Special Article
Definitions and Predictors of Successful Aging: A Comprehensive Review of Larger Quantitative Studies

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Objective

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.

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. The authors categorized the components of these definitions and independent variables examined in relation to successful aging (e.g., gender, education, and social contacts).

Results

The authors identified 28 studies with 29 different definitions that met our criteria. Most investigations used large samples of community-dwelling older adults. The mean reported proportion of successful agers was 35.8% (standard deviation: 19.8) but varied widely (interquartile range: 31%). Multiple components of these definitions were identified, although 26 of 29 included disability/physical functioning. The most frequent significant correlates of the various definitions of successful aging were age (young-old), nonsmoking, and absence of disability, arthritis, and diabetes. 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. Gender, income, education, and marital status generally did not relate to successful aging.

Conclusion

Despite variability among definitions, approximately one-third of elderly individuals were classified as aging successfully. The majority of these definitions were based on the absence of disability with lesser inclusion of psychosocial variables. Predictors of successful aging varied yet point to several potentially modifiable targets for increasing the likelihood of successful aging.

Section snippets

Data Sources

We searched the following databases: PubMed and www.scholar.google.com using the following terms: successful aging/aging, healthy aging/aging, productive aging/aging, optimal aging/aging, aging/aging well. Next, we used the “related articles” function on the PubMed web site and examined reference lists from published articles to obtain additional papers.

Selections of Definition of Successful Aging

We restricted this search to only those articles that were published in English in peer-reviewed journals that met the following criteria: 1)

RESULTS

Our database search of English-language articles from PubMed yielded 407 articles for “successful aging,” 490 articles for “healthy aging 12 for “productive aging,” one for “aging well” or “robust aging” (We also found 51 articles for successful aging and 91 for healthy aging.). Duplicate articles from these searches were eliminated; reviews were excluded (N = 192), as were qualitative studies on successful aging (N = 9) and those that included adults younger than age 60 (N = 2). After also

DISCUSSION

We found considerable variability among the studies of successful aging in the proportion of subjects meeting operationally defined criteria, the domains that constituted definitions, how these domains were measured, and in the independent variables examined in relation to successful aging. Nonetheless, most investigations based their definitions, in part, on absence of physical disability/physical performance and, to a lesser extent, on absence of cognitive impairment. Approximately one-third

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    This work was supported, in part, by the Sam and Rose Stein Institute for Research on Aging at the University of California San Diego; by the National Institute of Mental Health grants P30MH066248, R25MH019946, T32MH019934; and by the Department of Veterans Affairs.

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