Successful Aging in Older Adults With Schizophrenia: Prevalence and Associated Factors

Abstract

Objective-This study contrasts the prevalence of successful aging in older adults with schizophrenia with their age peers in the community, and examines variables associated with successful aging in the schizophrenia group.Methods-The schizophrenia group consisted of 198 community-dwelling persons aged ≥55 years who developed schizophrenia before age 45. A community comparison group (N = 113) was recruited using randomly selected block-groups. The three objective criteria proposed by Rowe and Kahn were operationalized using a 6-item summed score. The association of 16 predictor variables with the successful aging score in the schizophrenia group was examined.Results-The community group had significantly higher successful aging scores than the schizophrenia group (4.3 vs. 3.0; t =8.36, df =309, p< .001). Nineteen percent of the community group met all 6 criteria on the Successful Aging Score versus 2% of the schizophrenia group. In regression analysis, only two variables -fewer negative symptoms and a higher quality of life index -were associated with the successful aging score within the schizophrenia group.Conclusion-Older adults with schizophrenia rarely achieve successful aging, and do so much less commonly than their age peers. Only two significant variables were associated with successful aging, neither of which are easily remediable. The elements that comprise the components of successful aging, especially physical health, may be better targets for intervention. Keywords successful aging; social integration; schizophrenia Psychology and medicine have increasingly broadened their interests from disability and disease to positive health and well-being (1,2). The latter, in later life, is sometimes termed "successful aging," and it is viewed as a state involving the absence of disability accompanied by high physical, cognitive, and social functioning (3-5). Successful aging is an ideal that all older persons might achieve under optimal circumstances. For persons with severe mental illness, the ideal life trajectory can be viewed as a process moving from diminishing psychopathology and impaired functioning to normalization to positive health and well-being. To our knowledge, there is no literature specifically examining factors that affect the prospects of successful aging among older adults with schizophrenia. The anticipated doubling of the older population with schizophrenia over the next two decades (6) makes the study of successful There is no consensual definition of successful aging (5,7-9). There are more than 29 different definitions that can be divided into objective and subjective factors (5,8,10). The most commonly cited objective factors are disability/physical functioning, cognition, social/ productive engagement, longevity, environmental/finances, and mastery/growth. Subjective factors comprising successful aging have included life satisfaction/well being, self-rated health, self-rated successful aging, personality, and perceived control. Rowe and Kahn (3,4) have posited the most widely ...

Promoting active ageing in older people with mental disorders living in the community: An integrative review

“…Successful ageing is defined as “low probability of disease and disease‐related disability, high cognitive and physical functional capacity, and active engagement with life” (Rowe & Kahn, , p. 433). Older people with mental disorders are less likely to achieve successful ageing, which is related to the concept of active ageing in terms of the key indicators of successful ageing were the maintenance of activity patterns in old age and values similar to those in middle age (Ibrahim, Cohen, & Ramirez, ; Jeste et al, ; Vahia et al, ; Walker, ). For example, Vahia et al used a survey questionnaire with a self‐rated assessment to compare successful ageing among older women classified into 3 groups: non‐depressed persons, sub‐threshold depression, and depression disorder.…”

“…The findings of this review raise issues around the need for appropriate policy, practice, and education of service providers to promote active ageing in older people, in particular, older people with mental disorders because they are less likely to achieve successful ageing compared with healthy older people (Ibrahim et al, ; Jeste et al, ; Vahia et al, ). However, there are several issues relating to promoting active ageing, and these include lack of time, lack of resources, and organizational constraints (Runciman et al, ).…”

Age, Aging, and Mental Health

“…Moreover, the onset of schizophrenia is usually during adolescence or early adulthood. There are very few older persons with schizophrenia, but generally they are persons who developed schizophrenia earlier in life and survived into later life (Ibrahim, Cohen, & Ramirez, 2010 ) .…”

Testing psychometric properties of a new instrument ‘Promoting Active Ageing in Older People with Mental Disorders Scale’ from a cross‐sectional study

“…Similar concepts include terms such as healthy ageing, productive ageing, ageing well, optimal ageing, positive ageing, and successful ageing which are often used interchangeably with active ageing . Previous studies indicate that older people with mental disorders, namely depression disorder and schizophrenia, are less likely to be successfully ageing compared with those who do not have mental illnesses . However, according to the World Federation for Mental Health, the outcomes for older people with mental disorders can be improved through the promotion of active and healthy ageing…”