How to age well

It is a sad fact that for many of us the prospect of getting old is quite scary. We look around and see old people hobbling slowly along the street and we look away. We think of retirement homes with distaste, if not with outright horror. Is that what will happen to us? Will we become old and sick and unable to function normally? We can hardly bear to think about it.

Of course, if we do think about it we can all identify old people who are mentally and physically active and lead satisfying lives. But it seems a matter of chance - some are lucky, some are not. Better not to dwell on it.

However, it is not a matter of chance - it's not about genes or bad luck, or being born into the wrong family. Studies by George Vaillant (2004) of the same people over 60 years show that aging well can be attributed to certain controllable factors, and they are not the ones we might think that they are.

He defined positive aging as consisting of six dimensions:

1. absence of objective physical disability as rated by a doctor
2. subjective physical health as rated by the person themselves
3. length of undisabled life - whether the person had lost any years before age 80 to actual or perceived disability
4. objective mental health as rated by success in work, love, play, and avoiding psychiatric care
5. objective social supports - good connections with wife, children and grandchildren, siblings, playmates (eg golf, tennis, sailing) and social networks (clubs, etc) as rated by others
6. subjective life satisfaction as rated by the person themselves

He used these dimensions to classify over 500 subjects from different class backgrounds (college and inner-city) along a continuum that ranged from "happy-well" to "sad-sick" at age 70-80. The happy-well tended to have high ratings in most or all of these dimensions; those with low ratings were more likely to be sad-sick, or had died before age 70-80. Then he looked at factors that had been measured earlier in their lives to see what contributed to this rating.

First let's look at what did not predict positive aging. The happy-well did not have longer-lived ancestors, higher cholesterol, higher social class, warmer childhoods, more stable childhood temperaments, or higher stress than the sad-sick. Contrary to what we would believe, better genes, low cholesterol, social class, upbringing, temperament and stress-free living do not contribute significantly to a healthy and happy old age.

So what did contribute to a happy and healthy old age? Each of the following variables were shown to lead to a positive old age, regardless of social class or other factors:

1. Not being a smoker or stopping smoking before age 45. Not smoking heavily before age 50 was the single best predictor of healthy aging, but if they quit smoking completely before age 45 the effect at 70-80 was much the same.
2. Using adaptive coping styles. Coping styles involve the use of defense mechanisms to deal with stressful situations. We all use them, but some, such as humour, altruism and stoicism are "more mature" than others such as denial and passive-aggression. It is more adaptive, and healthier, to laugh at misfortune than to deny it is happening.
3. Not abusing alcohol. Alcohol abuse was defined as "the evidence of multiple alcohol-related problems" with family, work, health, and the law.
4. Healthy weight. Weight was measured using the body mass index (BMI). Being overweight (BMI> 28) or underweight (BMI<22) class="blsp-spelling-error" id="SPELLING_ERROR_1">positive aging.
5. Stable marriage. Getting to age 50 without divorce, separation or serious problems contributed to positive aging.
6. Exercise. Regular exercise of more than 500 kilocalories per week was required.
7. Years of education. Those with higher education tended to stop smoking, eat sensibly and drink in moderation because they were higher in self-care, future orientation and perseverance.

This is great news for all of us. All of these factors are controllable - we can ensure that we remain healthy and happy into old age just by controlling our smoking, alcohol consumption, weight and exercise, and by working on ourselves and our marriages to cope better with stress and setbacks. The fact that a higher education makes us more likely to do these things should not stop us just because we didn't go on to college or university.



Sources:

Christopher Peterson. (2006). A Primer in Positive Psychology. New York: Oxford University Press.

Vaillant, George E. (2004). Positive Aging. In P. Alex Linley & Stephen Joseph (Eds.), Positive psychology in practice (pp.561-578). New York: Wiley.