Are you ageing well?

Are you ageing well?


By Dr NOORLAILI MOHD TOHIT @ MOHD TAUHID

HEALTHY ageing can also be described as successful ageing, active ageing, productive ageing and good ageing.

But, what does it mean? How well you age is very subjective and depends on the individual and their definition of happy and healthy ageing. This definition may also change as one ages.

One popular biomedical perspective says that successful ageing, in contrast to usual ageing, comprises of three components:

  • Not having any illness or any risk factor for disease.
  • Good cognitive (not demented) and physical functioning.
  • Active engagement with life – measured by interpersonal relations and productive activities.

Do you agree with this definition?

There is some truth to this, but the characteristics are not “a must” to describe good ageing.

This definition has been criticised for stigmatising and reinforcing negative stereotypes towards older people with an illness or disability. Studies have shown that older people are more likely to self-rate themselves as ageing well despite having multiple chronic illnesses.

Another description of good ageing looks at the psychological perspective. It recognises the importance of adaptation in ageing well. It is known as the SOC (Selection, Optimisation, and Compensation) model of ageing, where the older person is viewed as an active participant in their own ageing.

This means that the older person uses personal and social resources to compensate for the impact of physical ageing. The three adaptation processes are described as:

  • Selection – Growing older may lead to restriction in some functional capacities;
  • Optimisation – Older people have the capacity to improve their level of functioning; and
  • Compensation – Older people learn to adapt when capacities are reduced or lost.

In this model, good ageing occurs when an individual achieves the goals he/she has selected as important to them and uses the described psychological processes to achieve these goals.

The views of older people

So far, the definitions of good or healthy ageing have been provided by researchers and policy makers.

What about the senior citizens themselves? What do they think is good or healthy ageing?

One study among older people aged 85 years and above in Europe found that older people “valued well-being and social functioning more than physical and psycho cognitive functioning”. In Britain, the older people relate successful ageing to:

  • good health and functioning;
  • enjoyment in life;
  • making a contribution to society; and
  • having a positive outlook as well as sense of purpose.

Middle-aged and older Chinese populations in Hong Kong described attributes of positive ageing as:

  • good health;
  • positive life attitude;
  • active engagement with an activity or society;
  • feeling supported by family and friends;
  • being financially secure; and
  • living in a place with emotional ties.

A study among the the ethnic Chinese aged 65 and above in Singapore reported the following factors determine successful ageing:

  • Younger age;
  • Female;
  • Higher housing status;
  • Better education;
  • Physical activity and exercise;
  • Spiritual or religious beliefs as a source of support or comfort; and
  • Low nutritional risk.

The many factors described above seem more relevant to our Asian populations.

The perspectives of older Malaysians

In a recent study involving older Malays in the Klang Valley, six salient features were used to describe healthy ageing:

  • Spirituality as a driving force to achieve healthy ageing.
  • Peace of mind is the ultimate aim in healthy ageing.
  • Physical health and function is an important dimension in healthy ageing.
  • Family plays an important role to support healthy ageing.
  • Financial independence is vital.
  • Living environment enhances their healthy ageing experiences.

In addition to the above features, healthy ageing at the individual level was described as:

  • A dynamic adaptation;
  • Prioritisation; and
  • Transcendent acceptance.

A dynamic adaptation is a continuous process of coping and adapting to biological (internal) and environmental (external) changes to achieve the acceptable situation to describe healthy ageing. The older people are free to define their own acceptable situation to describe healthy ageing, according to individual context.

Prioritisation is the ability to identify and arrange factors according to their relative importance to achieve healthy ageing. For some older people, a peaceful life is experienced by having their family members around, whereas for some other people, living in their own home could be their priority to give them peace of mind.

Transcendent acceptance is the description of an individual’s spiritual experience of acceptance that supports and provides them with the strength to adapt and accept their biological or environmental changes. This highest level of acceptance is known as “redha” in Malay. It simply means a sense of acceptance of any event, wholeheartedly and to feel at peace with it.

Looking at the many perspectives of healthy ageing above, which one suits you?

Each of us experiences ageing differently. Let us appreciate our differences and celebrate our similarities. Happy and healthy ageing to all!

References:

Baltes, P. B., & Baltes, M. M. (1990). Psychological perspectives on successful ageing: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful ageing: perspectives from the behavioural sciences (pp. 1-34). Cambridge: University of Cambridge.

Bowling, A., & Dieppe, P. (2005). What is successful ageing and who should define it? British Medical Journal, 331, 1548-51.

Chong, A. M., Ng, S., Woo, J., & Kwan, A. Y. (2006). Positive ageing: the views of middle-aged and older adults in Hong Kong. Ageing and Society, 26, 243-65.

Ng, T. P. (2009). Determinants of successful ageing using a multidimensional definition among Chinese elderly in Singapore. The American Journal of Geriatric Psychiatry, 17(5), 407-16.

Rowe, J. W., & Kahn, R. L. (1997). Successful aging. The Gerontologist, 37(4), 433-40.

Tohit, N., Browning, C. J., & Radermacher, H. (2012). We want a peaceful life here and hereafter: Healthy ageing perspectives of older Malays in Malaysia. Ageing & Society, 32(3), 405 – 424.

Dr Noorlaili Mohd Tohit @ Mohd Tauhid is a senior lecturer at the Department of Family Medicine, UKMMC.

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