Finding the Balance to Quiet the Striving: The Difference Between Successful Aging and Wise Aging.

This paper draws on wisdom and lifespan development research to propose a conception of "wise aging", which may become particularly relevant in very old age as people's capacities for successful aging decline. We propose that three types of balance distinguish wise aging from successful aging. First, wisdom balances one's own interest with a greater good, emphasizing self-transcendence and compassion. Second, wisdom balances control striving with acceptance of uncontrollability. Wise aging involves a realistic awareness of one's decreasing levels of control and one's interconnectedness to and dependence on other people. Third, wisdom acknowledges, regulates, and balances positive and negative affect. Wise aging involves the ability to appreciate and relish the joys of life, but also to accept and embrace more negative emotions and fully support others going through different times.

'Successfully' Aging 'Alone'?: Unequal Global Opportunities and Rising Risks in Family-Based Models of Care Cross-Nationally.

BACKGROUND AND OBJECTIVES: For the first time in human history, older adults will outnumber children and a substantial and growing proportion will live alone and lack one or more nuclear family tie. Such unprecedented shifts require a reevaluation of existing models of "successful aging", particularly in terms of long-term care policies. RESEARCH DESIGN AND METHODS: This paper draws on country-level data from multiple publicly available sources (e.g., World Bank, Organization for Economic Cooperation and Development, Our World in Data, and the World Values Survey) to examine cross-national patterns of development, health, demography, resources and policies, and cultural values in low-, middle-, and high-income countries. RESULTS: Although there exists substantial heterogeneity across countries, country-level patterns illustrate the economic privilege of living alone and the dominance of "successful aging" opportunities in high income countries. Cultural values about family reflect standard patterns of economic development, yet friendship emerges as a particularly consistent global value. At the country-level, living alone and health are associated in higher income countries with lower within-country inequality. DISCUSSION AND IMPLICATIONS: Aging "alone" is a risk factor in some contexts, yet a marker of privilege in others. Models of "successful aging" are largely unobtainable in lower income countries or high inequality countries, and therefore require a thorough incorporation of global realities, or final abandonment in favor of more nuanced structural perspectives. Long-term care policies that assume the presence of family will yield increasing risk over time across all global contexts and represent a key vulnerability in the future of healthy aging policy.

What Does It Mean to Successfully Age?: Multinational Study of Older Adults' Perceptions.

BACKGROUND AND OBJECTIVES: Successful aging is a mainstay of the gerontological literature, but it is not without criticism, including the often-limited way that it is studied and measured as well as the exclusion of older adults' voices in its formulation and understanding. This study sought to address these issues through a qualitative investigation across multiple countries. RESEARCH DESIGN AND METHODS: This was a mixed-methods, cross-sectional, exploratory study, using an online survey. Nations that received the survey included Australia, New Zealand, the United Kingdom, Ireland, Canada, and the Unites States. Participants aged 65 and older were asked to describe what successful aging means to them in an open-ended survey item. Summative content analysis was utilized to examine the responses. RESULTS: Successful aging was defined by 1,994 participants, and six themes along with 20 subthemes were found. In contrast to conception that successful aging is solely or predominantly related to the absence of disease and decline, the most prominent theme in this study was "active, independent, and engaged" as the hallmark of success. DISCUSSION AND IMPLICATIONS: While health and health maintenance were present in other themes, these findings support a multidimensional definition of successful aging that promotes the perspectives of older people. Future research should seek to further investigate the ways in which person-in-environment factors influence definitions of successful aging, including culture, gender and gender identity, race and ethnicity, and socioeconomic background.

Factors Affecting Successful Aging of Older Adults and the Relationship Between Leisure Activities Duration and Successful Aging.

The study was conducted with older adults who lived in a nursing home and applied to the geriatric outpatient clinic of a university hospital between April and August 2022. The study sample was 516 older adults and the data were collected by using the Older Information Form and Successful Aging Scale (SAS). It was determined that the mean duration of daily leisure activities was 6.61 ± 3.69 hours, and their mean SAS score was 58.31 ± 15.21. A moderate positive correlation was found between the SAS scores of the older adults and the activities of shopping; whereas a low positive correlation was found between their SAS scores and activities of walking, visiting friends and relatives, growing flowers, listening to music, reading, hand knitting, spending time on social media, exercising, and puzzles (p < .05). The main results of our study revealed that planned leisure activities that older adults engage in would contribute to their successful aging.

The Role of Life Satisfaction and Optimism for Successful Aging in Mid and Late Life.

Guided by the Rowe and Kahn model, the current study examined the longitudinal association of objective and subjective components of successful aging (SA) with individuals' life satisfaction and level of optimism across adulthood aiming to validate the related scanty existing research. Data were from waves 2 and 3 (2004-14) of the Midlife in the United States (MIDUS) study. Using structural equation modeling, we examined (N = 2,040) whether subjective life satisfaction (wave 2) has any effect on a composite measure of SA (wave 3) while controlling for baseline sociodemographic and health factors. We also examined the mediation effects of optimism in the above associations. Findings revealed that life satisfaction has a significant positive effect on SA; also, this effect is bidirectional. Further, high optimism positively mediated the bidirectional association between life satisfaction and SA. This study identified life satisfaction and optimism as having potentially positive impacts on achieving SA in middle-aged and older adults.

[Efficiency of computerized cognitive training for prevention of cognitive impairments and stimulation of neuroplasticity.]

Computerized cognitive training (CCT) is a rapidly developing area of cognitive rehabilitation at the intersection of information technology and healthcare, the constantly updated results of which can be successfully translated into practical application in clinical medicine and in particular in gerontology. The basis of CCT, as a non-invasive method of influencing the functional activity of the brain and the processes of neuroplasticity, is software for stimulating cognitive functions in order to improve their productivity. The level of scientific and practical interest in CCP technology is growing rapidly. The article reports on the current state of research on the use of CCT aimed at correcting cognitive impairment. The purpose of this work is to systematize the available scientific data in this area, as well as to promote further integration of research in the field of information technology into clinical practice, in particular, to study the potential of CCT as a promising therapeutic tool in the paradigm of successful aging and prevention of the progression of cognitive impairment. This noninvasive intervention may improve global cognitive function in patients with clinically defined impairments and during normal aging in cognitively healthy older adults. However, new studies with fully comparable protocols are needed to evaluate in more detail the duration of the effect and the effectiveness of CCT in preventing cognitive decline in the long term.

Redefining the Successful Aging of veterans: A scoping review.

BACKGROUND AND OBJECTIVES: The aging experiences of military veterans provide critical insights into what successful aging is and means for later life contexts constrained by distinct health and social needs. Can veterans 'successfully' age when they are exposed to so many stressors with serious health and social consequences for later life? Veterans can offer valuable lessons for developing comprehensive approaches to refining successful aging, ensuring inclusivity of different older populations. Building on Rowe and Kahn's idea of successful aging, we utilize the complementary concept of 'active aging' to explore if there are unique factors, characteristics, and interventions that support active aging in veterans, compared to non-veteran populations. RESEARCH DESIGN AND METHODS: A rapid review and evidence synthesis was conducted across 9 databases in medicine, psychology, anthropology, sociology, and public health to search for peer-reviewed articles and research reports. RESULTS: Findings suggest that programs linking health and social dimensions can support the active aging of veterans, namely interventions promoting active physical and cognitive lifestyle as well as social connectedness and engagement. Such programs and interventions help prevent and combat mental and physical health decline and increase quality of life and well-being. DISCUSSION AND IMPLICATIONS: Findings have implications for veteran and non-veteran populations more broadly, as people can actively age even when they have unique health and social needs.

Lifestyle, cognitive, and psychological factors associated with a resilience phenotype in aging: a multidimensional approach on a population-based sample of oldest-old (80+).

OBJECTIVES: To investigate the determinants of resilience phenotype in aging, operationalized as the maintenance of cognitive, physical, and psychological health in very old individuals (80+), we investigated the structure and interrelated impact of the main resilience-enhancing factors, which are usually studied in separate research fields. METHOD: Participants were older adults without dementia recruited for the fifth wave of the InveCe.Ab population-based cohort study (aged 83-87 years). Multidimensional evaluation comprised blood sampling, social and lifestyle survey, geriatric and neuropsychological assessment. We classified resilient individuals as displaying normal cognition, functional independence, and mental health. First, we performed exploratory factor analysis (EFA) to examine the underlying structure of the relevant cognitive, lifestyle, physical, and psychological resilience-enhancing factors. The factors obtained were included as predictors of the resilience phenotype in the logistic regression model, controlling for sociodemographic and cumulative exposure to physical and psychosocial stressors, including COVID-19 infection. RESULTS: Among the 404 enrolled participants, 153 (38%) exhibited the resilience phenotype. EFA resulted in the identification of 6 factors (59% of variance): cognitive reserve, affective reserve, insecure attachment, current lifestyle, physical reserve, and avoidant attachment. Among these factors, cognitive reserve, affective reserve, and current lifestyle significantly and independently predicted resilience status, controlling for cumulative exposure to age-related stressors and COVID-19 infection. DISCUSSION: Our findings showed that, even in very old age, both early and late life modifiable factors affect individuals' ability to adapt to the aging process, thus confirming the importance of a life-course approach to improve health outcomes in the aged population.

Gerotranscendence, Hope, and Coherence in the Face of Life Adversity.

Background and Purpose: Older adults are living longer and becoming more diverse. The current study examined the relationship between traumatic life events, hope, coherence, and successful aging in Black and White older adults with at least one chronic health condition, and the influence of life events on gerotranscendence. Methods: Fifty older adults from two senior centers participated. Participants completed the Successful Aging Inventory, Life Events Checklist, Herth Hope Index, and Sense of Coherence Scale. Results: Significant correlations were found between successful aging and gerotranscendence (r = .290; p = .048) and hope (r = .585; p = <.001). Simple linear regression found that Successful Aging Index (SAI) scores significantly predicted gerotranscendence (R2 = .10, F(1, 46) = 5.157, p = .028) and Herth Hope Index scores (R2 = .36, F(1, 46) = 25.850, p <.001). Higher Sense of Coherence (SoC) and Gerotranscendence Scale scores among those with no firsthand trauma experience suggest that experiencing traumatic events firsthand may adversely affect the aging process. Implications: Therefore, exploration of trauma experiences, with mental health referrals as appropriate are clinical implications to consider.

Prevalence of successful aging in older adults: A systematic review and meta-analysis.

BACKGROUND: Successful aging (SA) describes the multidimensional aspects of achieving optimal physical and mental health and social well-being combinations in old age. Recent years have seen increasing interest in understanding SA prevalence. This study systematically evaluates the current state of SA globally, defined as multidimensional outcomes. OBJECTIVE: To systematically evaluate the global prevalence of SA in older adults. METHODS: We searched PubMed, Embase, Web of Science, Cochrane Library, China Biomedical Database, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and Weipu Database from inception to February 14, 2024. Two researchers independently conducted literature screening, data extraction, and quality evaluation. Meta-analysis was performed using Stata 16.0. RESULTS: Thirty studies comprising 250,460 older adults were included. Meta-analysis showed the overall global prevalence of SA was 24.0 % [95 % CI (20.7 %, 27.3 %)]. Prevalence rates were 25.1 % in Asia, 21.5 % in Europe, 20.6 % in the Americas; 16.8 % in developed and 27.1 % in developing countries. Subgroup analyses indicated higher SA rates among male older adults, married/cohabiting, living in urban areas, and having higher education levels. CONCLUSIONS: The global prevalence of SA among older adults is low, with variations across age groups, regions, and education levels. Due to the limitations of the included studies, further high-quality research is needed to validate these findings.

Changes in successful aging and its related indicators among community-dwelling older adults: The Korean Frailty and Aging Cohort Study (KFACS).

This study aims to determine the prevalence of successful aging (SA) and examine the association of changes in the indicators of SA and variations in SA status between 2016 and 2020. The study included 548 participants recruited for the Korean Frailty and Aging Cohort Study (KFACS). Compared to participants who achieved SA in 2016 (N = 393, 71.7%), the number of older adults with SA decreased by 7.8% in 2020. Among older adults preserving SA (SA→SA group, 54%), there were relatively small numbers of older adults who successfully maintained indicators, including chronic diseases (no→no, 9.5%), employment (yes→yes, 12.2%), and volunteer activities (yes→yes, 2.9%). Our findings suggest that interventions to strengthen the physical and psychological function of older adults are needed, and social support needs to be guaranteed to improve social engagement for older adults.

Impact of Death Anxiety on Psychological Well-Being and Successful Aging of Older Adults With Chronic Illness.

Comorbidities due to aging and the COVID-19 pandemic together are expected to cause death anxiety among older adults. This study aimed to assess the prevalence of death anxiety and its impact on psychological well-being and successful aging of older adults with chronic illness. A cross-sectional correlational survey was conducted on 79 older adults with chronic illness, drawn with a stratified random sampling method. Self-report measures were used to assess death anxiety, psychological well-being, and successful aging. A high prevalence of death anxiety was reported among older adults. Psychological well-being and successful aging in these older adults were significantly and negatively associated with death anxiety. Further, death anxiety showed substantial predictive valence for psychological well-being and successful aging of older adults with chronic illness. Findings strongly advocate and call for timely intervention programs for chronically ill older adults to reduce their death anxiety for enhanced psychological well-being and promote successful aging.

How Does Successful Aging Apply To Black Women?: A Latent Class Analysis.

BACKGROUND AND OBJECTIVES: Although prior research has identified racial/ethnic and gender differences in successful aging (SA), heterogeneity within groups has been little examined. We consequently explore the variety of aging experiences among older Black women. RESEARCH DESIGN AND METHODS: We used the 2010/2012 U.S. Health and Retirement Study, limiting analyses to Black women who completed the Psychosocial Leave-Behind Questionnaire (N = 1,186). We conducted latent class analysis (LCA) using indicators of physical health, psychological well-being, social support/strain, and social engagement. RESULTS: Six SA latent classes were identified and labeled according to their distinctive characteristics: infirm, isolated, taxed, independent, vivacious, and robust. The infirm class had uniformly poor health, while the isolated class was in poor physical health but also lacked social relations. Although both had average physical health and psychological well-being, the taxed class experienced high levels of social support and social strain compared to the high support (and unpartnered) independent class. The vivacious and robust classes exhibited high physical health and psychological well-being, high social support/low social strain, and high social engagement, but vivacious women (23% of respondents) were unpartnered and robust women (16% of respondents) were partnered. The robust class had the highest physical and psychological well-being, and best social relations across all classes. DISCUSSION AND IMPLICATIONS: Using nationally representative data, we reveal significant heterogeneity in Black women's aging experiences. Although many face difficult aging experiences, 39% of older Black women fit the SA framework well. Future work should recognize that Black women's aging experiences are not homogenous.

Serious leisure and successful aging among elderly air volleyball players: examining the mediating role of social support and flow experience.

Introduction: Previous literature has demonstrated that engagement in serious leisure (SL) is associated with subjective well-being among older adults, while the relationship between successful aging (SA) and SL remains unexplored. This study aims to investigated the association between SL, social support (SS), flow experience (FE), and SA. Methods: A total of 435 older adults participating in air volleyball events were included in this study. Results: The findings revealed that: (i) SL directly and positively influences on SS, FE, and SA; (ii) SS is positively related to FE, and FE is positively associated with older adults'SA; (iii) Both SS and FE fully mediate the relationship between SL and SA, with SS partially explaining this mediation through FE. Discussion: This study builds upon prior research in this field and highlights the significance of SL for the SA among older adults. Future studies should further explore the underlying mechanisms linking serious sport experiences to successful elderly life.

Looking Back on Career, Looking Forward to Retirement: Antecedents of Subjective Career Evaluations and Their Impact on Retirement Adjustment.

OBJECTIVES: An individual's past, and reflections on it, may influence current and future well-being. Recent qualitative studies suggest retirees' recollections about their careers relate to well-being in retirement. We investigated associations between life course events and subjective career evaluations, gender differences in these associations, and their subsequent association with retirement adjustment. METHODS: We used data from three waves (2015, 2018, and 2023) of the (NIDI Pension Panel Study (NPPS), a longitudinal survey of Dutch older workers. Using a sample of 6,109 respondents, we used ordinary least squares (OLS) regression models to investigate associations between employment stability facilitators and inhibitors (e.g., promotion, demotion, unemployment) and personal shocks (e.g., divorce, widowhood) and subjective evaluations of satisfaction with the work and family domains of career between genders. Using a follow-up sample (N=4,106), we employed ordinal logistic regression models to investigate the impact of these baseline subjective evaluations on retirement adjustment at follow-up. RESULTS: Employment stability factors such as demotion and unemployment, and personal shocks such as poor psychological health were associated with subjective evaluations of the work and family career domains. Gender differences in these associations were found. Evaluations in both the work and family domains were associated with retirement adjustment at follow-up. DISCUSSION: Our results demonstrate the importance of life course events on older workers' evaluations of their careers and the long-term impact of subjective career evaluations. Further research is needed to evaluate the predictive utility of these evaluations for other outcomes in older adulthood.

Successful Aging in US Veterans with Mental Disorders: Results From the National Health and Resilience in Veterans Study.

OBJECTIVES: To determine the prevalence and correlates of successful aging in US veterans who screened positive for current major depressive disorder (MDD), generalized anxiety disorder (GAD), and/or posttraumatic stress disorder (PTSD). METHODS: In a nationally representative sample of 475 US military veterans (mean age=58.3, SD=14.7; range 24-92) who screened positive for MDD, GAD, and/or PTSD, multivariable logistic regression and relative importance analyses were conducted to identify independent correlates of successful aging. RESULTS: One-in-five (20.6%) veterans rated themselves as aging successfully. Resilience and gratitude were the strongest positive correlates of successful aging, accounting for 38.1% and 32.4% of the explained variance, respectively. Greater somatic symptoms were the strongest negative correlate, accounting for 11.2% of the explained variance. Higher gratitude moderated the negative association between somatic symptoms and successful aging. CONCLUSIONS: Positive psychiatry interventions targeting psychosocial factors such as resilience and gratitude may help promote successful aging among US veterans with mental disorders.

Resilience to AD pathology in Top Cognitive Performers.

Successful cognitive aging is often thought to result from resistance to the accumulation of pathology, resilience to the effects of pathological accumulation, or some combination of the two. While evidence for resilience has been found in typical aging populations, the oldest-old provide us with a unique window into the role of pathological accumulation in impacting cognition. Here, we aimed to assess group differences in measures of amyloid and tau across older age groups using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI age: 60-89) and The 90+ Study (age: 90-101). Additionally, using the ADNI dataset, we performed exploratory analyses of regional cingulate AV-45 SUVRs to assess if amyloid load in particular areas was associated with Top Cognitive Performance (TCP). Consistent with the literature, results showed no group differences in amyloid SUVRs both regionally and in the whole cortex. For tau with AV-1451, we also observed no differences in Braak composite SUVRs. Interestingly, these relationships persisted in the oldest-old. This indicates that Top Cognitive Performance throughout aging does not reflect resistance to amyloid and tau burden, but that other mechanisms may be associated with protection against amyloid and tau related neurodegeneration.

The impact of yoga on successful aging based on the selection, optimization, and compensation model in elderly women: A quasi-experimental study.

OBJECTIVE: To investigate the impact of yoga on successful aging based on the selection, optimization, and compensation model in elderly women. DESIGN: Quasi-experimental study. SAMPLE: Seniors' meeting points and parks and clubs for the old age pensioners of the ministry of education, ministry of healthcare, and the oil corporation in Shiraz, Iran. 68 elderly women within the age range of 60-86 years were divided into a yoga and a control group. MEASUREMENTS: The subjects in both groups were asked to complete the selection, optimization, and compensation model questionnaire before and after the intervention. Successful aging was measured using the selection, optimization, and compensation questionnaire. INTERVENTION: The yoga training program was implemented in 1-h sessions twice a week for eight weeks. RESULTS: After eight weeks of yoga training, the results showed a significant difference between the pretest and posttest successful aging total scores of the yoga group (P = .005). However, the difference between the yoga and control groups' posttest mean total scores was not significant (P = .601). CONCLUSION: Based on the results, it seems that yoga training can improve successful aging. Thus, yoga is recommended as an inexpensive and entertaining method.

The individual and work-related factors associated with the occupational future time perspective: a cross-sectional study of older workers in Japan.

OBJECTIVES: Occupational future time perspective (OFTP) is important concept for a successful career in older workers. The purpose of this study was to examine the associations between individual and work-related factors and OFTP. METHODS: We conducted a cross-sectional study via an online questionnaire survey. Respondents were stratified sampled according to the distribution of workers across Japan. To assess OFTP, we used the Japanese version of the OFTP scale. We included factors such as sex, age, education, marital status, subjective health status, personal income, length of employment, industry, size of company, employment status, working days per week, and night shift. Multiple regression analysis was employed to calculate the regression coefficients for each factor, with OFTP serving as the dependent variable. RESULTS: In total we included 1484 respondents. Our findings indicated that higher OFTP was associated with higher education, better subjective health status, higher personal income, and smaller size of company. Compared with manufacturing, certain industries such as agriculture and forestry, transportation and postal services, and health care showed lower OFTP. In contrast to permanent workers, contract and part-time workers demonstrated lower OFTP, whereas owners of non-family businesses exhibited higher OFTP. Furthermore, individuals working 1-4 d/wk showed lower OFTP compared with those working 5 d/wk. CONCLUSIONS: Older workers facing limitations in resources, such as educational background, personal income, precarious employment, and health status, tend to have lower OFTP. Such individuals should be given priority for support and assistance.

SuperAging functional connectomics from resting-state functional MRI.

Understanding the relationship between functional connectivity (FC) of higher-order neurocognitive networks and age-related cognitive decline is a complex and evolving field of research. Decreases in FC have been associated with cognitive decline in persons with Alzheimer's disease and related dementias (ADRD). However, the contributions of FC have been less straightforward in typical cognitive aging. Some investigations suggest relatively robust FC within neurocognitive networks differentiates unusually successful cognitive aging from average aging, while others do not. Methodologic limitations in data processing and varying definitions of 'successful aging' may have contributed to the inconsistent results to date. The current study seeks to address previous limitations by optimized MRI methods to examine FC in the well-established SuperAging phenotype, defined by age and cognitive performance as individuals 80 and older with episodic memory performance equal to or better than 50-to-60-year-olds. Within- and between-network FC of large-scale neurocognitive networks were compared between 24 SuperAgers and 16 cognitively average older-aged control (OACs) with stable cognitive profiles using resting-state functional MRI (rs-fMRI) from a single visit. Group classification was determined based on measures of episodic memory, executive functioning, verbal fluency and picture naming. Inclusion criteria required stable cognitive status across two visits. First, we investigated the FC within and between seven resting-state networks from a common atlas parcellation. A separate index of network segregation was also compared between groups. Second, we investigated the FC between six subcomponents of the default mode network (DMN), the neurocognitive network commonly associated with memory performance and disrupted in persons with ADRD. For each analysis, FCs were compared across groups using two-sample independent t-tests and corrected for multiple comparisons. There were no significant between-group differences in demographic characteristics including age, sex and education. At the group-level, within-network FC, between-network FC, and segregation measurements of seven large-scale networks, including subcomponents of the DMN, were not a primary differentiator between cognitively average aging and SuperAging phenotypes. Thus, FC within or between large-scale networks does not appear to be a primary driver of the exceptional memory performance observed in SuperAgers. These results have relevance for differentiating the role of FC changes associated with cognitive aging from those associated with ADRD.