Personal adjustment in late life: successful aging

Cognitive reserve and depression predict subjective reports of successful aging

BACKGROUND

With graying of western societies, successful aging is a hotly debated topic. Attaining successful aging brings benefits not only at the individual level, but also to society. To better understand successful aging, we conducted a study of older adults in the Republic of Slovenia.

METHODS

We recruited 213 community-dwelling adults, age 65 years and older, who responded to the Successful Aging Inventory (SAI), Purpose of Life Questionnaire (PIL), Satisfaction with Life Scale (SWLS), Beck Depression Inventory (BDI), Cognitive Reserve Index, Functional Activities Questionnaire (FAQ), and Multiple Abilities Self-Report Questionnaire (MASQ).

RESULTS

Responses to all scales were significantly correlated, which was taken into account when identifying covariates of latent successful aging in a structural equation model. Successful aging, as evaluated by the combination questionnaire responses, was most strongly associated with depression and marginally associated with cognitive reserve. Self-rated functional and cognitive capacities did not significantly explain individual differences in successful aging.

DISCUSSION

In our study of community-dwelling, older Slovenes, self-rated depression emerged as a strong correlate of successful aging and, to a lesser degree, cognitive reserve. Future studies of interventions that aim to promote successful aging should consider the role of depression and cognitive reserve in the older adult's experience of aging.

Successful aging and its discontents: a systematic review of the social gerontology literature

PURPOSE OF THE STUDY

The purpose of this study was to analyze the range of critiques of successful aging models and the suggestions for improvement as expressed in the social gerontology literature.

DESIGN AND METHODS

We conducted a systematic literature review using the following criteria: journal articles retrieved in the Abstracts in Social Gerontology, published 1987-2013, successful aging/ageing in the title or text (n = 453), a critique of successful aging models as a key component of the article. Sixty-seven articles met the criteria. Qualitative methods were used to identify key themes and inductively configure meanings across the range of critiques.

RESULTS

The critiques and remedies fell into 4 categories. The Add and Stir group suggested a multidimensional expansion of successful aging criteria and offered an array of additions. The Missing Voices group advocated for adding older adults' subjective meanings of successful aging to established objective measures. The Hard Hitting Critiques group called for more just and inclusive frameworks that embrace diversity, avoid stigma and discrimination, and intervene at structural contexts of aging. The New Frames and Names group presented alternative ideal models often grounded in Eastern philosophies.

IMPLICATIONS

The vast array of criteria that gerontologists collectively offered to expand Rowe and Kahn's original successful model is symptomatic of the problem that a normative model is by definition exclusionary. Greater reflexivity about gerontology's use of "successful aging" and other normative models is needed.

The effects of reminiscence on psychological well-being in older adults: a meta-analysis

This paper presents the results of a meta-analysis to assess the effectiveness of reminiscence on psychological well-being across different target groups and treatment modalities. Fifteen controlled outcome studies were included. An overall effect size of 0.54 was found, indicating a moderate influence of reminiscence on life-satisfaction and emotional well-being in older adults. Life-review was found to have significantly greater effect on psychological well-being than simple reminiscence. In addition, reminiscence had significantly greater effect on community-dwelling adults than adults living in nursing homes or residential care. Other characteristics of participants or interventions were not found to moderate effects. It is concluded that reminiscence in general, but especially life review, are potentially effective methods for the enhancement of psychological well-being in older adults. However, a replication of effectiveness studies of the well-defined protocols is now warranted.

Spiritual belief and quality of life: The experience of older bereaved spouses

Spiritual wellbeing is a neglected aspect of quality of life in British research on ageing. US research emphasises the health and other benefits of religious belief for American older people. However, whereas the US is still a strongly religious society, in Britain there has been a steady erosion of membership of Christian churches, accompanied by a loss of respect for the authority of the church and an increased freedom of expression in belief. In an exploratory study the implications of spiritual belief for adjustment have been studied in a sample of 28 older bereaved spouses, who have been followed from the first to the second anniversary of the death. Using a recently developed measure of strength of spiritual belief, a clear pattern was found of greater depressive symptomatology and lower perception of personal meaning among those of moderate belief; ie those who still held to a belief in a spiritual power outside of themselves but who were not sure of its efficacy. Investigation of this group of 11 moderate believers provided many illustrations of spiritual questioning, uncertainty and unease. It appears likely that a substantial proportion of the older population in Britain has become isolated from their churches of origin, yet maintains forms of spiritual belief, often hesitant in character. Some may benefit from renewed contact. Statutory health and welfare agencies need to consider their own role in promoting such re‐engagement.

Interest in participation in a peer-led senior health education program

A study was made of the characteristics of older adults showing an interest in participating in a health education course given by peers. Determining the degree of interest in health education is important for assessing the impact on the target-population and evaluating the dissemination strategy. In the course 'Successful Aging' groups of older adults came together to discuss health related issues. The course was given by senior health educators aged 55 years and over from the peer group. To determine interest in the course answer cards were sent with a letter of invitation to all independently living inhabitants aged between 55 an 79 in a Dutch community. The rate of expressed interest in the course was 5.8%. Interest was highest among females in the 55-64 age group, the unmarried and those with low wellbeing. Males in the age group 65-79, females aged 75-79, those with a lower socio-economic status and the inactive were comparatively less interested. Subscription to the course was distinguished from mere interest in the course. From those who expressed interest, more people of low socio-economic status, with a reduced level of wellbeing, many physical limitations and poor self-efficacy actually subscribed. It is concluded that the health education program will be continued and that special attention will be paid to groups that showed lower levels of uptake. Involving intermediates from these groups in the course development is recommended.