Flourishing in older age:Scottish and other realities

(Positive Ageing)

Professor Mary GilhoolyDirector

Brunel Institute for Ageing Studies

PresentationCentre for Confidence and Well-Being

GlasgowOctober 11, 2007

Positive ageing

• Why should we care?– Wish to reduce burden on the NHS– Wish to encourage participation and

productivity– Wish to make older people happy

Ageism is rampant

• Gerontologists are partly responsible for negative views of old age– We focus our research on poor health

and other ‘problems’ associated with ageing, older people and the demographic ‘time bomb’

• Positive ageing

• Successful ageing

• Active ageing

• Productive ageing

• Healthy ageing

Why I dislike these terms

• Trendy

• Politicians use them

• Used interchangeably

• No inherent meaning

• Moral dimension

Suggestion that the problems of old age are an individual, internal, or psychological matter, rather than something to do with the way we structure society and exclude older people from access to jobs and other meaningful roles

Puts an obligation on older people to stay active, healthy and happy

Victim blaming

Many examples of active/successful/ positive ageing

59 year old woman59 year old woman

At 60 years

• I was riding down the mountain with a sheer drop to my right when I suddenly thought………….. “I wouldn’t walk down a path like this, what am I doing on this horse?”

• “If I die, who will look after my mother?!”

Healthy ageing• Age is the main risk factor for almost all diseases

– Heart disease– Stroke– Alzheimer’s disease

• Disability levels rise with age– 70% of disabled people are old

• There is little evidence for ‘compression of morbidity’– Major disability levels are decreasing in USA; minor

disability levels are increasing– Not much sign of compression of morbidity in Scotland

Q. Why is age the main risk factor for disease?

• Increased exposure to toxins over a life time

• Ageing itself creates the conditions for the emergence of disease

Incidence of large bowel cancer by age band (Scotland 1993-1997)

0.30.9

1.9

3.2

4.4

6.4

5

3.1

1.4

0.4

0

1

2

3

4

5

6

7

45-54 55-64 65-74 75-84 85+

Age Band

Incid

en

ce R

ate

per 1

,000

Females

Males

Incidence of Stroke by Age (England)

15.9

8.1

3.58

0.7

18.4

20.4

13.4

5.8

2.40.50

5

10

15

20

25

45-54 55-64 65-74 75-84 85+

Age Band

Inci

denc

e R

ate

per 1

,000

Males

Females

Incidence of dementia by age (Scotland 2000)

1.6

8.1

11.2

18.7

20.30.01

17.2

0.10.10

2

4

6

8

10

12

14

16

18

20

45-54 55-64 65-74 75-84 85+

Age Band

Inci

den

ce r

ate

per

1,0

00

Femaels

Males

Health is more than physical functioning

• WHO definition

Psychological well-being

• Dementia

• Cognitive functioning

• Depression?

Social well-being• Negative life events increase

– Loss of spouse– Loss of friends

• Poverty is linked to age– A high proportion of those who are defined as

poor are old.– Women are more affected by poverty in old

age than men

Facts

• Ageing without disease is almost impossible

• Cognitive functioning declines with age• Social networks diminish, friends die

Quality of life

• All the factors known to be associated with a good quality of life decline with age– Health– Wealth– Social networks and support

Future cohorts (baby boomers) of older people will be healthier.

Not– The baby boomers are too fat– And they drink too much

Q. In the face of these realities, what does it mean to age positively?

Q. In the face of these realities, what does it mean to age positively?

• Lest you think that interest in positive ageing is new…..– Cicero challenged the negative stereotypes of old

age and pointed to the importance of motivation, values, good habits and social encouragement for optimising human potentialities in later years.

– Jung and Erikson elaborated normative stage theories of adult development that were a reaction against the negative stereotypes of ageing predominant in the late 19th century

• There is no denial in these writings about the reality of old age

• Assumption of generalized age changes

Recent theorizing

• Focus on differential ageingthat is…• Why it is that some older adults

show characteristics similar to the negative stereotypes of old ages, whereas others age much more positively

Positive Ageing = Adaptation

Thank You

Flourishing in older age:Scottish and other realities(Positive Ageing)

Professor Mary GilhoolyDirector

Brunel Institute for Ageing Studies

PresentationCentre for Confidence and Well-Being

GlasgowOctober 11, 2007

ThankYou