The factors behind successful ageing have been the subject of research for decades, but the subjective side of ageing still needs to be explored. Because successful ageing is more than an attempt to defy age and its frailties, it is a process in which, in addition to losses, benefits need to be taken into account—not just those delivered by good genetics or a healthy lifestyle, but also those generated by a positive outlook on life, even as it nears its sunset.
One of the difficult-to-ignore proofs of the fears unleashed by ageing is that we have created a new stage of life, the “fourth age,” in an attempt to postpone the encounter with the losses and sufferings that happen near the finish line of life, writes sociologist Anne Karpf.
In fact, some studies show that we tend to push the threshold of old age well beyond our statistical chances of reaching it, Karpf points out, recalling the results of an American survey in which subjects (who were around 50 years old) were asked the age at which they believed old age begins. The average age they responded was 79.5, up from previous surveys, and slightly higher than Americans’ life expectancy (which ranged from 78.8 to 79.05 years in the 2019-2022 interval).
The concerns about the losses that accompany the third age (from the loss of autonomy to the loss of social roles) are at the core of the aversion to ageing. However, “successful” ageing involves more than the absence of illness or disability—this is according to researchers as well as those who have walked the bumpy road of old age.
What are the factors of successful ageing?
Over the years, theorists of successful ageing have begun to explore, in addition to the biological and medical side of the process, the social and psychological dimensions.
Early theories that attempted to explain how people age included activity theory and disengagement theory. The first theory emphasised the need to maintain social roles and activities even in the late stages of life, to compensate for the losses brought by retirement, the death of a life partner or other substantial changes that emerge in the life of the elderly. Disengagement theory focused on the narrowing of the social universe of older adults, arguing for the natural character of this gradual disengagement from social and emotional life.
Today, gerontologists consider both theories too simplistic, either because they encourage a negative view of old age or because they focus too much on an active life as a defining element of successful ageing, writes Professor Kathryn Betts Adams. Presently, researchers are less focused on formulating a single theory of ageing, better understanding that there are a multitude of ways to tackle ageing and that the elderly population is quite heterogeneous, Adams points out.
As we grow older, the feeling that we have limited time at our disposal increases, and we tend to select more strictly the relationships in which we invest emotionally, says Laura Carstensen, the author of the socio-emotional selectivity theory. On the one hand, this selectivity explains why the elderly have a smaller social network than younger adults, and on the other hand, it represents a strategy not only for maintaining emotional comfort, but also for regaining a sense of control when control over many aspects of life is lost.
The classic approach to successful ageing focuses on health and the physical and cognitive functioning of the elderly, but new approaches (including those that have explored subjective perspectives on ageing) show that the factors of successful ageing are of a complexity that has yet to be fully explored.
Researchers John Rowe and Robert Kahn differentiated successful ageing from ordinary ageing by identifying three main elements: the absence of illness and disability, cognitive and physical functionality, and a productive and socially active life.
However, studies have shown that few elderly people manage to check the first two conditions from the list. “Healthy centenarians do not exist, but autonomous centenarians do,” concluded a study on Danish centenarians, which found that 60% had been treated for illness with a high mortality rate. Cardiovascular diseases were present in 72% of the subjects (while 54% had osteoarthritis, 52% suffered from hypertension and 51% from dementia), with only one centenarian being found to have no chronic disease.
A study that analysed the health of more than 5,800 individuals over four decades found that, between the ages of 54 and 85, only 11% of the subjects of the investigated group managed to avoid illness and maintain their physical and cognitive functionality at a high level. Analysing a group of healthy men aged 70, another study found that 77% survived to the age of 85 (34% of them maintained their health), and 24% reached the age of 95 (less than 1% of them managed to maintain their physical and cognitive health and functionality, thus qualifying for successful ageing).
The model of successful ageing is still under scrutiny by researchers, who are trying to refine it and extend it beyond the biological dimension. Relatively few studies have asked the elderly to self-assess their ageing process, and their conclusion has been that most older adults consider their ageing to be successful, even if they do not meet objective criteria.
There is a real chasm between the scientific and popular perspectives on successful ageing, concludes neuropsychiatrist Dilip Jeste, emphasising that the former focuses on freedom from illness and disability, while the latter focuses on psychosocial elements such as adaptation, meaning, and connection.
The concept of successful ageing is dampened by a focus on the absence of illness, says researcher Thomas Glass, stressing the need to learn more about the things older people value and their own definitions of successful ageing.
Subjective age: one of the factors of successful ageing?
Subjective age, which refers to how young or old we feel, intersects in many ways with our well-being and may be one factor in successful ageing.
We feel younger than we actually are, according to a 2022 study, which highlighted that this tendency accentuates as we age. Collecting data from people between the ages of 21 and 100, the researchers observed that, on average, the subjective perceived age of the individuals was 11.5 years lower than their biological age, and that a low subjective age correlated with a state of better health, the increased probability of a positive evaluation of one’s own ageing, a higher level of optimism, hope, resilience, and curiosity, but also with the perception of higher social support.
Old people who perceive themselves as younger have a larger volume of grey matter in the inferior frontal gyrus and superior temporal gyrus, so their brains suffer less damage, which is otherwise inevitable in the ageing process.
About 80% of people tend to feel younger than they are and less than 10% perceive themselves to be older than the calendar shows, says Professor Yannick Stephan. Even though it is difficult to establish cause and effect (Do people feel younger because they are healthier, or does robust health make them not feel their age?), doctors may be able to identify people who are more at risk of developing health problems just by asking their patients what age they feel they are, concludes the professor.
Younger subjective age is a good predictor of less abrupt health deterioration, but also a buffer against stress induced by changes in health status, German researchers found.
“Children as young as three or four have already taken in the age stereotypes of their culture,” says Professor Becca Levy, author of a study showing that seniors who have a positive outlook on old age have a lower risk of developing dementia, even if there is a genetic predisposition to the disease. People of all ages benefit from positive images of ageing, Levy explains.
Successful ageing and the loss-gain ratio
The optimistic view of ageing, which accounts for the gains, is not the rule but rather the exception in Western society, which is steeped in negative stereotypes about old age, says Professor Susan Krauss Whitbourne.
Nevertheless, there is no way to a successful old age that bypasses positive views about this stage of life, Whitbourne points out, explaining that it is not about an unrealistic perspective that ignores the negative aspects of the third age, but about the decision to enjoy and celebrate the gains rather than mourn the losses that mark this season.
Trying to identify the combined role of subjective age and perceived ageing on longevity, German researchers Susanne Wurm and Sarah Schäfer analysed data on 2,400 subjects between the ages of 40 and 85, who were studied over a period of 23 years.
Contrary to expectations, subjective age did not influence the life span of the subjects, but people who associated ageing with a period of gains and development had half the mortality of people who viewed old age through the lens of loss.
Commenting on the study’s results, Whitbourne says that perceiving yourself as younger than you are seems to have less influence on your life span than thinking that ageing is “not that bad” but can actually be a positive experience.
Enjoying the last few moments of a life, whatever its length, is certainly a challenge, for what makes old age especially undesirable is the narrowing of space and time: “When the future simply no longer exists, the space of life is reduced to the size of a death row cell,” writes essayist Sever Voinescu.
Answering the childish question “Are we there yet?” writer Alexandru Papilian observes that the “there” of old age is disembodied by time and space and that, at the same time, every rumour of the new, the unused, and every gesture of affection from our loved ones is like an infusion of life: “Your ‘Are we there yet,’ my dears, makes our elders live longer.”
And not just to live, but to enjoy everything that they live, seeing more and more clearly, as their eyes get cloudy, the abundance that has been prepared for them beyond what seems to be a definitive exit from the scene.