week 12 successful aging Flashcards
Learning Objectives
Describe the meaning of successful aging
Understand how heath promotion and quality of life can enhance competence and prevent illness
–Describe SOC model and relate to successful aging
–Describe 4 types of prevention
demiographic cliff
-societys are aging
The Dependency Ratio
The number of people under 15 compared to the number of people over 65
Successful Aging
Biomedical theories defined in terms of the optimisation of life expectancy while minimising physical and mental deterioration and disability
Sociopsychological models emphasise life satisfaction, social participation and functioning, and psychological resources, including personal growth
Rowe and Kahn
A person was deemed to have successfully aged if the person:
- Lives free of disability or disease
- Has high cognitive and physical abilities
- Is interacting with others in meaningful ways
Valliant
Three criteria related to health:
- No physical disability at age 75
- Good subjective health
- Length of undisabled life
And three related to social and productive activity:
- Good mental health
- Objective social support
- Self-rated life satisfaction in eight domains
How do you predict successful aging?
Six domains of functioning (objective & subjective physical health, length of active life, objective & subjective mental health, social support)
- Individuals who did well in all 6 areas until age 80 were classified as “happy-well”
- Those who were both psycho-socially unhappy and physically disabled were “sad-sick”
- Those who fell in between were classified as intermediate
Outcomes
College cohort
-Happy-well=26%(62){>80}
-Intermediate=32%(75){77.6}
-Sad-sick=17%(40){71.4}
Prematurely dead=25%(60){62.3}
City cohort
-Happy-well=29%(95){>70}
-Intermediate=34%(114){65.6}
-Sad-sick=14%(48){62.3}
Prematurely dead=23%(75){55.0}
What predicts outcomes?
Controllable variables:
- Smoking
- Alcohol
- Exercise
- BMI
- Stable marriage
- Maturity of defenses
Uncontrollable variables:
- Depression
- Parental social class
- Warmth of childhood
- Ancestral longevity
- Childhood temperament
- Objective disability at age 50
What predicts outcomes?
self-care/[perseverance
Exercise and education are indirect measures of self-care and perseverance
Both appeared to be important predictors of multiple domains of successful aging
–Preseverance (tested by the 5 mts treadmill test) at age 19 predicts 61% happy-well vs. 13% of the sad-sick (NOT explained by physical fitness)
Criticisms and Controversies
- Successful aging implies some people are “unsuccessful”
- People have the resources to live a healthy life
- Access to health care
- Live in a safe environment
- Have life experiences that support individual decision making
Alternative terms used by other researchers include healthy aging, aging well, effective aging, and productive aging
Self-Reports and Lay Definitions
The most commonly mentioned definition of successful aging, in response to open ended questioning, is having good health and functioning.
These were rarely mentioned in isolation, and most people mentioned more than one definition.
The percentage of those rating themselves as aging successfully was 50.3% compared with 18.8% classified according to Rowe and Kahn (Strawbridge, Wallhagen, & Cohen, 2002)
Successful Aging
- Accomplishments
- Enjoyment of diet
- Financial security
- Neighbourhood
- Physical appearance
- Productivity
- Sense of humour
- Sense of purpose
- Spirituality
Selection, optimization, and compensation (SOC)
Baltes: Developmentcomprises developmental trajectories of growth and decline
Internal and external resources are finite, aging brings about change in availability and efficiency of resources
The (pro)active role of the individual in successful aging.
–People can use their resources to promote continued growth and the maintenance of functioning in the face of losses and people both react to environmental demands, as well as shaping their environment to fit their needs.
SOC
definition
One important way in which individuals play an active role in their development is by choosing, committing to, and pursuing a set of goals. SOC model of goal selection and goal pursuit:
Selection = developing, elaborating and committing to goals (elective and loss-based)
Optimization = application and refinement of goal-relevant means and actions
Compensation = acquiring new resources or activating unused internal or external resources for alternative means of pursuing goals
Health Promotion for Older Adults
The elderly have long been neglected as the addressee of health promotion activities
Aims; (1) maintaining and increasing functional capacity (2) maintaining and improving self-care (3) stimulating social network
Difficulties in health promotion
- Chronic conditions and multi-morbidities
- Lifestyle
Why is it so important? QoL
Compression of Morbidity
see slide 19
Prevention and Successful Aging
see slide 21 for examples
and slide 22
Primary prevention
-Intervention that prevents a disease or condition from occurring
Secondary prevention
-Instituted after a condition has begun
Tertiary Prevention
-Efforts to avoid complications or secondary chronic conditions
Quaternary prevention
-Aimed at improving functional capacities of people with chronic conditions
Generativity and Successful aging
A positive, enthusiastic, and affective connection with a role that both motivates individuals to invest their resources and simultaneously energises them.
- Energy- a high degree of investment of personal energies (physical, cognitive, or emotional)
- Focus- being highly focused on the role activities
- Interest- being genuinely enthusiastic and interested in the role
Generativity and Successful aging
Quality over quantity
- High quality engagement was associated with the most positive well-being outcomes
- Those who experienced low/moderate engagement quality had lower psychological well-being than those not involved in the role at all
The “encore” movement
- Task identity and significance
- Task autonomy
- Task and skill variety
- Feedback
- Social support
- Opportunities for continued learning and growth
Summary
With greater recognition that older people are not a homogeneous group, we need more balanced, interdisciplinary perspectives of older age.
Must be aware of personal values and expectations of aging in order to enhance older adults health goals and priorities, and to consider interventions that will optimise chances of “aging successfully” in their own terms.
