A new view of successful aging?

Amid the flood of news coverage that followed Pope Benedict XVI’s surprise announcement yesterday that he is retiring this month as the spiritual leader of the world’s 1.1 billion Roman Catholics, there were constant reminders of his age – 85 years – to illustrate that the Pope is in fact elderly.

Commentators wasted no time examining his infirmities: his difficulties with walking, for instance, and his declining vigor.

For someone of advancing years, this is hardly unusual. At 85, the Pope has joined the ranks of what’s often referred to as the “old old” – those 85 and older (ages 65-84 are known as the “young old”).

It raises a question, however: What do we really mean when we say someone is “old”, and what does it mean to age well?

For years, successful aging has been defined as aging in good health. A recent study in the Canadian Medical Association Journal, for instance, defined successful aging past 60 as: good cognitive, physical, respiratory and cardiovascular functioning; absence of disability; absence of mental health problems; and absence of chronic disease such as coronary artery disease diabetes, stroke or cancer.

But an intriguing new paper, published late last year in The Gerontologist, challenges this as too narrow a definition.

The authors interviewed 56 older adults at an eldercare program in California to explore their perceptions about being old and aging successfully. The participants represented a cultural cross-section that included whites, African Americans, Latinos and Cantonese-speaking Chinese.

All of them had at least one late-life disability which, objectively speaking, excluded them from most traditional definitions of successful aging. But as the researchers talked with these older adults, they learned that the majority saw themselves as aging successfully anyway. The elders who felt this way had an attitude of counting their blessings, of being able to adapt and reframe their situation in ways that helped them cope.

Have we taken too limited a view of aging? If you consider successful aging to be the absence of any disease or disability, most of the population would likely flunk this test. Even with optimal health behavior, most people will eventually acquire some health baggage as they age.

The real message of this study, say the researchers, is that the definition of successful aging ought to be broader and more realistic.

“Efforts to minimize disease and disability in late-life are important and cannot be dismissed; however, it is inevitable that everyone will age, and for most, a period of deterioration will precede death,” they wrote. “… From a policy perspective, the major implication is that more funding should be directed toward understanding and supporting those who live with late-life disability, as opposed to the current emphasis on prevention.”

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