But despite the large number and the longevity of older people in developed countries such as the United States and Japan, the elderly as individuals are in many ways still invisible.
They tend to be perceived as recipients of health care, consumers of social security savings, and the passive targets of scientific research and public policy; their faces and voices seem hidden behind statistics of the elderly population at large. Except for the fortunate who in their early years had intimate contact with old people, younger people may find it difficult to understand or appreciate the experience of the elderly.
Even those with such contact may not fully comprehend what it is like to be older since it is not yet their experience. The perceived distance of the lives and concerns of older people from those of younger generations seems also to affect scholarly research, and may. An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while. No cover image. Read preview.
Thirty-seven articles were excluded according to the exclusion criteria; the subject matter of excluded articles is shown in Figure 1. Twenty-nine percent of articles included participants aged 50 years or older. Six percent of studies included participants older than 70 years.
Faces of Aging: The Lived Experiences of the Elderly in Japan | Edited by Yoshiko Matsumoto
One article included participants who were 40 years and older. The oldest participants included were 90— years old. All the articles reviewed employed multidimensional models of successful aging. Non-biomedical constructs used in the included articles are reviewed and shown in Figure 2. Some of the articles included constructs that could also be considered outcome measures eg, self-rated successful aging, well-being, life satisfaction in their successful aging models.
These constructs were not categorized as non-biomedical constructs here. Health protective behaviors eg, non-smoking, frequent exercise were also excluded from this discussion. Figure 2 Components of successful aging articles included in scoping review. Engagement was the most frequently used construct. Sixty-three percent of articles reviewed included engagement in their successful aging models Figure 2.
In the articles reviewed, engagement was expressed as active engagement, 20 — 22 caring engagement CE and productive engagement PE , 23 and social activity dimensions. Using a bivariate logistic regression analysis, they found that increased age was significantly related to engagement with life.
In fact, participants who were between 70 and 74 years were more engaged than those between 60 and 64 years odds ratio 0. Weir et al 20 suggest that it is important to note the changes in engagement over the lifespan. CE and PE is defined as support given to significant others eg, friends, family , and PE is represented by activities that contributed to others individuals such as family, organizations such as workplace or the community.
Social activity was the third conceptualization of engagement used to explain successful aging. Overall, using the biomedical criteria, successful aging was found in only 8. Hank 12 concluded that there was a lack of engagement among a large number of older adults with good health. Community engagement is another component of successful aging. In the majority of the reviewed articles, engagement seemed to have a significant association with age, 20 and in some cases, could be used to discriminate between those aging successfully and those who were not.
Optimism and positive attitude are similar psychological characteristics that involve the expectation that events will resolve with the best possible outcome. Optimism and positive attitude have been associated with life satisfaction and have similar effects on individuals irrespective of socioeconomic status or physical health. A number of researchers have proposed that successful aging requires psychological resources to enable individuals to adapt in the face of the challenges created by illness, loss of loved ones, and changes in functional ability.
Resilience is not just a psychological trait; it can also be considered as a process.
Faces of Aging: The Lived Experiences of the Elderly in Japan
Resilience as a process is a compensatory response to adversity or risk. Aging brings many forms of adversity, including potential loss of loved ones, illness, and decline in functional abilities. In this study, 40 qualitative interviews with two individuals were used to explore resilience and successful aging among older adults living with dementia, a major source of adversity.
The results indicated that resilience can be present among people living with dementia and that they can live meaningful lives. Harris 40 suggests that there is an:.
Rather than considering successful aging as a consequence of perfect health, it could be considered a reflection, at least in part, of resilience in the face of the adversity that life presents — a far more obtainable goal for most older adults. In the reviewed articles, successful agers exhibited resilience in the presence of physical and mental health challenges. Spirituality is not constrained by institutions or formal rituals. Religion can be considered intrinsic eg, religion is for personal comfort and extrinsic eg, religion provides membership in a social group. Gerotranscendence involves a shift in perspective and the recognition that the task at hand is self-awareness and preparation for death.
Gerotranscendence includes an acceptance of life as meaningful, purposeful, and coherent, as well as feelings of connection to earlier generations. Gerotranscendence is the ability to be positive as life is ending 61 and to take time for retrospection.
Engagement in career has generally ended and the past is revisited. Gerotranscendence includes, but is not limited to, aspects of spirituality and has shown some predictive ability in successful aging research. The multidimensionality of successful aging is now acknowledged in the literature. The goal of this article was to review recent literature on successful aging and identify the non-biomedical constructs most frequently employed.
Like other reviews of successful aging constructs, 8 , 9 a majority of the articles included similar biomedical constructs in their models but were heterogeneous in terms of their non-biomedical constructs.
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The limitations of this review included the restricted search criteria. Examining the various models built around specific perspectives eg, feminist or disease-related groups were beyond the scope of this article as was the inclusion of the terms healthy aging or aging well. The number of articles found would have been greater if we had included these perspectives and related terms such as aging well.
It is also important to recognize that the choice of both successful aging model and outcome measures profoundly impacts the results. Measurement tools selected in each research project reflected the models proposed within, and therefore, it is difficult to compare results from one study to another because each includes and measures different constructs. Over the last several decades, there has been a move to consider the whole patient when designing treatment protocols.
This scoping review suggests that by stepping away from the definition of success in aging as non-diseased and embracing the idea that people with illness can continue to self-define as successful agers, we can build a clinician—patient interface that acknowledges the patient as a person who happens to have an illness.
In the context of chronic disease, it may be appropriate for clinicians to focus on the quality of life, in terms of both pharmaceutical and behavioral prescriptions. Furthermore, many of these constructs eg, resilience, self-esteem can be fostered through education. Successful aging could be bolstered by suggesting programs to build skills in these areas along with the usual treatment modalities.
This is not the first article to call for modifications to the biomedically based MacArthur model of successful aging.
In fact, according to a recent article by Rowe and Kahn, 66 at least variations to this model have been suggested. The unique element of this study is that we compiled the non-biomedical constructs used in the recent research. As suggested in another recent article:. The task ahead is to agree on key concepts and definitions, understand plausible pathways, and develop comprehensive multisector and intersectoral approaches to support healthy ageing and in particular older adults. Our scoping review provides contemporary constructs that can be used in successful aging model building in the hopes of encouraging future successful aging research that is inclusive of those aging with illness.
The right to participate as active members of society and community and to engage in self-determination are vital components of meaningful life for all elders, regardless of physical health and dis ability.
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In the clinical context, we need to consider that non-biomedical components of successful aging are often modifiable and engage in referrals to public programs designed to enhance these modifiable characteristics. By developing skills related to constructs that are predictive of successful aging, there is the potential for improvement in the quality of life and possibly better health outcomes for a broad population of elders.
Study on the lived experience of aging. Nurs Health Sci. The older they are, the less successful they become? Findings from the Georgia Centenarian Study. J Aging Res. J Am Geriatr Soc. Pruchno RA. Successful aging: contentious past, productive future. Successful aging. Definitions and predictors of successful aging: a comprehensive review of larger quantitative studies.
Am J Geriatr Psychiatry. Operational definitions of successful aging: a systematic review. Int Psychogeriatr. Successful cognitive and emotional aging. World Psychiatry.
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