Capturing the Diversity of Successful Aging: An Operational Definition Based on 16-Year Trajectories of Functioning

Kok, A.; Aartsen, Marja; Deeg, Dorly J. H.; Huisman, Martijn

doi:10.1093/geront/gnv127

Cited by 59 publications

(78 citation statements)

References 38 publications

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“…Cluster 3 'Depressed' is an intermediary group with both functional limitations and depression values between these two extremes but notable depression levels despite only physical limitations (see averages in Table 1). Clusters 1, 3, and 5 are in line with a linear and mutually reinforcing association between physical and mental health in the last years of life (Chang et al 2009;Hsu and Jones 2012;Kok et al 2015). In contrast, the 'Resilient' and 'Moderately impaired' groups both show stable low depression trajectories combined with very high and medium functional limitations, thus supporting a nonlinear interactive relationship between physical and mental health at the end of life for part of the population (RQ 1).…”

Section: Methodsmentioning

confidence: 54%

“…Findings thereby support a nonlinear interactive pattern between physical and mental health in the medium and high range of functional limitations. The 'Functional' and 'Moderately impaired' groups highlight heterogeneity within relatively high functioning aging processes and could be considered different variants of 'successful aging' (Kok et al 2015). In addition, the 'Resilient' group could be considered as successful aging in terms of psychological wellbeing despite severe functional limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Research has only relatively recently started to examine longitudinal trajectories of change in physical and mental health at the end of life, usually focusing on only one health dimension (Diegelmann, Schilling, and Wahl 2016;Gill et al 2010;Wolf 2016). A multidimensional perspective on end-of-life health trajectories is important to assess the variants of 'successful aging' and their temporal dynamics in order to give a more complete picture of individual aging experiences (Kok et al 2015;Rowe and Kahn 1987). To date, the dynamic parallel development of physical and mental health in old age remains relatively unexplored for at least two reasons.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pathways to death: The co-occurrence of physical and mental health in the last years of life

Raab¹,

Fasang²,

Heß³

2018

DemRes

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Section: Methodsmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pathways to death: The co-occurrence of physical and mental health in the last years of life

Raab¹,

Fasang²,

Heß³

2018

DemRes

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“…Prior studies on trajectories of functional decline during various stages of the aging process have identified up to 8 different trajectories [6][7][8][9][10]. One study in 65-to 85year-olds identified 3 distinct trajectories over 10 years: one including people with substantial decline at the age of 65 years, one including people who gradually started to decline at the age of 65 years with increased progression from the age of 75 years, and one including people who did not decline until above 80 years [8].…”

Section: Introductionmentioning

confidence: 99%

Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

Jonkman

Panta²,

Hoekstra³

et al. 2017

Gerontology

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Background: Early identification of people at risk of functional decline is essential for delivering targeted preventive interventions. Objective: The aim of this study is to identify and predict trajectories of functional decline over 9 years in males and females aged 60-70 years. Methods: We included 403 community-dwelling participants from the InCHIANTI study and 395 from the LASA study aged 60-70 years at baseline, of whom the majority reported no functional decline at baseline (median 0, interquartile range 0-1). Participants were included if they reported data on ≥2 measurements of functional ability during a 9-year follow-up. Functional ability was scored with 6 self-reported items on activities of daily living. We performed latent class growth analysis to identify trajectories of functional decline and applied multinomial regression models to develop prediction models of identified trajectories. Analyses were stratified for sex. Results: Three distinct trajectories were identified: no/

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“…Most older adults value emotional functioning highly, in addition to physical functioning (Bowling & Dieppe, 2005). Following those suggestions, studies have incorporated indicators of mental health, such as depressive symptomatology, in operational definitions of successful ageing (Kok et al 2017). Even if depression is not considered to be part of successful ageing, it is strongly associated with it (Jeste et al 2013).…”

mentioning

confidence: 99%

Successful ageing, depression and resilience research; a call for a priori approaches to investigations of resilience

Huisman

Klokgieters²,

Beekman

2017

Epidemiol Psychiatr Sci

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Given the multitude of risk factors for depression in modern society and given the negative consequences of depressive problems for successful ageing, investigating resilience in relation to depression may help identifying entry points for reducing the burden of morbidity. Research on resilience begins with the realisation that individuals may demonstrate good physical or psychological functioning despite being exposed to risk experiences that can have serious negative impact on functioning. Interest in investigating resilience within ageing research has been increasing. Among the approaches toward investigating resilience are so-called a priori approaches, where criteria for inferring resilience are established a priori. In this editorial, we highlight some of the advantages of taking a priori approaches to the study of resilience and we touch on the implications for a priori approaches for the topic of resilience and depression. We argue that depression should take a prominent role in resilience research, because depression is strongly associated with opportunities for successful ageing. First published online 10 July 2017Key words: Depression, elderly, epidemiology, models/theories of psychiatry.Successful ageing and resilience -these are concepts that occupy the minds of scholars, as societies are confronted with unprecedented population ageing. The application of these concepts in empirical research generates much interest and discussion. The implications of these concepts for depression research should be debated, because good mental health is instrumental to both of them.Successful ageing is among the core concepts of gerontology, but the operational definition of successful ageing has been heavily debated (Cosco et al. 2013). Articulated suggestions for modification of approaches to define successful ageing pointed toward the necessity to incorporate information on mental health. Most older adults value emotional functioning highly, in addition to physical functioning (Bowling & Dieppe, 2005). Following those suggestions, studies have incorporated indicators of mental health, such as depressive symptomatology, in operational definitions of successful ageing (Kok et al. 2017). Even if depression is not considered to be part of successful ageing, it is strongly associated with it (Jeste et al. 2013).From the perspective of public health, it has been clear that the burden of depressive problems has been a considerable challenge to healthy population ageing (Murray & Lopez, 1997). Given the multitude of risk factors for depression in modern society and given the consequences of depressive problems, investigating resilience in relation to depression seems an obvious route toward identifying entry points for reducing the burden of morbidity.Research on resilience is the science that explains why people thrive despite being exposed to specific risk experiences. In the remainder of this editorial we refer to resilience among human beings. However, research from other academic disciplines study resilience of othe...

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Capturing the Diversity of Successful Aging: An Operational Definition Based on 16-Year Trajectories of Functioning

Abstract: Many older adults age relatively successfully, but the character of successful functioning over time varies between indicators, and the combinations of successful indicators vary between individuals.

Cited by 59 publications

References 38 publications

Pathways to death: The co-occurrence of physical and mental health in the last years of life

Pathways to death: The co-occurrence of physical and mental health in the last years of life

Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

Successful ageing, depression and resilience research; a call for a priori approaches to investigations of resilience

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