How to age successfully

Question 1

Growing older takes a lifetime to complete

Answer 1

• Development extends across the entire lifespan
  
  • Can split it up into phases in life but get the most meaningful information from a holistic approach- how things effect us across the entirety of our lives
  • Adult development is about the ageing process
• Ageing often about decline, or biological ageing
  
  • Negative aspects e.g. decline in mobility and cognitive function
  • Most research done in a negative life
• Classifications tend to be based on biological and functional age
  
  • Biological age- changes that happen as we get older measured using biomarkers e.g. skin elasticity
  • Functional age- how well we function in daily life without care or support e.g. how well we are able to make our dinner
  • Age can be broken down into many concepts
  • e.g. ‘Young-old’ ‘Oldest-old’
    ‘Third age’ (period where we more independent, active- era of personal fulfilment ) ‘Fourth age’ (period more around dependency)

Question 2

you are as old as you feel

Answer 2

• Lots of psychological aspects to ageing- all experience it differently
  
  • Although there are commonalities the experience and journey is very unique
• We all experience ageing differently
• Subjective age
  
  • How old you feel- many people feel older than they actually are and many feel younger
  • Many people feel older or younger than their chronological age
  • Study took a sample of young and old people and they found that when they ask younger people (under 25) they were more likely to feel older than their actual age. When they took an older sample (over 30) they found that they felt younger than they actually were
  • Subjective age can shift over time
  • Younger subjective age- more positive outcomes e.g. lower risk of cognitive decline
• Psychological ageing- idea that we go through different changes (gains and losses)
  
  • About how positively we adapt to changes
  • Adaptation to the multidimensional nature of ageing
    Complex process

Question 3

biopsychosocial approach to ageing

Answer 3

• Biopsychosocial approach- range of biological, psychological and social factors influence our health and ageing
  
  • Biological force e.g. genetic predisposition to different age related health conditions e.g. dementia
  • Psychological forces- how we feel in our self e.g. mental heath, resilience
    Sociocultural; forces- maintaining good relationships plays an important protective effect for maintaining goid health e.g. loneliness is the one of the most modifiable risk factors for dementia

Question 4

gerontology- bigger picture to ageing

Answer 4

• Geriatrics is very medical- field of medicine that focuses on the diagnosis and treatment of medical problems on older people
  Gerontology more broader- considers perspectives from biology, psychology and sociology and focuses on how we can improve the lives of older people- how to mitigate the negative impacts of medical problems

Question 5

early academic definitions of ageing

Answer 5

• Early origins in 1950s with research on functional age- how well we function e.g. wash, prepare food, mobility etc
  
  • Some people age better than others- and why this was
• A focus on subgroups of older people who have aged ‘successfully’ i.e. with minimal functional limitations (do not need day to day care)
• Older adults grouped into dichotomous categories
  
  • Impaired (some kind of functional impairment) vs. normal ageing (not impaired)
• The problem with this view:
  
  • Doesn’t reflect the heterogeneity in ageing experience- should not dichotomise data as we lose nuance in ageing experience- just grouping people into broad categories to the point it loses meaning
    May limit research into the most psychologically and physically healthy groups

Question 6

biomedical theories

Answer 6

• Tend to focus on optimisation of life expectancy and emphasise absence of disease
  
  • Number of years lived as well as the absence of disease (being physically well)
• Distinguish between usual and successful ageing
  
  • ‘Usual’ ageing - normal decline in physical, social and cognitive functioning
  • ‘Successful’ ageing – functional losses minimised
• Differs from early theories: instead of splitting into impaired and normal they divide into normal and successful
  Rowe & Kahn’s (1998) model is one of the most well known and widely published biomedical examples

Question 7

Rowe & Kahns model (1998)

Answer 7

• Based on their MacArthur Research Network studies
  
  • Longitudinal cohort study, across three community-based sites: collecting data from lots of participants at different points in their life (can track these people over the course of their entire life- understand how influneces over the entire life impact what is going on later)
  • Older adults (aged 70-79 in 1988) living in the US (cultural generalisability- individualistic society)
  • Divided into high, medium, and low functioning subgroups
    ○ Avoidance of disease and risk factors associated e.g. COPD and not being a smoker
    ○ Maintaining good physical and cognitive health
    ○ Active engagement tin life e.g. continuing working or volunteering in the community or social networks
    ○ They suggest that in order to successfully age they have to meet all three criteria
• Problems with this study:
  Think about psychological ageing- some people may adapt to problems really well to issues socould still successfully age

Question 8

criticisms of Rowe & Kahns model

Answer 8

• Underestimates a complex concept
  
  • Oversimplification to just have 3 elements to ageing
  • Not very realistic- most people will get some kind of chronic health problem
• Disease free older age is unrealistic for most people
• Doesn’t really acknowledge capacity for ongoing change and development
  
  • Viewing successful ageing as a fixed outcome which is not true
• Academic vs. lay perceptions (Strawbridge et al., 2002)
  
  • “A definition of successful ageing needs to include elements that matter to elderly people” (Bowling & Dieppe, 2005, p.1548)- big discrepancy between what this model said vs what old people perceive
    Model is academic in orientation e.g. what researchers think is important- does not take into account what is important to older people

Question 9

Hung, Kempen & De Vries (2010)

Answer 9

• Systematic review- where we find all the evidence on a particular topic and bring it together to summarise everything that is known on this topic
• Reviewed over 30 peer-reviewed studies
  
  • Revealed significant differences in what was valued between academics and lay groups
  • Academic more likely to say successful ageing is about absence of disease, longer life expectancy- more about health and longevity
  • More broader for lay people- emotional needs, flexibility to change and social relationships (quality of life just as important)
  • And, differences across cultures
  • Western cultures more likely to consider successful ageing in terms of things like personal achievements and accomplishments, maintaining independence and staying active
  • Non western populations more likely to emphasises community, spirituality and family roles
• For ‘real people’, it’s about more than just longevity and the absence of disease or disability
  Need an inclusive and culturally sensitive approach to defining ageing

Question 10

Reichstad et a;., 2008, 2010

Answer 10

• Wanted to focus on individuals’ experiences of ageing and navigating age related challenges
• Instead of researcher-defined questions, asked older people (64-96 years) to talk about ageing, and ‘successful’ ageing
• Focus groups and one-to-one interviews revealed two key themes:
  
  • Self knowledge- understanding yourself, your values, your limitations but also understanding what brings meaning and joy
  • Continuing growth- idea that successful ageing is not a static and fixed outcome but an ongoing process that starts at birth and ends at death
    Successful ageing viewed as an ongoing developmental process (rather than an outcome)

Question 11

Bowling & Dieppe, 2005

Answer 11

• Indicators of successful ageing- what were the signs that someone ages well
• Physical appearance- idea of feeling confident in your body and your own physical self e.g. recognising changes in your body but feeling comfortable with this
• Productivity and contribution to life- about staying in work, volunteering, being involved in the community. Also about contributing to broader society in a way that feels meaningful
• Accomplishments- reflecting on our achievements in life but also thinking into the future and goal setting
• Enjoyment of diet- having a healthy and balanced diet, finding enjoyment in food (social activity)
• Financial security- having resources to live a comfortable life
• Neighbourhood- where they live, feeling safe and supported and access to social and community groups
• Sense of humour- finding joy in daily life
• Sense of purpose- feeling you have a meaning
• Spirituality- not abut religion exclusively but also about a connection to something greater, finding comfort in a personal philosophy
  Differs from Rowe & Kahn- potentially complex construct was underestimated

Question 12

towards a sociopsychological perspective

Answer 12

• Multidimensional approach, including a combination of objective and subjective factors, recognising different perspectives
• Life expectancy, mental and physical health, as well as:
  
  • Life satisfaction and wellbeing (includes happiness and contentment)
  • Personal growth, learning new things
  • Psychological characteristics and resources, including perceived autonomy, control, independence, adaptability, coping, self esteem, positive outlook, goals, sense of self
  • Integration and participation in social, community, leisure activities
    Social networks and support

Question 13

why is successful ageing worth thinking about?

Answer 13

• Demographic trends
  
  • Substantial increases in life expectancy
  • Growing proportion of people aged 65 or older, locally and globally- growing population of older adults
  • Also increase in the number of years living in ill health- need to improve quality of life
• Important for helping to improve the quality of life as people age
• May also address escalating health and social care costs
  
  • More and more people ageing and becoming older- putting increased demand on services which are already stretched
    Research to promote healthier ages can reduce that demand

Question 14

importance of a lifespan approach

Answer 14

• Ageing is a lifelong process
  
  • Many of the factors that influence health in later life act across the life course
• By changing our lifestyles in early- and mid- life, we can influence the way that we age
  
  • Early life interventions can have long lasting effects
• Evidence it’s never too late to take action to promote good health in later life
  
  • Changing lifestyles can have an effect on ageing e.g. early life interventions can have long lasting effects
    Early life interventions are important but interventions later can also help promote good ageing

Question 15

lifecourse studies: what can we learn?

Answer 15

• Longitudinal studies that follow groups of people through their lives to see how they change over time
  
  • Track how things change for them e.g. health and lifestyle factors (can see what is happening over time)
• Examine micro and macro level factors that influence health (e.g. intrapersonal and social networks, living conditions, environment, social and economic policies)
• Show life stages when we may be particularly susceptible to the effects of age-influencing factors related to lifestyle or environment
  
  • e.g. Adolescence is a sensitive period for bone development
  • Cognitive ageing and dementia
    Can inform when, as well as how to intervene, to influence ageing e..g early childhood exposure to adversity help reduce cognitive decline

Question 16

english longitudinal study for ageing

Answer 16

• Follows people of different ages from mid-adulthood into old age
  
  • Collects information to do with health, social activities, biological measurements
• Many useful insights into what facilitates health ageing
  
  • In depth information over several decades- useful insights that have come out
  • e.g. Sustained physical activity in older age is associated with improved overall health (Hamer, Lavoie & Bacon, 2014)
  • Lower levels of social engagement related to poorer health, impaired cognitive function, and higher loneliness (ELSA report)
  • Factors that are associated with health- lots to learn from this cohort
    People who have higher levels of quality of life more likely to have persistently better cognitive outcomes

Question 17

healthy ageing across the lifecourse study

Answer 17

• Aimed to examine healthy ageing across the life course
  
  • Ageing relevant measures
• CANVAS» HALCyon booklet for general public
  
  • Highlights importance of life stories
    Offers guidance on ‘lifestyle makeovers’ – keeping physically active, being in others’ company, eating healthily, avoiding risky health behaviours e.g. smoking, staying socially engaged

Question 18

Valliant’s Harvard Grant study

Answer 18

• World’s longest continuous study of ageing and health
  Followed two socially diverse groups of Harvard men, from college years (in 1930s/40s) through to later life

Question 19

successful ageing as a dynamic adaptation process

Answer 19

• Successful ageing is not just about maintaining physical health but the ability adapt to change and to thrive in later life
  
  • Know that successful ageing is static but rather is a process f adaptation and resilience
• Resilience as a resource (e.g. Jeste et al., 2013)
  
  • A person’s ability to bounce back from the variety of challenges that can arise in life
  • Suggests that it is not about never facing adversity but more about how we flexibly adapt to these changes
• Age related changes in emotional processing
  
  • Positive psychology movement - benefits of learnt optimism (train ourselves to adopt a more positive outlook)
  • Carstensen’s Socioemotional Selectivity Theory
  • Baltes and Baltes’ Selective Optimisation with Compensation
    Spirituality (e.g. Sadler & Biggs, 2006; Wong, 1998)

Question 20

Carstensens socioemotional selectivity theory

Answer 20

• As we get older priorities change
• Motivational goals in later life about promoting emotional wellbeing
• Evidence pointing to the importance of social networks to successful aging
  
  • Social networks, through the support they provide, contribute positively to emotional well-being across the lifespan
    With age, we become more motivated to reduce social network size and increase intimacy, to priories and maximise emotional meaningful relationships and support emotional wellbeing

Question 21

Baltes & Baltes selective optimisation with compensation

Answer 21

• A strategy to reconcile the emotional and social aspects of ageing
  
  • Acknowledges the losses and gains typical in later life
• Older adults efficiently allocate available resources to meet goals through a process of selection, optimisation, and compensation
  
  • Suggest we have limited resources- acknowledges that we have limited time and energy and physical capability
  • Less important goals sacrificed at the cost of maintaining or achieving more important goals
  • Pursuing these selective goals in an optimised way
  • If some of the goals cannot be achieved, older adults engage in compensatory activities to overcome barriers
• Process 1: selection
  
  • Where we decide which goal is the most meaningful, sacrificing other goals
• Process 2: optimisation
  
  • how we pursue the selected goals in an optimised way
• Process 3: compensation
  Thinking about alternative strategies that we dan use to overcome barriers in achieving our goals

Question 22

Wong (1998) spiritual model of ageing

Answer 22

• Spirituality is not specifically about religion but more broadly refers to purpose, meaning and connection to something greater
• Model suggests that as we get older we go through life transitions- prompts us to be reflect more deeply on lifes purpose
• Existential and transformative coping strategies become more important
• Importance of having existential and spiritual needs met for successful ageing
  
  • increasingly importance of existential and transformative coping with increasing age
  • Positive meaning and purpose not only add years to one’s life, but also add life to one’s years
  • Stressing how important it is to feel like you have purpose in your life- associated with longer life so increased life expectancy but better health outcomes as well
    People who have higher levels of purpose in life were significantly less likely to develop dementia and had significantly slower cognitive decline

Question 23

what are the wider implications of how we define successful ageinf=g

Answer 23

• A shift in policy towards a successful ageing model (Loos & Ivan, 2018)
  
  • Increase in positive media representations of older people, ageing and the ageing population
  • Successful agers depicted as active, socially-engaged, healthy, independent
    Potential to counter negative old-age stereotypes of decline and dependency

Question 24

should successful ageing be pitches as an individual responsibility

Answer 24

• What’s the issue with a policy focus on personal agency and responsibility?
  
  • Individual blame for ‘bad ageing’&raquo_space; attributed to sub-optimal life choices
  • ‘Unsuccessful’ agers depicted as unhealthy, unproductive, and a burden on society
  • Risks further marginalising already stigmatised groups of older people
    Ignores role of macro level factors such as public policy