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W11 Successful Ageing - Coggle Diagram

- - - - some scholars argue as such and contend that successful ageing is not ageing at all
      - ageing process associated with physical, cognitive and social decline but also growth, vitality, striving, contentment
        
        acknowledging positive and negative changes of ageing and heterogeneity of paths people can follow as they age
- - - - maintaining vigour and being free from disability until end of life (Job 5:26)
      - honour of having grey hair (Proverbs 20:29)
      - days complete with riches and honour and leaving a legacy (1 Chronicles 29:28)
      - Being wise (Job 12:12)
      - dying after living satisfying life (Genesis 25:8)
    - - defining successful ageing with objective and subjective criteria
      - ageing process involving growth and decline
  - - - tension between aging as growth or as decline
    - - 380BCE Socratic dialogue "The Republic" associates wisdom with age
    - - ultimate purpose of life to maximise life's pleasures (simplicity and friendship
    - - 44BCE essay De Senectute
        
        old age harbors opportunity for positive change & productive functioning
  - - - theory of successful ageing impt to identify conditions for maximum happiness and satisfaction
      - gerontology exists to "add life to the years" and advice on societal and individual choices that lead to successful ageing
    - - Engagement Theories
        
        Activity theory
        
        maintaining activities & attitudes of middle age for as long as possible
        
        substitution of new activities for those that are abandoned
        
        Continuity Theory
        
        SA => maintenance of level and range of activities characteristic of person in prime with minimum downward adjustment
        
        :older_man::skin-tone-3: continues to engage with activities proactively
      - Disengagement Theory
        
        acceptance and desire for process of disengagement from active life
        
        criticised for suggesting disengagement as innate, universal and unidirectional (:older_man::skin-tone-3: pulls out of society)
    - - believed in imp of operational definition & measures to determine degree of fit to definitions
        
        developed life satisfaction measure to test Activity Theory with 5 components
        
        zest vs apathy
        
        resoluton & fortitude
        
        goodness of fit between desired and achieved goals
        
        mood tone
        
        positive self-concept
  - - - Index of Activities of Daily Living (ADLs)
        
        identified as origin of biomedical objective conceptualisation of successful ageing
        
        Gains & losses in physical functioning become integral component of meaning of SA with SA research developments
        
        ageing considered composite of number of deteriorating physiological functions
        
        objective approach for studying aging process
- - - - :two: High cognitive and physical functional capacity
      - :three: Active engagement with life (interpersonal relations & productive activity)
      - :one: low probability of disease and disease-related disability
    - - Riley
        
        does not adequately acknowledge that life changes & social structure changes fundamentally interdependent
        
        place full responsibility for attaining SA on individual
      - questioned value of a construct that applies to small segment of older people
      - missing dimensions such as spirituality, marital quality, psychological well-being
      - created a new or polarised ageism that blamed individuals for not ageing successfully
        
        provide physicians & others w club to beat "unsuccessfully ageing" patients
        
        :older_man::skin-tone-3: blamed for disabilities
      - use of binary or nonbinary models to characterise successful ageing
      - missing voice of older people
        
        heart of Havighurst's SA which lost traction as R&K definition gained scholar attention
        
        sharp contrasts between subjective self-reports of :older_man::skin-tone-3: & objective biomedical assessments
        
        due to
        
        function of culture
        
        personality differences
        
        SA is more than aging free of disability & disease
    - - usual aging involves substantial loss
      - some experience minimal or even no loss despite avg declines in physiologic or psychosocial characteristics over time
  - - - substantial variability in physiologic and psychological declines
- - - - altered conceptualisations of SA
      - Multidimensional
        
        SA as multidimensional construct w several distinct but related dimensions
        
        functional
        
        physiological
        
        social
        
        physical
        
        SA definitions & indicators vary across studies
        
        lack of consensus definition => creation of variety of measures
        
        Lit Review (Depp and Jeste, 2006)
        
        28 studies with 29 different definitions
        
        Lit Review (Cosco, Prina , Perales, Stephan B.C.M, and Brayne, 2014)
        
        84 studies with 105 operational definitions
        
        Indicators
        
        49.5% => some form of engagement
        
        48.6% => aspect of wellbeing
        
        25.7% => personal resources
        
        5.7% => extrinsic factors (finances)
        
        13.1% => subjective perceptions of SA
        
        92.4% => physical functioning
        
        usually from 1 to 5 constructs
        
        2 more items...
        
        :arrow_up: heterogeneity in SA operationalisation & conceptual ambiguity
        
        confounded predictors with construct
        
        hindered cross-study comparisons
        
        SA indicators in 1 study were SA predictors in other studies
        
        broad defns including multiple components
        
        difficult to distinguish SA construct from predictors or outcomes
        
        Prevalence of SA
        
        ranges from 0.4% to 91.7% based on SA definition used
        (Cosco lit review)
        
        percentage varies based on objective or subjective assessments
        
        Objective => 26% SA
        
        Subjective => 71.3% SA
  - - - Subjective assessments found education had strongest effect on SA
        (Jopp et al., 2015)
        
        :arrow_up: => education experience aging as continuous growth rather than loss
      - Biomedical model found no rs between education & SA
  - - - far from meaningless concept
- - - - experiences of pleasure & enjoyment
      - from Aristippus (4th century BC) => maximise pleasure, minimise pain
    - - experiences of meaning and purpose
      - Aristotle (4th century BC) => live life based on virtues & strive to attain potential
  - - - acknowledges individual diversity
      - SA as balance between life satisfaction & dissatisfaction.
      - related health policies should focus on :arrow_up: subjective satisfaction of :older_man::skin-tone-3:
    - - SA examined through human development perspective
        
        examining experiences throughout individual's life span
      - negative experiences are opportunities for growth
      - policies should focus on counselling & educational support help older adults achieve life stage appropriate milestones
    - - values subjectivity & recognises human diversity
      - SA centered on diverse pathways connecting individual's values to
        
        functioning (goals)
        
        commodities (resources)
        
        capabilities (opportunity structures)
      - policies should boost environmental needs & opportunity structures of :older_man::skin-tone-3:
    - - SA being joint efforts of care recipients & caregivers (formal & informal) in
        
        maintaining care recipients quality of life
        
        not dismissing :older_man::skin-tone-3: w impariments as unsuccessful agers
      - policies should ensure caregivers & care institutions maintain quality care that address long-term care needs of :older_man::skin-tone-3:
- - - - both objective & subjective SA aspects important
        
        form a Gordian knot no one is able to untie
        
        need to integrate SA knowledge & Havighurst roots
    - - Depp & Jeste review (2006)
        
        most consistent predictor of SA is age
        
        almost 90% of studies report sig rs with :arrow_down: age & probability of SA
      - McLaughin et al. (2010)
        
        :older_man::skin-tone-3: aged ≥ 75 were 70% :arrow_down: likely to experience SA compared to young-old
        
        based on assesor-rated objective indicators
        
        SA measured w self-ratings
        
        older age associated w :arrow_up: ratings of SA
        
        even after accounting for :arrow_down: physical & cognitive function
- - - - Recent cohorts had :arrow_up: cognitive functioning & well being than previous cohorts
  - - - people select functional domains to
        
        focus resources
        
        optimise developmental potential
        
        compensate for losses
    - - rs bet personality characteristics & SA
      - impact of early adversities (child abuse, neglect) on SA
      - effect on impactful life events on SA
        
        Individual (eg. widowhood)
        
        Communal (natural disasters)
        
        factors that moderate these associations
      - impact of individual & environmental characteristics on SA
  - - - Study of 90-99 yr olds (Nosraty et al., 2017)
        
        :arrow_down: incidence rate of entering LTC for :older_man::skin-tone-3: with SA
        
        :arrow_up: mortality risk for :older_man::skin-tone-3: aging normally
    - - death free from avoidable stress & suffering as SA outcome
      - heatlh care utilisation & cost variations as function of SA status
  - - - need to study SA changes over time
        
        before that need to confirm that
        
        :one: SA is stable across time
        
        :two: Measurement invariance in SA over time (can be measured same way)
        
        does SA ebb and flow?
        
        does SA have a downward trajectory?
    - - :older_man::skin-tone-3: currently SA not always meeting SA criteria in the past
  - - - Torres (1999)
        
        Hong Kong :flag-hk: :older_man::skin-tone-3: associated SA with family willingness to meet their needs
        
        American :flag-us: :older_man::skin-tone-3: associate SA with self-sufficiency & ability to live alone
      - Hsu (2007)
        
        5 major factors of 23 SA factors in Taiwan :flag-tw: :older_man::skin-tone-3:
        
        family & social support
        
        mastery over life
        
        health
        
        enjoyment of life
        
        autonomy
      - Chung & Parl (2008)
        
        3 key concerns for :arrow_down: income :older_man::skin-tone-3: in South Korea :flag-kr:
        
        positive attitude to life
        
        success of adult children
        
        relationships with others