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SUCCESSFUL AGING |
a Survey Research Center, University of Michigan, Ann Arbor
Correspondence: Robert L. Kahn, PhD, Survey Research Center, 1328 ISR, University of Michigan, Ann Arbor, MI 48109. E-mail: rlkahn{at}umich.edu.
Decision Editor: Laurence G. Branch, PhD
I welcome the invitation to offer an editorial comment on the article "Successful Aging and Well-Being: Self-Rated Compared With Rowe and Kahn" (Strawbridge, Wallhagen, and Cohen 2002
). I do so for two rather different reasons—appreciation for the data and analysis, but disagreement with parts of the interpretation and conclusion.
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on the following points. assert that Rowe and Kahn 1998 proposed "that those aging successfully would show little or no age-related decrements in physiologic function ..." (p. 727). On the contrary, we stated that "successful aging means just what it says—aging well, which is very different from not aging at all" (Rowe and Kahn 1998, p. 49). We emphasized this point with specific examples of decrements and losses that are age-determined and not merely age-related. "For example, the time required to recover from infections and injuries increases markedly with age, as does the possibility that either can cause death" (Rowe & Kahn, p. 49). "Gradual decreases in physical reserve and maximum performance are not only age-related; they are to some extent age-determined" (Rowe & Kahn, p. 50). We made comparable statements with respect to the increasing incidence of cancer as people age (p. 69), osteoporosis (p. 86), and other diseases. And to the question "are cognitive losses an inevitable part of aging?" We answered "yes and no, or perhaps, yes, but ..." (p. 128). We go on to discuss age-determined reductions in speed of information processing (pp. 129–130) and explicit memory (pp. 131–132). cite the opinions of Masoro 2001 and Kaplan and Strawbridge 1994 regarding the unintended consequences of the successful aging concept itself. Masoro argues that the concept of successful aging, by celebrating a genetically fortunate elite, misleads individuals and leads policy makers to neglect or blame those less fortunate. Strawbridge and colleagues 2002 describe the "potential unintended consequence of reducing interest in better managing age-related functional declines through secondary and tertiary prevention" and add that "the adjective successful has proven itself problematical because it implies a contest in which there are winners and losers" (p. 728).
All this, of course, is opposite to Rowe's and my (Rowe and Kahn 1998) intentions in proposing the concept of successful aging and the several continua that defined it. We hoped to invite researchers to investigate the heterogeneity among older people and to discover its causes—genetic, psychosocial, and environmental. We hoped that research on successful aging and its biopsychosocial determinants would encourage people to make lifestyle choices that would maximize their own likelihood of aging well, that is, maintaining a high quality of life in old age. And with respect to policy makers, we hoped for the kinds of changes—access, quality of care, and opportunity structure—that would facilitate such individual efforts. The surge of interest in successful aging, by researchers and the larger public, suggests that these hopes may have been more realistic than the pessimistic predictions of some critics.
Nevertheless, I share the concerns of Strawbridge and colleagues 2002 that the term successful aging may itself have the unintended effect of defining the majority of the elderly population as unsuccessful and therefore as failing. I believe that this problem, to the extent that it exists, reflects a characteristic of contemporary American culture rather than something intrinsic to the concept. We Americans seem locked into a dichotomous all-or-nothing, succeed-or-fail view of the world, in spite of the natural world's constant reminders to think in terms of continua rather than dichotomies.
It thus becomes a pragmatic question whether researchers, practitioners, and the general public are enlightened and motivated or misled and discouraged by an approach to successful aging that acknowledges its multidimensionality, encourages behaviors that maximize individual attainment on its several dimensions, and honors those who excel on some dimensions while being limited on others.
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, in a letter to The Gerontologist. She pointed out that "what Drs. Rowe and Kahn neglect is this dependence of successful aging upon structural opportunities in schools, offices, nursing homes, families, communities, social networks, and society at large" (p. 151). These factors are central to Riley and Riley 1990 model of structural lag as the result of two interdependent but differently paced societal processes, the dynamism of changing lives and the dynamism of structural change.
Rakowski, Clark, Miller, and Berg in press express a preference for the Baltes and Baltes model of successful aging (Baltes 1997; Baltes and Baltes 1990), mainly on the basis of its inclusiveness. They feel that Baltes and Baltes's concept of "selective optimization with compensation" defines "successful aging as individuals' choosing to make the best use of certain capacities and resources that they still have ... while finding ways to compensate for other limitations" (Rakowski et al., p. 4).
My own view is that the Rowe-Kahn (1998), Baltes and Baltes (Baltes 1997; Baltes and Baltes 1990), and Riley and Riley 1990 models are complementary rather than in conflict. The Baltes and Baltes model emphasizes accepting age-determined decrements and doing the best you can with what you have—physically, mentally, and situationally. The Rowe-Kahn model emphasizes what individuals themselves can do to use, maintain, and perhaps even improve what they have—their physical and mental capacities. The Riley and Riley model emphasizes what societies can do—through laws, organizational policies, and customs—to provide external resources that enlarge individuals' opportunities and thus facilitate the behaviors that make for success in old age.
The theoretical integration of these three models is a task for the future. In the meantime, all three are useful as research guides. And among them, despite the discomfort it has evoked from some of our colleagues, I think the Rowe-Kahn concept of successful aging serves us well.
Received for publication August 5, 2002. Accepted for publication August 5, 2002.
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This article has been cited by other articles:
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  N. C. Franklin and C. A. Tate Lifestyle and Successful Aging: An Overview American Journal of Lifestyle Medicine, January 1, 2009; 3(1): 6 - 11. [Abstract] [PDF]
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