Download - SUCCESSFUL AGING
Successful Aging: What Is It?
• “…our concept of success connotes more than a happy outcome; it implies achievement rather than mere good luck”. Rowe & Kahn (p.37)
• Successful aging:
– Is dependent upon individual choices and behaviors
– Can be attained through individual choice and effort
• Successful and Unsuccessful Aging:
– The difference between sickness and health?
– Focus of “traditional gerontology”
– Absence of disease is not enough.
Rowe & Kahn’s Definition
• …Successful aging…the ability to maintain three key behaviors or characteristics:– Low risk of disease & Disease-related disability
– High mental & physical function
– Active engagement with life
Avoiding Disease & Disability
• “Modern medicine..an applied science of repair rather than prevention”. (p. 40)
• “The very word ‘patient’…implies passivity rather than responsibility for our own health”. (p. 40)
• “many illnesses & disabilities, especially the chronic diseases of old age, are preceded by signs of future problems. And too often, we--and our doctors--ignore those signs.”
• e.g.: systolic BP, abdominal fat, blood sugar; decreases in lung, kidney & immune fx; decreases in bone density & muscle mass--what we often call “USUAL AGING”
An Alternative? A Preventive Orientation
• BP as an example:– Periodic monitoring and action, initially through diet &
exercise, in responses to modes increases in BP--even the range usually considered “normal”
– “…prevention does not supplant surgical & medical remedies of disability & illness”. E.g. hip replacements for OA’s w/ arthritis
Maintaining Mental & Physical Functioning
• INDEPENDENCE
• The principal goal of many OA’s
• “…few issues strike greater fear than the prospect of depending on other for the most basic daily needs”. (p. 42)
BUT--Much of the MacArthur Research Demonstrated:
• Fears about functional loss in old age are exaggerated
• Much functional loss can be prevented
• Many functional losses can be regained
More About: Exaggerated Fears
• Alzheimer’s disease & Nursing Homes are the Biggies
– AD: Over 90% DON’T have it– It’s not an all-or-nothing phenomenon– (Srs. Bernadette & Rose in the Nun Study--pp. 97-
100 in Snowdon)
• Nursing Homes– <5% of OA over 65 are in nursing homes– The % has been falling for at least 10 years
– Of those living in the community at large, <5% need help with basic ADL’s
Research--The Bottom Line on Age-related Declined in Cognitive Fx:
• Declines rarely affect all kinds of cognitive performance
• Most of the losses come late in life
• Many OA’s are NOT significantly affected by even minor losses of mental ability
Continuing Engagement With Life
• “MacArthur research shows clearly that our ‘happy activities’ are essential to successful aging. But this is a relatively novel idea”. ( p. 45)
• ‘60’s--Disengagement Theory. Neugarten & Havighurst (Sociologists, not Gerontologists)– “The final act of relinquishment was letting go ot life
itself”. (p. 46)
• Relating to Others:
• “Being part of a social network of friends and family is one of the most effective predictors of longevity. Men & women, perhaps especially men, who do not have close fiends of family are more likely to become Ill and less likely to live long lives”. (p. 46)
• Continuing Productive Activity
– “Most people, when they think of being productive, thing about earning money”.
– “…we count as productive allactivities, paid or untain, that create goods or services of value”. (p. 47)
Research HX Context of the MacArthur Study
• References go back >50 years
• Problems with definitions:– tended to define successful aging in a narrow
fashion rather than making a coherent theory of human development
– treated success as no more than the absence of explicit failure
Research Context: cont’d
• Neglected positive aspects of aging and possible gains in old age, as if successful aging were merely aging as little as possible
• failed to acknowledge the unavoidable place of values in defining what is good or bad, successful or unsuccessful