Upload
others
View
4
Download
0
Embed Size (px)
Citation preview
HEALTHY AGING IN OLDER ADULTS 1
Healthy Aging in Older Adults:
Promoting Healthy Aging
By
Sophia Song
HEALTHY AGING IN OLDER ADULTS 2
Abstract
Healthy aging in a broader perspective entails the multidimensional processes of lifelong
learning and personal development aimed at accomplishing autonomy and independence for
elderly people. Thus, it requires the balance of the interactions between the various
dimensions in the lives of older adults from physical health, to independence and autonomy
in activities of daily living, and to social involvement. The present study identifies and
discusses various important factors including physical, psychological, and societal that can
promote healthy aging. Based on the premises of such factors, potential changes in public
policy aimed at enhancing the mobility of older adults as well as encouraging positive
behavioral changes in the lifestyles of older individuals were proposed to advance the agenda
of healthy aging.
HEALTHY AGING IN OLDER ADULTS 3
Introduction
The world is facing an unprecedented demographic milestone. 526 million people out of
the global population of 7 billion in 2012 (or 8%) were aged 65 and over. By 2015, the older
adult population rose by an astonishing 55 million (8.5% ratio to the rest of the world’s
population) (Goodkind & Kowal, 2016), and will continue to rise exponentially. America
within this world wide demographic boom, is seeing the same results due to improvements in
public health, and it is projected that adults aged 65+ will surpass the 98 million count by
2060 (Mather, 2016). The remarkable improvements in life expectancy over the past decades
can be viewed as a human success story of increased longevity as well as a significant
challenge.
Individuals who lack access to social protections, such as healthcare, will face significant
challenges due to the increasing risk of Non-communicable diseases as they age. In the
United States alone, more than 90% of older adults (65 and over) reported living with at least
one chronic disease in 2016 (National Council on Aging, 2017). Furthermore, the lack of
mental health assistance and awareness among older adults poses severe limitations on their
ability to exercise control over their lives and function properly (Conner, Copeland, & Grote,
2010). Not only is the call for governmental and societal interventions becoming increasingly
important for the well being of the aging population, but also for individuals themselves to
care for their bodies.
Before addressing these issues, it is imperative to focus on how societies and individuals
can promote healthy aging. So what exactly does healthy aging look like? According to
McLaughlin, Jette, and Connell (2012), a healthily aging adult can be defined as an
individual who is not only both physically and mentally healthy, but one who is also socially
engaged.
HEALTHY AGING IN OLDER ADULTS 4
Will the significant increase in the aging population be accompanied with improved
health, increased quality of life, social integration, and economic stability for those in later
life? The answer to this question lies in the hands of public policy makers, communities, as
well as the perceptions of people themselves on aging (National Research Council, 2001).
The study of psychology along with gerontology, (which studies the aging of older adults
through the scientific studies of physiology, societal changes, and implementation of their
knowledge to policies), has greatly contributed our understanding of how to promote healthy
aging. In the following paragraphs, this paper will aim to unravel and examine the complex
web of physiological, psychological, and societal factors, which can promote healthy aging
specifically among individuals transitioning from midlife into later-life (aged 65 and older).
HEALTHY AGING IN OLDER ADULTS 5
Physical Factors
Many physiological changes occur during the normal process of healthy aging for the
better or for worse. Visible wrinkles and sprouts of grayed hair are only few of the physical
indicators of aging individuals in later life. Much of the complex aging process can be
examined within the body’s internal systems. With old age brings the growing risk of chronic
diseases and impairment of bodily functions (White, et. al. 2015). Sensory decline, such as
the diminishing ability to see objects closely and hear also accompany people in the aging
process and can negatively affect older adults’ functional abilities in daily life (Salvi, Akhtar,
& Currie, 2006).
Though physiological changes of aging differ by individuals due to heredity, it is
fallacious to simply disregard the significance of lifestyle choices, which can affect the
normal aging process. Therefore, it becomes evident that proper nutrition is one factor that
may help to promote longevity and suffice the health related aspect of normal healthy aging,
as many diseases that older people suffer from are due to dietary factors (Ahmed & Haboubi,
2010). For example, nutritional intervention, such as incorporating Vitamin E, which
functions as an antioxidant and plays a role in aiding the anti-inflammatory processes, into
people’s diet may be correlated to the decreased risk of cardiovascular disease (Lobo et al.,
2010). More importantly, refraining from substance abuse as well as from overeating can
significantly decrease the risk of chronic illnesses since drugs, like tobacco, can increase the
victim’s risk of cancer (NIHD, 2014) and since overeating can lead to obesity, which is
correlated to heart disease (Nakamura, Fuster, & Walsh, 2014).
Apart from chronic illnesses and sensory decline, healthy older adults are at more risk
of falls than any other age group, with around 30 to 50% in health care institutions falling
annually (World Health Organization, 2007). Therefore, efforts to reduce falls have been one
of the primary concerns in the public health sector. Fortunately, home modifications, such as
HEALTHY AGING IN OLDER ADULTS 6
installing grab bars and shower benches in fall risk areas, like the bathroom, can promote
physical safety for older adults (The American Occupational Therapy Association, 2010). As
an alternative method to home modifications, which may be a burden to those in lower income
families, engaging in regular exercise, such as Tai Chi, can decrease the risks of falling.
According to a study examining the correlation between Tai Chi and fall reduction, the group
of older individuals who practiced Tai Chi daily had a 55% decrease in their risk of falling
when compared to the control group (Li et al, 2005).
Since the quality of life is directly related to the functional status of older adults and
their feeling of control over their environment, it is necessary to promote exercise, which
may reduce the risk of muscle, bone, (osteoporosis and arthritis), cardiovascular, and
metabolic diseases (National Institute of Arthritis and Musculoskeletal and Skin Diseases,
2015). Furthermore, frequent physical activity accompanied with proper nutrition has been
labeled as the best type of “medicine” for all age groups and studies have shown the
promising cognitive benefits of physical activity. For example, researchers in the Nurses’
Health Study found that female participants between the age of 70 to 81 who were in the
highest quintile in physical activity had 20% lower risk of cognitive impairment than their
counterparts who scored lowest in the physical activity quintile (Weuve et al., 2004).
HEALTHY AGING IN OLDER ADULTS 7
Psychological Factors
The important factors to be considered for healthy aging within the psychological
perspective include life satisfaction, positive well-being, and cognitive functioning (McKee
& Schüz, 2015). When concerning the mental health of older adults, the most prevalent issues
are the prevention, treatment, and quality of life interventions (Fingerman & Constança,
2017). Among these issues, depression can be thought of as a paramount challenge among
senior citizens because it is often undiagnosed and untreated, yet widespread (Conner,
Copeland, & Grote, 2010). This problem is particularly concentrated in rural and underserved
groups, for those living in poverty, or in some ethnic groups (Cutrona, Wallace, & Wesner,
2006).
Conclusions drawn from a 2009 meta regression analysis study suggest that
psychological therapy is equally effective in older and younger adults with depression
(Cuijpers et al., 2009), which shows the importance of various psychotherapies, like
cognitive behavioral, interpersonal, and psychodynamic psychotherapy. There has been
skepticism towards whether or not “Reminiscence Therapy,” which involves reflecting on the
past to improve psychological well-being, can actually boost well being in older adults.
However, this type of therapy has shown promising leads according to meta analysis studies,
which showed that patients after three months of “Reminiscence Therapy,” reported overall
positive mental health and cognitive performance (Gaggioli et al., 2014). If further studies
confirm this, we can address the often overlooked psychological problems for the elderly by
increasing access to mental health services, which will reduce healthcare expenditures by
decreasing the frequent medical procedures and primary care visits.
Psychologists in the field of positive psychology also have presented several ways
older adults can increase their overall subjective well-being, such as through social
participation. When surveying more than 200,000 people in 136 different countries,
HEALTHY AGING IN OLDER ADULTS 8
researchers found that everywhere, people reported feeling happier when spending money on
others than on themselves (Aknin, Norton, & Dunn, 2009). Moderate charitable giving has
also been seen to have a significant effect on older people’s psychological well-being and has
been found to have positive physical, functional, and mental health outcomes for elderly
volunteers (Choi & Kim, 2011). Studies examine that altruism and a sense of social
responsibility accompanies people when they feel like they can actively contribute to society.
HEALTHY AGING IN OLDER ADULTS 9
Social Factors
Since an active and socially engaged lifestyle as well as autonomy over one’s
environment are important factors to consider when addressing healthy aging, the narrowing
of social network connections and opportunities to exert personal control over environments
(common amongst elders especially after retirement), poses challenges to their self-
perceived levels of subjective well-being (Coehn, 2004).
Fortunately, many social interventions, such as making contributions within
volunteering organizations and investing time into leisure activities, have shown to enhance
the subjective well being of older individuals (especially for those transitioning into
retirement). Older adults who reported that they were useful to their friends and family had
lower rates of disability and mortality seven years later when compared to older adults who
rated themselves as lower on their perceived usefulness to their social network (Greunewald
et al., 2007). This means that older adults can replace lost social roles with compensatory
activities, like volunteer work, and boost their self-esteem, while preserving self-identity. For
example, adults with frequent participation in volunteer work, reported greater levels of
healthy wellbeing according to a study that interviewed members of an environmental
organization (Wong, 2010). Furthermore, these volunteers enjoyed even more benefits when
the organization provided training, support, and flexibility in the decision-making processes,
which shows the overall importance of the decision-making community environment when
promoting healthy aging.
Moving on, it is also imperative to address the ways by which communities can
increase access to forms of social support, vital to the healthy aging of older adults, especially
since the narrowing of social networks can be attributable to the more frequented losses of
loved ones amongst older adults. Maintaining continuity in the realm of social participation are
strategies older adults may be able to use in order to cope with spousal loss because the
HEALTHY AGING IN OLDER ADULTS 10
opportunity to express one’s grief may help attenuate the negative outcomes of bereavement
(Tatum, 2006). The building of non-profit organizations such as “Vital Communities” within
rural and urban communities can help individuals cope with spousal loss by connecting their
strengths with community assets and creating a body of people who can mutually care for
each other.
HEALTHY AGING IN OLDER ADULTS 11
Conclusion
Keeping in mind that psychological, social, and physical factors are all interwoven and
correlated with each other, it is crucial for older adults to have an integrated perspective on
adopting healthy lifestyles, so that they can enjoy all aspects of healthy aging. Older adults in
particular, must break the existing barriers, which myths create, such as the stigma that frailty
prohibits them from physical activity. Arbaje explains that it is a common misconception both
adolescents and elders to think that old age is associated with the loss of balance, when in
reality, the loss of balance are the symptoms of sedentary lifestyles (Seaton,
2015). Habitual inactivity among older individuals has been increasing over decades so the
need to examine behavioral and lifestyle changes has become an ever pressing issue for
today’s gerontologists as well as psychologists.
Pioneering psychologist, William James once explained that habits, in particular,
make up a vital part of our behavior, which in return, influences our perceived quality of life
(James, 1890). According to previous studies examining how new habits are built (Clear,
2014), it takes more than two months before new behaviors become automatic (though it may
vary by person). The question then becomes, how can individuals foster positive physical
habits? Self-motivation and perseverance on the individual’s parts are promising catalysts for
beneficial physical change as people transition into later life. Setting goals and positive
reinforcers when scheduling exercise regimes can quicken the realization of such physical
benefits. A multitude of studies have confirmed the benefits of continued (habitual) sessions
of physical exercise (Warburton, Nicol, & Bredin, 2008; Weuve et al., 2004). If exercising is
not a preferred choice, then opening oneself up to participation within preferred communities
could be an alternative approach to healthy aging and successfully help older adults adjust to
healthy behaviors. In this subtle behavioral transition, older adults must also realize their
potential to continue contributing to the community.
HEALTHY AGING IN OLDER ADULTS 12
Moving away from lifestyle and behavioral changes, it has become apparent that
larger governing sources like public policies play a substantial role when determining the
quality of the life in senior citizens. In the coming years, it will be of paramount importance
for psychologists and policy makers alike to come up with creative changes in public policy
for older adults, especially for those persons with disabilities or chronic diseases.
In this discussion, transportation and enhancing the mobility of older adults must be
put on top of a pedestal for evaluation. As more than 20% of Americans over the age of 65 do
not drive a vehicle, improving transportation systems has become a must, so that senior
citizens can take more control over their lives and enjoy opportunities for social engagement
by being able to freely explore the environment (Suttie, 2014; Shallcross et al., 2012).
Experts must pay closer attention to the mobility of the community of older people as current
public investment in senior transportation alternatives lacks resources.
Although there are several programs and non-profit organizations available, which
provide safe routes to transits, such as “Bus Stops Under El,” or covers rural areas such as
“Ride Partners,” there is still a growing need to pass bills on a national and local level for
more funding and for creating incentives for transit operators and local communities to
engage in new practices. This can be benefited through the coordination of the existing
transportations programs aforementioned.
Funds can be channeled towards supporting research on how and where to implement
the transportation options already open to senior citizens so that its positive impacts will best
serve the physical and social well being of older adults. Case studies can be carried out
evaluating positive and negative effects of the existing supplemental transportation system on
senior citizens’ self reported levels of well-being and physical health, which can then be used
to evaluate which programs would fit the needs of the older population the most. It is
HEALTHY AGING IN OLDER ADULTS 13
important for public policy makers to work with gerontologists as well as psychologists in
order to evaluate rural and separate ethnic communities differently as their interests could
vary from the urban or homogenous populations.
In all, longer lives must be thoroughly planned for in order to prepare for the increasing
numbers of persons who are surviving to older ages, both on an individual and societal level
and promote healthy aging. The path, however, towards promoting the physical,
psychological, and social well-being, all required to fit the terms of healthy aging, will be
complex. Yet, psychology and all of its subfields, has led way towards understanding the
dynamics of what a healthy society truly is. We must be reminded that there can always be
room for positive change as long as policy makers, communities, and people themselves are
willing to rally their support behind healthy longevity.
HEALTHY AGING IN OLDER ADULTS 14
REFERENCES
Ahmed, T., & Haboubi, N. (2010). Assessment and management of nutrition in older people
and its importance to health. Clinical Interventions in Aging, 5, 207–216.
Aknin, L. B., Norton, M. I., & Dunn, E. W. (2009, November 05). From Wealth to well-being?
Money matters, but less than people think . Retrieved February 3, 2017, from
http://www.tandfonline.com/doi/abs/10.1080/17439760903271421
Choi, N. G., & Kim, J. (2010, December 21). The effect of time volunteering and charitable
donations in later life on psychological wellbeing | Ageing & Society. Retrieved
February 11, 2017, from https://www.cambridge.org/core/journals/ageing-and-
society/article/div-classtitlethe-effect-of-time-volunteering-and-charitable-donations-
in-later-life-on-psychological-
wellbeingdiv/FD56C48FD2F8F68C642B29867B99CFA1 Clear, J. (2014, March) How Long Does it Actually Take to Form a New Habit? Retrieved
March 15, 2017, from http://jamesclear.com/new-habit
Conner, K. O., Copeland, V. C., Grote, N. K., Koeske, G., Rosen, D., Reynolds, C. F., &
Brown, C. (2010). Mental Health Treatment Seeking Among Older Adults with
Depression: The Impact of Stigma and Race. The American Journal of Geriatric
Psychiatry : Official Journal of the American Association for Geriatric Psychiatry,
18(6), 531–543. http://doi.org/10.1097/JGP.0b013e3181cc0366
Cutrona, C. E., Wallace, G., & Wesner, K. A. (2006). Neighborhood Characteristics and
Depression: An Examination of Stress Processes. Current Directions in Psychological
Science, 15(4), 188–192. http://doi.org/10.1111/j.1467-8721.2006.00433.x
Fingerman, & Charles. (2010, June 10). Sign In: Registered Users. Retrieved March 1, 2017,
from http://journals.sagepub.com/doi/abs/10.1177/0963721410370297
HEALTHY AGING IN OLDER ADULTS 15
Gaggioli, A., Scaratti, C., Morganti, L., Stramba-Badiale, M., Agostoni, M., Spatola, C. A., …
Riva, G. (2014). Effectiveness of group reminiscence for improving wellbeing of
institutionalized elderly adults: study protocol for a randomized controlled trial. Trials,
15, 408. http://doi.org/10.1186/1745-6215-15-408
He, W., Goodkind, D., & Kowal, P. (2016, March). An Aging World: 2015. Retrieved from
https://www.census.gov/content/dam/Census/library/publications/2016/demo/p95-16-
1.pdf
James, W. (1890). The Principles of Psychology, retrieved from
http://psychclassics.yorku.ca/James/Principles/prin6.htm
Lobo, V., Patil, A., Phatak, A., & Chandra, N. (2010). Free radicals, antioxidants and
functional foods: Impact on human health. Pharmacognosy Reviews, 4(8), 118–126.
http://doi.org/10.4103/0973-7847.70902 Mather, M. (2016). Fact Sheet: Aging in the United States. Retrieved March 1, 2017, from
http://www.prb.org/Publications/Media-Guides/2016/aging-unitedstates-fact-sheet.aspx
McKee K.J. & Schüz, B. (2015) Psychosocial factors in healthy ageing, Psychology & Health,
30:6, 607-626
Mclaughlin, S. J., Jette, A. M., & Connell, C. M. (2012). An Examination of Healthy Aging
Across a Conceptual Continuum: Prevalence Estimates, Demographic Patterns, and
Validity. The Journals of Gerontology Series A: Biological Sciences and Medical
Sciences,67(7), 783-789. doi:10.1093/gerona/glr234
Nakamura, K., Fuster, J. J., & Walsh, K. (2014). Adipokines: A link between obesity and
cardiovascular disease. Journal of Cardiology, 63(4), 250–259.
http://doi.org/10.1016/j.jjcc.2013.11.006
HEALTHY AGING IN OLDER ADULTS 16
National Council on Aging. (2017, January 27). Facts About Healthy Aging. Retrieved March
1, 2017, from https://www.ncoa.org/news/resources-for-reporters/get-the-facts/healthy-
aging-facts/
National institute of Arthritis and Musculoskeletal and Skin Diseases. (2015, May). Retrieved
March 1, 2017, from
https://www.niams.nih.gov/health_info/bone/Bone_Health/Exercise/default.asp National Research Council (US) Panel on a Research Agenda and New Data for an Aging
World. (1970, January 01). The Health of Aging Populations. Retrieved February 15,
2017, from https://www.ncbi.nlm.nih.gov/books/NBK98373/
Salvi, S. M., Akhtar, S., & Currie, Z. (2006, September). Ageing changes in the eye. Retrieved
February 10, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585730/
Seaton, M. (2015, November). What You Need to Know about Taking Care of Aging Parents.
Retrieved Feburary 26, 2017, from http://robbreport.com/health-and-wellness/living-
well/what-you-need-know-about-taking-care-aging-parents
Shallcross, A. J., Ford, B. Q., Floerke, V. A., & Mauss, I. B. (2012, December 31). Getting
Better With Age: The Relationship Between Age, Acceptance, and Negative Affect.
Journal of Personality and Social Psychology. Advance online publication. doi:
10.1037/a0031180
Signs of Aging. (n.d.). Retrieved March 08, 2017, from
http://genetics.thetech.org/original_news/news15 Suttie, J. (2014, March 14). How Social Connections Keep Seniors Healthy. Retrieved March
13, 2017, from
http://greatergood.berkeley.edu/article/item/how_social_connections_keep_seniors_hea
lthy
HEALTHY AGING IN OLDER ADULTS 17
Tatum, B. T. (2006). The Role of Social Support and Positive Affect During Conjugal
Bereavement . Retrieved February 6, 2017, from
http://www.tc.columbia.edu/publications/gsjp/gsjp-volumes-archive/gspj-volume-8-
2006/
The American Occupational Therapy Association. (2010, July). Retrieved March 12, 2017,
from http://www.aota.org/Practice/Productive-Aging/Falls/CDC/Final.aspx
Warburton, D.E., Nicol, C.W., & Bredin, S.S.(2008, March 11). Prescribing exercise as
preventive therapy. Retrieved March 1, 2017, from
https://www.ncbi.nlm.nih.gov/pubmed/16567757 Weuve, Kang, Manson, Breteler, Ware, & Grodstein. (2004, September 22). Physical activity,
including walking, and cognitive function in older women. Retrieved February 5, 2017,
from https://www.ncbi.nlm.nih.gov/pubmed/15383516/ White, M. C., Holman, D. M., Boehm, J. E., Peipins, L. A., Grossman, M., & Henley, S. J.
(2014). Age and Cancer Risk: A Potentially Modifiable Relationship. American
Journal of Preventive Medicine, 46(3 0 1), S7–15.
http://doi.org/10.1016/j.amepre.2013.10.029 Wong, B. (2010, July 22). What Seniors Get from Giving Back. Retrieved March 1, 2017,
from http://greatergood.berkeley.edu/article/item
World Health Organization. (2007). WHO Global Report on Falls Prevention in Older Age.
Retrieved from http://www.who.int/ageing/publications/Falls_prevention7March.pdf