The Concept of Successful Aging

Abstract

Aging is characterized by progressive and predictable changes that include gradual, unrepaired accumulations of biochemical tissue alterations that compromise cell and tissue systems, rendering individuals to become less fit to reproduce, and survive. The complex processes of aging are not homogenious among individuals and in various tissue systems, and are influenced by genetic, lifestyle and environmental factors. Aging can be healthy or pathological. The Concept of successful aging is related to opportunities for continued activity and productivity that should represent an essential strategy from both social and medical perspectives. The heterogenous deterioration of functions are initially detectable as loss of reserve capacity to restore homeostasis under stress, followed by altered functions at rest. This article will present contemporary knowledge related to health and psychosocial parameters and undertakings that aim at achieving continued healthy lifestyle, generatively and making significant contribution by the elderly.International Journal of Human and Health Sciences Vol. 01 No. 01 January’17. Page : 22-25

Full text

International Journal of Human and Health Sciences Vol. 01 No. 01 January’17
22
Review article
The Concept of Successful Aging
Misha’l AA1
Abstract
Aging is characterized by progressive and predictable changes that include gradual,
unrepaired accumulations of biochemical tissue alterations that compromise cell and tissue
systems, rendering individuals to become less t to reproduce, and survive.
The complex processes of aging are not homogenious among individuals and in various
tissue systems, and are inuenced by genetic, lifestyle and environmental factors.
Aging can be healthy or pathological. The Concept of successful aging is related to
opportunities for continued activity and productivity that should represent an essential
strategy from both social and medical perspectives.
The heterogenous deterioration of functions are initially detectable as loss of reserve
capacity to restore homeostasis under stress, followed by altered functions at rest.
This article will present contemporary knowledge related to health and psychosocial
parameters and undertakings that aim at achieving continued healthy lifestyle, generatively
and making signicant contribution by the elderly.
Keywords: Aging; lifestyle; retirement; successful aging
Correspondence to: Aly A. Misha’l, Ex-Executive Director, Islamic Hospital, Amman, Jordan.
email:mainfo@islamic-hospital.org
International Journal of Human and Health Sciences Vol. 01 No. 01 January’17. Page : 22-25
Introduction
Aging is characterized by a progressive loss of
coordinated cell and tissue function, a process
that is manifested, at variable extents, across body
organs and systems that renders individuals to
become gradually less t to reproduce and survive.
Deterioration of function is heterogeneous among
systems and individuals. It is initially observed as
a gradual loss of reserve capacity, and the ability
to restore homeostasis under stress, followed, later
in life, by altered function even at rest1,2.
Biological age, in contrast to chronological age,
is synonymous with functional and physiological
age, and it is an indicator of the general health
status of individuals, their remaining healthy life
span and active life expectancy.
Biological age may help in identifying individuals
at risk for age-related disorders, serve as a measure
of relative tness, and predict disability in later life
and mortality, independent of chronological age2.
People who function poorly are looked upon as
being “biologically older” than their chronological
age. Conversely, people who function well are
deemed as “biologically younger”. This concept
may be best represented by construction of an
index derived from biological markers (called
biomarkers of aging)1.
Dierent researchers have developed several
types of biomarkers. But because dierent tissues
and organs age at dierent rates, there is a need
to obtain dierent biomarkers for dierent body
systems.
Some of the newly developed biomarkers include:
 Changes in telomere length
 Cross-linking of collagen
 Glycosylation and glycoxidation
 Pulse wave velocity
 Sarcopenia (changes in muscles)
 Inammatory markers
 Clotting markers
 Immune function markers
Such biomarkers may be looked upon as
only predictors of more relevant regulatory
mechanisms and systems, which need time and
eort to elucidate1. Moreover, most biomarkers
are under substantial genetic inuence, which
strengthens the concept that longevity is heritable.
This concept does not negate the importance of
environmental inuences.
The development of biological age estimates,
using a combination of reliable biomarkers,
together with the search for genes which contribute
to aging, will benet in extending a healthy life
span, and maintaining well-being, both physical

23
The Concept of Successful Aging
and psychological.
Although the basic mechanisms under-lying
aging processes are unknown, available evidence
is consistent with accumulation of a variety of
biochemical alterations that impair functions of
nucleic acids, proteins and lipid membranes.
These alterations probably include, but are not
limited to:
 Oxidation by free radicals3.
 Non-enzymatic glycosylation4.
 Epigenetic changes, such as DNA
methylation and histone acetylation5.
The extent to which dierentiated cells are aected
by aging determines physiologic function, while
the extent to which stem and precursor cells (the
reserve cells) are aected determines the capacity
to replace and repair damaged cells and tissues6.
In studying of changes in older people, it is
important to distinguish between eects of aging
per se, and those caused by age-related illnesses.
A twin study found that genetics accounted for
about 25% of the variation in longevity among
twins, and environ-mental factors accounted for
about 50%7. However, with greater longevity (to
age 90 or 100 years), genetic inuences become
more important.
Age-associated body system changes
Age impacts widespread changes, involve various
body tissues and systems, at variable rates8-13.
Despite all these changes, elderly individuals
may signicantly expand their productive life at
home, in society and the workplace, by engaging
in social, physical and cognitive activities. In
healthy older volunteers, cognitive training can
lead to increases in brain grey matter volume in
the “exercised” areas14.
Lifestyle and behavioral measures, with specic
carefully designed, age oriented medical care and
specic devices wherever needed, are instrumental
to achieve successful aging. Remaining active
physically, cognitively, and socially, with
continued generativity and making a contribution,
are the main parameters of successful aging2,15.
Remaining active has specic health benets,
both in the physical and cognitive domains. There
is evidence to support the old saying “use it or lose
it”: to live longer and also healthier.
There is abundance of evidence suggesting that
mental health diverges from physical health, in
that coping, adaptation and resilience functions
are surprisingly well preserved throughout most
of the human life span16. This important aspect
of aging has very signicant implications in the
various roles that older people can perform in
various aspects of their societies. Their input
could be extremely fruitful in many areas that
need cognitive capability. The physical aging
should not bar them from providing this crucial
input. This may add to the various shortcomings
and fallacies of the arbitrary retirement age of 65
years.
Being able to make a contribution has been
described as an essential element of “successful
aging”. It has been reported that women who
participated in voluntary work or activity had
greater longevity than those who did not. Moreover,
this voluntary work is essential to psychological
well-being in late life. Physical and cognitive
activity, along with social engagement, are related
to improved health and function with aging. In
addition to the generativity and contributions,
elderly individuals can ensure their legacy
through dening one’s life contributions and
achievements. Staying cognitively active helps to
protect memory in older people. Regular physical
activity, both of moderate and high intensity, are
associated with lower frequency of heart disease,
diabetes mellitus, maintenance of proper weight,
more benecial levels of cardiovascular disease
risk factors, and lower likelihood of disability
and dependence. Much has been learned recently
regarding the adaptability of various biological
systems by exercise17. Regular exercise is eective
to reduce or prevent a number of functional
declines associated with aging, and contributes to
an increase in healthy life expectancy.
Additional benets include:
 Improved bone health with reduction in risk
of fractures.
 Improved postural stability, with reduction
in falls.
 Increased coordination, exibility and range
of motion.
 Psychological benets: related to preserved
cognitive function and alleviation of
depression.
 Improved concept of personal control
and self-ecacy, in-dependent lifestyle,
functional capacity and quality of life.
A good number of clinical studies showed
signicant benets of exercise and community
involvement18,19.
Those who live longer lives, and are vibrant
until shortly before death, may provide the best
possible example of successful aging. From the
psychological domain, aging is seen as a life-long

Misha’l AA
24
adaptive process, an ongoing dynamic of selective
optimization with compensation, involving the
following three elements, which provide a general
framework for understanding the developmental
changes and resilience across the life span17.
1. Selection: as a result of physical and cognitive
limitations, individuals select, or optimize,
their eorts into areas of high priority.
2. Optimization: individuals continue to engage
in behaviors that enrich and augment their
physical and mental reserves.
3. Compensation: individuals compensate
by using psychological and techno-logical
strategies.
Psychological strategies may involve using
external memory aids. Technological strategies
may include a hearing aid. The three elements
interplay with one another so that a person
may suer from a reduction in general capacity
and losses in specic functions, but creates a
transformed and eective life, and thereby the
older person maximizes and attains positive
or desired outcomes, and minimizes or avoids
negative or undesired ones.
The role of society/state
It may be very dicult for old individuals to get
involved in activities that produce successful
aging. It is hard to accomplish in a retirement
setting or in isolation. In most countries, very few
eorts are made to open organized avenues for old
people to play meaningful roles as they age2.
The experiences, abilities and time of older
adults are largely not harnessed, and most eorts
are limited to the variable needs of the elderly,
without making use of their contributions to their
societies. Some workers in this area describe the
older generations as the only increasing natural
resource, but the least used one!2.
In the post retirement years, more than half of
people aged 65 and older are without signicant
disabilities, although 80% of them have one or
more chronic disease2.
Such chronic diseases are usually managed
successfully, and most aected people lead
near normal life. Most of them are, however,
marginalized from productivity, while having
plenty of time and experience.
The family, society and the state need to develop
modalities, policies, strategies and legislations to
achieve this, in active eorts towards maximizing
productive and healthy years of life, side by side
with minimizing the number of years of late life
lived sick and disabled. Such modalities also help
to decrease costs.
It is the duty of society to create widely accessible
opportunities for older adults to remain active and
productive.
Positive social support, and social activity of the
older adults have been related to improving their
health, functioning and happiness.
A prominent example of opportunities for older
people to accomplish is the eld of children
education2.
In most societies there is a two way deciency of
time and attention provided by working parents,
as well as by the school systems to provide
various types of care to the young generation. This
deciency includes teaching and education, as well
as areas of culture and general knowledge. With
their wide knowledge and experiences, together
with their valuable support, advice and helping
hand, both at home and school levels, the older
generation can provide valuable contributions and
role models. In addition, it provides them with the
joy of giving and happiness of more achievements.
Programs must be designed that are attractive
and convenient to old people, to maximize their
eectiveness and contributions, as long as possible.
This educational model could be conveniently and
actively extended to include other areas of health,
environment, social and charitable work to serve
and support their communities.
Concluding Remarks
In the post retirement years, more than half of
subjects aged 65 and older, lead healthy lives, with
no signicant disabilities, although the majority
have one or more successfully managed chronic
illnesses. However, most of them are marginalized
from productivity.
The prevailing approach, by society and medical
professionals, is limited to addressing only some
of the variable needs of the elderly, without
making proper use of their contributions in their
post-retirement years.
The family, society and medical professionals have
an obligation to develop modalities to achieve the
concept of “successful aging” towards maximizing
productive and healthy years of the older subjects,
with minimizing the years of illness and disability.
Healthy and competent older people, with their
knowledge experiences and wisdom, may have
signicant and constructive roles to play in their
societies.

25
The Concept of Successful Aging
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