The Paradox of Successful Aging: It's Not Physical
Mental health may be more important than physical health when it comes to successful aging.
--by Nina Lincoff
In fewer than 20 years, there will an estimated 72 million Americans over the age of 65—that’s 30 million more than there are now. With such a fast growing elderly population, many are taking steps to age successfully, countering the stereotype that as you age, your physical, mental, and social health decline.
The results of the Successful AGing Evaluation (SAGE) study conducted by researchers at the University of California, San Diego and Stanford University were published online this week in the American Journal of Psychiatry, and the findings were somewhat surprising. From a pool of more than one thousand participants, self-reported successful aging was more common the older the participants were.
But what is successful aging? How is it possible to quantify something as seemingly intangible as success? For the elderly, characteristics of a full life may be different than they are for a twenty year old, someone just starting a family, or a parent whose kids have gone off to college. Researchers defined a successful aging model as one with great resilience, lower depression, and better physical health sustained into older age.
For clinicians looking to help patients age successfully, the study points to three potential avenues: flexibility in attitude toward aging, using successful aging as a patient outcome, and the fostering of resilience and treatment of depression to support successful aging. What’s more, it seems that patients show a remarkable improvement in standards of ‘success’ the older they get. By turning successful old age into a positive outcome, it seems that clinicians can help improve patient perception of aging.
The Expert Take
For middled-aged individuals who are starting to think about aging, study author Dilip Jeste, M.D., says that a "positive and optimistic attitude toward aging combined with resilience, along with prevention or treatment of depression will go a long way to achieving successful aging."
Psychosocial factors serve to reduce the level of stress that comes with aging, he
says. While much of life can't be controlled, people can have agency in the way they deal with stress. Even for those in perfect physical health,
"resilience and positive approach can be very helpful," Jeste says. As a bonus,
a positive perspective generally leads to a more active and stimulating
life, which also contributes to successful aging.
The surprise of the study, according to Jeste, "was the divergence between physical health and the feeling of aging successfully. In our sample of people aged 50 to 99 years, aging was associated with worse physical health but with a higher self-rating of successful aging." So, someone who is in physical disrepair, but who has strong resilience and receives treatment for depression can age just as successfully as someone in excellent physical health.
Although causal relationships can’t be drawn from the study, it seems that increasing resilience and reducing depression may affect successful aging just as much as physical health interventions. Resilience, as defined by the authors, may “be an important aspect of maintain well-being in the context of losses in functioning with aging.”
while it’s important to spend time working on your body and diet, prep
for the future by spending time honing your mind as well, whether that means solving more Sudoku or learning a bit more about
"Aging begins at conception," says Jeste, "while development continues into old age. More seriously, it is never too early nor too late to start on the path to successful aging." And it's never to late to establish good behaviors. Studies have shown, says Jeste, "that middle aged people who had regular physical exercise did better in their old age than their counterparts who tended to be sedentary in middle age."
Source & Method
Just over 1,000 participants 50 to 99 years old in San Diego took part in the two-part SAGE study. Following a random-digit dialing process to recruit participants, a 25-minutes phone interview was conducted followed by a mail-in survey that participants completed themselves. The study included questions designed to determine self-rated successful aging and to identify factors that contribute to positive well-being, such as physical, mental, and social activities.
If successful aging means having a positive mental outlook, it may be time to read up on the research concerning successful cognitive and emotional aging. In a 2010 study published in World Psychiatry, successful aging is defined as a longer life and positives states of mental and physical health.