Successful Aging: Contentious Past, Productive Future

Rowe and Kahn’s (1987) article created a sea change for the field of gerontology. By distinguishing “successful aging” from “usual aging,” it took a discipline fixated on loss and transformed it to one characterized by heterogeneity and the potential for growth. Long before this, Cicero (44 B.C.) argued in his essay De Senectute that old age, if approached properly, harbors opportunities for positive change and productive functioning. In the first issue of The Gerontologist, Havighurst (1961) proposed successful aging as both an adaptable theory and a testable experience. One could say, therefore, that successful aging has been a topic of interest throughout gerontology’s history.

Scholars have debated what successful aging is, how to measure it, and how to develop interventions to promote it. They have questioned whether success should be defined objectively or subjectively, examined the role of culture, and deliberated whether successful aging is a process or an outcome. Yet, one of the greatest challenges faced by scholars of successful aging is the inconsistency with which successful aging is conceptualized and measured. In their review of 28 successful aging studies, Depp and Jeste (2006) identified 29 definitions of successful aging.

In an effort to further a scholarly, multidisciplinary dialog about successful aging, The Gerontologist invited authors to contribute novel conceptual manuscripts, empirical research articles and innovative review articles focused on successful aging. We encouraged articles that were conceptually based, methodologically sophisticated, and oriented toward policy and practice.

We received 90 abstracts in response to our call for articles—well beyond what we had imagined. Our team of associate editors encouraged the authors of 28.9% of these abstracts to develop their work into full manuscripts. Of the 26 manuscripts that went through our usual peer-review process, 11 were rejected; 15 are included in this special issue. The collection of articles in this special issue informs readers about the rich history of successful aging and encourages the next generation of theory, research, and practice.

The Successful Aging Concept

Rowe and Kahn’s article sparked many fiery debates as scholars questioned what successful aging is and whether successful aging is a worthwhile construct to study. These tensions, evident in this special issue, have pushed the field forward.

Peterson and Martin (2014), drawing on historical and linguistic humanistic perspectives, critically examine the word success. They explain that the term “success,” often used in the contexts of war, religion, and medicine can have neutral or negative connotations, and suggest that success is something to be approached carefully. They posit that attending to the origins of success can help gerontologists understand the meaning of successful aging.

Martin et al. (2014) begin by reviewing historical and early definitions of successful aging. They then elaborate on more recent conceptualizations, concluding that additional theoretical work is needed to better integrate physical and psychological asects of successful aging and to understand the way successful aging can encompass disability and dying. They identify questions that the next generation of gerontologists must address.

Knowledge develops through critical evaluation. Riley (1998), in a letter to the editor of The Gerontologist, called Rowe and Kahn’s model “seriously incomplete,” citing its neglect of the structural and social factors that influence aging. Katz and Calasanti (2014) develop this line of concern as they focus on disparities and social inequality of aging in the United States. They remind us that while there is much to like about the concept of successful aging, it also has a long history of criticism, largely because of its contention that individual responsibility and lifestyles drive success. They caution that critical perspectives on lifestyles are lost in the successful aging literature because individual choice is reduced to decontextualized health-relevant choices such as smoking, diet, and exercise and they contend that the most contentious critiques of the successful aging construct target those whom it excludes—those labeled unsuccessful agers. Warning that social inequalities evident earlier in life become more salient in later life, they highlight the importance of gender, race, ethnicity, and age and caution that social exclusion has the potential to harm.

Rubinstein and de Medeiros (2014) criticize Rowe and Kahn’s paradigm of successful aging for: (a) putting emphasis on individual social action and (b) failing to provide a policy agenda for the social and cultural change. Expressing concern for older adults who do not age successfully, Rubinstein and de Medeiros contend that the Rowe and Kahn paradigm implicitly sets up a two-class system of older adults which is not an optimal means for addressing the needs of older adults.

Stowe and Cooney (2014) take issue with the relatively static nature of Rowe and Kahn’s successful aging model, its emphasis on personal control over late-life outcomes, and neglect of historical and cultural context, social relationships, and structural forces in influencing late-life functioning. Embracing a life course perspective, they promote thinking about how successful aging can better align with micro- and macro-level issues. In a related article, Baker, Buchanan, Mingo, Roker, and Brown (2014) examine what it means to be successful among a group of people that often experience marginalization—Black women. Their conceptual review examines the Strong Black Women archetype as it applies to theories of successful aging.

Clearly, successful aging has had a blustery past. Martinson and Berridge (2014) provide a systematic review of the concerns and critiques expressed about the successful aging concept. Four themes emerge from their analysis: (a) “Add and Stir,” suggesting that the criteria for defining successful aging be loosened and the model expanded by adding missing criteria; (b) “Missing Voices,” urging the importance of understanding the subjective perspectives of older people; (c) “Hard Hitting Critiques” identifying key concerns about successful aging, including its individualistic approach, implied ageism and ableism, neoliberal contexts, negative influences on society and lived experience of older adults and impacts on social justice; and (d) “New Frames and Names,” rejecting the basic tenets of successful aging as exclusionary and limiting and embracing more universal models that give all individuals an equal chance to age with dignity, embracing loss, and integrating spiritual meaning, often with explicit influences from Eastern philosophies.

Golant’s (2014) article reminds us of the important role that environment plays vis-à-vis successful aging. He outlines a conceptual model explaining why older occupants of incongruent residential environments cope differently with their unmet needs and goals and contends that how well older persons cope with their incongruent residential environments depends on how they subjectively appraise their coping opportunities or repertoires. Focusing on older people who feel they occupy incongruent places, the model explains why over time these people adapt differently to their inappropriate circumstances by scrutinizing their secondary appraisal decision-making efforts and assess the viability and efficaciousness of their available coping strategies. Individual and environmental differences matter as they explain why some older people have more enriched coping repertoires and adapt more successfully than others.

Providing an alternative to the successful aging perspective that has dominated the United States, Foster and Walker (2014) note that “active aging” has emerged in Europe as the foremost policy response to the challenges of population aging. Acknowledging that active aging has been dominated by a narrow economic or productivist perspective as well as gender blindness, Foster and Walker suggest that active aging has the potential to enable countries to respond to the challenges of population aging because of its comprehensive focus and emphasis on societal as well as individual responsibility.

Empirical Studies

Alongside the growth of interest in the successful aging construct has been a surge in the number of empirical studies focused on successful aging. Articles included in this Special Issue reflect the general trend in articles submitted to The Gerontologist.

Jopp et al. (2014) examined the lay perspectives that young, middle-aged, and older adults from the United States and Germany have of successful aging. They found striking similarities across countries, age, and gender in the themes mentioned, which included resources (health, social), behaviors (activities), and psychological factors (strategies, attitudes/beliefs, well-being, and meaning). Of particular interest is that laypeople viewed successful aging in far more multidimensional terms than do established scientific theories.

Johnson, Sarkisian, and Williamson (2014) focus on the relationship between productive activity and successful aging. Analyzing data for 24 high-income Organization for Economic Co-operation and Development countries at seven time points, they find that countries with higher labor force participation rates among older workers have higher life expectancies. Moreover, labor force participation mediates the effects of gross domestic product per capita on male and female life expectancy and it mediates the effects of self-employment rates for men, but acts as a suppressor with regard to the effect of public spending on male and female life expectancy.

Examining 8-year trajectories of functioning in a large Australian sample of three cohorts, Sargent-Cox, Butterworth, and Anstey (2014) found that mastery was positively related to within-person change in physical and psychological health for all cohorts and to processing speed for the oldest cohort. Between-person mastery was positively associated with health across all cohorts. Physical activity indirectly influenced the between-person relationships between mastery and handgrip strength, physical health, and psychological health in all cohorts, and between master and processing speed for the oldest cohort. Sargent-Cox et al. conclude that psychological resources are important mechanisms for understanding the complexities of successful aging.

As the successful aging literature has grown, so too has interest in the extent to which a host of populations heretofore excluded from study are aging successfully. Cho, Martin, and Poon’s (2014) analysis of the experiences of centenarians and octogenarians revealed that: (a) physical health and social resources had direct effects on positive aspects of subjective well-being, (b) cognitive functioning and education had indirect effects on positive affect, (c) social resources mediated the relationship between cognitive functioning and positive affect, (d) cognitive functioning and social resources mediated the relationship between education and positive affect, (e) physical health mediated the relationship between cognitive functioning and positive affect, and (f) cognitive functioning and physical health mediated the relationship between education and positive affect.

Articles by Fabbre (2014) and Fredriksen-Goldsen, Kim, Shiu, Goldsen, and Emlet (2014) focus on successful aging among Lesbian Gay, Bisexual, & Transgender (LGBT) populations. Fabbre’s article used queer theory to explore the experiences of transgender persons who contemplate or pursue a gender transition in later life. Findings suggest that many transgender older adults experience challenges to their gender identities that put their emotional and physical well-being at risk. Fredriksen-Goldsen et al., using a resilience framework, investigated the relationship between physical and mental health quality of life in a large cross-sectional survey of LGBT adults aged 50 and older.

The Future of Successful Aging

Where do we go from here? Some have suggested that the concept of successful aging should be abandoned. They point to social inequalities and the problems associated with labeling a person as an unsuccessful ager and suggest alternative labels, including “healthy,” “positive,” “active,” “productive,” and “effective” aging. These terms, lacking the long history that successful aging has enjoyed, struggle with similar conceptual and methodological limitations. The popular press has become fascinated with the topic of successful aging, and tips for achieving successful aging are abundant in magazines and on the Internet. It would be irresponsible for gerontologists to abandon the concept of successful aging.

Nearly three decades after Rowe and Kahn’s initial article was published, it is incumbent on gerontologists to use the conceptual and empirical knowledge base that now exists to develop consensus about what successful aging is and how it should be measured. We should approach this goal knowing that our measures will not be perfect, but at least our findings will be comparable. Advancing this work will help us learn how individuals can experience successful aging regardless of their social or health conditions. Finally, with an enhanced understanding of what successful aging is, we will be in a stronger position to develop interventions that will enable more people to age successfully. The sheer number of people comprising the Baby Boom generation transformed academic interest in successful aging to a public policy imperative. Now more than ever it is critical to develop science that empowers people to experience the best old age possible.