Published on 23 Jun 2011
Health Studies
of 5
CHAPTER 12: What is optimal Aging?
Optimal aging is more than just good health; it must included notions of adult development as
Optimal aging allows for the recognition that there may be different ways of aging well,
depending on the choices that individual makes.
Overwhelming majority of studies predicting health in late life use unidimensional outcome
measures such as longevity, avoidance of particular illnesses such as cardiovascular disease or
depression, and self-reported health.
Thus, most models of optimal or successful aging are multidimensional.
Models of optimal aging are teleological, in that they specify a desirable outcome or telos (goals)
Rowe and Kahns Model of Successful Aging (model is hierarchical):
o3 components of aging:
Avoidance of disease
Maintenance of high cognitive and physical function
Active engagement with life
Avoidance of disease:
oOnce individuals have survived into later life, their own behaviour plays a much greater
role in future longevity.
oexposure to toxins accelerates the aging process. Ex: excessive exposure to sun promotes
cancer and wrinkles and cataracts and blindness
omany are exposed to toxins in their work environments- including agricultural pesticides,
benzenes in cleaning solutions, coal dust, and asbestos- that constitute major risk factors
for disease and can accelerate aging.
oGood nutrition: Mediterranean diet, low in fats and proteins but high in carbohydrates
oWhat constitutes good nutrition for any particular individual depends on a variety of
factors, including age, gender, family history of illness, body type, and a host of other
oYoung, active people flourish on Mediterranean diets
oCaloric restriction clearly decelerates the aging process
oLosing weight in late life has been associated with heightened risk of mortality
oNeed for supplements may also depend age, genetic endowment, and health behaviour
Maintenance of high cognitive and physical function:
oExcercise includes not only physical activity but cognitive activity as well
oOverlap between avoiding disease and maintenance of physical function.
Active Engagement With Life = increase social support and productive work
oHelping to maintain good mental and physical health
oBeing surrounded by family and friends can protect against depression, help people
adhere to medical regimes and get medical treatment when needed, improve health
behaviour habits, and may decrease stress hormones.
oDyadic memory in older couples is often quite as good as that in younger people, other
words, older couples working together on a memory task can perform as well as a
younger person.
oSocial support is not always beneficial. Negative interactions can have a toll on physical
and mental health, but people may provide bad advice.
oDysfunctional autonomy: when one member of such a couple is released from the
hospital, its generally assumed that the spouse will provide the primary caregiving.
Old-old couples ‘fake good’ in order to avoid closer scrutiny from medical
professionals, deny existence of any problems.
oCare-giving is one form of productive work engaged by elders.
oElders often continue to provide support for their own children and often help other
seniors as well.
oPhone circles are also common: if someone doesnt call at a certain time, a member of the
circle will go over to find out why.
oThus, elders contribute not only to their families but to the larger community as well. By
doing so, they maintain their own well-being.
Valiants Model of Aging Well
o1. No physical disability at age 75
o2. Good subjective physical health (no problems with instrumental activities of daily
o3. Length of undisabled life.
o4. Good mental health
o5. Objective social support
o6. Self-rated life satisfaction in eight domains: marriage, income-producing work,
children, friendships and social contacts, hobbies, community service activities, and
recreation/ sports.
oStable marriage was predictive of aging well
oPoor childhood environment can lead to problems with depression, 1/6 men who were
emotionally stable had died.
oUse of mature defences: altruism, humor, suppression, and sublimation was an important
component of successful aging.
oTransformational aging: the ability to perceive benefit in stressful situations and to
resolve them in a manner that maximizes whatever gain can be derived from the problem
and that facilitates the growth of positive characteristics such as empathy, altruism, and an
increase in mastery.
o Model emphasizes on physical health, social integration, and productivity.
oConcluded that wisdom could be equated with the use of mature defences
Wisdom and Optimal aging
Fundamental life pragmatics, focus on perspicacity ( ability to see through illusions)
Wisdom= cognitive and emotional complexity.
To refer to motivation: cognitive, affective, and conative
Thus, wisdom reflects an advanced development of personality
Wisdom is a multidimensional construct that includes 3 domains: cognition, personality and
interpersonal processes.
Thus, the ability to be calm and detached can facilitate both perspicacity and moral behaviour.
Wisdom must be seen in the integration of these domains.