Gerontologist最新文献

This paper considers the concept of successful aging by means of a dialogue with the concept of frailty. This dialogue reveals the limits and blind spots of both concepts as well as their apparent dichotomy and the importance of understanding both the objective and subjective experience of aging. In particular, the dialogue highlights that both frailty and successful aging are social constructs that derive their meaning from what society values (autonomy, youthful capacities). They cannot by themselves account for the fact that flourishing and frailty are often found together whilst conversely successful aging may not bring satisfaction. I argue that the arts and humanities supply us with conceptual and methodological tools with which to revisit what it is to age well offering a holistic approach that combines sensitivity both to older people's lived experience and to the underpinning material conditions and embodied realities. For this purpose, and building on previous scholarship in cultural gerontology, I suggest the unique value of concepts and frameworks associated by Simone de Beauvoir. When brought into alignment with the tenets of cultural and narrative gerontology, these concepts facilitate a rich understanding of the nuances and paradoxes of flourishing in deep old age which can also aid in restorying both old age and the life course more generally. I illustrate this through two examples: a feminist self-help guide to aging, which accepts both limitations and growth and a film that imagines the possibilities of authentic aging even despite a context of poverty, patriarchy, and Alzheimer's disease.

Background and objectives: Active engagement with life (AE) is an integral aspect of successful aging. Using time diary data, this study explored how U.S. older adults structure their daily lives involving social participation and productive engagement, and the extent to which these patterns differ by race and gender.

Research design and methods: We used American Time Use Survey (ATUS) data (n = 17,990) and sequence and cluster analyses to identify distinctive daily AE patterns. Multivariable linear regression models were used to evaluate associations between AE patterns and self-rated health, and the moderating roles of race and gender.

Results: Five AE clusters were identified: Low Degree of AE (26%), Moderate Unpaid Work and Light Social Participation (39%), Persistent Unpaid Work (20%), Persistent Paid Work (10%), and Persistent Social Participation (4%). White women were the most likely and Black men the least likely to have any AE. Compared to "Low Degree of AE," all other AE clusters were associated with better self-rated health, with these associations varying by gender and race. The strongest positive association was observed for "Persistent Paid Work," especially among women. Racial differences in the association between AE and health were more prominent among women than men. Differences by AE were less pronounced among Black women in comparison to White women.

Discussion and implications: We found that the association between AE and self-rated health varies by race and gender. Persistent structural barriers may prevent older adults from historically minoritized backgrounds, particularly Black women, from benefiting from AE.

Background and objectives: Few people who are ages 80+ meet the criteria of successful aging (SA) proposed by Rowe and Kahn. Going beyond the individual-level conceptualization, we argue that SA always operates in multiple contexts and that context may become most critical in advanced old age. However, we are not aware of any previous study providing an empirical test of how contexts for SA unfold across persons 80 years and older, including those living in institutions.

Research design and methods: We estimated and compared prevalences of SA based on a classic versus context-enriched understanding of SA in multiple large surveys of older adults, that is, the D80+ study (N = 3.233) and the NRW80+ study (N [baseline] = 1.863). In addition to replication across independent samples, we investigated the stability of context-related SA across time.

Results: Prevalences of SA according to Rowe and Kahn were 9.1% in adults aged 80-84 and 0.7% in persons 90 years or older. However, prevalence rates for those with good contexts at their disposal even if not fulfilling Rowe and Kahn's criteria were much higher across all age groups (80-84 years: 54.9%, 90 years and older: 44.4%). Greater 2-year stability was observed for contextual compared to individual criteria. Notably, positive effects of context on SA were stronger at onset compared to late fourth age.

Discussion and implications: Our findings support a contextualized understanding of SA and inform policy that furthering SA in the fourth age requires the optimization of multiple contexts at the community level.

As society rapidly digitizes, successful aging necessitates using technology for health and social care and social engagement. Technologies aimed to support older adults (e.g., smart homes, assistive robots, wheelchairs) are increasingly applying artificial intelligence (AI), and thereby creating ethical challenges to technology development and use. The international debate on AI ethics focuses on implications to society (e.g., bias, equity) and to individuals (e.g., privacy, consent). The relational nature of care, however, warrants a humanistic lens to examine how "AI AgeTech" will shape, and be shaped by, social networks or care ecosystems in terms of their care actors (i.e., older adults, care partners, service providers); inter-actor relations (e.g., care decision making) and relationships (e.g., social, professional); and evolving care arrangements. For instance, if an older adult's reduced functioning leads actors to renegotiate their risk tolerances and care routines, smart homes or robots become more than tools that actors configure; they become semiautonomous actors, in themselves, with the potential to influence functioning and interpersonal relationships. As an experientially diverse, transdisciplinary working group of older adults, care partners, researchers, clinicians, and entrepreneurs, we co-constructed intersectional care experiences, to guide technology research, development, and use. Our synthesis contributes a preliminary guiding model for AI AgeTech innovation that delineates humanistic attributes, values, and design orientations, and captures the ethical, sociological, and technological nuances of dynamic care ecosystems. Our visual probes and recommended tools and techniques offer researchers, developers/innovators, and care actors concrete ways of using this model to promote successful aging in AI-enabled futures.

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 3 types of balance distinguish wise aging from successful aging. First, wisdom balances one's own interest with the 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 to support others going through different times.

Background and objectives: Although the model of successful aging is already well discussed and has received considerable critical responses, its intersection with the growing enthusiasm for creative engagement among older adults needs further exploration. This article contributes to the growing literature on later-life creativity by examining its relationship with the discourse of successful aging.

Research design and methods: The study employs critical humanities-based perspectives and the literature on later life to address creativity in older age within contemporary neoliberal imperatives.

Results: Although successful aging is an antithesis to the narrative of decline, it often fails to capture alternative meanings of aging and the creative engagement in later life. The commercialization and commodification of creativity often function to discipline individuals toward a culture of productivity, optimization, and innovation. However, many older individuals challenge these notions as they create their own models of aging well and authentically that do not align with the ideals of successful aging.

Discussion and implications: Reductionist, individualistic, and capital-driven understandings of later-life creativity can be broadened by employing critical interdisciplinary approaches, which also help rethink the current meanings of old age and aging. The article will be of interest to scholars, policymakers, artists, and practitioners in gerontological scholarship and the humanities.

Background and objectives: Since the early 2000s, a global age-friendly communities (AFC) movement has called for improving the built, social, and service environments of localities for aging. Yet research on the outcomes of AFC initiatives, as programmatic efforts toward AFC progress, remains in its nascence. Drawing on "The Water of Systems Change" framework, our study aimed to address this gap by exploring the extent to which accomplishments of AFC initiatives are indicative of altering six conditions for systems change: policies, organizational practices, resource allocations, power dynamics, relationships, and mental models.

Research design and methods: We analyzed qualitative data from 26 key informant interviews across eight mature AFC initiatives in the northeastern United States (U.S.). We engaged in iterative phases of thematic analysis to explore how the initiatives' accomplishments, as described by the participants, align with each of six focal conditions for systems change.

Results: We found especially robust and consistent evidence for outcomes in terms of enhanced organizational practices on aging; resource flows; connections within and across communities; and mental models about older adults. Evidence for outcomes concerning changes in power dynamics and policy was more limited.

Discussion and implications: Conceptualizing AFC initiatives as systems-change interventions can bolster research, evaluation, and program development as the movement proliferates and diversifies into the 21st century. Insights can help to advance praxis that empowers AFC leaders as changemakers for "successful aging" at the level of society.

Background and objectives: Literature regarding successful aging reflects a wide variety of fields and perspectives. Given the range of definitions and approaches found in published literature, it is important to investigate clusters of topics studied over time. This study aimed to show the change of topic clusters within successful aging studies.

Research design and methods: The study used topic modeling methodology to analyze vast amounts of abstract data. Among publications collected from Scopus (4,458) and Web of Science (5,187), 5,610 publications were analyzed. Topic clusters were analyzed in 2 ways: by (a) division of time (1960s-1990s, 2000s, 2010s, 2020s) and (b) all years combined.

Results: In the 1960s-1990s, 11 topic clusters ranging from health to emotional well-being emerged without any dominant domain. In the 2000s, 2 clusters related to social support and health appeared as major clusters. In the 2010s, 1 topic cluster that included words related to health and social participation was the biggest. In the 2020s, emotional health and social participation appeared again as one of the major clusters and health-related topics started to diverge into subgroups like physical health and mental health. In all years of publications combined, the major cluster involved words that are related to either health or social domains.

Discussion and implications: Results revealed that successful aging has been studied in many fields using multidimensional perspectives. The dominant categories were health and social domains. These findings suggest interprofessional practice, an interdisciplinary approach in research, and multisector involvement in policy.

Background and objectives: Critiques of the concept of successful aging (SA) include attention to its foundation on an individualized western medical approach that emphasizes personal choice, agency, and lifestyle. This paper aims to examine how individual notions of SA can be linked to, and co-constituted by, relational and intergenerational notions of personhood within the broader socioeconomic, familial, and cultural contexts of migration.

Research design and methods: Qualitative research was conducted in Australia (2020-2021) with 42 Vietnamese migrants using ethnographic interviews and participant observation. Data analysis applied inductive reasoning and intersectional analysis to investigate the notion of SA from the perspectives of research participants.

Results: Vietnamese migrants identified 3 dimensions of SA as significant: family fulfillment, individual achievements, and social engagement and protection. Family fulfilment is the most important; other dimensions are rendered meaningless without it. We found out that different generations interpreted SA in varying ways. Adult children prioritize personal success, self-independence, and longevity whereas grandparents place greater emphasis on the success of their adult children and maintenance of intergenerational relationships.

Discussion and implications: Migrant understandings of SA are deeply influenced by the sociocultural contexts of both their homeland and current residence. The emphasis on family in shaping SA reflects a social-relational understanding that contrasts with dominant individualistic models of SA. Given the social-relational dimension of SA, further research should investigate how distinct migrant experiences of SA shape access to wellbeing in later life.

Background and objectives: "Successful aging" concerns the process of growing older while maintaining physical, cognitive, and social well-being, emphasizing independence for overall satisfaction and quality of life. We investigate the impact of eHealth literacy on reducing loneliness and sustaining well-being during the pandemic, comparing middle- and high-income countries.

Research design and methods: Online surveys were conducted between April 4, 2020, and September 30, 2021, collecting responses (N = 2,091) from medium- and high-income countries in Europe, Asia, and North America. T-tests and ANOVAs were used to test how sociodemographic predictors were associated with differences in e-Health literacy, loneliness, and well-being.

Results: Respondents from high-income countries reported significantly higher well-being scores than those from middle-income countries and respondents from high-income countries had significantly higher e-HEALS (e-Health literacy) scores compared to middle-income countries. No significant difference was observed in loneliness scores between high-income and middle-income country respondents. Well-being is associated with age, with younger adults (18-29 years) and those aged 40+ reporting higher levels. Higher education and income are linked to greater well-being. Gender differences are observed, with females and those with a partner reporting higher well-being. In middle-income countries, higher education levels are more linked to loneliness, while in higher-income countries, loneliness is observed across education levels.

Discussion and implications: Future interventions by governments and policymakers should consider intersectionality in e-Health planning and offer digital literacy and digital skills training to those with lower education levels.