Successful ageing : perceptions of adults aged between 70 and 101 years

In this research, content analysis was employed to investigate older adults' perceptions of successful aging and the relationship of these perceptions to definitions given in the literature to date. Participants were 18 males and 42 females between the ages of 70 and 101 years. Analyses revealed older adults mentioned only 1 or 2 criteria of successful aging if asked for a definition; however, when prompted, they rated almost all the criteria emerging from the literature as highly important. Participants reported adjusting to the situations they were in by compensating for losses that occurred and selecting activities that best suited their capabilities. Overall, older adults' perceptions of successful aging were similar to aspects identified in the literature. Not all aspects, however, were seen as important by all participants, and only low to moderate correlations were found between some aspects of successful aging. (Contains 3 figures and 4 tables.)

Factors associated with successful ageing

This research explored the extent to which adaptability, self-acceptance, religiosity, attitudes to ageing, and flexibility are associated with seven criteria of successful ageing (health, activity, life satisfaction, personal growth, positive relationships, autonomy, and purpose in life). Also considered was the level of importance participants assigned to these criteria. The participants were 200 females and 140 males aged between 70 and 95 years. Structural equation modelling was employed to determine significant paths between the variables. Direct and mediating effects of older adults’ importance ratings for different criteria of successful ageing were analysed. The main factors associated with successful ageing were self-acceptance and flexibility, both of which contributed significantly to almost all of the criteria examined. Importance ratings did not play a mediating role. It was concluded that self-acceptance and flexibility might enhance the process of successful ageing and could be targeted in programmes that assist older adults to adjust to life changes.

Exploration of the multifaceted dimensions of successful ageing

This thesis explored older adults' experiences of successful ageing. Self-acceptance, attitudes to ageing, and flexibility emerged as influencing factors. Acceptance was described as a personal struggle and underpinned criteria of successful ageing. Overall, ageing successfully seems anchored in our need to become integrated and find meaning in life.

Dietary patterns and successful ageing: a systematic review

PURPOSE: Nutrition is a key determinant of chronic disease in later life. A systematic review was conducted of studies examining dietary patterns and quality of life, physical function, cognitive function and mental health among older adults. METHODS: Literature searches in MEDLINE complete, Academic Search Complete, CINAHL Complete, Ageline, Global health, PsycINFO, SCOPUS and EMBASE and hand searching from 1980 up to December 2014 yielded 1236 results. Inclusion criteria included dietary pattern assessment via dietary indices or statistical approaches, a sample of community-dwelling adults aged 45 years and over at baseline and a cross-sectional or longitudinal study design. Exclusion criteria included a single 24-h recall of diet, evaluation of single foods or nutrients, clinical or institutionalised samples and intervention studies. Risk of bias was assessed using the six-item Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies. RESULTS: There were 34 articles (11 cross-sectional and 23 longitudinal) included with 23 studies examining dietary indices and 13 studies using empirical analysis. Most studies examined mental health (n = 10) or cognitive function (n = 18), with fewer studies examining quality of life (n = 6) and physical function (n = 8). Although dietary pattern and outcome assessment methods varied, most studies reported positive associations between a healthier diet and better health outcomes. CONCLUSION: Overall, the number of studies using dietary patterns to investigate diet and successful ageing is small, and further investigation in longitudinal studies is needed, particularly for quality-of-life outcomes. This review provides support for the importance of a healthy diet for the ageing population globally.

The neglected dimension of community liveability : impact on social connectedness and active ageing in higher density accommodation

Purpose This thesis is about liveability, place and ageing in the high density urban landscape of Brisbane, Australia. As with other major developed cities around the globe, Brisbane has adopted policies to increase urban residential densities to meet the main liveability and sustainability aim of decreasing car dependence and therefore pollution, as well as to minimise the loss of greenfield areas and habitats to developers. This objective hinges on urban neighbourhoods/communities being liveable places, which residents do not have to leave for everyday living. Community/neighbourhood liveability is an essential ingredient in healthy ageing in place and has a substantial impact upon the safety, independence and well-being of older adults. It is generally accepted that ageing in place is optimal for both older people and the state. The optimality of ageing in place generally assumes that there is a particular quality to environments or standard of liveability in which people successfully age in place. The aim of this thesis was to examine if there are particular environmental qualities or aspects of liveability that test optimality and to better understand the key liveability factors that contribute to successful ageing in place. Method A strength of this thesis is that it draws on two separate studies to address the research question of what makes high density liveable for older people. In Chapter 3, the two methods are identified and differentiated as Method 1 (used in Paper 1) and Method 2 (used in Papers 2, 3, 4 and 5). Method 1 involved qualitative interviews with 24 inner city high density Brisbane residents. The major strength of this thesis is the innovative methodology outlined in the thesis as Method 2. Method 2 involved a case study approach employing qualitative and quantitative methods. Qualitative data was collected using semi-structured, in-depth interviews and time-use diaries completed by participants during the week of tracking. The quantitative data was gathered using Global Positioning Systems for tracking and Geographical Information Systems for mapping and analysis of participants’ activities. The combination of quantitative and qualitative analysis captured both participants’ subjective perceptions of their neighbourhoods and their patterns of movement. This enhanced understanding of how neighbourhoods and communities function and of the various liveability dimensions that contribute to active ageing and ageing in place for older people living in high density environments. Both studies’ participants were inner-city high density residents of Brisbane. The study based on Method 1 drew on a wider age demographic than the study based on Method 2. Findings The five papers presented in this thesis by publication indicate a complex inter-relationship of the factors that make a place liveable. The first three papers identify what is comparable and different between the physical and social factors of high density communities/neighbourhoods. The last two papers explore relationships between social engagement and broader community variables such as infrastructure and the physical built environments that are risk or protective factors relevant to community liveability, active ageing and ageing in place in high density. The research highlights the importance of creating and/or maintaining a barrier-free environment and liveable community for ageing adults. Together, the papers promote liveability, social engagement and active ageing in high density neighbourhoods by identifying factors that constitute liveability and strategies that foster active ageing and ageing in place, social connections and well-being. Recommendations There is a strong need to offer more support for active ageing and ageing in place. While the data analyses of this research provide insight into the lived experience of high density residents, further research is warranted. Further qualitative and quantitative research is needed to explore in more depth, the urban experience and opinions of older people living in urban environments. In particular, more empirical research and theory-building is needed in order to expand understanding of the particular environmental qualities that enable successful ageing in place in our cities and to guide efforts aimed at meeting this objective. The results suggest that encouraging the presence of more inner city retail outlets, particularly services that are utilised frequently in people’s daily lives such as supermarkets, medical services and pharmacies, would potentially help ensure residents fully engage in their local community. The connectivity of streets, footpaths and their role in facilitating the reaching of destinations are well understood as an important dimension of liveability. To encourage uptake of sustainable transport, the built environment must provide easy, accessible connections between buildings, walkways, cycle paths and public transport nodes. Wider streets, given that they take more time to cross than narrow streets, tend to .compromise safety - especially for older people. Similarly, the width of footpaths, the level of buffering, the presence of trees, lighting, seating and design of and distance between pedestrian crossings significantly affects the pedestrian experience for older people and impacts upon their choice of transportation. High density neighbourhoods also require greater levels of street fixtures and furniture for everyday life to make places more useable and comfortable for regular use. The importance of making the public realm useful and habitable for older people cannot be over-emphasised. Originality/value While older people are attracted to high density settings, there has been little empirical evidence linking liveability satisfaction with older people’s use of urban neighbourhoods. The current study examined the relationships between community/neighbourhood liveability, place and ageing to better understand the implications for those adults who age in place. The five papers presented in this thesis add to the understanding of what high density liveable age-friendly communities/ neighbourhoods are and what makes them so for older Australians. Neighbourhood liveability for older people is about being able to age in place and remain active. Issues of ageing in Australia and other areas of the developed world will become more critical in the coming decades. Creating livable communities for all ages calls for partnerships across all levels of government agencies and among different sectors within communities. The increasing percentage of older people in the community will have increasing political influence and it will be a foolish government who ignores the needs of an older society.

Ageing and learning as conceptualized by senior adults in two cultures: Hong Kong and Australia

This paper is about a study aimed to understand what successful ageing and later life learning mean to older adults in two cultures: Hong Kong and Australia. Findings from the study were reported in this paper to shed light on: (1) the meaning of ageing and learning as conceptualized by elders in Hong Kong and Australia; (2) the reasons for participation in later life learning, as well as, barriers for non-participation; (3) their learning interests and instructional preferences, and finally (4) the correlation between learning and successful ageing, and between learning and other well-being variables, including health, happiness and satisfaction of elders in Hong Kong and Australia. Two large samples of elders from Hong Kong (n=519) and Queensland, Australia (n=421) participated in the study. Within group analysis of the data from the two locations indicated that there are more similarities, rather than differences, between elders in Hong Kong and Australia with respect to background characteristics, meanings of ageing and learning, reasons for participation, barriers for non-participation, learning interests and instructional preferences.

Profiles of ageing in the South of Portugal: education and cognitive functioning in elderly persons living in institutionalized and community contexts

The region of the Algarve shows huge differences between the coastline where population in the urban areas grows, and the inland rural areas, in some cases very isolated, which frequently have high ageing indexes. This general scenario, with an elderly population with very different economic and social conditions, frames the ongoing PhD research designed as a cross-sectional study of an intentional sample of elderly persons. The basic theoretical framework departs from the perspective of developmental psychology of life-span and the model of selection, optimisation and compensation for optimal ageing (Baltes & Baltes, 1990; Freund & Baltes, 2002). The present study is a first step in the analysis of empirical data collected in the PhD sample (N=156; age range 65 to 97 years; M = 80.4 years; SD = 7.2 years). Its purpose is to assess the cognitive functioning of participants, screening for cognitive impairment and examine the relations between the cognitive status of the subjects and a number of selected variables including educational level, age, physical activity and living contexts of the subjects. We accessed the cognitive status of the participants with the Portuguese version of Mini Mental State Examination (MMSE) finding a 10.3% prevalence of positive cases with cognitive impairment. The results also show significant relationships between the cognitive status accessed by the MMSE and educational level, professional qualification, age, living arrangement and activity level of the participants. The relationship verified between educational level and cognitive status of the participants was the largest correlation found in the study with the variability in educational level accounting for 44.8% of the variability in MMSE score. This results points in the same direction of several lines of research that corroborate the strong intercorrelation between education and cognitive functioning in old age.

Belonging to a Victorian community choir : ageing, music and culture

Australia's ageing population created challenges for maintaining well-being and combating social isolation. Older Australians frequently rely on community arts organizations to enhance quality of life, specifically in health, happiness and community. Arts engagement takes place in many different contexts, from formal to informal and throughout the lifespan of the individual. Culture shapes the way in which we age and cultural identity is celebrated through the arts. This study will explore ageing and cultural diversity within Australian society through an examination of community arts engagement, specifically a community choir in Melbourne, Victoria, Australia. Much previous research concerning music engagement by older people has focused on its therapeutic applications, but there have been less attention given to healthy older people still living in communities. This paper reports on how music engagement can facilitate successful ageing be encouraging a sense of community, enhancing well-being and supporting cultural identity.

Crafts and successful aging: the Découpage Guild Australia

Promoting healthy, productive ageing: plan early, plan well

This article reports that the population bulge of the post-war baby boom, increased life expectancy and declining birth rates are forcing governments to address the changing demographic of an "older" society. Successful ageing revolves around optimum health and well-being, active support networks and engagement in the community, and personal autonomy over life choices. Despite the social and financial advantages of work, many people look forward to retirement and begin retirement planning in the latter part of their working life.

What has ageing to do with periodontal health and disease?

Periodontitis is a multi-factorial disease and in most cases also a disease with a chronic progression. Exposure to factors which contribute to periodontitis occurs over a long period, so that at the time of diagnosis it may be difficult to identify and evaluate what co-factors have contributed to its development. These include exposure to bacteria and viruses, inflammation, genetic factors, health behaviours and a variety of social factors, socio-economic status, behavioural and nutritional habits, the ability to cope with stress and the ability of the immune system to fight infections. Many patients in their 50s also experience other conditions such as heart disease, diabetes mellitus, or rheumatoid arthritis and recent reports on the associations and potential biological mechanisms by which periodontitis can be linked to other systemic diseases suggest that the patient with periodontitis is a challenged individual. Neither individuals nor their oral health care providers are currently prepared for the challenges in oral health care as the expectation of successful ageing with remaining and aesthetically functional teeth is increasing. The scientific evidence is, however, growing, and while the opportunities to prepare for successful ageing exist they must be included in the educational process of both current and future oral health care providers and their patients.

Patterns of engagement in workplace learning amongst employees from social sectors

Continuous learning and development has become increasingly important in the information age. However, employees with limited formal education in lower status occupations may be disadvantaged in their opportunities for development, as their jobs tend to require more limited knowledge and skills. In mature age, such workers may be subject to cumulative disadvantage with respect to work related learning and development, as well as negative stereotyping. This thesis concerns work related learning and development from a lifespan development psychology perspective. Development across the lifespan is grounded in biocultural co-constructivism. That is, the reciprocal influences of the individual and environment produce change in the individual. Existing theories and models of adaptive development attempt to explain how developmental resources are allocated across the lifespan. These included the Meta- theory of Selective Optimisation with Compensation, Dual Process Model of Self Regulation, and Developmental Regulation via Optimisation and Primary and Secondary Control. These models were integrated to create the Model of Adaptive Development for Work Related Learning. The Learning and Development Survey (LDS) was constructed to measure the hypothesised processes of adaptive development for work related learning, which were individual goal selection, individual goal engagement, individual goal disengagement, organisational opportunities (selection and engagement), and organisational constraints. Data collection was undertaken in two phases: the pilot study and the main study. The objective of the pilot study was to test the LDS on a target population of 112 employees from a local government organisation. Exploratory factor analysis reduced the pilot version of the survey to 38 items encompassing eight constructs which covered the processes of the model of adaptive development for work related learning. In the main study, the Revised Learning and Development Survey (R-LDS) was administered to another group of 137 employees from the local government organisation, as well as 110 employees from a private healthcare organisation. The purpose of the main study was to validate the R-LDS on two different groups to provide evidence of stability, and compare survey scores according to age and occupational status to determine construct validity. Findings from the main study indicated that only four constructs of the R-LDS were stable, which were organisational opportunities – selection, individual goal engagement, organisational constraints – disengagement and organisational opportunities – engagement. In addition, MANOVA studies revealed that the demographic variables affected organisational opportunities and constraints in the workplace, although individual goal engagement was not influenced by age. The findings from the pilot and main study partially supported the model of adaptive development for work related learning. Given that only four factors displayed adequate reliability in terms of internal consistency and stability, the findings suggest that individual goal selection and individual goal disengagement are less relevant to work related learning and development. Some recent research which emerged during the course of the current study has suggested that individual goal selection and individual goal disengagement are more relevant when goal achievement is impeded by biological constraints such as ageing. However, correlations between the retained factors support the model of adaptive development for work related learning, and represent the role of biocultural co-constructivism in development. Individual goal engagement was positively correlated with both opportunity factors (selection and engagement), while organisational constraints – disengagement was negatively correlated with organisational opportunities – selection. Demographic findings indicated that higher occupational status was associated with more opportunities for development. Age was associated with fewer opportunities or greater constraints for development, especially for lower status workers.

Wellness in older adults

Understanding perception of wellness in older adults is a question to be understood against the backdrop of concerns about whether global ageing and the ‘bulge’ of ageing baby boomers will increase health care cost beyond what modern economies can deal with. Older adults who age in a healthy way and who take responsibility for their own health offer a positive alternative and change the perception that older adults are a burden on their society’s health system. The concept of successful ageing introduced by Rowe and Kahn (1987; 1997) suggested that older adults age successfully if they avoid disease and disability, maintain high cognitive and physical functioning and remain actively engaged with life. This concept, however, did not reflect older adults’ own perceptions of what constitutes successful ageing or how perceptions of wellness or health-related quality of life influenced the older adult’s understanding of his or her own health and ageing. A research project was designed to examine older adults’ perceptions of wellness in order to gain an understanding of the factors that influence perception of their own wellness. Specifically, the research wanted to explore two aspects: whether belonging to a unique organisation, in this instance a Returned Services Club, influenced perceptions of wellness; and whether there are significant gender differences for the perception of wellness. A mixed method project with two consecutive studies was designed to answer these questions: a quantitative survey of members of a Returned Services Club and of the surrounding community in Queensland, Australia, and a qualitative study conducting focus groups to explore findings of the survey. The results of the survey were used to determine the composition of the focus groups. The participants for the first study, (N=257), community living adults 65 years and older, were chosen from the membership role of a Returned Services Club or recruited by personal approach from the community surrounding the Services Club. Participants completed a survey that consisted of a perception of wellness instrument, a health-related quality of life instrument, and questions on morbidities, modifiable life style factors and demographics. Data analysis found that a number of individual factors influenced perception of wellness and health-related quality of life. Positive influences were independent mobility, exercise and gambling at non-hazardous levels, and negative influences were hearing loss, memory problems, chronic disease and being single. Membership of the Services Club did not contribute to perception of wellness beyond being a member of a social group. While there may have been an expectation that members of an organisation that is traditionally associated with high alcohol use and problematic gambling may have lower perceptions of wellness, this study suggested that the negative influences may have been counteracted by the positive effects of social interaction, thus having neither negative nor positive influences on perception of wellness. There were significant differences in perception of wellness and in health-related quality of life for women and men. The most significant difference was for women aged 85-90 who had significantly lower scores for perception of wellness than men or than any other age group. This result was the impetus for conducting focus groups with adults aged 85-90 years of age. Focus groups were conducted with 24 women and four men aged 85-90 to explore the survey findings for this age group. Results from the focus groups indicated that for older adults perception of wellness was a multidimensional construct of more complexity than indicated by the survey instrument. Elite older women (women over 85 years of age) related their perception of wellness to their ability to do what they wanted to do, and what they wanted to do significantly more than anything else, was to stay connected to family, friends and the community to which they belonged. From the focus group results it appeared that elite older women identified with the three elements of successful ageing – low incidence of disability and disease, high physical and cognitive functioning, and active engagement with life – but not in a flat structure. It appears that for elite older women good physical and mental health function to enable social connectedness. It is the elements of health that impact on the ability to do what they wanted to do that were identified as key factors: independent mobility, hearing and memory - factors that impact on the ability to interact socially. These elements were only identified when they impacted on the person’s ability to do what they wanted to do, for example mobility problems that were managed were not considered a problem. The study also revealed that older women use selection, optimisation and compensation to meet their goal of staying socially connected. The shopping centre was a key factor in this goal and older women used shopping centres to stay connected to the community and for exercise as well as shopping. Personal and public safety and other environmental concerns were viewed in the same context of enabling or disabling social connectedness. This suggested that for elite older women the model of successful ageing was hierarchical rather than flat, with social connectedness at the top, supported by cognitive functioning and good physical and mental health. In conclusion, this research revealed that perception of wellness in older adults is a complex, multidimensional construct. For older adults good health is related to social connectedness and is not a goal in itself. Health professionals and the community at large have a responsibility to take into account the ability of the older adult to stay socially connected to their community and to enable this, if the goal is to keep older adults healthy for as long as possible. Maintaining or improving perception of wellness in older adults will require a broad biopsychosocial approach that utilises findings such as older adults’ use of shopping centres for non-shopping purposes, concerns about personal and environmental safety and supporting older adults to maintain or improve their social connectedness to their communities.