Transcript Document

“How old would be if you didn’t
know how old you was?”
Satchel Paige
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
• Pictorial representation on p. 39
What do “successful agers” do?
• “Just keep on going!”
Avoiding Disease & Disability
• “Modern 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
• 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
• 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
• Much functional loss can be prevented
• Many functional losses can be regained
More About: Exaggerated Fears
• Alzheimer’s disease & Nursing Homes are the
– AD:
Over 90% DON’T have it
– It’s not an all-or-nothing phenomenon
– (Srs. Bernadette & Rose in the Nun Study--pp. 97100 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 Agerelated Declined in Cognitive Fx:
• Declines rarely affect all kinds of cognitive
• 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.
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
How Did the MacArthur Study
• “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)