ArticlePDF Available


Healthy aging and prevention efforts for the elderly warrant attention in a world where the average mortality rate continues to increase. The current literature review is an overview of current findings related to healthy aging and recommendations for older adults who are living longer and healthier; as well as facing the physical and psychological challenges that come with extended life. Staying active, eating right, utilizing social and environmental resources, employing coping skills developed across the lifespan, as well as developing new strategies can enhance the quality of life for older adults. Helping professionals from all disciplines who are able to recognize the needs of this growing group, and recognize the resiliency factors inherent in healthy aging, have the best chance of designing and implementing successful preventionand intervention efforts.The purpose of the present literature review is twofold: 1) To systematically review the important factors that affect an individual's longevity and to raise awareness of the importance of those factors that are within one's control; and 2) To inform health care providers of prevention efforts important to older adults;encouraging an integration of research and practice to preventative efforts. Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
ISSN 1927-0526 E-ISSN 1927-0534
Principles of Longevity and Aging: Interventions to
Enhance Older Adulthood
Ryan Wessell (Corresponding author)
Department of Psychology Sociology, & Counseling, Northwest Missouri State University
2410 Colden Hall 800 University Dr., Maryville, MO 64468, USA
Tel: 1-660-562-1264 E-mail:
Carla Edwards
Department of Psychology Sociology, & Counseling, Northwest Missouri State University
2430 Colden Hall 800 University Dr, Maryville, MO 64468, USA
Tel: 1-660-562-1263 E-mail:
Received: January 30, 2011 Accepted: March 6, 2012 Published: May 1, 2012
doi:10.5539/jedp.v2n1p108 URL:
Healthy aging and prevention efforts for the elderly warrant attention in a world where the average mortality rate
continues to increase. The current literature review is an overview of current findings related to healthy aging
and recommendations for older adults who are living longer and healthier; as well as facing the physical and
psychological challenges that come with extended life. Staying active, eating right, utilizing social and
environmental resources, employing coping skills developed across the lifespan, as well as developing new
strategies can enhance the quality of life for older adults. Helping professionals from all disciplines who are able
to recognize the needs of this growing group, and recognize the resiliency factors inherent in healthy aging, have
the best chance of designing and implementing successful preventionand intervention efforts.The purpose of the
present literature review is twofold: 1) To systematically review the important factors that affect an individual’s
longevity and to raise awareness of the importance of those factors that are within one’s control; and 2) To
inform health care providers of prevention efforts important to older adults;encouraging an integration of
research and practice to preventative efforts.
Keywords: Aging, Gerontology, Diet, Exercise, Substance abuse, Stress
1. Overview
Human beings are surviving much longer and the population over 55 is expanding exponentially with
expectations of growth as high as 41% by 2041 in the United States (de Vaus & Wolcott, 1997; Snarksi, Scogin,
DiNapoli, Presnell, McAlpine, & Marcinak, 2010). This “graying of America” has unavoidable implications for
health care practitioners across disciplines. Up until recently, most prevention efforts for aging adults were
actually tailored to middle-aged adultsor infirm older adults. Of note, research points out the consistently poor
response of older adults to these interventions efforts usually effective with younger individuals (Alexopoulos,
Raue, & Arean, 2003; Nebes, Butters, & Mulsant, 2000). Little is known about personality or environmental
variables, which enhance the experience of aging, outside of research in health care settings and very few
researchers, focus on positive aspects of coping with growing older (e.g., Row & Kahn, 1998; Hung, Kempen, &
DeVries, 2010). An exploration of aspects of healthy aging with attention to a model for implementing
recommendations would enhance the ability of educators and practitioners to facilitate healthy aging.
Empirical data suggests that, helping professionals often overlook the possibility that the most older adults have
strong life coping skills from adaptation across a lifetime of stress (Alwin, 1994; Valliant, 1993). Many
individuals over 65 have experienced wars, natural disaster, poor economic conditions, lower standards of living,
and lack of available treatment as a part of their environment from the 1930s and 1940s. At the dawn of the
research on aging adults, Valiant (1993) even suggested that older adults who have coped with more negative Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
Published by Canadian Center of Science and Education 109
events emerge into older adulthood with an increased ability to cope as compared with others. Aging brings new
and unexpected developmental and environmental changes to play; which may require a return to or
enhancement of previously used coping skill sets.
These older adults are much more likely to use medical care, than their younger counter parts, due to health
concerns (Frank, McDaniel, Bray, & Heldring, 2004).Yet, by many reports, this demographic group is likely to
underutilize services to assist in healthy aging and prevention efforts because of stigma that marks such help
seeking as an indication of weakness (Shore, 1997; Snarksi et al, 2010). This avoidance of help seeking, for
preventative services, is further exacerbated by the shortage of health care and mental health care providers
specializing in Geriatric clients (Panchana, Emery, Konnert, Woodhead, & Edelstein, 2010; Perry and
Boccaaccini, 2009; Qualls, Segal, Norman, Niederche, & Gallagher-Thompson, 2002). Of serious concern is the
lack of focus, by health care providers, on prevention and early intervention for this age group (Rowan, Gillette,
Yankeelov, Borders, Nicholas, & Wiegand, 2009). Especially given that researchers have estimated that roughly
two-thirds of the variance in longevity is due to environmental factors that are within one’s control (Ljungquist et
al., 1998). The purpose of the current article is to analyze the existing data, using a biopsychosocial approach, to
explore preventative and early intervention efforts to enhance healthy aging and to provide models to facilitate
application of the findings.
2. Healthy Diet
Diet plays a substantial role in positive aging. The association between diet and healthy aging has been examined
in comparative studies, where animals were placed on healthy diet regimens and compared to control groups
with no restrictions. The results of comparative studies consistently indicate a strong relationship between
longevity and caloric restriction, in a variety of animals, from protozoa to monkeys (Masoro, 2002; Weindruch,
1996). Some research has even suggested that healthy diet and dietary restrictions are a preventative factor
related to the effects of Alzheimer’s disease, Parkinson’s disease and Cancer (Solfrizzi, Panza, Frisardi, Seripe,
Logreoscino, Imbimbo, & Pilotto, 2011; Uranga, Bruce-Keller, Morrison, Fernandez-Kim, Ebenezer, Zhang,
Dasuri, & Keller, 2010). These positive prophylactic longevity enhancing benefits of calorie restriction are due
to its ability to reduce oxidative damage produced by the synthesis of free radicals as a normal metabolic
function, resulting in cellular damage and mutations in the DNA, ultimately leading to disease and premature
death (Qiu, Brown, Hirschey, Verdin, & Chen, 2010).
A healthy body weight calculated according to current Body Mass Index (BMI) tables; between 18.5 and 24.9, is
considered normal and healthy (Foos, 2001). Both low and high BMIs are considered risky for older adults. A
BMI of less than 20 has been associated with an increased risk of death, especially related to pneumonia (Adams
et al., 2006; Jee et al., 2006). A very low BMI may also indicate malnutrition and may also suggest anorexia or
bulimia. High BMIs in both males and females of all ethnic groups are associated with earlier mortality rates
(Wray et al., 2005). A high BMI (over 30), which may just be one part of an overall lifestyle that includes lack of
exercise, is associated with a 2-3 times increase in risk of early death, particularly from heart attack, stroke, and
diabetes (Adams et al., 2006; Jee et al., 2006). Other evidence shows that even being overweight, rather than
obese (BMI of 25-29.9) results in a 40 percent increase in the risk of early death (Adams et al. 2006). In fact, one
study of healthy aging, 2000 men were followed for over three decades. Those with below-average caloric intake
and healthy BMI had the lowest risk of death over this time period (Wilcox et al., 2004).
But it isn’t just the quantity that counts—poor quality of diet is unhealthy too. Intake of recommended vitamins
has been linked to longevity (Milgram et al., 2002). A non-nutritious diet can accelerate physical decline. One
study on diet and physical decline in a thousand older adults, found that low intake of vitamins C, D, E, and
protein were strongly correlated with accelerated physical decline (Bartali et al., 2006). Other studies have
focused on vitamin E and found that it decelerates the pace of aging and cognitive decline (Morris et al., 2006).
Caution should be taken when exploring dietary supplements to enhance older adult functioning. Focus on
supplements with empirical evidence to support use is advisable. Aspirin, as a daily supplement, has been shown
to be effective in reducing the risk of cardiovascular accidents (Raju, Sobieraj-Teague, Hirsh, O’Donnell,
Eikelboom, 2011; Ansara, Nisly, Arif, Koehler, Nordmeyer, 2010). One dose of 325-mg aspirin daily can cut the
risk of heart attack in half (Mahoney & Restak, 1998). Another diet supplement for healthy aging is green tea. In
an examination of over 40,000 older Japanese participants; researchers found that the mortality, in general, but
particularly from cardiovascular disease, but not cancer, was lower for those who consumed at least one cup
every day (Kuriyama et al., 2006). Other work shows the benefits of reservitol, in red wine, which is involved in
the expression of a gene that repairs mutated DNA. Reservitol consumption allowed rodents to live 70% longer
than control mice in one experiment (Baur et al., 2006). Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
ISSN 1927-0526 E-ISSN 1927-0534
Balance seems to be a key to a healthy diet supporting longevity and a common sense diet approach indicates
that high levels of refined sugar and high fructose corn syrup, which is associated with high BMI and tooth decay,
is not healthy. However, it may be unwise to forgo sweets altogether. Chocolate, particularly dark chocolate, may
also be beneficial (Langer, Marshall, Day, & Morgan, 2011). Chocolate contains flavonoids that stimulate
antioxidants reducing the risk of heart attack and stroke (Becker et al., 2006). In one large study investigating the
effects of sweets on long term health, Lee and Paffenbarger (1998) examined candy eating and other lifestyle
variables in over 7000subjects. Candy consumers lived almost a year longer than candy abstainers (Lee &
Paffenbarger, 1998), even when physical exercise was controlled.
Building a healthy diet based on calorie restriction, appropriate nutrient intake, and balance may benefit older
adults. This aspect of healthy aging should not be ignored by individuals working with older adults.
Understanding the key role that diet plays in healthy aging cannot be underestimated and geriatric care providers
would do well to focus on this preventative effort.
3. Physical Exercise
An abundance of research demonstrates the many benefits of physical fitness, indicating that regular exercise
slows the physiological process of aging (Aldwin & Gilmer, 2004; Barrientos, Frank, Crysdale, Chapman,
Ahrendsen, Day, Campeau, Watkins, Patterson, & Maier, 2011). Most of the data explains the health benefits, of
exercise, in terms of lower levels of oxidative damage and a reduction of free radicals, both related to shortened
life span (Faulks et al., 2006). Aerobic exercise increases blood flow and resistance exercise strengthens muscles
and bones. An overall improvement in the functioning of the heart lowers the blood pressure and increases
oxygen use efficiency (Gavin et al. 2011; Gunn, Smith, McKelvie, & Arthur, 2006). Both aerobic and resistance
exercise are essential for healthy aging and especially for avoiding hypokinesia, the decline of muscle and bone
mass; which is a significant factor contributing to physiological decline. Both types of exercise are related to
reduce risk of cancer, diabetes, and osteoporosis. There are also psychological benefits which include lower
stress and better moods (Gunn, Smith, McKelvie, & Arthur, 2006; Keese, Farinatti, Pescatello, & Monteiro,
2011). Regular exercise may also reduce anxiety and depression and increase cognitive activity (Colcombe &
Kramer, 2003).
Many studies have looked at the benefits of certain exercise programs on specific benefits for older adults. In one
large 8-year study, the death rate largely from heart disease and cancer, in the least-fit group was more than
twicethe rate compared with the most-fit group (Blair et al., 1989). Another study revealed increases in oxygen
consumption, muscle strength, flexibility, endurance, and coordination for those who exercised at least three
times a week for only 4 to 6 months (Lazowski et al., 1999). Ferrarra, et al. (2006) focused on diabetes and
found that exercise improves the metabolism of glucose in older men who were overweight, reducing the risk of
diabetes and cardiovascular diseases. In another study, which focused on nursing home residents, the participants
were assigned to either exercise groups for 10 weeks: high-intensity, low-moderate intensity, or no exercise
groups (Seynnes et al., 2004). By the end, participants in both experimental groups spent more time standing,
walking, and using the stairs.
Some researchers go so far as to claim that much of senescence appears to come with a failure to continue to use
the body in effective ways (Gavin et al., 2011; Gunn et al., 2011). “Use it or lose it” depicts the mentality that
researchers, exploring aging processes, have developed. Like diet, integrating preventative efforts in this area are
crucial to the positive experience of aging.
4. Environmental Considerations
The area of psychology devoted to the environment as intervention for the older adult is referred to as
environmental gerontology and has been a focus of gerontological literature since the early 70s (Wahl, 2001).
Multiple models address the adaptation of the older adult to changing and new environments and focus largely
on the importance of understanding individual needs and matching the environment to meet the specific needs.
More recent authors have even suggested that an that is community oriented, diverse, and offers enhanced
services is important to healthy aging as the ability to meet individual needs increases (Ejogu, Norbeck, Mason,
Cromwell, Zonderman, & Evans, 2011; Saarloos, Alfonso, Giles-Corti, Middleton, & Almeida, 2011).
Environmental changes beyond the control of the older adult (e.g., crime increases in a neighborhood or fear in
the hospital setting) have been found to increase the tendency to isolate and reduce the activity level of older
adults (Thompson & Krause 1998).
The living area is considered the “home space” of the individual and as developmental needs change, this
environment warrants continued attention (Sixsmith & Sixsmith, 1991; Wahl, 2001). Wahl’s (2001) review of the
literature suggests that the adapted home environment may be crucial to the aging adult’s ability to respond to Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
Published by Canadian Center of Science and Education 111
other prevention and intervention efforts. Older adults who are more comfortable in their “home space” are more
likely to participate in healthy living strategies. Maintaining the home environment and adapting the home or
institutional area to meet the needs of older adults may also be crucial to maintaining their independence
(Oswald, Wahl & Gang, 1999). Creating security and safety, while focusing on changes needed for adaptation, is
a balancing act that can be difficult for practitioners inexperienced in providing interventions for older adults.
“Place Attachment” is an aspect of growing older that is much more important for older adults than for their
younger counterparts (Rubinstein & Parmelee, 1992; Wahl, 2001). Creating a living space with feelings of
“home attachment” promote feelings of safety and security. Positive subjective feelings about the “home space”
seem to be good predictors of satisfaction for older adults regardless of their level of physical well-being
(Christianson, Carp, Cranz, & Whiley, 1992).
One extensive study by Gill, Robinson, Williams, and Tinetti (1999) examined the home environment of over
1000 adults over 70 and found that home hazards (e.g., obstructed pathways) are prevalent for both impaired and
non-impaired older adults suggesting that older adults may benefit from educational interventions related to
creating safe space in the home. Wahl (2001) indicates that older adults may find needed changes to the home
environment prohibitive related to information available, others in the home objecting, and cost of changes
needed. Creating and sustaining a positive and helpful “home space” may require family education and
exploration of social services resources.
5. Substance Use
Tobacco use is the leading cause of premature preventable death in America (American Cancer Society, 2011).
Smoking is closely linked to cancer of the lungs, mouth, larynx, kidneys, pancreas, and cervix; it is also strongly
associated with emphysema and heart disease (American Cancer Society, 2011). Nicotine is a powerfully
addictive drug that raises the blood pressure; smoke particles and tar produce respiratory problems and tar is a
known carcinogen. Carbon monoxide and cyanide are additional toxins that interfere with red blood cell
functioning by blocking the transportation of oxygen to body. Cigarette smoking is also strongly linked with
shortened telomeres, a region of repetitive DNA sequencing that protects chromosomes from deteriorating
(Valdes et al., 2005). Fortunately, smoking cessation produces almost immediate improvements in oxygen
delivery and blood circulation. The risks of heart attack and stroke also subsides within a year of cessation and
the likelihood of cancer returns to normal levels after 10 years (National Institute on Aging, 1993).
For older adults motivated to quit using nicotine, a biopsychosocial approach is most effective. Nicotine
replacement therapy, combined with social support and counseling yields the highest abstinence rates (Katz et al.,
2011). In one study involving 165 older adults seeking smoking cessation therapy, 20% were abstinent for six
months post-intervention, compared with 0% for the control group (Tait et al., 2007). Some factors increased the
probability of successfully quitting: being male, having high anxiety, and reporting reduce illness by not smoking.
Interestingly, older adults with greater health problems and psychological distress are more likely to be
successful at stopping smoking suggesting that referrals from health care professionals related to health problems
can motivate older adults to quit (Katz et al., 2011; Sachs-Ericsson, et al., 2009). For example, community nurses
have successfully intervened and increase smoking abstinence (Rowa-Dewar & Ritchie, 2010).
Moderate consumption of alcoholic beverages, however, seems to be beneficial. Those who drink moderately are
usually healthier and live longer than those who drink excessively or those that abstain completely. Studies have
consistently found moderate consumption to be positively correlated with longevity (Stampfer et al., 2005),
negatively correlated with cholesterol (Doll & Peto, 1994), and negatively correlated with heart attack or stroke
(Doll, 1997). One recent study of alcohol use in older adults found that moderate use compared to no use was
associated with fewer cognitive deficits throughout the two-year study (Stampfer et al., 2005). These benefits
appear to be due to the blood thinning properties of alcohol, which reduces the risk of heart attack and stroke,
similar to aspirin.
However, research also suggests that older adults have a significant incidence of SUDS. Substanceuse disorders
(SUDS) are associated with early death from liver damage and disease (Cirrhosis), accidents, and a heightened
risk for suicide. Excess use is associated with physical, cognitive, and emotional impairments (Perreira, 2002).
One study yielded a 35% incidence rate, of alcohol abuse, among older adults (Barnes et al., 2010). Among these
substance abusers, over 60% exhibited high risk alcohol behaviors that could threaten mortality. Those with
lower education had the highest incidence of high-risk alcohol use. Other risk factors for older adults include
having more friends who drink heavily and drinking for stress reduction. Interestingly, Moos, Schutte, Brennan, &
Moos (2010), found that wealthier individuals were more likely to exhibit significant alcohol problems. These
epidemiological data should help physicians and mental health care provider identify and educate at-risk Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
ISSN 1927-0526 E-ISSN 1927-0534
Twelve Step groups and other recovery support groups are available for adults who are motivated to limit their
intake and empirical support for the overall efficacy of these groups exists in reduction of alcohol consumption.
However, little research actually explores appropriate substance use prevention and intervention efforts with older
adults. One randomized-controlled study, with older adults, does advocate for cognitive-behavioral SUD treatment
as a useful way to reduce high-risk drinking, although less useful for total abstinence as a goal (Moore et al., 2011).
SUD prevention is an area of concern, in this population, that warrants further understanding and research related
to prevention and intervention.
6. Mental Health
It is estimated that almost 20% of older adults experience some mental problems that are diagnosable and others
struggle with less severe mental health changes (Rowan, Gillette, Yankeelov, Borders, Nicholas, & Wiegand,
2009). Unutzer, Patrick, Simon, Grembowske, Walker, Rutter, and Katon (1997) indicate that older patients with
mental health issues tend to wait until problems effect physical health, or an accident occurs, to seek help and
then help is often sought from medical professional. To complicate the issue, comorbidity of mental health issues
and physical issues, in older adults, patients is quite common (Unutzer et al, 1997; Whitbourne, 2010). Leventhal,
Rabin, Leventhal, and Burns (2001) even suggest that the psychological problems associated with physical
problems “feed forward” and actually contribute to expeditious increases in physical decline. Avoidant help
seeking, isolative tendencies and social ageism may contribute to heightened risk for depression onset of
escalation in older adults. The interaction between Geropsychiatric mental health issues and health issues is
interwoven and complicated. Ferguson and Koder (1998) strongly assert that preventative psychological
interventions could be effective including, adjustment to chronic illness, pain management, treatment of sleep
disturbance, grief and loss support, support for caregivers, and retirement counseling.
The two most commonly reported psychological problems in older adulthood are depression and anxiety (Baker,
1996; Frank, et al, 2004). Depression is often noted by physicians as older patients are forced to cope with
impairment onset in later years of life (Benyamini, Idler, Leventhal, & Leventhal, 2000; Leventhal et al, 2001).
Of note, impairment in cognitive functioning is common in depressed and anxious older adults and can mimic
dementia making this group especially difficult to treat (Alexopoulos, Raue, & Arean, 2003; Nebes, Butters, &
Mulsant, 2000). By most reports (i.e., Paukert, Phillips, Cully, Loboprabhu, Lomax & Stanely, 2009) guidance
and brief psychotherapy can be effective in treating these problems in older adults with preventative training in
cognitive and behavioral models effective for many. For example, Scogin and McElreath (1994) reviewed
outcome studies on mild depression in older adults and found the older adults respond to psychotherapy at rates
comparable to their younger counter parts. Practitioners have also consistently found that short-term family
oriented prevention and intervention efforts with older adults can reduce mild depression and anxiety (Knight,
1996; Shileds, King, & Wynne, 1995). Additionally, older adult males have suicide rates, above many other
younger groups, related to isolation and end of life concerns (Fung & Chan, 2011; Hoyert, Kochanke & Murphey,
1999). Suicide prevention research and programming for this population is a necessary focus for researchers and
Minimal research addresses primary prevention efforts in geriatric psychiatry and psychology. Madusoodanan,
Ibrahim, and Malik (2010) reviewed the English literature and found that behavioral psychosocial efforts were
most positive in prevention of depressive symptoms and suicide prevention. These authors indicate that focuses
on modification of behaviors that create risk (e.g., diet, exercise, social support, and education) are most
beneficial in prevention of psychological problems. However, it is important to understand the extent of
problems in older adults, who come with a wide variety of cognitive, physical, emotional issues, and to consider
the individual developing in later years within a larger psychosocial and context; and increase the focus in
research in this area of geropsychology when developing prevention efforts. Certainly this is also an area for
future research efforts.
7. Activity and Mental Health
Overall, the research strongly indicates that keeping older adults active and engaged in life activities seems
essential not only to physical wellness, but for psychological well-being too (Rowan, Gillette, Yankeelov,
Borders, Nicholas, & Wiegand, 2009). Behavior activation (BA) is a preventative intervention that has empirical
support with younger individuals (Dimidjan, Dobson, Kohlenberg, Gallop, Markey, & Atkins, 2006; Hopko,
Lejuez, Lapage, Hopklo, & McNeil, 2003) and modest support for older adults (Martell, Addis, & Jacobson,
2001). This strategy to increase activity levels, in small, planned, and individualized efforts, adds to the current
research focus on activity regardless of level of impairment (Hanneman, 2006; Nystrom & Lauritzen, 2005; Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
Published by Canadian Center of Science and Education 113
Yassuda & Nunes, 2009). Motivala, Sollers, Thayer, and Irwin (2006) have even found that music and hobby
focused activities can enhance nervous system functioning and assist in combating agitation for individuals who
resist physical activity.
Case Studies (e.g., McGuire, 1997) have indicated that activities, such as horticultural, are beneficial in
increasing socialization, stimulating cognitive activity, and increasing physical activity for older adults. Inherent
in horticulture therapy, found to be successful in reengaging older adults, are activities such as arranging flowers,
planning a small garden, and sending flowers to others in a structured format that includes verbal interaction,
sensory stimulation, and positive reinforcement for increasing activity and social interaction.
Music, with activity, has also been used successfully in enhancing later life satisfaction; in palliative care, in
hospital settings, in community centers, in religious settings, and nursing homes in efforts to reduce pain
perception, enhance positive affect, and increase coping skills Ledger & Baker, 2007; Myskja & Nord, 2008).
With the use of music, the individual can be stimulated or calmed as dictated by personal needs and preferences
(Yassuda & Nunes, 2009). Listening and reacting physically to music is one of a few activities also effective
across culture. Chan, Chan, Mok, and Tse (2009) found decreases in blood pressure and in depression scores in a
sample of Chinese elderly. When music is paired with dance; researchers have found beneficial effects to balance
and gait in healthy older adults (Hackney, Kantorovich, & Gammon, 2007). Although the research on music, as a
preventative measure is somewhat sparse, research can be a guide for appropriate loudness and functional
singing range for older adults (Hintz, 2000). Individualizing and strategizing to incorporate music into healthy
aging that takes personal preferences into consideration is an important aspect of using this method in
preemptive efforts.
Artistic activities can facilitate relationship building, expression of end of life experiences, and enhance
cognitive activity (Kates, 2008). In addition, art activities, as a preventative measure and as an intervention effort,
are considered safe and helpful strategies for working with older adults (Kates, 2008; Shore, 1997). Facilitating
artistic activities for older adults presents special problems related to time to complete activities, ability level,
feelings of inadequacy in the activity, and controversy about the ability of older adults to sublimate through art
(Shore, 1997). As such, special problems younger family members and helping professionals face, in facilitating
art for this population, include the tendency to want to take over the creative process or to minimize performance.
Educating involved parties to the unique abilities of art to improve motor functioning, stimulate activity, and
enhance social interaction (as well as to stimulate creative activity) can enhance the use of this activity strategy.
Interacting and caring for a pet, has also been found to enhance the later life experience (Harris & Gellin, 1992;
Katcher, Friedman, Zisselman, Rovner, Shmuely, Ferrie, 1996). Successful pet interactions include verbalized
reminisce of childhood beloved pets, contact and caretaking of pets, and interaction with others involved in the
caretaking of the animals (Zisselman et al., 1996). These activities address psychosocial needs of the older adult
as well as providing companionship and a sense of purpose. The plethora of research in this area is in need of
updating and replication in preventative efforts to substantiate use.
8. Spirituality in Older Adulthood
Recently, a large body of literature has arisen suggesting that spiritual needs of older individuals are also
important (Puchalski, Ferrell, Virani, Otis-Green, Baird, Bull, et al., 2009). Older adults facing illness and death
often turn to spirituality to cope and research has suggests that this is beneficial (Krause, 2003; Kirbey, Coleman,
& Daley, 2004). Spirituality is reported as very important by over half of older adults (Chen, Cheal, & Herr,
2007; Newport, 2006). Older adults may look to religious communities to sustain independent living and to help
with facing end of life issues (Wink & Dillon, 2002). Most research suggests that spirituality can effectively
benefit the lives of older adults (Koenig, 2001; Paukert et al, 2009). This positive effect is most likely to occur
when decisions to use spiritual activities are desired by the older adult, without challenging existing beliefs. One
study (Mayers, Leavey, & Vallianatour, 2007) actually found that cognitive behavioral therapy that incorporated
religion was most effective when used by non-religious helping professionals.
Monod, Rochat, Bula, and Spencer (2010) suggest that spirituality in older adulthood should be addressed
differently than in middle age. These authors developed a Spiritual Needs model based on developmental needs
of older adults; balance, connection, values, personal control, and maintenance of identity. Recognizing the
importance of spirituality can help professional and family caregivers enrich the lives they touch.
9. Cognitive Strategies
The use of cognitive strategies to improve the quality of life of older individuals with normal aging issues is
relatively new and usually focused on maintenance of a positive mood (Kasl-Godley, & Gatz, 2000). Prevention Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
ISSN 1927-0526 E-ISSN 1927-0534
efforts focusing on building thought patterns that motivate activity to fend off lethargy, anhedonia, and social
isolation were developed by Jacobsen and colleagues (1996) and modified into simple applicable terms for
geriatric settings by Leguez, Hopko and Hopko (2001). Cognitive strategies have been used successfully with
older adults to increase feelings of satisfaction and pleasure in daily life activities leading to fewer symptoms of
depression (Teri, Logsdon, Uomoto, & McCurry, 1997). Functional analysis is another strategy used by
clinicians and heavily based in behavioral theory that can be adapted and taught to higher functioning older
adults. This prevention and intervention effort focuses on mapping out basic life activities, and thinking patterns
related to these activities, noting simple stimulus response relationships in order to build successful plans for
behavior modification (Hayes, Wilson, Gifford, Folette, & Strosahl, 1996).
10. Recommendations and Conclusion
In application, of recommended preventative directions, it is crucial for the practitioner and facilitator of
preventative medicine to utilize strong models to guide and direct their work. The following models are models
of prevention and intervention that give direction and the ability to plan appropriate preventative strategies for
the older adult.
Lehr’s (1977, p. 7) important description of geroprohylaxis, in outlining intervention directions appropriate in
geropsychology, provides a foundation for describing various prevention and intervention strategies for
enhancing the aging experience. Lehr suggests that the main focus of geropsychological interventions should:
1) Educate the older adults to a healthy lifestyle based on current intrinsic and extrinsic resources
2) Focus on the management of current stressors
3) Focus on adequate exercise and appropriate diet
4) Assist in maintaining autonomy
5) Address prevention of disease
Leer’s model remains important forty years later; and the dearth of research reviewed herein continues to support
this basic model of healthy strategies to enhance life into the later years.
Another model by Baltes (1997) organizes the important focus of selective optimization with compensation. The
key to preventative and intervention efforts, in this model, is to clearly outline the individual limitations and seek
to enrich and augment reserves optimizing the quality of life for the aging adult. Baltes also recognizes the
importance in using new resources and external aid to address these limits placed on the individual through the
aging process. Wagner’s (1998) Chronic Care Model (CCM) has been used widely and has sturdy empirical
support. The model predicts that improvement in the interrelated areas of self-management support, clinical
system redesign, and decision support activates individuals to be prepared and proactively address health and
mental health issues in older adulthood.
Leventhal et al’s (2001) model, of “Self-Regulation” as intervention, for the elderly suggests that any model of
effective intervention includes:
1) Increasing motivation and decreasing barriers to intervention
2) A plan for change that matches current life situation
3) Evidence that other adults improve functioning based on the planned interventions
4) Addressing environmental supports and barriers to intervention
Professional training for geropsychological settings is unique in its focus as often services are delivered in
residential care settings. The need exists to train mental health professionals in team and interdisciplinary
strategies that are effective with service delivery to this population (Bodenheimer, Wagner, & Grumbach, 2002).
An increase in life expectancy is permitting older adults to live longer—and healthier longer. This is creating a
situation which stands to be a heavy burden on health care cost and economy, placing a great importance on
prevention and intervention efforts for this developmental cohort. However, research points to the use of
preventative strategies and their significant impact on healthy aging. By using models of prevention that address
key issues of healthy aging and motivating older adults to practice healthy habits while utilizing previously
learned coping skills the older adult can decrease the negative changes associated with aging. Healthy diet,
regular exercise, and moderating substance use are healthy habits for older adults, just like for their younger
counterparts. In addition, learning about the importance of maintaining mental and physical health, employing
already in place coping skills, and learning new strategies for life’s changes are important to healthy aging. In
addition, maintaining social support through family, friends, and spiritual organizations facilitate increased and Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
Published by Canadian Center of Science and Education 115
more productive longevity.
Traditionally, physical and psychological ailments are defined differently and are usually treated by a distinct set
of professional health care providers. However, this research suggests that a healthy body and mind are both
especially important for one’s physical well-being. Thus, it is important to provide an impetus for the integration
of psychological and physical health care that fosters a healthy lifestyle.
This suggested integrative approach to prevention efforts with older adults relies heavily on the assumption of
more in depth and cross-disciplinary research and practice. Several areas of further research are suggested
including prevention research further supporting the use of physical, mental, and spiritual prevention efforts for
aging adults. The need for this research and application in the field will enable the “greying of America” to stand
on positive and empirically supportive prevention efforts long into the future.
Adams, K. F., Schatzkin, A., Harris, T. B., Kipnis, V. Mouw, T., Ballard-Barbash, R., … & Leitzmann, M. F.
(2006). Overweight, obesity, and mortality in a large prospective cohort of persons 50-71 years old. The New
England Journal of Medicine, 355, 763-778.
Aldwin, C. M. (1994). Stress, coping, and development: An integrative perspective. New York: Guilford Press.
Alexopoulos, G. S., Raue, P., & Areán, P. (2003). Problem-solving therapy versus supportive therapy in geriatric
major depression with executive dysfunction. The American Journal of Geriatric Psychiatry, 11(1), 46-52.
American Cancer Society. (2011). Cancer Facts and Figures-2011. Atlanta, GA: Author
Ansara, A. J., Nisly, S. A., Arif, S. A., Koehler, J. M., Nordmeyer, S. T. (2010). Aspirin dosing for the prevention
and treatment of ischemic stroke: an indication-specific review of the literature. The Annals of Pharmacotherapy,
44, 851-862.
Baker, F. M. (1996). An overview of depression in the elderly: A US perspective. Journal of the National
Medical Association, 88, 178-184.
Baltes, P. B. (1997). On the incomplete architecture of human ontogeny: Selection, optimization, and
compensation as foundation of developmental theory. American Psychologist, 52, 366-380.
Barnes, A. J., Moore, A. A., Xu, H., Ang, A., Tallen, L., Mirkin, M., & Ettner, S. L. (2010). Prevelance and
correlates of at-risk drinking among older adults: the project SHARE study. Journal of General Internal
Medicine, 25, 840-846.
Barrientos, R. M., Frank, M. G., Crysdale, N. Y., Chapman, T. R., Ahrendsen, J. T., Day, H. E., Campeau, S.,
Watkins, L. R., Patterson, S. L., & Maier, S. F., (2011). Little exercise, big effects: Reversing aging and
infection-induced memory deficits, and underlying processes. The Journal of Neuroscience, 31, 11578-11586.
Bartali, B., Frongillo, E. A., Bandinelli, S., Lauretania, F., Semba, R. D., Fried, L. P., & Ferrucci, L. (2006). Low
nutrient intake is an essential component of frailty in older persons. Journal of Gerontology: Medical Sciences,
61A, 589-593.
Baur, J. A., Pearson, K. J., Price, N. L., Jaimeson, H. A., Lerin, C., Kalra, A., et al. (2006). Reservatrol improves
health and survival of mice on a high-calorie diet. Nature, 1-6.
Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2002). Improving primary care for patients with.
Chan, M. F., Chan, E. A., Mok, E., & Tse, F. Y. K. (2009). Effect of music on depression levels and physiological
responses in community-based older adults. International Journal of Mental Health Nursing, 18(4), 285-294.
Chen, H., Cheal, K., & Herr, E. C. M. (2007). Religious participation as a predictor or mental health status and
treatment outcomes in older persons. International Journal of Geriatric Psychiatry, 22, 144-53.
Christensen, D. L., Carp, F. M., Cranz, G. L., & Whiley, J. A. (1992). Objective housing indicators as predictors of
the subjective evaluations of elderly resident. Journal of Environmental Psychology, 12, 225-236. Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
ISSN 1927-0526 E-ISSN 1927-0534
Colcombe, S., & Kramer, A. F. (2003). Fitness effects on the cognitive function of older adults: A meta-analysis.
Psychological Science, 14, 125-130.
DeVaus, D., & Wolcott, I. (1997). Australian family profiles: social and demographic patterns. Melbourne:
Australian Institute of Family Studies.
Dimidjian, S., Dobson, K. S., Kohlenberg, R. J., Gallop, R., Markley, D. K., Atkins, D. C., et al. (2006).
Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment
of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658-670.
Doll, R. (1997). One for the heart. British Medical Journal, 315, 1664-1668.
Doll, R., & Peto, R. (1994). Mortality in relation to consumption of alcohol: 13 years’ observations on male British
doctors. British Medical Journal, 309, 911-918.
Ejogu, N., Norbeck, J. H., Mason, M. A., Cromwell, B. C., Zonderman, A. B., & Evans, M. K. (2011). Recruitment
and retention strategies for minority or poor clinical research participants: lessons from the healthy aging in
neighborhoods of diversity across the life span study. The Gerontologist, 51, S33-S45.
Faulks, S. C., Turner, N., Else, P. L., & Hulbert, A. J. (2006). Caloric restriction in mice: Effects on body
composition, daily activity, metabolic rate, mitochondrial reactive oxygen species production, and membrane fatty
acid composition. Journal of Gerontology: Biological Sciences, 61A, 781-794.
Ferrara, C., M., Goldeberg, A. P., Ortmeyer, H. K., & Ryan, A. S. (2006). Effects of aerobic and resistance
exercise training on glucose disposal and skeletal muscle metabolism in older men. Journal of Gerontology:
medical Sciences, 61A, 480-487.
Foos, P. W., Clark, M. C., & Terrell, D. (2006). Adult age, gender, and race group differences in of aging. Journal
of Genetic Psychology, 167, 309-325.
Frank, R. G., McDaniel, S. H., Bray, J. H., Heldring, M. (2004). Primary Care Psychology. Washington, DC, US:
American Psychological Association.
Fung, Y., & Chan, Z. C. Y. (2011). A systematic review of suicidal behavior in old age: A gender perspective.
Journal of Clinical Nursing, 20, 2109-2124.
Gavin, C., Sigal, R. J., Cousins, M., Menard, M. L., Atkinson, M., Khandwala, F., Kenny, G. P., … Ooi, T. C.
(2010). Resistance exercise but not aerobic exercise lowers remnant-like lipoprotein particle cholesterol in type 2
diabetes: a randomized controlled trial. Atherosclerosis, 213, 552-557.
Gill, T. M., Rovinson, J. T., Williams, C. S., & Tinetti, M. E. (1999). Mismatches between the home environment
and physical capabilities among community-living older persons. Journal of the American Geriatric Society, 47,
Gunn, E., Smith, K. M., McKelvie, R. S., Arthur, H. M. (2006). Exercise and heart failure patient: aerobics vs
strength training—is there a need for both? Progress in Cardiovascular Nursing, 21, 146-150.
Hackney, M. E., Kantorovich, S., & Earhart, G. M. (2007). A study on the effects of Argentine tango as a form of
partnered dance for those with Parkinson Disease and the healthy elderly. American Journal of Dance Therapy,
29(2), 109-127.
Hannemann, B. T. (2006). Creativity with dementia patients: Can creativity and art stimulate dementia patients
positively? Gerontology, 52(1), 59-65.
Harris, M. D., & Gellin, M. (1992). The effects of weekly pet visits upon the circulatory system and the personal
adjustment of homebound elderly persons. Pennsylvania Nurse, 47(4), 12-13.
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. D. (1996). Experimental avoidance and
behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and
Clinical Psychology, 64, 1152-1168.
Hintz, M. R. (2000). Geriatric music therapy clinical assessment: Assessment of music skills and related behaviors.
Music Therapy Perspectives, 18(1), 31-40. Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
Published by Canadian Center of Science and Education 117
Hopko, D. R., Lejuez, C. W., LePage, J. P., Hopko, S. D., & McNeil, D. W. (2003) A brief behavioral activation
treatment for depression. A randomized pilot trial within an inpatient psychiatric hospital. Behavior Modification,
27, 458-469.
Hoyert, D. L., Dochanke, K. D., & Murphy, S. L. (1999). Deaths: Final data for 1997. National Vital Statistics
Reports, 47(9), Hyattsville, MD: National Center for Health Statistics.
Hung, L., Kempen, G. I., & DeVries, N. K. (2010). Cross-cultural comparison between academic and lay views of
healthy aging: A literature review. Aging and Society, 30, 1372-1391.
Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., et al. (1996). A component
analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64,
Jee, S., H., Sull., J. W., Park, J., Lee, S-Y., Ohrr, H., Guallar, E., & Samet, J. M. (2006). Body-mass index and
mortality in Korean men and women. The New England Journal of Medicine, 355, 779-787.
Kasl-Godley, J., & Gatz, M. (2000). Psychosocial interventions for individuals with dementia: An integration of
theory, therapy, and a clinical understanding of dementia. Clinical Psychology Review, 6, 755-782.
Katcher, A. II., Friedmann, E., Beck, A., & Lynch, J. (1981, October). Talking, looking, and blood pressure:
Physiological consequences of interaction with the living environment. Paper presented at the International
Conference on the Human/Companion Animal Bond. Philadelphia, PA.
Kates, N. (2008). Individual art therapy for elderly clients. Canadian Art Therapy Association Journal, 21(1),
Katz, D. A., Tang, F., Faseru, B., Horwitz, P. A., Jones, P., Spertus, J. (2011). Prevelance and correlates of smoking
cessation pharmacotherapy in hospitalized smokers with acute myocardial infarction. American Heart Journal,
162, 74-80.
Keese, F., Farinatti, P., Pescatello, L., Monteiro, W. (2011). A comparison of the immediate effects of resistance,
aerobic, and concurrent exercise on post exercise hypotension. Journal of Strength and Conditioning Research, 25,
Kirby, S. E., Coleman, P. G., & Daley, D. (2004). Spirituality and well-being in frail and nonfrail older adults. The
Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 3, 123-129.
Knight, B. G. (1996). Overview of psychotherapy with the elderly: The contextual, cohort-based,
maturity-specific-challenge model. In S. Zarit & B. Knight (Eds.), Geriatric medicine (2nd ed., pp. 473-490). New
York: Springer-Verlag.
Koenig, H. R. (2001). Religion and medicine II: Religions, mental health, and relatedbehaviors. In Paukert, A. L.,
Phillips, L., Cully, J. A., Loboprabhu, S. M., Lomax, J. W., & Stanely, M. A. (2009). Integration of religion into
cognitive-behavioral therapy for geriatric anxiety and depression. Journal of Psychiatric Practice, 15, 103-112.
Krause, N. (2003). Neighborhood deterioration and social isolation in later life. International Journal of Aging
and Human Development, 36, 9-38.
Krause, N. (2003). Religious meaning and subjective well-being in late life. The Journals of Gerontology: Series
B: Psychological Sciences and Social Sciences, 3, 160-170.
Kuriyama, S., Shimazu, T., Ohmori, K., Kikuchi, N., Nakaya, N., Nishino, Y., … & Tsuji, I. (2006). Green tea
consumption and mortality due to cardiovascular disease, cancer, and all causes in Japan: The Ohsaki study.
Journal of the American Medical Association, 296, 1255-1265.
Langer, S., Marshall, L., Day, A., & Morgan, M. (2011). Flavanols and methylxanthines in commercially available
dark chocolate: a study of the correlation with nonfat cocoa solids. Journal of Agricultural And Food Chemistry,
59(15), 8435-8441.
Lazowski, D-A., Eccleston, N. A., Myers, A., M. Paterson, D., H., Tudor-Locke, C., Fitzgerald, C., Jones, G., …
Cunningham, D. A. (1999). A Randomized-outcome evaluation of group exercise programs in long-term care Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
ISSN 1927-0526 E-ISSN 1927-0534
institutions. Journal of Gerontology: Medical Sciences, 54A, M621-M628.
Ledger, A. J., & Baker, F. A. (2007). An investigation of long-term effects of group music therapy on agitation
levels of people with Alzheimer's Disease. Aging & Mental Health, 11(3), 330-338.
Lee, I., & Paffenbarger, R. (1998). Life is sweet: candy consumption and longevity. BMJ (Clinical Research Ed.),
317(7174), 1683-1684.
Lejuez, C. W., Hopko, D. R., & Hopko, S. D. (2001). A brief behavioral activation treatment for depression:
Treatment manual. Behavior Modification, 25, 255-286.
Leventhal, H., Rabin, C., Leventhal, E. A., & Burns, E. (2001). Health risk behaviors and aging. The Psychology of
Aging, 5, 186-213.
Ljungquist, B., Berg, S., Lanke, J., McClearn, G. E., & Pedersen, N. L. (1998). The effect of genetic factors for
longevity: A comparison of identical and fraternal twins in the Swedish Twin Registry. Journal of Gerontology:
Medical Sciences, 53A, M441-446.
Madusoodanan, S., Ibrahim, F. A., & Malik, A. (2010). Primary prevention in geriatric psychiatry. Annals of
Clinical Psychiatry, 22, 249-261.
Mahoney, D., & Restak, R. (1998). The longevity strategy: How to live to 100 using the brain-body connection.
New York: John Wiley & Sons.
Martell, C. R., Addis, M. E., & Jacobson, N. S. (2001). Depression in context: Strategies for guided action. New
York: W. W. Norton.
Masoro, E. J. (2002). Caloric Restriction: A key to understanding and modulating aging. Amsterdam: Elsevier.
Mayers, C., Leavey, G., Vallianatour, C., (2007). How clients with religious or spiritual beliefs experience
psychological help-seeking and therapy: A qualitative study. Clinical Psychology& Psychotherapy, 14, 317-27.
McGuire, D. L. (1997). Implementing horticultural therapy into a geriatric long-term care facility. Activities,
Adaptation, & Aging, 22(1-2), 61-81.
Milgram, N. W., Head, E. E., Muggenburg, B. B., Holowachuk, D. D., Murphey, H. H., Estrada, J. J., & ... Cotman,
C. W. (2002). Landmark discrimination learning in the dog: Effects of age, an antioxidant fortified food, and
cognitive strategy. Neuroscience and Biobehavioral Reviews, 26(6), 679-695.
Monod, S., Rochat, E., Büla, C., & Spencer, B. (2010, October). The spiritual needs model: Spirituality assessment
in the geriatric hospital setting. Journal of Religion, Spirituality & Aging, 22(4), 271-282.
Moore, A. A., Blow, F. C., Hoffing, M., Welgreen, S., Davis, J. W., Lin, J. C., Ramirez, K. D… Barry, K. L.
(2011). Primary care-based intervention to reduce at-risk drinking in older adults: a randomized controlled trial.
Addiction, 106, 111-120.
Moos, R. H., Schutte, K. K., Brennan, P. L., & Moos, B. S. (2010). Late-life and life history predictors of
olderadults' high-risk alcohol consumption and drinking problems. Drug and Alcohol Dependence, 108, 13-20.
Morris, M. C., Evans, D. A., Tangney, C. C., Bienias, J. L., & Wilson, R. S. (2006). Associations of vegetable
and fruit consumption with age-related cognitive change. Neurology, 67, 1370-1376.
Motivala, S. J., Sollers, J., Thayer, J., & Irwin, M. R. (2006). Tai Chi Chih acutely decreases sympathetic
nervous system activity in older adults. The Journals of Gerontology, 61A(11), 1177-1180.
Myskja, A., & Nord, P. G. (2008). 'The day the music died': A pilot study on music and depression in a nursing
home. Nordic Journal of Music Therapy, 17(1), 30-40.
National Institute on Aging. (1993). Bound for good health: A collection of age pages. Washington, D.C.: U. S.
Government Printing Office. Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
Published by Canadian Center of Science and Education 119
Nebes R. D., Butters M. A., Mulsant B. H., et al: Decreased working memory and processing speed mediate
cognitive impairment in geriatric depression. Psychology Medicine 2000, 30, 679-691.
Nyström, K., & Lauritzen, S. O. (2005). Expressive bodies: Demented persons' communication in a dance therapy
context. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 9(3), 297-317.
Oswald, F., Wahl, H.-W., & Gäng, K. (1999). Relocation in old age: An environmental gerontology study on
home-to-home moves of elders in Heidelberg. Zeitschrift für Gerontopsychologie und – psychiatrie, 12, 1-19.
Pachana, N., Emery, E., Konnert, C., Woodhead, E., & Edelstein, B. A. (2010). Geropsychology content in clinical
training programs: A comparison of Australian, Canadian, and U.S. data. International Psychogeriatrics, 22(6),
Paukert, A. L., Phillips, L., Cully, J. A., Loboprabhu, S. M., Lomax, J. W., & Stanley, M. A. (2009). Integration of
religion into cognitive-behavioral therapy for geriatric anxiety and depression. Journal of Psychiatric Practice,
15(2), 103-112.
Perreira, K. M. (2002). Excess alcohol consumption and health outcomes: A 6-year follow-up of men over 50 form
the health and retirement study. Addiction, 97, 301-310.
Perry, K. M. and Boccaccini, M. T. (2009). Specialized training in APA-accredited clinical psychology doctoral
programs: findings from a review of websites. Clinical Psychology Science and Practice, 16, 348-359.
Phillips, L., Cully, J. A., Paukert, A. L., Loboprabhu, S. M., Lomax, J. W., & Stanley, M. A. (2009). Integration of
religion into cognitive-behavioral therapy for geriatric anxiety and depression. Journal of Psychiatric Practice,
15(2), 103-112.
Puchalski, C., Ferrell, B., Virani, R., Otis-Green, S., Baird, P., Bull, J., Chochinov, H., & Sulmasy, D. (2009).
Improving the quality of spiritual care as a dimension of palliative care: The report of the consensus conference.
Journal of Palliative Medicine, 12(10), 885-904.
Qiu, X., Brown, K., Hirschey, M., Verdin, E., & Chen, D. (2010). Calorie restriction reduces oxidative stress by
SIRT3-mediated SOD2 activation. Cell Metabolism, 12, 662-667.
Qualls, S. H., Segal, D. L., Norman, S., Niederche, G., & Gallagher-Thompson, D. (2002). Psychologists in
practice with older adults: current patterns, sources of training, and need for continuing education. Professional
Psychology: Research and Practice, 33, 435-442.
Raju, N., Sobieraj-Teague, M., Hirsh, J., O’Donnell, M., Eikelboom, J. (2011). Effects of Aspirin on Mortality in
the primary prevention of cardiovascular disease. The American Journal of Medicine, 124, 621-629.
Rowa-Dewar & Ritchie, D. (2010). Smoking cessation for older people: neither to little nor too late. British
Journal of Community Nursing, 15, 578-582.
Rowan, N. L., Gillette, P. D., Faul, A. C., Yankeelov, P. A., Borders, K. W., Deck, S., & Wiegand, M. (2009).
Innovative interdisciplinary training in and delivery of evidence-based geriatric services: Creating a bridge with
social work and psychical therapy. Gerontology & Geriatrics Education, 30, 187-204.
Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon.
Rubinstein, R. L., & Parmelee, P. A. (1992). Attachment to place and representation of life course by the elderly.
In I. Altman & S. M. Low(eds.), Human behavior and environment, Vol. 12: Place attachment (pp. 139-163).
New York: Plenum Press.
Saarloos, D., Alfonso, H., Giles-Corti, B., Middleton, N., & Almeida, O. (2011). The built environment and
depression in later life: The health in men study. The American Journal of Geriatric Psychiatry, 19, 461-470.
Sachs-Ericsson N., Schmidt, N. B., Zvolensky, M.J., Mitchell, M., Collins, N., & Blazer, D. G. (2009). Smoking
cessation behavior in older adults by race and gender: the role of health problems and psychological distress.
Nicotine & Tobacco Research, 11, 433-443. Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
ISSN 1927-0526 E-ISSN 1927-0534
Scogin, F. R., & McElreath, L. (1994). Efficacy of psychosocial treatments for geriatric depression: A quantitative
review. Journal of Consulting and Clinical Psychology, 62, 69-74.
Seynnes, O., Singh, M. A. F., Hue, O., Pras, P., Legros, P., & Bernard, P. L. (2004). Physiological and functional
responses to low-moderate versus high-intensity progressive resistance training in frail elders. Journal of
Gerontology: Medical Sciences, 59A, 503-509.
Shields, C. G., King, D. A., & Wynne, L. C. (1995). Interventions with later life families. In R. H. Mikesell, D. D.
Lusterman, & S. H. McDaniel (Eds.), Integrating family therapy (pp. 141-158). Washington, DC: American
Psychological Association.
Shore, A. (1997). Promoting wisdom: The role of art therapy in geriatric settings. Art Therapy: Journal of the
American Art Therapy Association, 14(3), 172-177.
Sixsmith, A., & Sixsmith, J. A. (1991). Transitions in home experience in later life. Journal of Architectural and
Planning Research, 8, 181-191.
Snarski, M., Scogin, F., DiNapoli, E., Presnell, A., McAlpine, J., & Marcinak, J. (2010). The effects of behavioral
activation therapy with inpatient geriatric psychiatry patients. Science Direct, 1-9.
Sofikitis, N., Miyagawa, I., Dimitriadis, D., Zavos, P., Sikka, S., & Hellstrom, W. (1995). Effects of smoking on
testicular function: semen quality and sperm fertilizing quality. Journal of Urology, 154, 1030-1034.
Solfrizzi, V., Panza, F., Frisardi, V., Seripe, D, Logreoscino, G., Imbimbo, B. P., & Pilotto, A. (2011). Diet and
Alzheimer’s disease risk factors or prevention: The current evidence. Expert Review of Neurotherapies, 11,
Stampfer, M. J., Kang, J. H., Chen, J., Cherry, R., & Grodstein, F. (2005). Effects of moderate alcohol consumption
on cognitive function in women. New England Journal of Medicine, 352, 245-253.
Tait, R. J., Hulse, G. K., Waterreus, A., Flicker, L., Lautenschlager, N. T., Jamrozik, K., & Almedida, O. P. (2007).
Effectiveness of a smoking cessation intervention in older adults. Addiction, 102, 148-155.
Teri, L., Longsdon, R. G., Uomoto, J., & McCurry, S. M. (1997). Behavioral treatment of depression in dementia
patients: A controlled clinical trial. Journal of Gerontology, 52B, 159-166.
Thompson, E. E., & Krause, N. (1998). Living alone and neighborhood characteristics as predictors of social
support in late life. Journal of Gerontology: Social Sciences, 53B, S354-S364.
Unutzer, J., Patrick, D. L., Simon, G., Grembowski, D., Walker, E., Rutter, C., & Katon, W. (1997). Depressive
symptoms and the cost of health services in HMO patients aged 65 years and older: A 4-year prospective study.
Journal of the American Medical Association, 277, 1618-1623.
Uranga, R. M., Bruce-Keller, A. J., Morrison, C. D., Fernandez-Kim, S. O., Ebenezer, P. J., Zhang, L., Dasuri, K,
& Keller, J. N. (2010). Intersection between metabolic dysfunction, high fat diet consumption, and brain aging.
Journal of Neurochemistry, 114, 344-361.
Vaillant, G. (1993). The Wisdom of the Ego. Cambridge: Harvard University Press.
Valdez, A. M., Andrew, T., Gardner, J. P., Kimura, M., Oelsner, E., Cherkas, L. F., … Spector, T. D. (2005).
Obesity, cigarette smoking, and telomere length in women. The Lancet, 366, 662-664.
Wagner, E. H. (1998). Chronic disease management: What will it take to improve care for chronic illness? Effective
Clinical Practice, 1, 2-4.
Wahl, H. W. (2001). Environmental influences on aging and behavior. The Psychology of Aging, 5, 215-237.
Whitbourne, S. B., (2010). The intersection of physical and mental health in aging: Minding the gap. In Aging in
America, Cavanaugh, J. C., Cavanaugh, C. K., Qualls, S., & McGuire, L. (2010) (eds.), 256-275. Journal of Educational and Developmental Psychology Vol. 2, No. 1; May 2012
Published by Canadian Center of Science and Education 121
Wilcox, B. J., Wilcox, D. C., He, Q., Curb, J. D., & Suzuki, M. (2006). Siblings of Okinawan residents share
lifelong mortality advantages. Journal of Gerontology: Biological Sciences, 61A, 345-354.
Wink, P., & Dillon, M. (2002). Spiritual development across the adult life course: Findings from a longitudinal
study. Journal of Adult Development, 9, 79-94.
Wray, L. A., Alwin, D. F., & McCammon, R. J. (2005). Social status and risky health behaviors: Results from the
health and retirement survey. Journal of Gerontology:Series B, 60B, (Special Issue II), 85-92.
Yassuda, M., & Nunes, P. V. (2009). Innovative psychosocial approaches in old age psychiatry. Current Opinion
in Psychiatry, 22(6), 527-531.
Zisselman, M. H., Rovner, B. W., Shmuely, Y., & Ferrie, P. (1996). A pet therapy intervention with geriatric
psychiatry inpatients. The American Journal of Occupational Therapy, 50(1), 47-51.
... The number of aging adults, in our culture, is expanding exponentially with expectations of growth as high as 41% by 2041 in the United States [1,2]. This "graying of America" has implications across disciplines and settings for the health care industry and for businesses that serve this group [3]. Up until recently, most efforts to address the needs of this group were based on clinical health care issues that viewed retirement as a time of loss and disease [4,5]. ...
... The variables, which enhance the experience of being older, outside of research in health care settings, is rare and does not consider an interdisciplinary approach to aging [3,7]. In addition, understanding how older adults face the years beyond their 80's is sorely lacking in the literature; as is exploration of the implications of limited and dwindling financial resources predicted by financial advisors and investment managers [6]. ...
... In American culture aging and the idea of aging is put forward as a negative event to avoid, rather than a positive event to plan for. A failure to plan for the transition to retirement at both the psychological and financial levels can mean that socio-economic status interplays with social and institutional ageism contributing to heightened risk for depression, isolation, and avoidance of help seeking [3]. The interaction between geropsychiatric mental health issues and health issues is interwoven and complicated. ...
This study determined the total phenolic content (TPC) and antioxidant activities of common teas in response to our tea drinking habits. Selected green and black tea (Chinese black and green tea, Lipton black and green tea, Twining black and green tea) were infused with water for 3, 5, 7, and 10 min, and the teabags were rebrewed for two cycles (an hour interval each). Results showed that the TPC and antioxidant activities increased throughout the infusion time, suggesting that the longer the infusion time, the higher the concentrations of antioxidants. On the contrary, the TPC and antioxidants activities decreased throughout the three brewing cycles, suggesting that the teabags are most suitably used only once. This study therefore revealed that 10 min is recommended for the infusion of green and black tea to derive optimum benefits, and rebrewing of teabags is not recommended.
Full-text available
In a pilot project, members of a community garden explored how they might provide better end-of-life support for their regional community. As part of the project, a literature review was undertaken to investigate the nexus between community gardens and end-of-life experiences (including grief and bereavement) in academic research. This article documents the findings of that review. The authors discovered there is little academic material that focuses specifically on community gardens and end-of-life experiences, but nonetheless the two subjects were seen to intersect. The authors found three points of commonality: both share a need and capacity for a) social/informal support, b) therapeutic space, and c) opportunities for solace.
Attachment to place is a set of feelings about a geographic location that emotionally binds a person to that place as a function of its role as a setting for experience. In other words, life experiences may have an emotional quality that suffuses the setting to produce an affective bond with the place itself. Attachment and attachment behavior have traditionally been viewed as arising from early life experiences (Bowlby, 1958). This chapter takes a complementary view, that attachment behavior and concerns are life course phenomena. For older people in particular, place attachment is related to experience of the life course and themes of self-identity that span that life course. While attachment to place may be lived either currently or as part of memory, it exists within the larger context of the events of the life course, how they are interpreted, and the need to maintain a coherent sense of self over time.
The purpose of this paper is to discuss rationale and provide a music therapy assessment model for geriatric clients in long-term care and rehabilitation facilities. This original music therapy assessment addresses client abilities, needs, and functioning levels for purposes of description, prescription, and evaluation. The assessment is based on over six years of clinical work with geriatric clients in long-term care and rehabilitation settings. It has been used and is appropriate for a wide range of geriatric clients with cognitive and/or physical deficits. The assessment addresses five main domains: expressive musical skills, receptive musical skills, behavioral/psychosocial skills, motor skills, and cognitive/memory skills. Assessment of these areas is likely to provide information about the client's tendencies to organize and process sensory data into meaningful information while engaging in musical experiences. Recommendations for administration of the assessment as well as examples of musical experiences during assessment are provided. Appendix A provides a sample geriatric music therapy assessment tool which is used to support this article's discussion.
Objective. —To examine whether depressive symptoms in older adults contribute to increased cost of general medical services.Design. —A 4-year prospective cohort study.Setting. —Four primary care clinics of a large staff-model health maintenance organization (HMO) in Seattle, Wash.Patients. —A total of 5012 Medicare enrollees older than 65 years were invited to participate in the study; 2558 subjects (51%) were successfully enrolled. Nonparticipants were somewhat older and had a higher level of chronic medical illness.Main Outcome Measures. —Depressive symptoms as measured by the Center for Epidemiological Studies Depression scale, which was administered as part of a mail survey at baseline, at 2 years, and at 4 years; and total cost of medical services from the perspective of the HMO. Data were obtained from the cost accounting system of the HMO.Results. —In this cohort of older adults, depressive symptoms were common, persistent, and associated with a significant increase in the cost of general medical services. This increase was seen for every component of health care costs and was not accounted for by an increase in specialty mental health care. The increase in health care costs remained significant after adjusting for differences in age, sex, and chronic medical illness.Conclusions. —Depressive symptoms in older adults are associated with a significant increase in the cost of medical services, even after adjusting for the severity of chronic medical illness.