

DESIGN

Community-based cohort study.

SETTING

Eight contiguous states in the Yoruba-speaking region of Nigeria.

PARTICIPANTS

A multistage clustered sampling of households was used to select a representative sample of individuals (N = 2,149) aged 65 and older at baseline. Nine hundred thirty were successfully followed for an average of 64 months between August 2003 and December 2009.

MEASUREMENTS

Lifestyle and behavioral factors were assessed at baseline. Successful aging, defined using each of three models (absence of chronic health conditions, functional independence, and satisfaction with life), was assessed at follow-up.

RESULTS

Between 16% and 75% of respondents could be classified as successful agers using one of the three models while 7.5% could be so classified using a combination of all the models. Correlations between the three models were small, ranging from 0.08 to 0.15. Different features predicted their outcomes, suggesting that they represent relatively independent trajectories of aging. Whichever model was used, more men than women tended to be classified as aging successfully. Men who aged successfully, using a combination of all the three models, were more likely never to have smoked (adjusted odds ratio (aOR) = 4.7, 95% confidence interval (CI) = 1.55-14.46) and to report, at baseline, having contacts with friends (aOR = 4.2, 95% CI = 1.0-18.76) or participating in community activities (aOR = 16.0, 95% CI = 1.23-204.40). In women, there was a nonlinear trend for younger age at baseline to predict this outcome.

CONCLUSION

Modifiable social and lifestyle factors predicted successful aging in this population, suggesting that health promotion targeting behavior change may lead to tangible benefits for health and well-being in old age.

Lay perspectives of successful ageing: a systematic review and meta-ethnography

OBJECTIVES

The aim of the current study was to conduct a systematic review of lay perspectives of successful ageing (SA), synthesise these data using a metaethnographic framework and to provide a snapshot of extant lay perspectives of SA.

DESIGN

A systematic review of layperson perspectives of SA was conducted across MEDLINE, PsycInfo, CINAHL, EMBASE and ISI Web of Knowledge.

PARTICIPANTS

Peer-reviewed studies conducting qualitative investigations of lay perspectives of SA were included. Included studies were coded and analysed using NVivo V.9 to examine underlying themes of SA.

RESULTS

The search strategy identified 7285 articles; 26 articles met the inclusion criteria. Laypersons identified psychosocial components, notably engagement (eg, social engagement), and personal resources (eg, attitude) as integral components of SA more often than 'physiological' components, such as longevity or physical functioning. These results also highlight the profound under-representation of non-Western countries and the cultural homogeneity of research participants.

CONCLUSIONS

The current study reveals the importance laypersons place on incorporating psychosocial components into multidimensional models of SA, as well as highlighting the need for increased research with under-represented populations.

Self-respect through ability to keep fear of frailty at a distance: successful ageing from the perspective of community-dwelling older people

With population ageing, there is an increased interest in how to promote a good old age. A predominant concept in these discussions is successful ageing, which is mainly based on researchers’ definitions. This article aims to explore successful ageing from the perspective of community-dwelling older people (24 persons aged 77–90 years). Individual open interviews were conducted and analysed according to qualitative content analysis. An overarching theme was formulated as “self-respect through ability to keep fear of frailty at a distance”. This embraced the content of four categories: “having sufficient bodily resources for security and opportunities”, “structures that promote security and opportunities”, “feeling valuable in relation to the outside world”, and “choosing gratitude instead of worries”. Ageing seems to be a dynamic process rather than a static structure and might therefore be susceptible to actions. Paying attention to attitudes and treating the older person with respect, particularly with regard to worries about increasing vulnerability, can lead to better ways of promoting successful ageing.

An examination of successful aging among Southern Black and White older adults

Research on successful aging in minority older adults and those from certain regions of the United States, such as the South, is lacking. It is important to learn whether disparities exist in Southern Black older adults' perceptions of successful aging compared to those of majority older adults. Thus, this study examined successful aging using focus groups to obtain a regionally and racially sensitive understanding of the phenomenon. Focus group sessions were facilitated with Southern Black and White older adults with questions on successful aging, using content analysis to interpret the findings. Four central themes were found: Connecting and Relating; Temporality; Perception and Interpretation; and Activity. Beliefs and decisions about managing oneself through life events, including health problems and disability, may have a major influence on the trajectory of progressive, chronic illness, and consequently, successful aging.

Universal Design: A Step toward Successful Aging

The concept of aging successfully has become increasingly important as demographics shift towards an aging population. Successful aging has been defined to include (1) a low probability of disease and disease-related disability; (2) a high level of physical and cognitive functioning; and (3) an active engagement in life. The built environment can create opportunities or constraints for seniors to participate in social and productive activities. Universally designed spaces are more easily accessed and used by a spectrum of people without specialized adaptations. Thus, a universally designed environment creates opportunities for older adults to participate in these activities without the stigmatization associated with adapted or accessible designs. Providing older adults with specific universal design options (e.g., lever handle faucets) has the potential to increase the ease of completing activities of daily living, which promotes a continual engagement in life. Literature regarding universal design is promising; however, its theory requires further attention from professionals designing the built environment, evidence of the significance of its application from academics, and the embracement of its core principles from society. Overall, universal design has the potential to provide a stepping stone toward successful aging.

"I'm still raring to go": successful aging among lesbian, gay, bisexual, and transgender older adults

While we know that minority status differentiates the experience of aging, little research has been done to examine the ways in which patterns of successful aging may differ in diverse subgroups of older adults. In this exploratory study, we investigated and described experiences of successful aging in a sample of lesbian, gay, bisexual and transgender (LGBT) older adults. Directed by a community-based participatory research process, we conducted semi-structured in-depth interviews with 22 LGBT adults, age 60 and older. We took an inductive, grounded theory approach to analyze the taped and transcribed interviews. We coded respondent experiences in four domains: physical health, mental health, emotional state and social engagement. Four gradations of successful aging emerged. Very few in our sample met the bar for "traditional success" characterized by the absence of problems in all four domains of health. Most of the sample was coping to a degree with problems and was categorized in one of two gradations on a continuum of successful aging: "surviving and thriving" and "working at it." A small number was "ailing": not coping well with problems. Some of the experiences that respondents described were related to LGBT status; others were related to more general processes of aging. The research suggests that a successful aging framework that is modified to include coping can better describe the experiences of LGBT older adults. The modified conceptual model outlined here may be useful in future research on this population, as well as more broadly for diverse populations of adults, and may be adapted for use in practice to assess and improve health and well-being.