Defining successful aging: the need to distinguish pathways from outcomes

Abstract

Motivated by a vision for a “new gerontology” that focuses on optimal functioning rather than losses and declines, Rowe and Kahn (1987) argued that many of the age-related declines that define usual aging are due to modifiable factors such as diet, exercise, personal habits such as smoking, and psychosocial factors. Thus, individuals may engage in lifestyle modifications to avoid diseases and, consequently, enhance their chance of aging well. Three domains of outcomes were said to jointly define successful aging: (a) low probability of disease and disease-related disability, (b) high cognitive and physical functioning, and (c) engagement with life (namely in the form of social connectedness and productive activities; Rowe and Kahn, 1997). All three criteria are meant to be relative (i.e. without absolute thresholds), although subsequent studies tend to adopt a threshold approach (see Depp and Jeste, 2006). The three criteria are somewhat hierarchical, in that avoiding diseases (and associated risk factors) makes high physical and cognitive functioning possible, which in turn enables the individual to engage in social and productive activities (Rowe and Kahn, 1997). However, remaining free of disease/disability and maintaining high physical and cognitive functioning are less likely as one ages, whereas participation in social and even productive activities may not be affected until significant physical and cognitive declines have occurred (McLaughlin et al., 2010; Yaffe et al., 2010; Hsu and Jones, 2012).

Age-Friendliness and Life Satisfaction of Young-Old and Old-Old in Hong Kong

“…The socioemotional selectivity theory underscores that the sense of limited future time motivates aged people to prioritize goals intended to derive emotional meaning from life [17]. The differentiation of process from outcomes enables the inclusion of age-graded expectations and the subjective criteria of psychological experience such as life satisfaction or psychological well-being [18]. …”

Complex Interplay Between Health and Successful Aging: Role of Perceived Stress, Resilience, and Social Support

“…The National Institutes of Health have identified a growing interest in patient-reported outcomes in physical (PH) and mental health (MH)(3), and self-rated successful aging (SRSA) has been described as a meaningful way for individuals to assess and integrate the multi-dimensional components of their past, present, and future(2, 4). From a mechanistic perspective, the achievement of SRSA can be enhanced though the various pathways of health functioning(5). Indeed, several models of successful aging have been proposed involving complex associations between physical, cognitive, emotional, and psychosocial functioning.…”

Validación del inventario de envejecimiento exitoso en personas mayores chilenas

“…teléfonos: 58 2205659 o 582205048 lgallardo@uta.cl E l proceso de envejecimiento característico de muchas sociedades contemporáneas ha obligado a numerosas disciplinas de las ciencias gerontológicas a propiciar alternativas teóricas/prácticas que permitan promover un envejecimiento funcional en las personas mayores. En este sentido, uno de los conceptos más relevantes en las últimas décadas es el de envejecimiento exitoso [1][2][3][4][5] . Se trata de un concepto multidimensional que contiene y trasciende la salud física y mental, incorporando distintos factores biológicos, psicológicos y sociales [6][7][8][9][10] .…”

“…La importancia que ha cobrado este concepto se debe a que no considera exclusivamente el envejecimiento como una etapa de declive o de pérdida progresiva e irreversible de las capacidades, sino que enfatiza la posibilidad de envejecer con un óptimo funcionamiento físico, cognitivo y social. Las personas pueden por tanto participar en acciones de promoción, cambio o trasformación de sus estilos de vida, evitando enfermedades y por tanto mejorando sus posibilidades de envejecer mejor 5,11 .…”