The fountain of mental youth. Search for homeostatic and adaptational hormonal processes

Mental health in the aged: prevalence, covariates and related neuroendocrine, cardiovascular and inflammatory factors of successful aging

Background

Although aging is accompanied by diminished functioning, many elderly individuals preserve a sense of well-being. While the concept of "successful aging" has been popular for many decades, little is known about its psycho-physiologic and endocrine underpinnings. KORA-Age is a population-based, longitudinal study designed to determine the prevalence of successfully aged men and women between 65 and 94 years old in the MONICA/KORA Augsburg cohort of randomly selected inhabitants. Specifically, we aim to identify predictors of successful aging and to elucidate bio-psychosocial mechanisms that maintain mental health and successful adaptation despite adverse experiences of life and aging.

Methods/Design

Components of successful aging were assessed in a telephone survey of 4,127 participants (2008-2009) enrolled in the MONICA/KORA cohort, on average, 13 years earlier. Psychosocial, somatic and behavioural predictors are used to determine factors that contribute to successful aging. An age-stratified random sub-sample (n = 1,079) participated in a personal interview where further psychological mechanisms that may underlie successful adaptation (resilience, social support, attachment) were examined. The interactions among neuroendocrine systems in the aging process are investigated by studying the cortisol/dehydroepiandrosterone-sulfate ratio, the level of insulin-like growth factor I, and oxytocin.

Discussion

Longitudinal determinants of successful aging can be assessed based on a follow-up of an average of 13 years. A comprehensive analysis of biological as well as physio-psychological information provides a unique opportunity to investigate relevant outcomes such as resilience and frailty in the elderly population.

New approach to gerontology: building up "successful aging" conditions

BACKGROUND AND AIMS

Great efforts have been made in developed societies to extend human life expectancy as much as possible. Continuing investments into extending the life-span into the "fourth age" actually reduce the opportunities of people to age successfully and die in dignity. Consequently, in recent years, the concept of "Successful Aging" (SA) has gained increased attention: investigators recognize the importance of separating pathologic changes from those which may be attributed to aging in itself, in order to interpret correctly the differences between Pathologic Aging, Normal Aging, and Successful Aging. Hence, according to recent literature on aging, our aim was to question here the validity of recommendations made in the literature for policy making in the treatment of aging and suggest new alternatives.

METHODS

We have tried to understand and develop a method of analysis to the following question: what do we actually mean by SA? Successful Aging may be seen as an arbitrary, subjective term, so we studied which indicators characterize elderly persons as successful aged.

RESULTS

The results of this study show that older people's views of SA appear to be multidimensional and more complex than the apparent viewpoint of many of early studies, which tended to focus on a single dimension of health - psychological or mental.

CONCLUSIONS

We argue the proper use of various health indicators and health enhancers, as proposed in the current international literature, in the definition of SA.