Failing to Focus on Healthy Aging: A Frailty of Our Discipline?

The academic geriatrics community has provided outstanding leadership in addressing frailty and complexity in older adults, but a minority of older adults are frail. Although resources to treat older adults are limited, and it is appropriate to focus clinical efforts on those with frailty and multimorbidity, there is also important expertise that can be brought to bear on the health of ALL older adults. A review of the literature suggests that attention to healthy or successful aging has failed to keep pace with the focus on frailty. By providing leadership to promote successful aging, the quality of life of older adults across the spectrum can be improved and transitions to frailty reduced. The template that leaders have established in understanding frailty—defining and operationalizing it, understanding outcomes, identifying pathophysiology—can be used as an approach to successful aging. Several community‐based programs have been successful in promoting successful aging. These are potentially highly scalable and could have a substantial effect on the aging population, but their essential components need to be better understood. The geriatrics community is uniquely positioned to take on this role. This is a critical time to work together to make the lives of all older adults as healthy and fulfilling as possible.     

A grounded theory of successful aging among select incarcerated older Filipino women

BackgroundAcross the literature, impairment and disability among the older people have been associated with a decline in meeting their special needs. Failure in meeting such needs may cause deterioration of function and threaten successful aging. Accordingly, successful aging studies were carried out among males, in health care institutions, and in communities. In spite of these, the process by which successful aging is experienced by incarcerated older women remains to be a blank spot in research.AimThis study purports to describe the process by which incarcerated older Filipino women experience successful aging.MethodsStrauss and Corbin's grounded theory design was employed. Semistructured interviews were conducted among 15 purposively selected incarcerated older Filipino from a Philippine penal institution exclusive for women. Further, data gathered was reduced to field text and was analyzed through open, axial and selective coding. Finally, truthfulness and trustworthiness of the findings were established through member checking.FindingsThe study generated “The Road to Success Model”. Interestingly, five phases relative to successful aging emerged, namely: Struggling, Remotivating, Reforming, Reintegrating and Sustaining. These phases describe how select incarcerated older Filipino women undergo transformation towards successful aging. Similar to a road, each phase is considered a station where one must pass through in order to get to the destination.ConclusionFindings of the study serve as an impetus for structural and procedural changes in prison, with a view to providing an environment conducive to successful aging and appropriate recognition to the older prisoner's efforts to achieve successful aging.     

Prospective predictors of successful aging in community-residing and institutionalized Canadian elderly

This study examined the unique and combined contribution of existential variables (purpose in life, religiousness, and death acceptance) and traditional resource measures (social resources, intellectual competence, and cognitive competence) as prospective predictors of successful aging in community-residing and institutionalized older adults. Using multiple hierarchical regression, the results showed that baseline successful aging, social resources, purpose in life, and low religiousness predicted successful aging in community-residing elderly 14 months later; baseline successful aging, social resources, purpose in life, and being of male gender predicted successful aging in institutionalized elderly. Intellectual and cognitive competence and death acceptance failed to account for significant variance in successful aging, although the latter approached significance in the community-residing older adults. In both samples, the existential variable of purpose in life accounted for unique variance in successful aging over and above that accounted for by demographic, baseline successful aging, and traditional predictors. The important role of existential constructs in promoting successful aging in community-residing and institutionalized elderly is discussed. Gary T. Reker is a full professor in the Department of Psychology of Trent University. His research interests have focused on the aging process, particularly in the role of personal optimism and personal meaning in wellness promotion. This work was supported by a Population Aging Grant from the Social Sciences and Humanities Research Council of Canada. The work was begun by Paul T.P. Wong and Gary T. Reker and continued by Gary T. Reker under grants from the Trent University Research Fund.     

Healthy aging and the University of the Third Age – Health behavior and subjective health outcomes in older adults

IntroductionBy participating in the University of the Third Age (U3A), retirees are offered the opportunity for activation and development in the later years of life. However, little is known how certain aspects of healthy aging, such as health-related behavior and subjective health outcomes, differ between U3A students and other older adults not taking part in any form of education. To address this, the aim of the present study was to compare selected aspects of healthy aging in a group of U3A members with older adults not taking part in any form of lifelong learning. The study also establishes relationships between the tested variables and predictors of health behavior.Materials and methods277 older adults (130 U3A members and 147 non-members) aged 60–92 (M = 68.84, SD = 5.32) completed measures of health behavior, self-rated physical health, self-rated sense of own health responsibility and satisfaction with life.ResultsThe U3A attendees presented significantly higher scores for general health behavior and some of its components, and declared higher self-rated health than their peers not affiliated to any educational organization. Self-rated health, responsibility for health and satisfaction with life were positively correlated with general health behavior and most of their categories. but the correlation coefficients differed between both groups. A hierarchical regression model demonstrated the predictive roles of attendance in U3A, sociodemographic and subjective factors in health behavior undertaking.ConclusionsThe study results may help to identify older adults who should be targeted in interventions aimed at supporting healthy aging.     

Longstanding Occupation: The Relation of the Continuity and Meaning of Productive Occupation to Life Satisfaction and Successful Aging

This study examined the relation of longstanding productive occupation to life satisfaction and successful aging in a sample of 292 community-dwelling older adults. The continuity and meaning dimensions of occupational engagement were used operationally to define longstanding occupation. Correlational procedures were used to collect and analyze data on longstanding occupation, successful aging, and life satisfaction. The meaning of longstanding productive occupation had a small significant correlation with life satisfaction. There were small to moderate significant correlations between longstanding productive occupation and successful aging. The study supports earlier findings that productive occupation is related to both life satisfaction and successful aging. For this sample of older adults the meaning of longstanding productive occupation significantly related to both life satisfaction and successful aging. The meaning or value of longstanding productive occupation was more related to life satisfaction than the continuity of occupation.     

Dispositional hope and life satisfaction among older adults attending lifelong learning programs

BackgroundThe aim of this study is to explore the indirect effects of dispositional hope in the life satisfaction of older adults attending a lifelong learning program at the University of Valencia, Spain. We examine the mediating impact of dispositional hope regarding its ability to impact life satisfaction while considering affective and confidant social support, perceived health and leisure activities, consciousness and spirituality as predictors.MethodsAnalysis were based on survey data (response rate 77.4%) provided by 737 adults 55 years old or more (Mean age = 65.41, SD = 6.60; 69% woman). A structural model with latent variables was specified and estimated in Mplus.ResultsThe results show the ability of just a few variables to sum up a reasonable model to apply to successful aging population. All these variables are correlated and significantly predict hope with the exception of health. The model additionally includes significant positive indirect effects from spirituality, affective support and consciousness on satisfaction. The model has a good fit in terms of both the measurement and structural model. Regarding predictive power, these comprehensive four main areas of successful aging account for 42% of hope and finally for one third of the life satisfaction variance.ConclusionsResults support the mediating role of dispositional hope on the life satisfaction among older adults attending lifelong learning programs. These findings also support the MacArthur model of successful aging adapted to older adults with high levels of functional, social and cognitive ability. Dispositional hope, perceived health, and social support were the strongest predictors of satisfaction with life.     

Cognitive reserve and depression predict subjective reports of successful aging

BackgroundWith graying of western societies, successful aging is a hotly debated topic. Attaining successful aging brings benefits not only at the individual level, but also to society. To better understand successful aging, we conducted a study of older adults in the Republic of Slovenia.MethodsWe recruited 213 community-dwelling adults, age 65 years and older, who responded to the Successful Aging Inventory (SAI), Purpose of Life Questionnaire (PIL), Satisfaction with Life Scale (SWLS), Beck Depression Inventory (BDI), Cognitive Reserve Index, Functional Activities Questionnaire (FAQ), and Multiple Abilities Self-Report Questionnaire (MASQ).ResultsResponses to all scales were significantly correlated, which was taken into account when identifying covariates of latent successful aging in a structural equation model. Successful aging, as evaluated by the combination questionnaire responses, was most strongly associated with depression and marginally associated with cognitive reserve. Self-rated functional and cognitive capacities did not significantly explain individual differences in successful aging.DiscussionIn our study of community-dwelling, older Slovenes, self-rated depression emerged as a strong correlate of successful aging and, to a lesser degree, cognitive reserve. Future studies of interventions that aim to promote successful aging should consider the role of depression and cognitive reserve in the older adult’s experience of aging.     

Effects of Good Life Program on Singaporean Older Adults' Psychological Well-Being

ABSTRACT

Population aging is a demographic trend and a growing concern in Singapore. This article explores through a qualitative research method the psychological well-being of 12 ambulant older adults aged 60 and older, participating in a senior center program. The comparative study examining the effects of the Good Life program on regular and new members has yielded findings in line with activity theory and Ryff's psychological well-being model. Regular members have reported improved psychological well-being after their participation at Good Life as compared to new members. With the increase in life expectancy and better health condition of our older adults, future research on the well-being of older adults in the local context is to be encouraged so that they can be better integrated into society.     

Physical activity in prefrail older adults: confidence and satisfaction related to physical function

We examined the hypothesis that physical activity will have favorable effects on measures of self-efficacy for a 400-m walk and satisfaction with physical functioning in older adults 70+ years of age who have deficits in mobility. We randomized a total of 412 adults aged 70-89 years at elevated risk for mobility disability to either a physical activity or a successful aging educational control intervention for 12 months. Participants in the physical activity intervention had more favorable changes in both outcomes as a result of treatment than those in the successful aging intervention. Gender, age, and scores on a short physical performance battery did not moderate these effects. Physical activity is an effective means of intervening on self-efficacy and satisfaction with physical function in older adults with impaired lower extremity functioning. This is an important finding in light of the importance of these process variables in behavior change and quality of life.     

Caring for the seniors with chronic illness: The lived experience of caregivers of older adults

BackgroundCaregivers of the elderly with chronic illnesses are exposed to the burden associated with their caregiving activities. This study described the lived experience of caregivers of older adults in Nigeria.MethodsA qualitative design guided by interpretive phenomenology informed the design of the research, whereby 15 in-depth interviews were conducted with caregivers of older adults with chronic illnesses. The interview sessions were audiotaped and transcribed verbatim and analysed using constant comparison analysis method.ResultsFifteen caregivers, from different parts of Osun State, Nigeria, took part in the in-depth interviews. The caregivers were aged between 19 and 70 years, ten were women, five of them had secondary education, seven were self-employed and six were in a spousal relationship. The study uncovered four interrelated themes with explanatory subthemes—commitment to preservation of life (managing challenges associated with daily routine, problem with mobility, bathing and grooming, feeding, and problem with hygiene) (ii) denial (refusal to accept that burden exists), other things suffer (disruption of family process, suffering from poor health and social isolation), (iv) reciprocity of care (pride in caregiving, caregiving as a necessity and not by choice, and law of karma).ConclusionThis study provides insight into the burden of care of older adults with chronic illness. Caregivers’ commitment to preserving life makes them provide assistance whose performance even run contrary to their own wellbeing. Intervention programme should be designed to support the caregivers thereby improving their wellbeing.     

Good News About the Effects of Bad Old-Age Stereotypes

The study investigates whether the confrontation with negative, age-stereotyped information leads to a deterioration of older adults' self-perceptions as suggested by the labeling theory, or whether older adults protect their self-perceptions against deterioration as suggested by theories of the resilience of the aging self. Self perceptions, as well as peer-perception of other older adults in general were assessed in a pre-post design. In the experimental group, 60 older adults received negative information about competence in old age. The control group of 40 older adults received neutral information. In the experimental condition, the general perceptions of other older adults worsened whereas their self-perception improved. In the control condition, only small changes emerged. Furthermore, the change of self-perceptions varied by the perceived applicability of the negative information for oneself. We conclude that older adults use negative age stereotypes more as a standard of reference for downward comparison rather than integrating them into their self-perceptions.     

Leisure Patterns and Health Among Recently Widowed Adults

ABSTRACT

The purpose of this study was to examine how leisure involvement changes with the transition to widowhood and to determine if change in leisure involvement during this time has an impact on widows' physical and mental health. Adults age 50 and older who had transitioned into widowhood between Waves 1 and 2 or Waves 2 and 3 of the Americans' Changing Lives (ACL) dataset (N = 154) were included in the study. Results indicated that during this time widows experienced changes in their leisure repertoire (the types of leisure activities in which they participate), and the frequency of their leisure involvement. These changes in leisure behavior were associated with functional impairment, depressive symptoms, and life satisfaction, as well as their ability to cope with the loss of their spouse. Findings were interpreted in terms of effective strategies that appear to be employed by widows in utilizing leisure activities following loss of a spouse.     

Healthy aging predicts mortality risks: Results from the Korean longitudinal study of aging (2006–2014)

IntroductionWhile there has been some gerontological research on healthy aging, few studies have identified a reasonable health status for the older adults. Guided by the four healthy aging concepts in studies from the US and Spain, this study sought to determine a useful definition for Korean older adults by examining the associations between each of the four healthy aging definitions and mortality.MethodsA longitudinal analysis was conducted based on the 2,960 older people (65 years or older) who participated in the Korean Longitudinal Study of Aging (2006–2014). Four healthy aging gradient definitions (Rowe and Kahn, Group Ⅰ, Group II, and Group III) were determined: absence of disease, free of disability, physical and cognitive function, and engagement with life.ResultsThe young old who failed to achieve healthy aging were found to have a higher risk of mortality in all four healthy aging gradient definitions in both males (HR range from 4.15 to 5.39) and females (HR range from 4.07 to 9.55). In old old, however, the unhealthy aging mortality risk in Rowe and Kahn's definition was disappeared, but predominant mortality risks were found in Group III for both male (HR = 3.16, 95% CI 1.67 – 5.98) and female (HR = 3.65, 95% CI 1.36 – 9.81)ConclusionTo promote healthy aging, we suggest that the definition for the young old includes rigid disease criteria, and old old emphasize functional ability. Age-specific aims for healthy aging may be useful for defining healthy aging.     

Social work students’ Service Learning experiences with grandfamilies: Contact,comfort, and attitudes

ABSTRACT

One way to increase student learning about older adults and aging family issues is to engage in community-based field experiences. Results from pre- and post-surveys with 29 Bachelors of Social Work students enrolled in a year-long practicum course to assess their change in the level of contact, comfort, and attitudes with older adults and grandfamilies (i.e., grandparents/kin and the children in their home) are discussed. Students who met with grandfamilies (n = 9) were compared to students who met with older adults in a nursing home (n = 6) and students who met with children from an afterschool program or child treatment facility (n = 9). One-way ANOVA’s revealed group differences in contact and quality of contact with grandfamilies. No significant differences were found for contact with older adults or comfort working with older adults and grandfamilies, or for attitudes toward older adults between the three groups. As a result of this project, educators should develop learning opportunities for students to increase their contact and comfort with older adults and aging families.     

Successful Aging: Definitions and Subjective Assessment According to Older Adults

There is no standard method for measuring successful aging or a consensus on its definition. Surveys about successful aging were administered to 53 older adults in New Jersey. Participants defined successful aging as including activity/exercise (56% of responses), physical health (46%), social relationships (41%), and psychological/ cognitive health (33%). Successful aging, as assessed by one question, was positively related to social support, life satisfaction, and subjective health. By understanding more about the concept of aging successfully, researchers can develop interventions to promote successful aging for older adults.     

What is important to me right now? Age differences in domain selectivity depend on the measure

Do older individuals have fewer important areas of life than their younger counterparts? While several recent theories of successful aging posit that selectivity in life domains and goal pursuits are important components of successful adult development and aging, it is not obvious how one would evaluate this claim empirically. The current study used four approaches to evaluate age differences in the number and content of life domains currently selected as important in an individual’s life. Two open-ended and two non-open-ended tools were used; the primary result was that age differences in number of selected domains emerged on the open-ended measures but not the others. Age differences in content of domains differed across assessment tools as well, but were consistent with an age-related shift in focus toward group involvement and leisure activities. Implications for practitioners attempting to discern optimal levels of life engagement for older individuals are discussed.     

When I’m 64: Effects of an interdisciplinary gerontology course on first-year undergraduates’ perceptions of aging

One challenge for gerontology is getting more students interested in aging at an earlier point in their academic career. This study evaluated the impact of an interdisciplinary course on aging designed for first-year undergraduate students. The course aimed to expand students’ appreciation of the personal and professional relevance of aging issues, with the goal of expanding their aging-related curricular and career interests. Main outcome variables of the study included knowledge of older adults and aging, attitudes toward older adults, and anxiety about personal aging. Participants included an intervention group enrolled in the course and a control group not enrolled in the course. Compared to baseline, at the end of the semester students in the class had more knowledge about aging and more positive explicit attitudes toward older adults, but their implicit attitudes toward older adults and anxiety about aging did not change. Control students showed no changes. These findings suggest that objective knowledge of aging and explicit attitudes improve with curricular intervention, but implicit attitudes and anxiety might be more difficult to change. Gerontology education is a complex undertaking whose diverse goals must be clearly articulated in order to guide curricular interventions and incite curiosity among young undergraduate students.     

Older adult Internet super-users: counsel from experience

ABSTRACT

There is evidence that digital technologies including the Internet have the potential to improve older adults’ social participation and inclusion. This in turn is said to improve their quality of life. Older Internet super-users are in a unique position to inform us about what it takes to be a successful “silver surfer”.

This article reports on a study exploring the digital experiences of older Australian (65+) retirees, who are Internet “super-users”. Super-users are defined as those who effectively use many Internet applications as part of the normal rhythm of daily life. The data gathering methods of this study were (1) photovoice, (2) a diary of Internet use, and (3) a semi-structured telephone interview.

The project identified what makes a good Internet experience for older adults. This was then translated into a set of guidelines to improve Internet use for other older adults, who are yet to fully realize the potential of the Internet to enhance daily life and wellbeing. The results are considered from the perspectives that older adults’ digital participation is best conceptualized by incorporating self-efficacy theory, digital competence and personal learning environments (PLEs) and demonstrates a pathway toward digital participation for older adults through the development of digital self-efficacy.