SUCCESSFUL AGING

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SUCCESSFUL AGING

• How old would be if you didnt know how old you
  was?
• Satchel Paige

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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)

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• Successful aging
• Is dependent upon individual choices and
  behaviors
• Can be attained through individual choice and
  effort

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• Successful and Unsuccessful Aging
• The difference between sickness and health?
• Focus of traditional gerontology
• Absence of disease is not enough.

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Rowe Kahns Definition

• Successful agingthe ability to maintain three
  key behaviors or characteristics
• Low risk of disease Disease-related disability
• High mental physical function
• Active engagement with life

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• Pictorial representation on p. 39

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What do successful agers do?

• Just keep on going!

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Avoiding Disease Disability

• Modern medicine..an applied science of repair
  rather than prevention. (p. 40)
• The very word patientimplies passivity rather
  than responsibility for our own health. (p. 40)

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• 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

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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 OAs w/ arthritis

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Maintaining Mental Physical Functioning

• INDEPENDENCE
• The principal goal of many OAs
• few issues strike greater fear than the
  prospect of depending on other for the most basic
  daily needs. (p. 42)

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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

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More About Exaggerated Fears

• Alzheimers disease Nursing Homes are the
  Biggies
• AD Over 90 DONT have it
• Its not an all-or-nothing phenomenon
• (Srs. Bernadette Rose in the Nun Study--pp.
  97-100 in Snowdon)

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• Nursing Homes
• lt5 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, lt5
  need help with basic ADLs

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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 OAs are NOT significantly affected by even
  minor losses of mental ability

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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)
• 60s--Disengagement Theory. Neugarten
  Havighurst (Sociologists, not Gerontologists)
• The final act of relinquishment was letting go
  ot life itself. (p. 46)

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• 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)

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• 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)

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Research HX Context of the MacArthur Study

• References go back gt50 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

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Research Context contd

• 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

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How Did the MacArthur Study Differ?

• By proposing a research-based model of
  successful aging, by going beyond absence of
  disease and disability, and by describing the
  ways in which personal relationships and
  productive behavior change as people move through
  the life course. (p. 52)