Successful aging (American English) or successful ageing (British English) refers to physical, mental and social well-being in older age. The concept of successful aging can be traced back to the 1950s, and was popularized in the 1980s. It reflects changing view on aging in Western countries, where a stigma associated with old age (see ageism) has led to considering older people as a burden on society. Consequently, in the past most of the scientists have been focusing on negative aspects of aging or preventing the decline of youth.
Research on successful aging, however, acknowledges the fact that there is a growing number of older adults functioning at a high level and contributing to the society. Scientists working in this area seek to define what differentiates successful from usual aging in order to design effective strategies and medical interventions to protect health and well-being from aging.
Definitions focusing on successful emotional and cognitive aging
Recent studies emphasize the importance of adaptation and emotional well-being in successful aging. New data suggests that for most senior citizens, subjective quality of life is more important than the absence of disease and other objective measures relating to physical and mental health. In two recent studies the vast majority of older people rated themselves as aging successfully, even when they did not meet all objective physical and mental criteria for successful aging. Studies which incorporated the perspectives of older adults into the model of successful aging found that optimism, effective coping styles, and social and community involvement are more important to aging successfully than traditional measures of health and wellness. Additionally, recent studies have shown that for most senior citizens, subjective quality of life is strongly tied with psychosocial protective traits such as resilience, optimism, and mental and emotional status.
Traditional definitions of successful aging have emphasized absence of physical and cognitive disabilities. In their 1987 article, Rowe and Kahn characterized successful aging as involving three components: a) freedom from disease and disability, b) high cognitive and physical functioning, and c) social and productive engagement.
Recently, many scientists have argued that the early definitions are overly restrictive and limit successful aging to an objective judgment made by others, thereby ignoring the seniors' perception. Others have pointed out that definitions focusing on physical functioning and freedom from disability are misleading and may lead to the conclusion that a large majority of individuals are getting older unsuccessfully, given the high incidence and prevalence of diseases that are common in later life.
Genetics of successful aging
A number of studies indicate that there are genetic influences on successful aging - beyond those that influence longevity alone. Evidence suggests that successful aging is a multifactorial trait influenced by numerous genes and environmental factors, each making a small contribution to the phenotype. Specifically, genes such as APOE, GSTT1, IL6, IL10, PON1, and SIRT3 may to have individual effects on the likelihood of aging successfully. Additionally, the genes contributing to successful aging can be grouped in several main categories (ontologies):
- Genes involved in the maintenance of cholesterol, lipid or lipoprotein levels. Their ability to metabolize and transport molecules such as cholesterol relates to cardiovascular health, which could directly influence physical activity levels and longevity.
- Genes related to cytokines, which influence inflammation and immune responses. These genes could influence successful aging by regulating cellular senescence, determining susceptibility to age-related cancers, or other mechanisms.
- Genes involved in drug metabolism and insulin signaling.
- Genes related to age-associated pathological processes (e.g., Alzheimer’s disease.)
In has been found that mental and psychosocial functioning often improve with age, even if physical health, and some elements of memory decline. Physicians, psychologists and gerontologists argue that age-related wisdom might serve to compensate for the biological losses in old age, thereby enabling older adults to better utilize their remaining resources and age successfully. Age-associated wisdom may help to overcome the negative effects of diseases and stressors that are common in late life and lead to improved mental health and psychosocial functioning. Neurological research has demonstrated that brain growth and development continue into old age – the concept known as neuroplasticity of aging.
Components of successful aging differ across cultures. In a 2004 survey, Japanese older adults were more likely to endorse social belonging as more important, whereas European American ranked independence as more important.
Strategies to enhance successful aging
The idea of successful aging is a social construct which aids in our acceptance of the apparent inevatibility and pain associated with the aging process. As successful aging tends to be more dependent on behavior, attitude and environment than to the hereditary traits, researchers and clinicians are developing strategies to enhance aging well. Current strategies include restricting calories intake, exercising, quitting smoking and substance use, obtaining appropriate health care, and eating healthy. Seeking help for mental illnesses such as depression is critical, as these conditions interfere with nearly all determinants of successful aging. Additionally, it is considered important to develop cognitive and psychological strategies such as positive attitude, resilience, and reducing stress. Cognitive and emotional adaptation to chronic illnesses that often impact older adults is also an important aspect. Finally, social strategies, such as seeking and giving social support through volunteering, working in a group, learning a new skill, or mentoring younger individuals, have been found to promote successful aging.
Although many dietary supplements on the market and advertised as having anti-aging effects, there is a general lack of evidence as for their impact on aging, and some researchers even point to several possible health risks. Currently most of these supplements are not categorized as drugs by the U.S. Food and Drug Administration.
Criticism of the term
|This section requires expansion. (October 2012)|
- Rowe, J. W.; Kahn, R. L. (1997). "Successful Aging". The Gerontologist 37 (4): 433–40. doi:10.1093/geront/37.4.433. PMID 9279031.
- Fries, J. F. (2002). "Reducing Disability in Older Age". JAMA 288 (24): 3164–6. doi:10.1001/jama.288.24.3164. PMID 12495399.
- Cantoni, Gabriella (1998). The Road to an Aging Policy for the 21st Century. ISBN 978-0-7881-4635-0.[page needed]
- "Gender, Health and Ageing". World Health Organization. 2003.
- Peel, Nancye M.; McClure, Roderick J.; Bartlett, Helen P. (2005). "Behavioral determinants of healthy aging1". American Journal of Preventive Medicine 28 (3): 298–304. doi:10.1016/j.amepre.2004.12.002. PMID 15766620.
- Phelan, Elizabeth A.; Larson, Eric B. (2002). "'Successful Aging'—Where Next?". Journal of the American Geriatrics Society 50 (7): 1306–8. doi:10.1046/j.1532-5415.2002.50324.x. PMID 12133032.
- Lupien, S. J.; Wan, N. (2004). "Successful Ageing: From Cell to Self". Philosophical Transactions of the Royal Society B: Biological Sciences 359 (1449): 1413–26. doi:10.1098/rstb.2004.1516. JSTOR 4142144. PMC 1693425. PMID 15347532.
- Montross, Lori P.; Depp, Colin; Daly, John; Reichstadt, Jennifer; Golshan, Shahrokh; Moore, David; Sitzer, David; Jeste, Dilip V. (2006). "Correlates of Self-Rated Successful Aging Among Community-Dwelling Older Adults". American Journal of Geriatric Psychiatry 14 (1): 43–51. doi:10.1097/01.JGP.0000192489.43179.31. PMID 16407581.
- Depp, Colin; Vahia, Ipsit V.; Jeste, Dilip (2010). "Successful Aging: Focus on Cognitive and Emotional Health". Annual Review of Clinical Psychology 6: 527–50. doi:10.1146/annurev.clinpsy.121208.131449. PMID 20192798.
- Depp, Colin A.; Jeste, Dilip V. (2009). "Definitions and Predictors of Successful Aging: A Comprehensive Review of Larger Quantitative Studies". FOCUS 7 (1): 137–50.
- Depp, CA; Glatt, SJ; Jeste, DV (2007). "Recent advances in research on successful or healthy aging". Current psychiatry reports 9 (1): 7–13. doi:10.1007/s11920-007-0003-0. PMID 17257507.
- Lamond, Amanda J.; Depp, Colin A.; Allison, Matthew; Langer, Robert; Reichstadt, Jennifer; Moore, David J.; Golshan, Shahrokh; Ganiats, Theodore G.; Jeste, Dilip V. (2008). "Measurement and predictors of resilience among community-dwelling older women". Journal of Psychiatric Research 43 (2): 148–54. doi:10.1016/j.jpsychires.2008.03.007. PMC 2613196. PMID 18455190.
- Jeste, DV; Depp, CA; Vahia, IV (2010). "Successful cognitive and emotional aging". World Psychiatry 9 (2): 78–84. PMC 2912035. PMID 20671889.
- Reichstadt, Jennifer; Sengupta, Geetika; Depp, Colin A.; Palinkas, Lawrence A.; Jeste, Dilip V. (2010). "Older Adults' Perspectives on Successful Aging: Qualitative Interviews". American Journal of Geriatric Psychiatry 18 (7): 567–75. doi:10.1097/JGP.0b013e3181e040bb. PMID 20593536.
- Baltes, Paul B.; Baltes, Margret M. (1990). "Psychological perspectives on successful aging: The model of selective optimization with compensation". In Baltes, Paul B.; Baltes, Margret M. Successful Aging. pp. 1–34. doi:10.1017/CBO9780511665684.003. ISBN 978-0-511-66568-4.
- Rowe, J.; Kahn, R. (1987). "Human aging: Usual and successful". Science 237 (4811): 143–9. doi:10.1126/science.3299702. PMID 3299702.
- Phelan, Elizabeth A.; Anderson, Lynda A.; Lacroix, Andrea Z.; Larson, Eric B. (2004). "Older Adults' Views of 'Successful Aging'—How Do They Compare with Researchers' Definitions?". Journal of the American Geriatrics Society 52 (2): 211–6. doi:10.1111/j.1532-5415.2004.52056.x. PMID 14728629.
- Knight, Marisa; Seymour, Travis L.; Gaunt, Joshua T.; Baker, Christopher; Nesmith, Kathryn; Mather, Mara (2007). "Aging and goal-directed emotional attention: Distraction reverses emotional biases". Emotion 7 (4): 705–14. doi:10.1037/1528-35184.108.40.2065. PMID 18039037.
- Von Faber, M.; Bootsma-Van Der Wiel, A; Van Exel, E; Gussekloo, J; Lagaay, AM; Van Dongen, E; Knook, DL; Van Der Geest, S; Westendorp, RG (2001). "Successful Aging in the Oldest Old: Who Can Be Characterized as Successfully Aged?". Archives of Internal Medicine 161 (22): 2694–700. doi:10.1001/archinte.161.22.2694. PMID 11732934.
- Hamet, Pavel; Tremblay, Johanne (2003). "Genes of aging". Metabolism 52 (10 Suppl 2): 5–9. doi:10.1053/S0026-0495(03)00294-4. PMID 14577056.
- Perls, Thomas; Terry, Dellara (2003). "Understanding the Determinants of Exceptional Longevity". Annals of Internal Medicine 139 (5 Pt 2): 445–9. PMID 12965974.
- Glatt, Stephen J.; Chayavichitsilp, Pamela; Depp, Colin; Schork, Nicholas J.; Jeste, Dilip V. (2007). "Successful Aging: From Phenotype to Genotype". Biological Psychiatry 62 (4): 282–93. doi:10.1016/j.biopsych.2006.09.015. PMID 17210144.
- Epel, Elissa S.; Blackburn, Elizabeth H.; Lin, Jue; Dhabhar, Firdaus S.; Adler, Nancy E.; Morrow, Jason D.; Cawthon, Richard M. (2004). "Accelerated telomere shortening in response to life stress". Proceedings of the National Academy of Sciences 101 (49): 17312–5. doi:10.1073/pnas.0407162101. PMC 534658. PMID 15574496.
- Small, Scott A.; Chawla, Monica K.; Buonocore, Michael; Rapp, Peter R.; Barnes, Carol A. (2004). "Imaging correlates of brain function in monkeys and rats isolates a hippocampal subregion differentially vulnerable to aging". Proceedings of the National Academy of Sciences 101 (18): 7181–6. doi:10.1073/pnas.0400285101. PMC 406486. PMID 15118105.
- Vaillant, GE (1993). The Wisdom of the Ego. Cambridge, MA: Harvard University Press. ISBN 0-674-95373-8.[page needed]
- Meeks, T. W.; Jeste, D. V. (2009). "Neurobiology of Wisdom: A Literature Overview". Archives of General Psychiatry 66 (4): 355–65. doi:10.1001/archgenpsychiatry.2009.8. PMID 19349305.
- Jeste, D. V.; Harris, J. C. (2010). "Wisdom--A Neuroscience Perspective". JAMA: the Journal of the American Medical Association 304 (14): 1602. doi:10.1001/jama.2010.1458.
- Jeste, D. V.; Ardelt, M.; Blazer, D.; Kraemer, H. C.; Vaillant, G.; Meeks, T. W. (2010). "Expert Consensus on Characteristics of Wisdom: A Delphi Method Study". The Gerontologist 50 (5): 668–80. doi:10.1093/geront/gnq022. PMC 2937249. PMID 20233730.
- Evert, J.; Lawler, E.; Bogan, H.; Perls, T. (2003). "Morbidity Profiles of Centenarians: Survivors, Delayers, and Escapers". The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58 (3): 232–7. doi:10.1093/gerona/58.3.M232. PMID 12634289.
- Small, Gary (2002). The Memory Bible: An Innovative Strategy for Keeping your Brain Young. ISBN 978-0-7868-6826-1.[page needed]
- Depp, Colin A.; Jeste, Dilip V., eds. (2010). Successful Cognitive and Emotional Aging. ISBN 978-1-58562-351-8.[page needed]
- Perls, Thomas T.; Reisman, Neal R.; Olshansky, S. Jay (2005). "Provision or Distribution of Growth Hormone for 'Antiaging': Clinical and Legal Issues". JAMA 294 (16): 2086–90. doi:10.1001/jama.294.16.2086. PMID 16249424.