The meaning and potential of active ageing: a mixed-methods analysis in a sample of Australian and Portuguese older adults

Abstract

The Active Ageing Policy Framework was introduced by the World Health Organisation (2002) as a more inclusive model of successful ageing. Active ageing is a holistic perspective that embraces successful, healthy and productive ageing, taking into account a broad range of factors that contribute to the quality of life and wellbeing of older adults. Active ageing plays an important role in healthy ageing agendas worldwide and has been rigorously promoted at the local and policy level. Despite the importance of active ageing as a policy concept, research into active ageing is still in its infancy. As a result, there is currently no quantitative standard to assess and measure active ageing at the individual level, and the meaning and relevance of active ageing to older adults is unclear. Researchers have expressed concerns that active ageing policies may marginalise people that do not live up to policy ideals (Ranzijn, 2010), and have called for a universally accepted definition of active ageing (Boudiny & Mortelmans, 2011; Bowling, 2008, 2009; Walker & Maltby, 2012). This thesis addressed shortcomings in the literature and aimed to further understandings of active ageing by exploring the concept in both an Australian and cross- cultural context. A mixed methods research design was employed using quantitative data from two Australian longitudinal studies: The Australian Longitudinal Study on Women’s Health (ALSWH) and the Health in Men Study (HIMS); as well as qualitative data derived from focus groups conducted with Australian and Portuguese older adults. The thesis introduction, aims and objectives are outlined in Chapter 1, followed by Chapter 2 which reviewed early and contemporary theories of successful ageing and introduces active ageing as a preferred policy concept. Chapter 3 (Study 1) aimed to reflect the determinants of active ageing using survey variables from the ALSWH and HIMS. Exploratory and confirmatory factor analyses indicated a reconfiguration of active ageing determinants into five factors that provided acceptable fit to the overall data: Physical Health, Healthcare Accessibility, Falls, Psychosocial, and Social Environment. Due to the reliance on predetermined questionnaire items that are not intended for the measurement of active ageing, and the difficulty of replicating the study in another sample, the next logical step in this thesis was to consult with older adults about how they viewed active ageing. Chapter 4 and 5 outline the findings from four Australian focus groups (Study 2) and three Portuguese focus groups (Study 3) that examined older adults perceptions of active ageing and opinions about the health, social, and financial resources in their country. These 2 studies indicate that active ageing is a meaningful concept and is understood in terms of four broad and often interrelated themes: Psychological Factors, Social Roles and Activity, Mental Function and Activity, and Physical Health and Function. Across all groups, subjective variables were shown to be important to conceptualisations of active ageing. Chapter 6 (Study 4) is a cross-cultural comparison of themes that were identified in the Australian and Portuguese focus groups. Analyses indicated that while general themes were similar, unique cultural variants were identified in subthemes. For example, both Australian and Portuguese older adults reported attitude and personal coping to be important for active ageing. However, Australians were more likely to report themes that were related to functional independence, whereas Portuguese older adults frequently reported the importance of group solidarity. While active ageing was not explicitly conceptualised in terms of socio- economic or environmental factors, these were considered to impact quality of life in each sample. Finally, Chapter 7 outlines a general discussion of the results, limitations, and implications of this active ageing research. This thesis offers valuable insight into the importance of including subjective measures of attitude, coping, and personal goals into future definitions and measurements of active ageing. The findings contribute to the understanding of how cultural and environmental factors influence conceptualisations of active ageing, and demonstrate the importance of active ageing policies and programs that take a culture-based approach.