Successful ageing is more than just health!

Older gentleman socialising

The term successful ageing has been around for over half a century and a more contemporary version was developed by Rowe and Kahn in the late 80s and 90s (1-4). They often described those ageing successfully as having a low probability of disease or disability related to disease; high cognitive and physical function capacity and active engagement in life. There was an emphasis on maintaining health and reversing disabling problems.

The issue I have with the term is that much of the early research was conducted without older people’s input and often more recent research has used large population health datasets to determine the proportion “successfully ageing” and again this is determined predominantly by health status.

Have a think about all of the older people you know, or if it’s you you’re thinking about, I would like you to come up with a convincing argument telling me you are only your health!! It is simply not true, you or the people you know are so much more than that.

Older woman in discussion with younger woman

It was because of these ideas that I teamed up with two colleagues in the US to get the opinion of thousands of older people from across Australia, New Zealand, the United Kingdom, Ireland, Canada and America and specifically to find out how they defined “successful ageing”.

We sent out Facebook adverts and it was amazing how many people answered the survey. If you were one and you’re now reading this, thank you so much, I hugely appreciate your time and most importantly your opinion. Collecting data through a social media portal is an interesting experience and some people who saw the advert voiced their opinion before even getting to the survey. Particularly about the spelling of ageing!! Apparently, it is only spelt, aging not ageing, yet more than half of the people who answered the survey came from countries where UK spelling is the predominant form, not US spelling. When I explained this and that ageing was UK spelling, they became very quiet, yet I thought keyboard warriors were meant to do the opposite. I kept a log of the comments, here are some of the colourful ones and some great ones too (all provided verbatim):

• No. This obviously nothing more than a ploy to get people to buy something.

• Ageing? How about not spelling well.

• What happens to our answers? I don’t want to be inundated with adverts for all sorts of “stuff”

• I've completed the survey, and I think it's sounding out people that are ripe for picking to go into old age people homes or nursing homes. (EB: obviously doesn’t know me like you all do, my mission is the exact opposite)

• NO PLASTIC SURGERY (EB: yes they used all caps!)

• Being a successful senior I resent people assuming I can't drive and/ or attend a function or appointment on my own

• Dying before the money does

• Thank you for the survey. It focussed me on priorities. Financial and independence, finding joy in weird things. No care homes, unless they really change how they do things.

• Completed ….. I often get told I am too independent for my own good!

• Interesting, made me think!

• I'm only 69 so haven't given it much thought

• I’m 71 and found it an interesting exercise. Made me think about my values

• I am 86 husband 96 we live in Canada in a really snowy area I still drive and go water aerobics I filled in survey I do not care where I get info from if I find it relevant to my life and will improve my life I will fill it in I do hope your survey is successful in that Doctors stop thinking old is a disease last week I had a Dr ask me who helps me dress I told him I am looking for a gentleman of the bed chamber. I have had x-ray techs ask me if I am pregnant the young do not understand us.

Now onto the interesting bit, the results. I had hoped that they would show that successful ageing was more than just health and the 1,985 participants certainly had a lot to say, we had over 4,000 initial codes to sift through. They were asked two questions:

1. Do you feel like you are successfully ageing? Respondents answered on a scale from "definitely not" through to "definitely yes", and

2. Please describe what successful ageing means to you? There were no examples given, nothing that could lead them in one direction or another, simply their own opinions.

We had people aged between 65 and 99 complete the survey, with the average age being 73 years old. Thirty-five percent were from Australia or New Zealand, 29% from UK, Ireland or Europe and 28% from the US or Canada, so a really, nice mix. There were also more people from regional areas who completed the survey than regional cities or capital cities and their surrounding suburbs.

Friends being active and enjoying life

So, what did we find, almost 85% said they were probably or definitely successfully ageing. Australians and New Zealanders were more likely to "definitely" be successfully ageing compared to the UK and Irish respondents. You can find the full results in our article by clicking here (5).

But now to the juicy bit. When analysing all of the responses we came up with six major themes:

1. Actively engaged and independent

2. Physical activity and well-being

3. Resilience and acceptance

4. Social-emotional connection and support

5. Health promotion and maintenance

6. Mentally healthy and cognitively sound

I’m not going to speak about the themes in today’s blog. I will go into more details about each of them over the coming months and give more in depth information about the different aspects to successful ageing from the perspective of older people. However, when you look at the six themes you can really see what is important in life and how holistic ageing is. Would there be any you disagree with?

• Successful ageing is not just about health and avoiding disability

• Being actively engaged and independent was the most reported response, 1,316 people noted this as being an important part of successful ageing

• As a society it feels like we underestimate older people’s abilities and capabilities. These were mentioned in the Facebook comments and also in the definitions of successful ageing. Apart from being ageist, why do we do this, and who are we to judge others, when we don’t know their story.

• I even hear older people downplaying their own capabilities. Our outlook on life and how we approach life can play a large role in what we get out of life and being able to age successfully.

• It is known that the expectation of the teacher often determines how well their students perform. Low teacher expectation, low student performance. What about health professionals, low expectations may potentially lead to low expectations and outcomes for the patient??

• What are your expectations for you? Are you going to age successfully?

  
  

Live the good life!

References:

1. Rowe, J. W. (1997). The new gerontology. Science, 278(5337), 367. https://doi.org/10.1126/science.278.5337.367

2. Rowe, J. W., & Kahn, R. L. (1987). Human aging: Usual and successful. Science, 237, 143–149. https://doi.org/10.1126/science.3299702

3. Rowe, J. W., & Kahn, R. L. (1997). Successful aging. Gerontologist, 37(4), 433–440. https://doi.org/10.1093/geront/37.4.433

4. Rowe, J. W., & Kahn, R. L. (1998). Successful aging. Random House

5. Burton, E., Teater, B., Chonody, J., Alford, S. 2024. What does it mean to successfully age? Multinational study of older adults’ perceptions. The Gerontologist; 64(10): gnae102. DOI: 10.1093/geront/gnae102