Abstract
Purpose of the Study:With increasing longevity in industrialized populations, there is growing interest in what defines “successful aging” (SA). Various SA measures have been proposed but no consensus has been reached and many have been criticized for not representing the views and priorities of older people. We consider whether the Rowe–Kahn SA model captures older individual’s perceptions of their own health and aging.Methods:Using two cohorts of 886 and 483 men and women from the West of Scotland Twenty-07 Study, aged around 57 and 76, respectively, we explored associations between Rowe–Kahn SA dimensions (absence of disease/disability; good physical/cognitive functioning; good interpersonal/productive social engagement) and four aspects of self-rated health and satisfaction (current general health; health for age; satisfaction with health; satisfaction with life).Results:Respondents’ self-rated health and satisfaction was generally good but few had all six Rowe–Kahn dimensions positive, the conventional definition of SA. All individual positive SA dimensions were associated with better self-rated health and satisfaction. This was consistent across age, gender, manual/nonmanual occupations, and personality. The prevalence of good self-rated health and satisfaction increased with increasing numbers of positive SA dimensions.Implications:The Rowe–Kahn model provides a functional definition of SA. Future work on ageing should include all Rowe–Kahn dimensions and consider SA as a continuum.
Highlights
Industrialized populations are aging (Christensen, Doblhammer, Rau, & Vaupel, 2009) and medical advances mean individuals are living for longer, with correspondingly increasing susceptibility to disease and disability in later life
Negative affect was measured using a general dimension of distress and unpleasurable engagement assessed using the trait version of the positive and negative affect scale (PANAS; Watson, Clark, & Tellegen, 1988) in the penultimate wave of data collection; strictly the measurement was made prior to successful aging” (SA) and self-rated health, the use of trait rather than state negative affect means it is likely to correlate well with negative affect at the time of the final wave.(Merz & Roesch, 2011) There was no evidence of any systematic differences between subgroups and we present results based on all respondents combined
We used logistic regression models to explore the possible interplay between SA dimensions by considering the impact on self-rated measures of each positive SA dimension adjusted for the others to establish whether associations were being driven by a specific subgroup of SA dimensions
Summary
Industrialized populations are aging (Christensen, Doblhammer, Rau, & Vaupel, 2009) and medical advances mean individuals are living for longer, with correspondingly increasing susceptibility to disease and disability in later life. SA measures based on longevity or clinical outcomes may fail to capture the complete aging experience of older people, many of whom demonstrate considerable resilience in the face of physical and cognitive decline (Manning, Carr, & Kail, 2014), and who may engage in compensatory strategies to maintain their preferred lifestyles (Glass, 2003; Martin et al, 2015) In light of these findings, the best measures of SA from the older person’s perspective may be self-rated (e.g., health or satisfaction with health and life, relative to age). To what extent do the Rowe–Kahn dimensions agree with self-rated health and overall satisfaction? Second, do these results vary according to population subgroups that have been shown to vary systematically in the importance they attach to different dimensions of health (Blaxter, 1990, 2004), for example, by gender, age, SES, and personality? Third, is there an interplay between SA dimensions, either hierarchical (e.g., recognizing that disease may reduce physical functioning, resulting in poor social engagement (Verbrugge & Jette, 1994) or multidirectional (e.g., acknowledging the potential feedback loop whereby poor social function may impact negatively on physical functioning, thereby increasing disability(World Health Organization, 2001)? given the continuum between poor and good health and previous evidence demonstrating that many older people who consider themselves to be aging well fail to succeed in all six Rowe–Kahn dimensions (McLaughlin, Connell, Heeringa, Li, & Roberts, 2010; McLaughlin et al, 2012; Montross et al, 2006; Strawbridge et al, 2002), we consider whether a continuum based on the number of successful Rowe–Kahn dimensions offers a more realistic measure of SA than the traditional binary measure
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