HEALTH AND AGING TEXTBOOK NOTES
Chapter 12: What is Optimal Aging?
¾ Optimal aging is more than just good health; it must include notions of adult development as well.
¾ We focus on factors that accelerate the aging process and as well as those that decelerate it.
Models of Optimal Aging
¾ The term optimal aging allows for the recognition that there may be different ways of aging well.
¾ Models of optimal aging are also teleological, in that they specify a desirable outcome of telos (goal). By
definition, a telos reflects the assumptions of the dominant paradigm, as well as cultural values.
¾ In some villages in ancient Japan, however, it was considered disgraceful to live too long. The problem was
simple ± if old people consumed too many resources, the survival of future generations might be threatened.
Thus, 20% of cultures in the world practiced some form of geronticide, either active or passive.
¾ Rowe and Kahn (1998) identified three components of successful aging; avoidance of disease, maintenance of
high cognitive and physical function, and an active engagement with life.
¾ The model is hierarchical: Good health is though to enable the other two.
¾ Absence of disease allows for the maintenance of good cognitive and physical function. In turn, good cognitive
and physical function is necessary (but not sufficient) for active engagement with life.
¾ Rowe and Kahn defined active engagement as relationships with other people and productive behaviour.
¾ There are three critical elements in the prevention of chronic illness in late life, all of which are related to health
behaviour habits; avoidance of toxins such as cigarette smoke, good nutrition and exercise.
¾ Once individuals have survived into later life, their own behaviours play a much greater role in future longevity.
¾ Exposure to toxins accelerates the aging process.
¾ Chronic methamphetamine users and those who abuse alcohol often look two or three decades older than they
¾ Bad nutrition is simple. It is generally agrees that diets too high in fats, simple sugars, and protein, without fresh
fruits and vegetables, and with too many calories promote cardiovascular disease, diabetes, and cancer.
¾ What 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 factors.
¾ An average weight seems to be most protective of good health in later years, and losing weight in late life has
been associated with heightened risk of mortality.
¾ Finally, the significance of moderate exercise as an aging decelerator cannot be overstated. Aerobic exercise
maintains or improves cardiovascular function and regulates weight.
¾ Exercise may also regulate endocrine and immune function. Older adults with a regular exercise program have
fewer respiratory illnesses.
Maintenance of High Cognitive and Physical Function
¾ The same factors that maintain good cardiovascular function in late life also maintain good cognitive function ±
that is, good diet, exercise, and avoiding toxins.
¾ In this instance, exercise includes not only physical activity but cognitive activity as well. Older adults with
active mental lives, such as emeritus professors, champion go players, and even those fond of bridge and
crossword puzzles, are much more likely to maintain cognitive function than less active individuals.
Active Engagement with Life
¾ Rowe and Kahn (1998) define active engagement with life as a high level of social support as well as
¾ Marital satisfaction tends to increase with life and marriage tends to promote longevity, especially for men.
¾ Caregiving from family and friends can help to mitigate disability and allow elders to remain in the community.
¾ Yet social support is not always beneficial. Not only do negative interactions take a toll on physical and mental
health, but people may provide poor or bad advice. In old-old dyads, we have observed something we term
dysfunctional autonomy. When one member of such a couple is released from the hospital it is generally
assumed that the spouse will provide the primary caregiving. Yet often the other member of the dyad is nearly
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