What is “Successful Aging”?

Every May, the Administration on Aging leads the national observance of “Older Americans Month.” The theme this year is “Engage at Any Age.”

But I found myself thinking that this would be a nice opportunity to consider: just what does it mean to “succeed” or do well as an older adult?

This is important, because our understanding of what is “success,” and what to strive for, is fundamental to how we judge ourselves and others.

And for us as a society, articulating what’s involved in experiencing “good” or “successful” aging is important because it can help us understand what kinds of things we should focus on, to help more older adults age well, or otherwise “succeed” in late-life.

So, just as philosophers and others have long debated what it means to “live a good life,” we should ask ourselves what it means to “succeed” as an older adult.

This way, we can know whether we are “succeeding” as a society that supports and values its older population.

What IS “successful aging?”

This is not a simple question to answer. It has long been the subject of vigorous inquiry and debate in gerontology. In fact, the journal The Gerontologist devoted an entire issue to the topic of “Successful Aging” in 2015.

(FYI: Gerontology is “the comprehensive study of aging and the problems of the aged,” whereas geriatrics is a medical specialty. We are related but not the same!)

I can’t summarize the debates on what constitutes successful aging here, but if you’d like to read more, this article from The Gerontologist offers a long and detailed overview of different ways that scholars have conceived of successful aging: Defining Successful Aging: A Tangible or Elusive Concept?

A common (and problematic) definition of successful aging

One prominent model of successful aging, developed in the 1990s (Rowe and Kahn), proposed that it means:

• freedom from disease and disability
• high cognitive and physical functioning
• active engagement with life

Gerontologists have gone way past this model, but this may be pretty close to what many people have in mind, when they think of “successful aging” or “aging well.”

And it’s certainly what many images of older adults convey: people who may “look older” but otherwise appear to do everything they could do earlier in life.

This is what we see in this AARP “Disrupting Aging” video, in which millennials are confronted with some older adults who are much more able than the millennials had expected.

But there’s an obvious problem with this conception of successful aging: many, if not most, older adults will eventually not be able to meet all three criteria.

So have they failed? And: will we tend to judge that it’s their fault if they don’t remain disease- and impairment-free as they age?

A better lens on “successful aging”

This article describes a newer way to frame successful aging that I find intriguing. (The authors are Eva Kahana, Boaz Kahana, and Jeong Eun Lee.)

The authors describe a model based on the assumption that with increasing age there is an accumulation of health-related and social stressors.”

They note that if it weren’t for common age-related challenges, there would be no need to distinguish successful aging from successful living at any age. (True!)

They propose that those who maintain good physical health, mental health, and engagement in social activities, without any conscious coping efforts, be referred to as “lucky agers”.

But most people will not be lucky, and hence they need to find ways to cope and adapt to age-related stressors, which include:

• chronic illness
• social losses
• “lack of person-environment fit”

Coping with age-related stressors in a purposeful way, and finding ways to maintain quality of life, is called making “proactive adaptations.”

The authors go on to describe how this can be done in a “preventive fashion” (e.g. anticipating a future or impending age-related stressor) and then also in a “corrective” way, which means making adaptations once a stressor or problem has occurred.

To adapt, an older person must marshal both internal resources (attitude, optimism, coping with challenges) and external resources (available social support, finances, etc).

The main quality of life outcomes in this model include:

• Self-evaluation of success
• Life satisfaction
• Meaning in life
• Positive affective state (which basically means positive mood or emotions)
• Valued activities

You can see the model diagrammed out in Figure 1 of the article.

In short: in this model, success is not defined as remaining free of disability or disease as one gets older.

Instead, succeeding means finding ways to cope with impending or existing illnesses, losses, and other challenges, by getting help and by marshaling one’s own resilience and internal resources.

In this way, despite experiencing losses and illness and “lack of person-environment fit” (e.g. a house that is a challenge or dangerous to live in), older people often find ways to meet these challenges.

In doing so, they continue to find ways to experience positive outcomes such as life satisfaction, meaning, contentment, and they are still able to participate in valued activities.

Personally, I like this model. (Granted, it’s a little wonky, but that’s true of all substantive academic work.) I especially like the attention to the way that older adults can be proactive and exert their autonomy by anticipating and adapting to common age-related challenges. In the words of the authors, this “reflects human agency directed at stress reduction, resource development, and problem resolution.”

In other words, this model gives credit to those who acknowledge that their lives may or are changing, and purposefully engage in addressing this.

This takes a certain courage. Which, in truth, is what most older adults muster when the time comes. But you’d never know it to see most media images of older adults, which either portray them as free of late-life stressors or instead emphasize their declines without highlighting their successes in adapting, and their ability to find meaning in a new normal.

How can we support older adults in anticipating & coping with age-related challenges?

Most people will encounter losses and impairments as they age.

What if, as a society, we were less afraid of this, and instead embraced it as an opportunity to be proactive, and then to step up to challenges?

What if as a society, we were better at acknowledging and celebrating the remarkable acts of resiliency and problem-solving that many older people are working their way through?

What if older people felt more comfortable getting help when it becomes necessary? What if we were better at providing it?

These are some of the things that I’ll be thinking about during Older Americans Month.

People really can engage at any age.

We need to make sure that message is clear — and actionable — even for those who aren’t among the “lucky agers.”

Now tell me: what comes to mind when you think of “successful aging”? And what could we collectively do to help more older adults feel successful?

Addendum: Here’s an important and relevant excerpt from the FrameWorks’ Institute’s 2015 analysis of the public view on aging:

“The biggest problem with the dominant patterns of public understanding identified in FrameWorks’ research is
the deep assumption that individuals are exclusively responsible for how they age.

In addition, while we know from previous research that the public maintains an ideal vision of aging, this “ideal” is uncontested in these stories, leaving people with a view of aging that, according to experts, is deeply unrealistic.

When the media and advocacy organizations fail to link successful aging to policies that enable older adults to remain active and socially engaged, they actually reinforce the public’s highly individualistic understandings of the aging process. The result is that people will understand the likelihood of successful aging to be about lifestyle choices rather than as affected by supports, larger social structures, or public policies.”

We must find ways to make it easier for aging adults to get the support they need, both to proactively prepare for late-life stressors and to help them adapt when they occur.