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- Aging and demographic changes
- Stereotypes of Aging: Their Effects on the Health of Older Adults
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Arch Intern Med. We explored the meaning of successful aging from 2 perspectives. All inhabitants of Leiden aged 85 years were eligible.
Successful aging from a public health perspective was defined as a state of being. All participants were classified as successful or not successful based on optimal scores for physical, social, and psychocognitive functioning and on feelings of well-being, using validated quantitative instruments.
Qualitative indepth interviews on the perspectives of elderly persons were held with a representative group of 27 participants. The qualitative interviews showed that most elderly persons viewed success as a process of adaptation rather than a state of being. They recognized the various domains of successful aging, but valued well-being and social functioning more than physical and psychocognitive functioning. However, elderly persons view successful aging as a process of adaptation.
Using this perspective, many more persons could be considered to be successfully aged. Demographic changes challenge policy makers to put increasing effort in dealing with the consequences of an aging population. The concept of successful aging, however, lends itself to more than one interpretation. Two main perspectives exist: one that looks at successful aging as a state of being, a condition that can be objectively measured at a certain moment; and one that views it as a process of continuous adaptation.
Rowe and Kahn 2 hold the former view and describe successful aging as the positive extreme of normal aging, while others 3 use definitions such as the elite of healthy elderly persons or robust aging. In these definitions, successful aging is a better than normal state of being old. Several population-based studies 4 - 8 on successful aging have adopted this concept. Others, like Baltes and Baltes, 9 see successful aging as a successful adaptation of the individual to changes during the aging process.
In a similar view, Havighurst 10 and Keith et al 11 define successful aging as reaching individual goals or experiencing individual feelings of well-being. Successful aging as an optimal state implicates more than physical well-being and fits the World Health Organization's definition of health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
This problem holds equal when using other models, like the International Classification of Impairments, Disabilities, and Handicaps model. To gain a deeper insight into the concept of successful aging, we will describe successful aging from 2 perspectives. In a quantitative approach, we defined successful aging as an optimal state of being.
In a qualitative approach, the aging process as experienced by elderly persons was the point of departure. Therefore, we measured the optimal functioning and well-being with established quantitative instruments in a community-based sample of year-old persons, and conducted in-depth interviews with a representative number of participants.
We explored the differences between the state of being, which mimics a public health perspective, and the perspective of the elderly persons themselves. The Leiden plus Study is a population-based prospective follow-up study on functioning and well-being in a delineated cohort of year-old persons.
The aims of the present study are to investigate determinants and preventable causes of unsuccessful aging and to explore the possibilities for investing in successful aging. The study was approved by the institutional medical ethical committee, and informed consent was provided by the participants or, in case of severe cognitive impairment, by the most significant other.
There was no exclusion on health, cognitive functioning, or living situation. Fourteen persons died before they could be enrolled, and 92 refused to participate. Table 1 shows the demographic characteristics of the participants. Demographic characteristics are representative for the general Dutch population of year-old persons. According to the World Health Organization's definition of health, the domains of physical, social, and psychocognitive functioning were assessed as was the domain of general well-being.
Established quantitative instruments were chosen after consultation with researchers from other studies of elderly persons. Trained physicians and research nurses visited the participants twice at home, and assessment took place in face-to-face interviews. Social functioning was measured with the Time Spending Pattern Questionnaire TSP , which lists regular involvement in social and leisure activities, leading to a sum score for 10 social activities eg, receiving visitors, visiting others, contact by telephone, and participation in church and associations.
Psychocognitive functioning was measured with the Mini-Mental State Examination MMSE as a screening instrument for severe cognitive impairment and dementia 17 , 18 and the short Geriatric Depression Scale 19 as a screening instrument for depression.
Well-being was assessed by the Cantril ladder, 20 a visual analog scale on perceived quality of life varying from 1 to 10 points, and by a general question: "Are you, in general, satisfied with your present life?
In case of severe cognitive impairment, defined by a score of 18 or less on the MMSE, depression and loneliness could not be assessed. We defined successful aging as the optimal state of overall functioning and well-being. Figure 1 gives an overview of this classification. Criteria for each domain were based on the quantitative scores at the moment of measurement. Cutoff points were chosen at the 33rd percentile to include the best third for each domain in addition to standard cutoff values.
This led to the following quantitative criteria for classification. The optimal state for physical functioning included minor physical disabilities GARS sum score at the 33rd percentile or less ; for social functioning, regular social activities TSP sum score at the 33rd percentile or greater ; and for psychocognitive functioning, the absence of cognitive impairment MMSE score greater than 18 , and the absence of marked depressive feelings Geriatric Depression Scale score of less than 4.
The optimal state for well-being included a good quality of life Cantril ladder score at the 33rd percentile or greater , satisfaction with present life score of 5-point question at the 33rd percentile or greater , and the absence of marked feelings of loneliness Loneliness Scale score of less than 4.
To investigate the influence of the previously mentioned cutoff at the 33rd percentile on the outcome of successful aging, we used alternative criteria as well. Optimal physical functioning was defined as having no disabilities in the basic self-care activities of daily living.
Optimal social functioning was defined as having at least 4 social activities within 2 weeks. Optimal well-being was defined as being satisfied with one's present life and awarding a pass mark of 7 or higher on the Cantril ladder, without being lonely. The anthropologist M.
The central research questions focused on the experience of growing old and being old, the perception of the concept of successful aging, and the role of health in successful aging from the perspective of the elderly persons. The unstructured and open-ended interviews enabled the researcher to discover motivations, ideas, and determinants from the perspective of the elderly persons.
Participants were selected in consultation with the other researchers of the study A. We interviewed participants with different physical conditions and in different housing situations. These participants turned out to be representative compared with the overall study group.
Their demographic characteristics are presented in Table 1. Persons with severe cognitive impairment were excluded because their impairment would prevent them from taking part in an in-depth interview. Most of the participants were visited twice or more often. Observation of the participants in their home situation was a complementary tool. All interviews were recorded on audiotape and transcribed.
In the analytic process, data were coded, closely examined, and compared for similarities and differences. Concepts such as health, successful aging, and social functioning were elaborated in terms of their properties, dimensions, and relationships.
In this article, the perceptions of the elderly persons about physical, social, and psychocognitive functioning and well-being are compared with the quantitative measurements at baseline to see whether these are concordant. To evaluate the classification of successful aging, the findings of the first participants were the subject of multidisciplinary discussions.
In a standard procedure, participants were discussed on an individual basis to clarify patterns, new determinants, and discrepancies. Arguments for and against the classification of successful aging were recorded. The team consisted of a nurse, an anthropologist M.
The median GARS score was The best third, a total of persons, had a GARS score of 23 or less and were classified as having an optimal state of physical functioning. This subgroup reported only minor disabilities in instrumental activities, meaning that they were independent in daily living but experienced minor difficulties in some activities like heavy housework and cutting toenails. Participants compared their functioning with the functioning of peers.
Most elderly persons talked about health at this age as the maintenance of basic functions vision, hearing, and mobility and the absence of life-threatening diseases, such as cancer. The multidimensional process of adaptation to changes eg, to the slowing of pace and the diminishing of strength was found to be inherent in aging. Elderly persons who were limited in their functioning, as shown in case 1, stated that acceptance and adaptation are essential in maintaining a feeling of well-being.
Those who enjoyed good health said they had been lucky and did not regard their health as a personal "success. Optimal physical functioning was perceived as an ideal situation but conflicted with the common knowledge that afflictions may occur unexpectedly at the age of 85 years. To preserve the privacy of informants, all names are chosen by the anthropologist or the informants themselves.
For a long time, he took care of his parents and he never got married. He is confined to a wheelchair after having experienced a stroke, almost 24 years ago. He has arranged many supportive aids in his home, and although limited, he feels healthy and independent.
It takes him all morning to put clean sheets on his bed, but he is proud to be able to do so without assistance. In his view, acceptance and adjustment to physical limitations is a characteristic of successful aging: "I am dependent in some aspects of my life, nobody can ever change that. But in other aspects, I will try to remain independent as long as I can. Social functioning varied from no involvement in any of the social activities TSP score, 10 to regular involvement in various activities TSP score, The median score was The best third, a total of persons, had a TSP score of 20 or greater and were classified as having an optimal state of social functioning.
They reported regular involvement in more social activities, especially visits and telephone calls, playing round games, going to clubs, and attending church services. Most elderly persons perceived social functioning as essential for well-being and successful aging. A significant group stated that the social contacts in old age reflected their investments at an earlier age. Notions of reciprocity, individual character, and the importance of choices influenced their statements.
Investments in social contacts were perceived as coping mechanisms to avoid loneliness. While social activities might have decreased as a consequence of physical dysfunction, social contacts continued to be important and influenced positive self-esteem.
In case 2, the couple evaluated their social functioning not as individuals but as a joint venture. Furthermore, one missing contact could count more than many existing ones, as case 3 shows. They complement each other well. Mr van der Meer is a good listener and has a special relationship with one son and one grandson.
His son and his grandson have a mental illness. They often come to visit him, and he gives them moral support.
Aging and demographic changes
Arch Intern Med. We explored the meaning of successful aging from 2 perspectives. All inhabitants of Leiden aged 85 years were eligible. Successful aging from a public health perspective was defined as a state of being. All participants were classified as successful or not successful based on optimal scores for physical, social, and psychocognitive functioning and on feelings of well-being, using validated quantitative instruments. Qualitative indepth interviews on the perspectives of elderly persons were held with a representative group of 27 participants.
Aging has a significant impact on society. People of different ages and gender tend to differ in many aspects, such as legal and social responsibilities, outlooks on life, and self-perceptions. Young people tend to have fewer legal privileges if they are below the age of majority , they are more likely to push for political and social change, to develop and adopt new technologies, and to need education. Older people have different requirements from society and government, and frequently have differing values as well, such as for property and pension rights. Thus, the aged have comparatively more, or at least different, political influence.
Stereotypes of Aging: Their Effects on the Health of Older Adults
There are at least 14 advantages of aging. Advantages to society of older persons include their lower criminal activity, greater political participation, increasing voluntary organization participation, work abilities, and visual perception abilities. Advantages for the individual include less criminal victimization, less accidents, social security and other pensions, guaranteed minimum income, tax benefits, Medicare, free programs and reduced rates, freedom from child rearing and work. Most users should sign in with their email address. If you originally registered with a username please use that to sign in.
What roles do individual senior citizens play in your life? How do you relate to and interact with older people? What role do they play in neighborhoods and communities, in cities and in states? Sociologists are interested in exploring the answers to questions such as these through three different perspectives: functionalism, symbolic interactionism, and conflict theory. Functionalists analyze how the parts of society work together.
The absolute number of people 60 years and older is projected to increase from million in to 1. The increase in life expectancy is due to several factors, including a decline in fertility rates and success in reducing fatal childhood diseases, maternal mortality, and mortality in older ages 1, 3. However, longer life expectancy is also a source of concern for policymakers; income growth may become harder to realize in countries with large populations of older people, and meeting the needs of a large elderly population will be especially difficult in low- and middle-income countries. It will be necessary to create economic and social institutions that provide income security, adequate health care, and other needs for the aging population 4. An additional issue that policymakers are facing today is how to best define an older person.