Week 11-How to age successfully

Question 1

What is meant by “Growing older takes a lifetime to complete”?

Answer 1

■ Development extends across the entire lifespan (you can get more meaningful definitions looking at this holistically rather than breaking down life into stages)
– Adult development is about the ageing process

■ Ageing often about decline, or biological ageing (e.g., elasticity=face wrinkles, grip strength and muscle mass decreases i.e., all biological markers of ageing)

■ Classifications tend to be based on biological and functional (activities of daily living e.g., medication, chores etc.,) age
– e.g. ‘Young-old’ ‘Oldest-old’
– ‘Third age’ (more independent, active 30-60s+) ‘Fourth age’ (more dependent on others)

Question 2

What is meant by “You’re as old as you feel”?

Answer 2

■ We all experience ageing differently

■ Subjective age
– Many people feel older or younger than their chronological age (under 25 feel older, over 30 feel younger). (Subjective age can be a better indicator of health and longevity).

■ Psychological ageing
– Adaptation to the multidimensional nature of ageing (cognitive skills, motor) i.e., those who feel younger have better adaptations as said above.
– Complex process

Question 3

What is Gerontology? The bigger picture of ageing

Answer 3

-Psychologists, Sociologists, Biologists chip into this

-The focus on the process of growing older and focuses on the individual and collective processes to improve our understanding on older adults

Question 4

What are the Early academic definitions of successful ageing?

Answer 4

■ Early origins in 1950s with research on functional age (i.e., looking at daily activities and level of support needed).

■ A focus on subgroups of older people who have aged ‘successfully’ i.e. with minimal functional limitations (i.e., people who can get up the stairs easily, good cognitive function etc.,).

■ Older adults grouped into dichotomous categories
– Impaired (had poor memory, cognition, functionality etc.,) vs. normal ageing (ageing as expected).

-Dichotomising people into 2 categories misses the nuance and subtle differences between people which will tell us what we need.

Question 5

What is the problem with this Early Academic View?

Answer 5

■ Doesn’t reflect the heterogeneity in ageing experience (i.e., the individual differences).

■ May limit research into the most psychologically and physically healthy groups (because you’re lumping them together).

-Doesn’t reflect psychological age and gains + losses

Question 6

What are some Biomedical theories on successful ageing?

Answer 6

■ Tend to focus on optimisation of life expectancy and emphasise absence of disease.

■ Distinguish between usual and successful ageing
– ‘Usual’ ageing - normal decline in physical, social and cognitive functioning.
– ‘Successful’ ageing – functional losses minimised.

■ Rowe & Kahn’s (1998) model is one of the most well known and widely published biomedical examples.

Question 7

What is Rowe & Kahn’s model (1998)?

Answer 7

Based on their MacArthur Research Network studies:
– Longitudinal cohort study (group of people with questions and tests repeated over multiple courses of their lifespan), across three community-based sites.

– Older adults (aged 70-79 in 1988) living in the US looking at biological and functioning levels.

– Divided into high, medium, and low-functioning subgroups based on the test results.

Components of Successful ageing:
1. Absence or avoidance of disease and risk factors for disease (e.g., may not be smoking)

2. Maintenance of physical and cognitive functioning
3. Active engagment with life

-High-functioning groups had all 3

Question 8

What are some Criticisms of Rowe & Kahn’s
model?

Answer 8

■ Underestimates a complex concept (ageing successfully means different things for different people).

■ Disease-free older age is unrealistic for most people (those who have recovered from injuries show successful ageing yet this model would disagree).

■ Doesn’t really acknowledge capacity for ongoing change and development (doesn’t address our want and need to learn and find purpose in life),

■ Academic vs. lay (non-academic) perceptions (Strawbridge et al., 2002)
– “A definition of successful ageing needs to include elements that matter to elderly people” (Bowling & Dieppe, 2005, p.1548)

-Derogatory for those who have a disability and the ability to adapt to that is a testament to their success (quite rude this model just excludes and doesn’t acknowledge that: shows a one fits all model for successful ageing)

-Is very biologically oriented and contains some social factors but doesn’t really include the psychological factors e.g., coping methods, resilience etc.,

Question 9

What did Hung, Kempen & De Vries
(2010) find on lay definitions for successful ageing?

Answer 9

■ Reviewed over 30 peer-reviewed studies
– Revealed significant differences in what was valued between academics and lay groups.
– And, differences across cultures.
-Used healthy ageing rather than successful ageing

■ For ‘real people’, it’s about more than just longevity and the absence of disease or disability (their results were more diverse, broader and holistic meaning it overlapped).
-12 key domains for successful ageing

-The main takeaway is that ageing successfully is the life in your years rather than the years in your life.

Question 10

What did Reichstad et al. (2008, 2010) find on lay definitions for successful ageing?

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:
1. Self-knowledge (who you are, your personal identity, where you fit in the group)
2. Continuing growth (on growing capacity for learning and change)

■ Successful ageing viewed as an ongoing developmental process (rather than an outcome).

-Older people also acknowledged their losses and adapted to them e.g., forgetting to take medication so put sticky notes everywhere.

Question 11

What did Bowling & Dieppe (2005) find on lay definitions for successful ageing?

Answer 11

■ Physical appearance

■ Productivity and contribution to life (e.g., volunteering)

■ Accomplishments

■ Enjoyment of diet

■ Financial security

■ Neighbourhood

■ Sense of humour

■ Sense of purpose

■ Spirituality (different from religion)

Question 12

Why should we shift successful ageing to 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 it worth thinking about successful ageing?

Answer 13

■ Demographic trends
– Substantial increases in life expectancy
– Growing proportion of people aged 65 or older, locally and globally

■ Important for helping to improve the quality of life as people age

■ May also address escalating health and social care costs

Question 14

What is the Importance of a lifespan perspective?

Answer 14

■ Ageing is a lifelong process
– Many of the factors that influence health in later life act across the lifecourse (these factors build up over our lives -understanding these can help us improve and maximise health and wellbeing).

■ 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 (e.g., quitting smoking)

■ Evidence it’s never too late to take action to promote good health in later life

Question 15

What can we learn from Lifecourse studies?

Answer 15

■ Longitudinal studies that follow groups of people through their lives to see how they change 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

■ Can inform when, as well as how to intervene, to influence ageing.

Question 16

What is the English Longitudinal Study for
Ageing? (aka ELSA)

Answer 16

■ Follows people of different ages from mid-adulthood into old age (interviewed every 2 years and measured on aspects such as cognition, mental wellbeing etc.,).

Many useful insights into what facilitates health ageing:
– e.g. Sustained physical activity in older age (e.g., taking the stairs rather than a lift, or joining a walking group etc.,) 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).

Question 17

What is the Healthy Ageing across the Life
Course study (HALCyon)?

Answer 17

■ Aimed to examine healthy ageing across the life course.

– Highlights importance of life stories (i.e., taking this across the lifespan approach).

– 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

What is Vaillant’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

-“Successful aging means giving to others joyously whenever one is able, receiving from others gratefully whenever one needs it, and being greedy enough to develop one’s own self in between.”

-“Being old, healthy, and without friends is no fun”

-“Don’t try to think less of yourself, but try to think of yourself less.

-Factors such as altruism (generosity), creativity are controllable and had far more of an impact on where someone sat on this continuum rather than the non-controllable factors such as socioeconomic status.

Question 19

How can we successfully age as a dynamic adaptation process?

Answer 19

■ Resilience as a resource (i.e., something that we can learn, develop and apply to our life) (e.g. Jeste et al., 2013)
– A person’s ability to bounce back from the variety of challenges that can arise in life

■ Age-related changes in emotional processing
– Positive psychology movement - benefits of learnt optimism
– Carstensen’s Socioemotional Selectivity Theory
– Baltes and Baltes’ Selective Optimisation with Compensation
– Spirituality (e.g. Sadler & Biggs, 2006; Wong, 1998)

Question 20

What is Carstensen’s Socioemotional Selectivity Theory?

Answer 20

■ 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 prioritise and maximise emotional meaningful relationships and support emotional wellbeing.

Question 21

What is Baltes & Baltes’ Selective
Optimisation with Compensation?

Answer 21

■ A strategy to reconcile the emotional and social aspects of aging
– 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 (i.e., choose what is important for them set some goals, and then try and maximise and achieve it).
– 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 (e.g., social network, mobility aids if difficulties with walking or going up the stairs)

Question 22

What is Wong’s (1998) spiritual model of
ageing?

Answer 22

■ 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 (i.e., quality > quantity)

Question 23

What are the wider implications of how we define successful ageing?

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 pitched 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