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. Researchers in ageing studies are critical of the very term 'successful ageing' as it implies failure on the part of those who do not meet arbitrary criteria derived from neoliberal and/or biomedical definitions.
- 1 Definitions
- 2 Social Support
- 3 Subjective well-being and Happiness
- 4 Cognitive Reserve
- 5 Genetics of successful aging
- 6 Aging-associated wisdom
- 7 Social Construct
- 8 Criticism of the term
- 9 See also
- 10 References
Previous research into ageing exaggerated the extent to which health disabilities, such as diabetes or osteoporosis, could be attributed exclusively to age, and research in gerontology exaggerated the homogeneity of samples of elderly people. Other research shows that even late in life, potential exists for physical, mental, and social growth and development.
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.
To date, there has not been a universal definition for successful aging. While researchers have for many years tried to create such a definition, nothing really took hold until the late 1990s. At that time the following definition (adopted by researchers Rowe & Kahn) started to become the operative standard: A person was deemed to have successfully aged if the person (1) lived free of disability or disease; (2) had high cognitive and physical abilities; and (3) was interacting with others in meaningful ways This definition was followed for a significant period of time, but, in the last ten years, its usefulness started to be questioned.
Physical and Mental Health
Initially, researchers, questioned the first listed criteria—living free of disability or disease. Although disease was decreasing, this factor was viewed as too restrictive. For older adults, life was no longer based on ego or endeavors. Life was different. Erickson referred to this stage of life as "Integrity," when a person comes to terms with the meaning of life. It was found that people adjusted to their respective ailments or diseases and gained a resiliency which allowed them to function in productive ways. This has been true for both physical and mental health. The term "successful adaptation" had become synonymous with successful aging. The key for older adults has been to effectively manage their chronic illnesses or disorders, whether physical or mental. They, to a large extent, do so through the use of "resiliency."  Even if a person had some physical restrictions, such a people could still lead a very productive life. Further, research found that more and more older people retained their physical abilities through exercise, among other health related factors. With respect to mental health, studies have shown that depression and strain can be as detrimental as poor physical health.
Next, the concept of high cognitive functioning was further analyzed. While it was widely acknowledged that some of a person's cognitive ability decreases after age 65, two factors exist that mitigate against the effects of the decrease. First, most older adults maintain enough cognitive ability to retain their ability to function well. To successfully age, a person must retain sufficient cognitive abilities, which include not only neuropsychological domains, such as memory and executive function, but also must retain cognitive schemas. While an older person may lose some processing speed, attention, concentration, and memory performance, such person's "crystallized intelligence," which covers previous verbal learning and a general fund of knowledge, remains fairly stable during a person's full lifetime. This level of retention while far from perfect, has been sufficient for many older adults to thrive during their retirement years. Second, researchers introduced a new concept—namely, "cognitive reserve" (see below) which supports the proposition that the brain can still grow and expand with older people.
The last factor—meaningful interaction with others—has been widely accepted (i.e. social interaction is at the heart of human existence). But, the level of importance of this factor has increased. In addition, its importance has been reinforced by studies relating to "loneliness." In these studies, researchers have established that loneliness creates a significant risk factor for the decline in physical activities—a negative sign with respect to successful aging. Further, the studies analyzing "cognitive reserve"—see below—have also supported this conclusion. Researchers have found that the richer the environment in which a person experiences life, the more the brain changes structurally. Our social interactions can be viewed in a variety of ways. First, a person's social network, including, spouse, families, friends, etc., can be analyzed. We can also view social interaction based on quality and quantity of interactions. Many researchers believed that quality has been most important. People need others for support and encouragement, as well as for feeling good about themselves.
A person's ability to interact with others has been consistently viewed as vitally important to successful aging. While the network size for older people decreases with age, the overall quality of the remaining social connections becomes stronger. When a person lacks such interaction, he/she will very well feel "loneliness," which has been viewed as one of the primary factors preventing a person from achieving successful aging. Individuals utilize social networks for two primary reasons: to receive emotional support and to enhance engagements with others. However, an increase or decrease in social engagement, but not in social support, over a period of years, has the greatest effect on a person's quality of life and such person's ability to successfully age. Many researchers have believed that social relationships have become the single most important factor in measuring a person's psychological well-being or happiness.
Subjective well-being and Happiness
Most researchers have measured whether a person has successfully aged by assessing (primarily through the use of self-reports) whether the effect of relevant factors (such as the factors referred to above) created a significant increase in "subjective well-being, "life satisfaction," and "happiness."  These terms have been used, in many cases, interchangeably. Specifically, for example, studies have shown that people who have been "happier" throughout their lives, live longer.
Although many older adults experience some level of deterioration in their cognitive abilities, new research has found that some older adults are better able to adapt to these potential changes through the application of a concept called "cognitive reserve."  Underlying this concept is the observation that the extent of brain pathology or brain damage does not correlate to clinical manifestations of a disease. In other words, cognitive reserve develops the ability to use alternative cognitive strategies in order to maximize or optimize performance on cognitive tasks. In essence, the relationship between neuropathology and clinical symptoms is not necessarily proportional. So, how does this work? Researchers have believed that the greater the education level achieved, the more neuropathology is necessary before clinical symptoms are experienced. Further, some researchers have believed also that academic achievement (rather than just education) is a very important factor. Others have concluded that frequent cognitive activity (such as playing chess or visiting a library) is also associated with creating a reduced risk for dementia. Still others, however, have focused on the level of social engagement (measured by size of a person's social network) -- as a main factor that creates such disparities. When "cognitive reserve" exists, a person's executive function is enhanced. Through this mechanism, a person is able to think with a greater amount of flexibility and function adaptively to novel environments. For normative and preclinical person's, cognitive training can be extremely instrumental in a person's ability to successfully age.
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.
The idea of successful aging is a social construct which aids in our acceptance of the apparent inevitability and pain associated with the aging process. As successful aging tends to be more dependent on behavior, attitude and environment than on 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.
Criticism of the term
The notion of successful ageing, a term used in global health and the knowledge-making areas related to ageing (mainly gerontology, the caring professions, and organizations such as WHO), is based on liberal ideas favoring individualistic principles of choice over processes of social constraint. A neo-liberal and entrepreneurial vision of aging, inspired by gerontological ideals about active and successful lifestyles, has entered the health and retirement fields, with practical and policy consequences. This governmental rationality maximizes individual responsibility in order to minimize dependency in Western countries. In this context, successful ageing depends on an individualistic set of practices determined by predictors around smoking, diet, and exercise. While claims of choice and experimentation have opened new avenues of self-definition, such ideals can diminish the more genuine struggles to live successfully and obscure social inequalities. Stephen Katz reminds us that "lifestyle" (a concept informing the notion of successful ageing) was first positioned by social theorists in a myriad of life chances, status hierarchies and social contexts. For example, falls are assumed to happen to people who lack some physical control. Prevention programs therefore advocate « active ageing », individual behavioral changes such as exercise regimes (and residential modifications like better lighting). These strategies do not take into account social differences like class and gender, and also require adequate resources. For example, it seems that women fall more often and suffer more fracture-related falls than do men. These falls take place in a context where femininity is culturally coded as more frail and vulnerable than masculinity and where physical strength in women is not encouraged. Other gendered factors may be causing their falls, such as their greater use of psychotropic drugs, and not their lack of physical strength. Policies often sustain and reinforce cultural constructs, such as "frailty", and therefore shape experiences. Such cultural constructions of gender and age, the global economic rationale of cost restriction and the biomedical focus on ageing collide as inscriptions on the bodies of older women.
- 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" (PDF). 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 . PMID 15347532.
- Katz, Stephen; Calasanti, Toni (2015). "Critical perspectives on successful aging: Does it appeal more than it illuminates?". The Gerontologist. 55 (1): 26–33. doi:10.1093/geront/gnu027. PMID 24747713.
- Strawbridge, W. J.; Wallhagen, M. I.; Cohen, R. D. (2002). "Successful Aging and Well-Being: Self-Rated Compared with Rowe and Kahn". The Gerontologist. 42 (6): 727–33. doi:10.1093/geront/42.6.727. PMID 12451153.
- Rowe, J.; Kahn, R. (1987). "Human aging: Usual and successful". Science. 237 (4811): 143–9. Bibcode:1987Sci...237..143R. doi:10.1126/science.3299702. PMID 3299702.
- Papalia, Diane. "Physical and Cognitive Development in Late Adulthood". Human Development. Mc-Graw Hill.
- 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 . PMID 18455190.
- Jeste, DV; Depp, CA; Vahia, IV (2010). "Successful cognitive and emotional aging". World Psychiatry. 9 (2): 78–84. PMC . 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. PMC . PMID 20593536.
- Phelan, Anderson, LaCroix, & Larson (2004). "Older adults' views of "successful aging" -- how do they compare with researchers' definition?". American Geriatrics Society (JAGS). 52 (2).
- Rowe & Kahn (1998). Successful Aging. Dell Publishing.
- Gow, Mortensen, & Avland (2012). "Active participation and cognitive aging from age 50 to 80 in the glostrup 1914 cohort". Journal of the American Geriatrics Society. 60 (10).
- Fries, James, F. (2002). "Reducing Disability in OIder age". JAMA. 288 (24).
- Corbett, L. "Successful Aging: Jungian contributions to development in later life". Psychological Perspectives. 56 (2).
- Depp, Vahia, and Jeste (2007). "The intersection of mental health and successful aging". psychiatrictimes.com.
- Jeste, MD, et.al. (2013). "Association between older age and more successful aging: critical role of resilience and depression". Am J Psychiatry.
- Westtermeyer, J.F. (2013). "Predictors and characteristics of successful aging among men". The International Journal of Aging & Human development. 76 (4): 323–345.
- Vaillant, G. E. (2007). Aging Well. Little Brown & Company.
- Chen & Feeley (2013). "Social support, social strain, loneliness, and well-being among older adults: An analysis of the health and retirement study". Journal of Social and Personal Relationships.
- Infurna, Gerstorf & Ryan (2011). "Dynamic links between memory and functional limitations in old age: longitudinal evidence for age-based structural dynamics from the ahead study". Psychology and Aging. 26 (3).
- Ardila (2007). "Normal aging increases cognitive heterogeneity: analysis of dispersion in WAIS-III scores across age". Archives of Clinical Neuropsychology. 22.
- Forstmeier & Maercker (2008). "Motivational Reserve: Lifetime motivational abilities contribute to cognitive and emotional health in old age". Psychology and Aging. 23 (4).
- Cozolino (2008). The healthy aging brain (first ed.). W.W. Norton & Company.
- Capioppo & Patrick (2008). Loneliness: Human nature and the need for social connection. W. Norton & Co.
- Fuller-Iglesias, Webster, & Antonucci (2015). "The complex nature of family support across the life span: implications for psychological well-being". Developmental Psychology. 51 (3).
- Huxhold, Fiori, & Windsor (2003). "The dynamic interplay of social network characteristics, subjective well-being and health". Psychology and Aging. 28 (1).
- Gurang, Taylor, & Seeman (2003). "Accounting for changes in social support among married older adults: insights from the MacArthur studies of successful aging". Psychology and Aging. 18 (3).
- Morack, Ram, Fauth & Gerstorf (2013). "Multidomain trajectories of psychological functioning in old age: a longitudinal perspective on (uneven) successful aging". Developmental Psychology. 49 (12).
- Caunt, Franklin, Brodaty, & Brodaty (2013). "Exploring the causes of subjective well-being: A content analysis of peoples' recipes for long-term happiness". Journal of Happiness Studies.
- Jayawickreme, Forgard & seligman (2012). "The engine of well-being". Review of General Psychology. 16 (4).
- Koopsman, Geleijnese, Zitman, & Giltay (2010). "Effects of Happiness on all-cause mortality during 15 year follow-up: The Arnhem Elderly Study". Journal of Happiness Studies.
- Giogkaraki, Michaelides, & Constantinidou (2013). "The role of cognitive reserve in cognitive aging: Results from the neurocognitive study on aging". Journal of Clinical and Experimental Neuropsychology. 35 (10).
- Puente, Lindbergh, & Miller (2015). "The relationship between cognitive reserve and functional ability is mediated by executive functioning in older adults". The Clinical Neuropsychologist. 29 (1).
- Richards & Deary (2005). "A life course approach to cognitive reserve: A model for cognitive aging and development". Annals of Neurology.
- Daffner (2010). "Promoting successful cognitive aging: a comprehensive review". Journal of Alzheimer's disease. 19.
- 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. doi:10.7326/0003-4819-139-5_part_2-200309021-00013. 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 . 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 . 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 . PMID 20233730.
- Katz, S (2013). "Active and Successful Aging. Lifestyle as a Gerontological Idea". Recherches sociologiques et anthropologiques. 44 (1): 33–49.
- Hamblin, K. A. (2010). "Changes to Policies for Work and Retirement in EU15 Nations (1995- 2005) : An Exploration of Policy Packages for the 50-plus Cohort". International Journal of Ageing and Later Life. 5 (1): 13–43. doi:10.3384/ijal.1652-8670.105113.
- MOULAERT, T. (2012). Gouverner les fins de carrière à distance : Outplacement et vieillissement actif en emploi, Frankfurt, Peter Lang.
- FEATHERSTONE, M., HEPWORTH, M., TURNER, B. (Eds) (1995). The Body : Social Process and Cultural Theory, Thousand Oaks, CA, Sage, p.371-388.
- GILLEARD C., HIGGS P., (2005) Contexts of Ageing : Class, Cohort and Community, Cambridge, Polity Press.
- WHO (2007). Global Report on Falls Prevention in Older Age, World Health Organization, Geneva.
- Grenier, A.; Hanley, J. (2007). "Older Women and 'Frailty' : Aged, Gendered and Embodied Resistance". Current Sociology. 55: 211–228. doi:10.1177/0011392107073303.
- FLETCHER, P. C. (2002). "Falls. An Issue Among Elderly Women", Senior Care Canada, 3d quarter, http://seniorcarecanada.com/articles/2002/q3/falls.
- Grenier, Amanda; Hanley, Jill (2007). "Older Women and 'Frailty' Aged, Gendered and Embodied Resistance". Current Sociology. 55 (2): 211–228. doi:10.1177/0011392107073303.