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What Does Aging Well Really Mean?

October 19, 2014

As an advocate for our aging population and an aging woman, I have spent a lot of time thinking about how I want to age and how I might do that successfully. What does aging well mean, anyway? In my role as a commissioner on the L.A. County Commission for Older Adults, I am quite aware that not everyone has the benefit of being able to make the best choices, and often all of life is a challenge.
 
I also was a caregiver for my mom. She had dementia and during the last six months of her life, she didn’t know who or where she was. But she was always smiling, laughing, and when music played, she danced. Was she aging well? Certainly not from my vantage point.
 
How Do We Define Aging Well?
When I began my research for this article, I thought the most appropriate jumping off point was Dr. George Vaillant’s book, Aging Well. As it turns out, Vaillant contributed an article to the In Focus section, on page 7. In it he shares results from the landmark 75-year-old Harvard Grant Study, recently mentioned by Roger Angell in his personal and wry New Yorker piece, “This Old Man.”  Angell wrote, “Recent and not so recent surveys including the six [sic] decade-long Harvard Grant Study confirm that the majority of us people over seventy-five keep surprising ourselves with happiness. Put me on that list.” Now 93, Angell has arthritis, macular degeneration, some nerve damage, a bad left knee and other chronic conditions. But he’s happy. Would I be? I don’t know. Would you?
 
During an interview in 2012, Dr. John W. Rowe was asked how he defined successful aging based on his MacArthur Foundation study published in The Gerontologist (37:4, 1987; http:// goo.gl/XCzXVl). “Our definition of successful aging deviated from the research prior to our study,” said Rowe. “Most research on aging was about avoiding a hip fracture or a nursing home admission. We saw it more broadly and think that avoiding disease and disability is important, as is maintaining physical and cognitive function. Very importantly, we added a third piece to our findings, and this is to maintain engagement.”
 
Professors Ann Bowling and Paul Dieppe at the University of South Hampton in 2005 conducted a national random population survey of perceptions of successful aging among 854 people ages 50 and older living at home in Britain, published in BMJ (331: 7531, 2005; http://goo.gl/SwlgbW). The most commonly mentioned definition was “experiencing good health and functioning.”
 
Following are some other comments: “It’s your outlook on life to start with. I think I have the most commonly mentioned definition was “experiencing good health and functioning.”  "I think I have been an active person. I don’t think about getting old. I just don’t feel old and act accordingly.” And, “Successful aging is to go out a lot and enjoy life, take it day by day and enjoy what you can, have good health, that’s more important than anything else. Keep active, and while your legs are moving get out on them.”
 
A single definition for aging well appears elusive, as it does for happiness and love. Studies are conducted, research is done and surveys are completed, but what older persons might define as “aging well” depends upon the circumstances that make up their lives and the reactions and attitudes with which they handle them.
 
What Contributes to Successful Aging?
For many years, to age well one needed to eat well, exercise regularly, not smoke and maintain a healthy weight and a social network. In the 1980s, as people began to live longer, a greater focus was placed on the importance of psychosocial components (such as civic engagement), volunteerism and building community, one of Rowe’s three tenets.
 
The more recent emphasis, which includes principles from positive psychology, is maintaining a positive outlook, self-worth and self-efficacy. Another is learned optimism—the belief that people can learn to see the bottle as half full.
 
Dr. Luigi Ferrucci, scientific director of the National Institute on Aging, offers three critical factors to a long, healthy life, as follows:
 
Find the right stress level. A little pressure is good for you. If you never have to react to anything demanding, the mechanisms in your brain that help you deal with taxing situations will atrophy.  The key is to find your personal tipping point between pressures that energize and pressures that paralyze.

Don’t think getting older is the end of the world. Researchers found that people in their 30s and 40s who looked on the bright side of aging (it brings wisdom, retirement and more time with family) were less likely to develop cardiovascular disease later in life—and had lower mortality rates—than those who were more pessimistic.

Build your reserves. You’ve socked away money for your golden years, but what are you doing to prepare your body? A large part of the physical energy you expend is simply to survive. But if you get sick, you need extra energy. If you have exhausted your reserves, your immunity can be compromised and you’re more prone to injury. Heredity plays a role, but only about 30 percent of the characteristics of aging are hereditary; and by age 80, genetics has virtually no influence. Research provides strong scientific evidence that we are, in large part, responsible for our old age.
 
Definition for Aging Well Remains Elusive
I have come to realize that my personal definition of aging well is fluid. It transforms as my body and the circumstances of my life shift. I love to dance, and believed I could do it forever, often attending Zumba classes. My physical therapist disagrees. “Something slower and smoother will do,” she says.
 
I envisioned more travel, classes and certainly more relaxation. Finances determined that I should continue with my business, and again I had to rethink my idea of successful aging. Trips became long weekends away, and instead of classes for fun, there were workshops and conferences. Worthwhile to be sure, but not that much fun. I am always cognizant that I am lucky. That I have choices, and not everyone does. Although I would rather Zumba, I am grateful every day for what I can do.
 
In The Longevity Revolution, Dr. Robert Butler wrote, “Longevity is desired if accompanied by a life of high quality. But what makes for such a good life? How can we measure quality of life? It is an amorphous concept, constantly changing with the historical period and one’s sculpture, personal background, stage of life and socio-economic status. A person’s definition of quality of life is, and should be, highly individualized and subjective.” I don’t think anyone could say it more eloquently.
 
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Barbara Meltzer is president of Barbara Meltzer & Associates Public Relations in Los Angeles,
Calif. She serves on the Aging Today Editorial Advisory Committee, as a commissioner on the L.A. County Commission for Older Adults and as a West Hollywood Human Services Commissioner. She can be contacted at Barbara@meltzerpr.com.

This article appeared in Aging Today newspaper and is reprinted with the permission of the American Society on Aging.