( 2) reviewed the behavioral predictors (e.g., smoking) of successful aging, no reviews to our knowledge have systematically examined the strength and consistency of the demographic, psychosocial, and biomedical correlates of successful aging as an operationally defined, dependent variable. We also categorized and examined the frequency and measurement of the various components used in these definitions. ( 21) and evaluated the factors that influence the reported proportion of successful agers. We restricted our search to data-based studies that examined successful aging as a dependent variable as in Peel et al. Previous reviews on this subject have examined the history of the concept ( 1, 3, 20), the prevalence of successful aging ( 21), its components ( 4), and/or its determinants ( 2, 4). There is even no agreement about the term to be used, with descriptors ranging from “healthy aging” ( 2), “successful aging” ( 6, 13), “productive aging” ( 18), to “aging well” ( 19). Furthermore, there is no consensus about whether successful aging should be defined objectively by others or subjectively by older adults themselves or about which components are necessary and/or sufficient ( 1, 4). There is considerable debate as to which components are essential to the definition of successful aging and which are overly restrictive or even possibly “ageist” ( 16, 17). Other ways of defining successful aging involve the degree to which elderly individuals adapt to age-associated changes ( 13, 14), view themselves as successfully aging ( 15), or avoid morbidity until the latest time point before death ( 7). The prevailing model, advanced by Rowe and Kahn and used in the MacArthur Research Network on Successful Aging ( 6, 12), characterizes successful aging as involving freedom from disability along with high cognitive, physical, and social functioning. Yet, further agreement on what factors constitute successful aging is surprisingly limited. The World Health Organization ( 9), the White House Conference of Aging ( 10), and the National Institute of Aging ( 11) have stressed that healthy aging goes beyond avoidance of disease and disability. However, at present, there is little agreement about the optimal definition of successful aging nor its measurement ( 1, 3, 4, 8) despite a clear need for consensus to facilitate effective promotion of public healthy-aging agendas ( 8). Empiric investigations of healthy aging question the popular notion that aging invariably involves a decline in functioning and quality of life, and point toward factors that can increase individuals' “health span” as they enter later life ( 6, 7). The systematic study of successful aging, or the capacity of elderly people to thrive, has, however, been a more recent phenomenon ( 1 – 5). The past century has witnessed a doubling of the human lifespan, remarkable developments in research methods, and advances in health care. (Reprinted with permission from American Journal of Geriatric Psychiatry 2006 14:6–20) Predictors of successful aging varied yet point to several potentially modifiable targets for increasing the likelihood of successful aging. The majority of these definitions were based on the absence of disability with lesser inclusion of psychosocial variables. Conclusion: Despite variability among definitions, approximately one-third of elderly individuals were classified as aging successfully. Gender, income, education, and marital status generally did not relate to successful aging. Moderate support was found for greater physical activity, more social contacts, better self-rated health, absence of depression and cognitive impairment, and fewer medical conditions. The most frequent significant correlates of the various definitions of successful aging were age (young-old), nonsmoking, and absence of disability, arthritis, and diabetes. Multiple components of these definitions were identified, although 26 of 29 included disability/physical functioning. The mean reported proportion of successful agers was 35.8% (standard deviation: 19.8) but varied widely (interquartile range: 31%). Most investigations used large samples of community-dwelling older adults. Results: The authors identified 28 studies with 29 different definitions that met our criteria. The authors categorized the components of these definitions and independent variables examined in relation to successful aging (e.g., gender, education, and social contacts). Methods: We conducted a literature search for published English-language peer-reviewed reports of data-based studies of adults over age 60 that included an operationalized definition of successful aging. There is no consensual definition of “successful aging.” Our aim was to review the literature on proportions of subjects meeting criteria and individual components of definitions of successful aging as well as correlates of these definitions.
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