How do you feel about growing old?
For some, it’s a scary time filled with change and loneliness.
But it doesn’t need to be that way. In fact, it shouldn’t. We’re social creatures and growing old isn’t a solo sport. That’s what positive aging is all about.
How we choose to define, view, and accept the changes is crucial to our ability to “age gracefully.” Positive aging allows us to weather the expected and unexpected changes we experience.
We’re living longer. How will you plan and prepare for the next decades of your life?
Before you read on, we thought you might like to download our 3 Positive Psychology Exercises for free. These science-based exercises will explore fundamental aspects of positive psychology, including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.
This Article Contains:
- What is Positive Aging?
- A Look at the Psychology of Aging
- The Principles and Philosophy Behind Positive Aging
- What Does the Research Say?
- Negative Beliefs on Aging
- How Does the Definition of Well-being Change For Older Adults?
- Brain Plasticity and Aging
- Positive Aging Theories
- 12 Interesting Facts
- 4 Examples of Positive Aging
- The Positive Aspects and Effects of Aging
- How Does Attitude Impact Aging?
- 10 Tips & Strategies to Promote Positive Aging
- A Look at Positive Ageing in Aged Care
- Recommended Positive Aging Articles
- When and What is Positive Aging Week?
- Positive Ageing in Various Countries
- 5 Recommended Books about Positive Aging
- 21 Quotes on the Topic
- A Take-Home Message
What is Positive Aging?
This is an interesting question. Worldwide cultures don’t define it the same way. Those who revere their elders look to them for wisdom and guidance. These cultures don’t see their elders as a burden or hinderance. They respect them.
Other cultures — those who value youth and physical beauty more than the wisdom that can come with age — have a different perspective. Oftentimes, it’s those in this group who choose to fight aging.
Aging is inevitable. We all know this to be true, but as you continue reading, you will learn that some people believe aging is a disease. They believe it’s curable.
For now, though, here are a few current definitions of positive aging.
A way of living rather than a state of being (Positive Ageing, n.d.).
“The process of maintaining a positive attitude, feeling good about yourself, keeping fit and healthy, and engaging fully in life as you age” (Positive Psychology Institute, n.d.).
“Positive aging reflects the attitudes and experiences older people have about themselves and how younger generations view the process of aging. It takes into account the health, financial security, independence, self-fulfillment, personal safety and living environment of older New Zealanders” (Ministry of Social Development, 2001).
“Successful aging is multidimensional, encompassing the avoidance of disease and disability, the maintenance of high physical and cognitive function, and sustained engagement in social and productive activities” (Rowe & Kahn, 1997).
World Health Organization (WHO)
“The process of developing and maintaining the functional ability that enables wellbeing in older age” (WHO, 2020).
“Japanese conceptions of aging are rooted in Buddhist, Confucian, and Taoist philosophical traditions that characterize aging as maturity. Old age is thus understood as a socially valuable part of life, even a time of “spring” or “rebirth” after a busy period of working and raising children” (Karasawa et al., 2011).
“The criteria are sufficiently inclusive, encompassing physical health, mental health, social engagement, and nutritional status, which in principle are in conformity with both the WHO definition and the Rowe and Kahn model” (Zhou, Liu, & Yu, 2018; referencing the Chinese health criteria for the elderly).
“Active aging is concerned with facilitating the rights of older people to remain healthy (reducing the costs of health and social care), remain in employment longer (reducing pension costs), while also participating in community and political life” (Foster & Walker, 2015).
Successful aging and active aging aren’t defined the same way worldwide. The former tends to follow the definition put forth by Rowe & Kahn (1997). The latter is akin to a life course-oriented perspective (Foster & Walker, 2015). See the section titled, “Positive Aging Theories” later in this article. Also, note that positive aging is closer to the definition of active aging.
These terms are sometimes used interchangeably. So, it’s good to know where the research originates. Other terms you might read are healthy aging, positive aging, productive aging, and competent aging (Foster & Walker, 2015). Again, each differs in meaning, but successful and active aging dominate the research.
Cathleen Toomey discusses the upside of aging in her Tedx Piscataqua River talk, The Secret of Successful Aging. The key? Don’t let loneliness take over your life. Real conversations are the answer. We’re social beings and need to stay connected to others.
She also suggests these three things:
- Celebrate your age
- Defy expectations
- Grow friendships
Economies and Opportunities
You might be curious why this is such a hot topic. WHO estimates that by the year 2050, the number of people over the age of 60 will be 2 billion. By 2020 this age group will outnumber children less than 5 years old.
Because people are living longer, many countries must adapt their health policies. Now more than in the past, we must consider how to better assist the transition from middle to old age. We must also reevaluate what “old” means.
As campaigns encourage engaging in an active lifestyle, more older adults continue working. This can ease the burden placed on pension programs. It also creates business opportunities.
The greying of societies shift the economic focus. Businesses can develop products and services to address the needs of older adults. For example, socially assistive robotics (SARs) have been in development since 1980. Honda conducted research that led to the creation of Asimo. It became the first humanoid robot to walk, climb stairs, and have the ability to interact based on pre-defined constructs (Miller, 2017).
A Look at the Psychology of Aging
Aging can be difficult to accept. Our body might not be able to do the things it did when we were young. Bones break easier. Aches and pains can be a daily occurrence. Our vision becomes impaired. Our hair turns grey or white. Sometimes it falls out. Our noses and ears stretch. We get shorter.
These experiences have a psychological impact on us. This is especially true in cultures that don’t revere their elders.
As we age and become less valued in our society, we struggle to find our place. We have to redefine who we are and identify our purpose. As you’ll read later in this article, this is important if you want to be a centenarian.
By 2030, it’s estimated that 15 million older adults will need mental and behavioral care (APA, n.d.). Coping with one’s disease or the disease of a loved one can lead to anxiety and depression. The loss of autonomy and loneliness also contributes to poor mental health.
Older adults might need help managing day-to-day activities that they used to do themselves. This can lead to frustration, anger, and family conflicts. Grieving a life partner is another reality of growing older.
Each of these instances, and others, can cause a person to experience a mental health disorder.
Geropsychologists specialize in providing care to older adults. They work in private practice and in health care facilities. These psychologists research the aging process, and design and test interventions. Their goal is to help the older adult overcome a problem and increase their wellbeing.
The Principles and Philosophy Behind Positive Aging
Greek philosophers wrote about aging. The Bible talks about aging. The Romans and Cicero “idealized old age” (Martin et al., 2015). Martin and his colleagues discuss aging from a cultural perspective first.
They explore the similarities between the last two stages of the Hindu model of the life span with more contemporary scholars. In their article, Defining successful aging: A tangible or elusive concept? the authors explain the history of theories contributing to positive aging.
The theorists they discuss are:
Jung who considered late life as a time to look inward.
Erikson’s eighth stage called integrity versus despair. Successful aging involves an “evaluation of one’s life as having been fulfilling and satisfying” (Martin et al., 2015).
Neugarten who agreed with Jung’s perspective. Later, she agreed with Reichard, Livson, and Peterson, that personality is important in the study of successful aging.
Havighurst’s focus was satisfaction and happiness as the basis for defining successful aging. He believed aging is either active or disengaging. Active means a person carries over activities and attitudes from middle age into later life. Disengaged means the person desires to remove him-herself from an active life. He’s credited with coining the term “successful aging” (Zhou et al., 2018).
Reichard, Livson, and Petersen defined successful aging as “being well-adjusted.” Their research, published in 1962, focused on 87 men and personality traits. The researchers identified the following as well-adjusted retirement types: the mature; the rocking chair; and, the armored.
Rowe and Kahn’s three-factor model is the one many follow today. Their focus is freedom from disease, remaining cognitively and physically adept, and social engagement.
Their model marked the beginning of discussions about successful aging. Prior research had centered on illness, disease, and decline in old age (Foster & Walker, 2015). It didn’t consider that older adults could thrive.
Not everyone agrees with Rowe and Kahn. Stowe and Cooney (2015) view successful aging from a life course perspective.
This approach looks at life as:
“a dynamic lifelong process, embedded in historical time and place, and influenced by the web of relationships individuals are linked to, as well as more distal social factors.”
In a nutshell, their perspective is holistic.
In several countries, the definition put forth by WHO tends to guide policy decisions.
Health for All is “values-based and values-driven” (WHO, 2005). It demands equity in the pursuit of one reaching one’s full health potential. The policy promotes collective responsibility (solidarity) and participation.
The vision of Health for All encompasses four areas:
- Patient care.
- Prevention which includes immunizations, monitoring, and early detection.
- Promotion of healthy lifestyles focused on educating people about the importance of exercise and nutrition. It also addresses the use of drugs and alcohol.
- Addressing health determinants focuses on society at large. It considers the physical, social, and economic factors affecting health (WHO, 2005).
What Does the Research Say?
This is the only information you need to read today about successful aging. It’s a “drop the mic” moment.
It all begins with Elizabeth Blackburn’s childhood fascination with life. She wanted to know everything she could about chromosomes. Blackburn was specifically interested in the ends where the telomeres are.
She wanted to know what’s inside telomeres, but she needed a lot of them to figure this out. Pond scum was the answer.
Every time DNA gets copied in humans, the telomeres at the ends get worn down. She learned that telomeres found in pond scum don’t shorten. Blackburn set out to find out what kept them from shortening and dying off.
As she studied, her research led to the discovery of telomerase. This is an enzyme that fixes the caps at the end of our chromosomes.
The shortening of telomeres is what creates the signs of aging. For example, grey hair, wrinkles, and a weak immune system. The longer our telomeres, the less the effects of aging.
How do we get more telomerase? On the surface, it’s not an easy answer. As she points out, we can’t go to Costco (or Amazon) and buy a big jug of telomerase.
Having less leads to certain diseases associated with aging, but too many increases our risk of some cancers.
We all want to live longer. She defines health span as the number of years we’re healthy, disease-free, and have a zest for life. How do we do that? And, what role can or do telomeres play?
Blackburn, along with a fellow researcher, set their sights on a real-world telomeres question.
What happens to people under consistent and constant psychological stress?
They studied caregivers whose children had a chronic condition. The more years a mother cared for their child, the shorter their telomeres. The woman’s age didn’t matter. The more the mother perceived her situation as stressful the less telomerase she had.
Some mothers maintained their telomeres. They were resilient and viewed their situation as a challenge. This reduced their perceived stress. Life events and the way we respond to them is something we can control.
She and her research partners received the 2009 Nobel Prize in Physiology or Medicine. Over 10,000 papers up to 2017 support Blackburn’s findings.
What can we do?
One study she referenced used meditation. The caregivers practiced for 12 minutes/day for two months. This improved their maintenance level of telomeres.
Change your attitude. If you’re negative, your body gets a surge of the stress hormone cortisol. This hurts your telomerase and telomeres.
Approaching stressful situations as a challenge, creates a surge of cortisol, too. But, in this case, it’s temporary and useful. Your telomeres are fine.
Can outside factors affect our telomeres? Are they social?
Violence, bullying, and racism have a long-term negative affect on a person’s telomeres. People living in dangerous neighborhoods with no sense of community, have shorter telomeres.
Healthy communities, being in a marriage long-term, and having lifelong friendships, maintain telomeres.
We affect each other.
Negative Beliefs on Aging
Stereotypes are “unchallenged myths or overstated beliefs” (Dionigi, 2015, p. 1) about a group. These beliefs become entrenched in verbal, written and visual media. Stereotypes affect the self-perception of individuals within the group. This can be negative or positive.
There are many stereotypes associated with aging, particularly in Western cultures. Some are negative. For example, older people are frail, forgetful, can’t drive, and are slow. Old people are always sick. They live in nursing homes. Elderly people can’t learn anything new. These are a few examples.
The adjectives used to describe anyone over the age of 55 are potentially negative. They can contribute to negative stereotyping. Terms such as elderly, old, old-old, oldest-old, seniors, old people, and the aged don’t speak to the wealth of knowledge this population contributes.
Stereotypes of aging: Their effects on the health of older adults (Dionigi, 2015) is an excellent resource. Its focus is the physical and mental aspects of stereotyping, and the well-being and perceived quality of life of older adults. Dionigi (201 5)explores the theory and method of various studies in the review.
Dionigi (2015) uncovers several disturbing findings. Among them are that the pervasiveness of negative stereotypes in Western culture affects older adults’ cognitive and physical performance and recovery from disease.
The older adult may also be part of another marginalized group. This compounds the negative stereotype issue. An important aspect of Dionigi’s (2015) review is it highlights the need to study a person’s holistic health from this perspective.
Ashton Applewhite tackles ageism, the ultimate negative stereotype, in a TedTalk, “Let’s end ageism.”
WHO (2016) conducted a World Values Survey to assess the level of discrimination and negative attitudes toward older adults. Their analysis revealed that “60% of respondents reported that older people aren’t respected.” The survey included responses from 83,000 people in 57 countries. High-income countries had the lowest level of respect for older adults.
The report from WHO echoes Dionigi’s findings. Negative perceptions and treatment of older adults contribute to a downward health spiral.
Dr. William Thomas specializes in caring for older people. There are only 6000 geriatricians in a population of 300 million in the U.S. Geriatricians are rare. The number of specialists has declined as the number of older Americans is rising. The reason? He believes it’s ageism.
American society, unlike some other cultures, has extended the cycle of adulthood. Baby Boomers want to remain in that stage as long as possible to avoid the labels, ‘old,’ ‘older,’ and ‘senior.’
He advocates a redesign of the human life cycle. In his words, “We’re living in a society of adults without elder supervision.” This has happened because of our obsession with youth. It’s time for Elderhood Rising – the dawn of a new world age.
How Does the Definition of Wellbeing Change For Older Adults?
There’s no consensus around a definition of well-being. At its core it is, “judging life positively and feeling good” (CDC, n.d.). From this perspective, any major life event can positively or negatively affect it. Age doesn’t matter.
From a general perspective, cultural differences predict subjective well-being (SWB). These include, cultural differences about the wealth of a nation and its effect on SWB. Some studies show that people in wealthier countries don’t feel more positive emotions. They think they’re happier, but they’re not when compared to people in poorer countries. Personal factors predict emotional well-being (Suh & Choi, 2018).
There also are cultural differences in defining happiness. Several studies compare collectivistic and individualistic cultures. The former tend to view it from an external, societal vantage point. The latter takes a more internal, personal perspective (Suh & Choi, 2018).
To further complicate definitions of SWB, not all cultures agree about how desirable or necessary happiness is. For example, Western culture prizes it, but East Asian and Islamic cultures don’t.
Differences in how one views emotions and wellbeing also exist. Researchers now understand that some cultures value high activation positive affect (HAP). These are things like excitement and elation. Other cultures prefer low activation positive affect (LAP). These are traits like calmness and serenity (Suh & Choi, 2018).
Cultures also differ in the importance placed on the self. A strong predictor of happiness in Western cultures is self-esteem. This isn’t true for Asian cultures. The latter appears to place a higher value on relationship harmony (Suh & Choi, 2018).
A few universal predictors of happiness exist. For example, income, extraversion, and positive affect, according to Suh and Choi (2018).
From a macro perspective, the definition of SWB doesn’t change based on age; it changes based on culture. This is one reason why there are challenges in creating a universally-accepted definition.
From a micro perspective, physical changes begin in the mid-to-late forties. Some are small, and don’t disrupt a person’s sense of well-being much. For example, needing to wear bifocals or reading glasses.
Other events, like bad knees, back pain, stiff joints, or a chronic disease can have a negative effect. Each of these effects one’s ability to stay involved in daily activities.
SWB is multidimensional. Jivraj, Nazroo, Vanhoutte, and Chandola, (2014) measured the quality of life, depressive symptoms, and life satisfaction. They wanted to know if age-related changes affected SWB. Their findings support that older adults experience equal or better SWB than younger people. But, SWB declines among the oldest people.
Jivraj and colleagues (2014) assert that there are differences in SWB among older people. As a result, it’s important to figure out when declines start across various measures, that is, at what age.
Karasawa and colleagues (2011) wanted to determine if differences exist between Japanese and American older adults. They measured three SWB factors: personal growth, purpose in life, and interpersonal well-being.
Their results showed lower scores for purpose in life in both cultures. Among older Japanese, personal growth was higher than for midlife adults. In the U.S. the opposite was true. Japanese rated interpersonal well-being higher than U.S. participants, but this was only true for younger adults.
The researchers also found gender differences. Men in both cultures had lower interpersonal well-being scores. Women had more negative affect.
They suggest that future studies include larger sample sizes and culturally sensitive measures. Their study used a convenience sampling of 482 Japanese adults and 3032 Americans.
Most studies acknowledge the need for continued research especially cross-culturally.
Brain Plasticity and Aging
Neuroplasticity doesn’t stop at age 55. The plasticity in the older brain is in a different area than in younger brains. In older brains, the change is in white matter. White matter houses the brains axons covered in myelin. Myelin makes the transfer of signals faster.
In Yotsumoto and Chang’s (2014) study, when older adults learned a new visual task, the white matter in their brains changed. This change was significant. Younger brains show changes in the cortex.
Park and Bischof (2013) examined the effect of brain training on adult learners. They wanted to know if the aged brain changes in response to stimulation. From their findings, they believe that changes in activation might be due to strategies employed by the participants. Park and Bischof (2013) couldn’t rule out that changes in neural activity indicated neural plasticity.
Cognitive training or participation in demanding tasks can improve cognitive function. This training-specific activity doesn’t have “far-transfer.” Far-transfer is the ability to apply the training to other tasks with similar processes. Park and Bischof (2013) acknowledged that the “persistence of training effects” is “impressive.”
The researchers argue that pleasurable leisure activities are better than computer-based training.
Pauwels, Chalavi, and Swinnen (2018) found that older adults learned tasks better when using a random practice schedule. In their study, they compared young and old participants’’ ability to learn three versions of a bimanual visuomotor tracking task.
They split participants between a block or random training schedule. Block schedules are more sequential and less demanding.
Training happened over a 3-day period with follow-up after six days. Both groups experienced temporary bad performance during the acquisition stage. This was due to contextual interference effects. In the retention phase, both groups demonstrated superior skills.
The bottom line is as we age, not only can we still learn complex tasks, we can retain our learning as well as a younger person. Older adults also have the benefit of crystallized intelligence. This is one’s ability to combine learned knowledge with experience to tackle new problems. This form of intelligence grows with age.
Positive Aging Theories
Elaine Cumming and William E. Henry (1961) developed the disengagement theory. Their theory is that as we age we remove ourselves from social roles and interactions. We do this because we realize death is imminent. Rather than have our reputation damaged due to the loss of skills, we retreat.
Cumming and Henry’s (1961) theory includes 9 beliefs. They are:
1. Everyone expects death.
Older adults accept that they’re losing abilities as they age, so they begin to leave their networks.
2. Fewer contacts create behavioral freedoms.
This creates an “I can do whatever I want” approach to their behavior.
3. Men and women differ in their experience.
Men have instrumental roles. Women don’t.
4. The ego evolves as it ages.
The older adult steps aside so the younger person can take over in whatever role the elder leaves. The older person seeks out personal enjoyment.
5. Complete disengagement occurs when society is ready for it.
Older adults can’t transition unless society is ready to let them.
6. Disengagement can occur if people lose their roles.
Roles are gender-specific. Men do labor. Women handle domestic responsibilities. If they’re unable to fulfill their role, then disengagement happens.
7. Readiness equates to societal permission.
When an older adult begins pondering their death, sense a loss of status, and lose “ego energy,” then society allows disengagement.
8. Relational rewards become more diverse
Societal rewards tend to include upward mobility. Disengagement creates horizontal rewards. People look to their remaining interpersonal relationships to fill the vertical reward void.
9. This theory is independent of culture.
It takes on the norms of the person’s culture.
The entire process is mutual and acceptable between the person and society. A person’s usefulness determines when they disengage. A delay in disengagement happens if society still deems the person useful.
Cumming and Henry developed and published their theory in 1961. It’s outdated. This theory also assumes that a family consists of a male and a female adult. It doesn’t consider same-gender or single parent families.
The Activity Theory
The activity theory proposes that aging adults who engage in daily activities, that they perceive as productive, age successfully. It takes into account the value of social interactions in aging gracefully.
Developed in 1961 by Robert Havighurst, it applies to anyone at any age. People are happier when engaged in activities they enjoy. This fits well with the Self-determination Theory of motivation.
SDT highlights the importance of autonomy, competence, and relatedness to increase intrinsic motivation. Combining the two concepts it’s easy to see why a person’s day-to-day happiness is greater.
There are a few critiques of the Activity Theory (Health Research Funding, n.d.).
First, it assumes equality. Not everyone has the same health status or economic footing. Sometimes pursuing one’s favorite activity isn’t possible.
Second, activities need to be meaningful to the person. Have you ever had a teacher who assigned “busy work?” It’s usually boring and you feel like you’re wasting time.
Third, this theory only looks at the older years. So, if your expertise has been a particular field for many years, what happens if you can’t do that anymore?
Continuity theory is a person’s ability to maintain their habits, preferences, lifestyle, and relationships as they age. It states that people try to maintain continuity between who they were and who they’re becoming. It’s like the concept of crystalized intelligence. A person takes their knowledge from the past and applies it to future changes.
There are three levels of continuity. Think of it like Goldilocks and the Three Bears. One is not enough, another is too much, but one is just right. Continuity Theory is about balance.
There also are two types of continuity: internal and external. Internal is about our personality traits while external is about our environment.
Read this article – A Continuity Theory of Normal Aging by Robert Atchley (1998) for more information.
The Life Course Perspective
This theory takes into consideration your previous life experiences including your family history. It’s a proactive, connected approach. It encompasses social, emotional, and physical development throughout the life span.
- Life-span development: Human development and aging are lifelong processes.
- Agency: Individuals construct their own lives through the choices and actions they take within the opportunities and constraints of history and social circumstance.
- Time and Place: The life course of individuals is embedded and shaped by the historical times and places they experience over their lifetime.
- Timing: The developmental antecedents and consequences of life transitions, events, and behavioral patterns vary according to their timing in a person’s life.
- Linked Lives: Lives are lived interdependently, and socio-historical influences are expressed through this network of shared relationships.
What is the life course approach to public health?
12 Interesting Facts
- Older adults enjoy social media. Sixty-four percent of Americans between the ages of 50-64 use social media. Thirty-seven percent of Americans over the age of 65 access social media sites. Facebook is the most popular with 41% of adults 65+ checking into their pages (Pew Research Center, 2018).
- Volunteerism is a big part of life for aging adults. In 2015, people over the age of 55 volunteered 3 billion hours to their communities (Carr, 2018). According to Carr, this is a value of $77 billion.
- Older female migraine sufferers might experience a decrease in the amount, intensity, and duration of their migraines (Hassan, n.d.). Researchers aren’t sure why but suspect it’s related to hormonal changes.
- Older adults are 11% more emotionally stable by the time they reach 70-years-old compared to Americans who are age 25-39 (Elder Options, 2018a).
- Aging adults have crystallized intelligence. This means that compared to younger people, they’ve gotten good at what they do, and can apply that knowledge to other areas more readily (Elder Options, 2018a).
- Older adults care less about what other people think of them (Elder Options, 2018a).
- Older Americans have more voting power because they’re the fastest growing demographic (Elder Options, 2018a).
- Older adults who stay connected to others have better health and life satisfaction (Elder Options, 2018b).
- Older women might have a better sex life (Thompson et al., 2011). Their study focused on older postmenopausal women. The researchers concluded that “self-rated successful aging, quality of life, and sexual satisfaction appear to be stable” (p. 1503). Their study included 1235 women aged 60-89.
- Sex doesn’t stop at 65. A healthy sex life and a healthy life go hand and hand. Older people in better shape (mentally and physically) are 1.5 to 1.8 times more likely to express interest in sex than unhealthy people (Lindau & Gavrilova, 2010).
- Quality of sex trumps quantity as people age (Forbes, Eaton, & Krueger, 2017). With age comes wisdom in the bedroom.
- Did you know that we have limits to the number of times our cells replicate? In humans, it’s about 50 times. Check out The Science of Aging (below) for a recap on why we get old, and why it’s okay.
4 Examples of Positive Aging
Author Isabel Allende shares her perspective on aging gracefully in How to live passionately – no matter your age. Her humor and honesty are engaging. Her message is timeless.
Ann Ranson encourages everyone to Celebrate Age in her Tedx SMU talk. She says,
“Embracing age is an art to be savored and celebrated lest we reach our end days in frustration, disappointment and fear. “
Fired at the age of 64, Paul Tasner shares his experience building his own company around clean technology. How I became an entrepreneur at 66, is his account of competing with younger tech-savvy entrepreneurs and succeeding.
He encourages older adults to venture out, solve a meaningful problem, and build a business. According to his research older entrepreneurs have a 70% success rate. Younger entrepreneurs have a 28% success rate.
Many of us collect things as we get older. We have trophies we’ve won, books we loved, and tons of pictures. What happens to them when we’re gone? Will they have meaning for someone else?
Some older adults ‘death clean.’ This process involves clearing out closets and getting rid of things before death. The intent is to reduce the burden on one’s family. In A rite of passage for late life, Ben Stein explains how he handled the ‘death cleaning’ process.
The Positive Aspects and Effects of Aging
Actress Jane Fonda shares her perspective on what she and researchers now call The Third Act. She offers a new metaphor for aging — a staircase. The human spirit evolves upward as though climbing a staircase.
Here’s how she explains it:
Kaoru Nashiro and colleagues (2011) earned an award from the APA for her research about older adults’ reversal learning. Reversal learning is teaching a person to discriminate between two items, then asking them to choose the reverse. For example, you’re asked to select the red dot during several trials. Then, you’re asked to select the blue dot.
Generally, younger people can do this better than older people. But, Nashiro and colleagues uncovered something interesting. When older participants received positive outcomes, they performed similarly to younger participants. Negative outcomes led to more errors for older participants.
Her study relates to previous research about attention and memory in older adults. Results from that area show that older adults prefer to pay more attention to positive than negative information. This might also connect to the findings that older people are more emotionally stable.
Maybe filtering out the negatives is one key to positive aging. Of course, it also helps that as we age we care a lot less about what others think of us.
How Does Attitude Impact Aging?
The Irish Longitudinal Study on Ageing (TILDA) offers a plethora of data. Its comprehensive research studies have garnered international attention.
In 2016, their researchers shared, You’re only as old as you feel! The report highlights two important findings about attitude.
Older adults with negative attitudes towards aging had slower walking speed and worse cognitive abilities two years later, compared to older adults with more positive attitudes towards aging.
This was true even after participants’ medications, mood, their life circumstances and other health changes that had occurred over the same two-year period were accounted for.
“Negative perceptions of aging may modify the association between frailty and frontal cognitive domains in older adults.”
Robertson & Kenny, 2016
Principal Investigator, Professor Rose Anne Kenny shares the results of the second wave of the TILDA study.
What these researchers are doing is an example for other countries. If you’d like to learn more about later waves visit their website.
If you have any doubts about how attitude affects well-being, 109-year-old Alice Herz-Sommer can change your mind. She survived the Holocaust and cancer. She says, “Everything in life is a present.”
10 Tips & Strategies to Promote Positive Aging
There are five places in the world where people live longer than anywhere else. Known as The Blue Zones they include Ikaria, Greece; Loma Linda, California; Sardinia, Italy; Okinawa, Japan; and, Nicoya, Costa Rica.
Researchers, Gianni Pes, Anne Herm, and Michel Poulain (2013) discovered that Sardinia has the most male centenarians. They wrote about this for the Journal of Experimental Gerontology. Blue Zones founder, Dan Buettner, decided to see if there were other ‘hot spots’ like Sardinia.
In collaboration with demographers and researchers, Buettner (n.d.) identified nine specific lifestyle habits of the Blue Zones.
People in the Blue Zones live in areas that push them to move without thinking much about it. Their exercise includes activities like gardening.
Called ‘Ikigai‘ by the Okinawans, this is your reason for getting up in the morning. Find it and you’ll live about seven years longer.
Learn how to manage stress. People in Blue Zones pray, remember their ancestors, take naps, or engage in happy hour.
Stop eating before you’re full. Eat your smallest meal in the late afternoon or early evening, and don’t eat anything else. This is how Blue Zone people live longer. They control their weight.
Eat more beans. Some people in the Blue Zones eat pork, but not more than a handful of times in a month. Serving sizes are 3-4 oz.
Wine at 5
Buettner discovered that everyone in the Blue Zones except Adventists, drink alcohol. They drink 1-2 glasses/day with friends and/or with food. He suggests Sardinian Cannonau wine.
Most of the centenarians belonged to a faith-based community. Their research shows that attending services four times per month adds 4-14 year to your life.
Loved Ones First
Blue Zone people put family and their partners first. Aging parents and grandparents often live in the same home with their children, or nearby. This lowers disease and mortality rates of children in the home, according to Buettner’s team.
Centenarians either chose their social circles or were born into them. Those circles supported healthy behaviors.
Here’s Buettner’s TedTalk, How to live to be 100+.
If you’re an aging advocate, check out Gaining Momentum. It’s a communications toolkit that can help you communicate better about this topic. It explains several evidenced-based resources. For example, Frameworks researchers tested various descriptors. They found the term “older people” led to “productive thinking about people in their 60s and beyond.”
A Look at Positive Ageing in Aged Care
Meaningful Ageing Australia is an incorporated association registered with the Australian Charities and Not-for-Profit Commission. Their focus is helping older adults navigate aged care decisions. They do this through an emphasis on the whole person, including spirituality.
The organization launched a campaign in February called See Me. Know Me. The purpose is to give older people resources when seeking aged care.
The See Me. Know Me. website provides free downloads and conversation starters for older people to engage their families. It also has questions to ask aged care providers.
Some of the questions are:
- How will you support me to maintain connections and relationships?
- What do you do to support a good transition?
- How is spirituality understood here?
- What opportunities will I have to reflect on my legacy?
- How will you find out about my sources of hope?
Aging in Place
Many older adults want to age-in-place. In the U.S. that number is 3 out of 4 adults age 50+ (Binette & Vasold, 2018). The desire to remain in their homes and communities is strong. Here are strategies respondents to the AARP survey said they’d consider.
32% sharing their home
31% building an extra dwelling
56% living in villages that support aging in place
Being able to remain in one’s home or community contributes to an older person’s well-being. In the U.S. there are organizations who assist people who want to pursue this option.
Aging In Place provides resources about products and services for older people. Their goal is to help older people age-in-place for as long as possible.
The 5 most important elements of home care for seniors guide (2019) suggests the following when choosing a home health aide:
- Experience – Interview the agency and the people they send. A trained aide can handle any tasks an older adult might have trouble doing on their own.
- Empathy – Home health aides need this trait. If the person you or your loved one hires lacks this, then file a complaint and find someone new.
- Professionalism – The aide needs to show up and do their job with respect.
- Affordability – If prices are too high or too low this could be a red flag. Most agencies charge similar prices.
- Reputation – Read reviews to determine if the agency provides consistent, quality service.
They might seem obvious, but when you or your loved one feels overwhelmed by changes, things aren’t always clear.
Nursing homes in America and other parts of the world vary in quality of care. When possible seek out those organizations whose focus is the whole person.
Above all, residing in an aged care facility doesn’t have to be a death sentence. As we discovered from the TILDA research, attitude is a critical part of our experience.
Recommended Positive Aging Articles
Following are a collection of articles to entertain, educate, and inspire you to embrace your third act.
- The Happiness India Project (HIP) promotes everyday happiness through science-backed articles and workshops. – You might enjoy reading, Positive aging: 7 Things to do to age gracefully.
- Aging in Sub-Saharan Africa: recommendations for furthering research
While not specifically about positive aging, this article gives insights into the challenges of aging in Sub-Saharan Africa. This is useful background for a better understanding of applying worldwide aging policies.
- Gerontogrowth and population aging in Africa: Why does the differentiation matter? offers further insight into why applying aging policies is important. African countries have been experiencing growth. Their aging population is smaller than that growth. This poster paper addresses this topic.
- Cultural perspectives on aging and well-being: A comparison of Japan and the U.S. addresses the differences between these two cultures. The results of their study might surprise you.
- If you’d like to understand a Middle Eastern perspective, read Ageing in the Middle East and North Africa: Towards a new model of care. The authors provide an excellent overview of current issues and challenges. They also explain how to move forward.
- Johnson and Mutchler (2014) discuss the transition from aging as disease and decline to aging as a positive, multidimensional experience. Read The emergence of a positive gerontology: From disengagement to social involvement.
When and What is Positive Aging Week?
Positive Aging Week started in Ireland. It’s a worldwide event celebrating aging. This year it happens September 30 – October 4, 2019, and you don’t want to miss the fun. Events, organized worldwide by a variety of groups, included 550 that took place in 25 countries last year.
Go to PositiveAgingWeek.com to schedule your event.
Events themes are:
- Monday – Grandparents Day/Intergenerational Day in Primary Schools;
- Tuesday – Assistive technology and supports for older people to maintain their independence. Maybe SARs will be a part of one in 2019.
- Wednesday – Wellbeing focused on exercise and nutrition
- Thursday – Positive aging
- Friday – Fundraising for the National Day of Support for Age Action.
Weekend AM Virginia Media Television interviewed two representatives from Age Action Ireland. They discuss the purpose of Positive Aging Week. Their goal is to transform our thinking around aging.
Positive Ageing in Various Countries
Positive Aging in the UK
Guy Robertson is the founding director of Positive Ageing Associates. Projects include: personal development, the Be Age Proud campaign, positive aging & resilience training.
In this video, he discusses age-friendly cities of the future that address loneliness. Isolation affects 10-15% of older people. These people are suffering from severe loneliness that negatively affects their health.
The Royal Society of Public Health (RSPH, n.d.) issued a report titled, That age old question, to examine attitudes about aging. Here’s what they found:
Millennials are the most ageist. People from black ethnic groups are a lot more positive about aging. The public is most ageist about memory, physical appearance, and participation in activities.
Adapting programs to meet the needs of older people is a priority in many communities. For example, One Dance UK received funding in 2017 to begin a Dance Activator program. The purpose is to engage older adults in physical activity that’s fun and social.
Positive Aging in Australia and NZ
Jane Caro shares her perspective on aging in Growing old: The unbearable lightness of aging. In this wonderful, humorous talk Caro gives us several upsides to growing old. She also challenges us to rethink the messages about aging today.
“Getting older concentrates the mind.”
Tim Sharp, founder and CHO of The Happiness Institute, discusses the realities of growing old. It’s not all doom and gloom. He asserts that most older adults the world over are active and healthy.
The Psychology of possibility based on Ellen Langer’s studies, is “the study of what might be” (Brzosko, 2020). From her perspective, mindfulness and mindset are critical components of a healthy life.
Gannawarra Shire is examining the needs of the older population in their area. Through several interviews with community members, they’re creating a more connected community.
The Council encourages people of all ages to remain active and pursue their goals.
In 2001, New Zealand adopted the New Zealand Positive Aging Strategy. It includes 10 goals that help other local governments to create their own plans. The goals center around income, health, housing, transportation, aging in place, cultural diversity, rural, attitudes, employment, and opportunities.
In 2014 the Ministry of Social Development evaluated their progress and identified successes, and areas needing more attention. Overall, they’ve seen several improvements for each target. For example, the number of health and wellbeing programs increased. Staffing issues for harder-to-serve areas are being addressed. And, using the principles of universal design to improve housing.
5 Recommended Books about Positive Aging
Live happier, live longer – Tim Sharp (Amazon)
Dr. Sharp challenges the idea that aging is all about disease and decline. He shows how it can be one of growth and wisdom.
How to live forever: The enduring power of connecting the generations – Marc Freedman (Amazon)
A bit about the book from Amazon: “Encore.org founder and CEO Marc Freedman tells the story of his thirty-year quest to answer some of contemporary life’s most urgent questions: With so many living so much longer, what is the meaning of the increasing years beyond 50? How can a society with more older people than younger ones thrive? How do we find happiness when we know life is long and time is short?”
Counter Clockwise – Ellen Langer (Amazon)
The book expounds on her seminal work. She’s a social psychologist who studies how opening our minds can lead to better health.
Women and positive aging – Lisa Hollis-Sawyer and Amanda Dykema-Engblade
Discusses the theoretical and practical applications of positive aging theories. They cover issues and trends affecting women through a holistic approach.
Deviate – Beau Lotto (Amazon)
An interesting and entertaining read. Lotto is a neuroscientist and psychologist studying perception. From his perspective, “perception is the foundation of human experience.”
21 Quotes on the Topic
“There is no such thing as maturity. There is instead an ever-evolving process of maturing. Because when there is a maturity, there is a conclusion and a cessation. That’s the end. That’s when the coffin is closed. You might be deteriorating physically in the long process of aging, but your personal process of daily discovery is ongoing. You continue to learn more and more about yourself every day.”
“Thou shalt rise up before the hoary head, and honour the face of the old man.”
“I wasted time, and now doth time waste me.”
William Shakespeare, Richard II
“We live in a youth-obsessed culture that is constantly trying to tell us that if we are not young, and we’re not glowing, and we’re not hot, that we don’t matter. I refuse to let a system or a culture or a distorted view of reality tell me that I don’t matter. I know that only by owning who and what you are can you start to step into the fullness of life. Every year should be teaching us all something valuable. Whether you get the lesson is really up to you.”
Oprah, O, the Oprah Magazine, May 2011
“Old age is not so fiery as youth, but when once provoked cannot be appeased.”
Thomas Fuller, Gnomologia
“Age imprints more wrinkles on the mind than it does on the face.”
I am convinced that most people do not grow up … We marry and dare to have children and call that growing up. I think what we do is mostly grow old. We carry accumulation of years in our bodies, and on our faces, but generally our real selves, the children inside, are innocent and shy as magnolias.”
Maya Angelou, Letter to My Daughter, October 2009
“Peu de gens savent être vieux.” “Few people know how to be old/how old they are.”
François de La Rochefoucauld, Maximes (1665–1678), 448.
“When grace is joined with wrinkles, it is adorable. There is an unspeakable dawn in happy old age.”
Victor Hugo, Les Miserables
“I do think that when it comes to aging, we’re held to a different standard than men. Some guy said to me: ‘Don’t you think you’re too old to sing rock n’ roll?’ I said: ‘You’d better check with Mick Jagger’.”
Cher, Fifty on Fifty, by Bonnie Miller Rubin, November 1998
“Old age deprives the intelligent man only of qualities useless to wisdom.”
Joseph Joubert, Penses
“Age is strictly a case of mind over matter. If you don’t mind, it doesn’t matter.”
Jack Benny, New York Times (1974)
“Here’s what I know: I’m a better person at fifty than I was at forty-eight … and better at fifty-two than I was at fifty. I’m calmer, easier to live with. All this stuff is in my soul forever. Just don’t get lazy. Work at your relationships all the time. Take care of friendships, hold people you love close to you, take advantage of birthdays to celebrate fiercely. It’s the worrying — not the years themselves — that will make you less of a woman.”
Patti LaBelle, Fifty on Fifty, by Bonnie Miller Rubin, November 1998
“Old age has its pleasures, which though different, are not less than the pleasures of youth.”
W. Somerset Maugham, The Summing Up
“The real affliction of old age is remorse.”
Cesare Pavese, The Moon and the Bonfire, chapter VIII, p. 49.
“Best thing about being in your 90s is you’re spoiled rotten. Everybody spoils you like mad and they treat you with such respect because you’re old. Little do they know, you haven’t changed. You haven’t changed in [the brain]. You’re just 90 every place else … Now that I’m 91, as opposed to being 90, I’m much wiser. I’m much more aware and I’m much sexier.”
Betty White, People, February 2013
“Nobody grows old by merely living a number of years; people grow old by deserting their ideals.”
Samuel Ullman, “Youth,” in The Silvery Treasure, (1934), p. 323-24.
“Some people are old when they’re 18 and some people are young when they’re 90. You can’t define people by whatever society determines as their age. Time is a concept that human beings created.”
Yoko Ono, The Guardian, February 2012
“In interviews, the first question I get in America is always: ‘What do you do to stay young?’ I do nothing. I don’t think aging is a problem. What irritates me a little is growing fatter. It irritates me that if I eat what I want to eat, it shows. Yes, my face has wrinkles. But I don’t find it monstrous. I’m so surprised that the emphasis on aging here is on physical decay, when aging brings such incredible freedom. Now what I want most is laughs. I don’t want to hurt anybody by laughing — there is no meanness to it. I just want to laugh.”
Isabella Rossellini, Oprah, September 2009
“I considered what it meant to be sixty-six. The same number as the original American highway, the celebrated Mother Road that George Maharis, as Buz Murdock, took as he tooled across the country in his Corvette, working on oil rigs and trawlers, breaking hearts and freeing junkies. Sixty-six, I thought, what the hell. I could feel my chronology mounting, snow approaching. I could feel the moon, but not see it. The sky was veiled with a heavy mist illuminated by the perpetual city lights. When I was a girl the night sky was a great map of constellations, a cornucopia spilling the crystalline dust of the Milky Way across its ebony expanse, layers of stars that I would deftly unfold in my mind … I’m still the same person, I thought, with all my flaws intact, same old bony knees, thanks be to God.”
Patti Smith, M Train, October 2015
“Old age is like everything else. To make a success of it, you’ve got to start young.”
A Take-Home Message
Attitude is everything. Regardless of how old you are, if you have a negative attitude, it makes your experience that much worse. Positive aging isn’t all “roses and daffodils.” Sometimes aging is difficult, and it can be depressing. But, research supports the fact that our attitude reigns supreme in how the negatives impact our lives.
At the beginning of this article, I asked, “How will you plan and prepare for the next decades of your life?” Some don’t want to think that far ahead. Others are already headed in that direction. One thing is for sure, we will get there eventually. We can do it kicking and screaming or in complete denial. Or, we can embrace the third act, have a bit of fun, and go to the grave worn out.
In the immortal words of Auntie Mame:
Life is a banquet and most poor suckers are starving to death.
We hope you enjoyed reading this article. Don’t forget to download our 3 Positive Psychology Exercises for free.
- Aging In Place. (2019, February 21). The 5 most important elements of home care for seniors. Retrieved from https://www.aginginplace.org/the-5-most-important-elements-of-home-care-for-seniors/
- American Psychological Association (APA). (n.d.). Older adults’ health. Retrieved from https://www.apa.org/advocacy/health/older-americans
- Atchley, R. C. (1989). A continuity theory of normal aging. The Gerontologist, 29(2), 183-190.
- Binette, J., & Vasold, K. (2018, August). 2018 Home and community preferences: A national survey of adults ages 18-plus. AARP. Retrieved from https://www.aarp.org/research/topics/community/info-2018/2018-home-community-preference.html
- Brzosko, M. (2020, February 17). How to be more mindful? Commit to the mindset of choice. The Self-Awareness Blog. Retrieved from https://selfawareness.blog/how-to-be-more-mindful/
- Buettner, D. (n.d.). Power 9: Reverse engineering longevity. Retrieved from https://www.bluezones.com/2016/11/power-9/
- Carr, D. (2018). Volunteering among older adults: Life course correlates and consequences. The Journals of Gerontology: Series B, 73(3), 479-481.
- Center for Disease Control and Prevention (CDC). (n.d.). Well-being concepts. Health-related quality of life. Retrieved from https://www.cdc.gov/hrqol/wellbeing.htm
- Cumming, E., & Henry, W. H. (1961). Growing old: The process of disengagement. New York, NY: Basic Books.
- Dionigi, R. A. (2015). Stereotypes of aging: Their effect on the health of older adults. Journal of Geriatrics, 2015, 1-9.
- Elder. (n.d.). Research. Retrieved from https://elder.web.unc.edu/research-projects/
- Elder Options (2018a, April 20). Aging: What there is to look forward to? Retrieved from https://agingresources.org/aging-what-there-is-to-look-forward-to/
- Elder Options (2018b, March 20). Interesting facts about older adults. Retrieved from https://agingresources.org/interesting-facts-about-older-adults/
- Forbes, M. K., Eaton, N. R., & Krueger, R. F. (2017). Sexual quality of life and aging: A prospective study of a nationally representative sample. The Journal of Sex Research, 54(2), 137-148.
- Foster, L., & Walker, A. (2015). Active and successful aging: A European policy perspective. The Gerontologist, 55(1), 83-90.
- Hassan, A. (n.d.). Migraine. Retrieved from https://www.bupa.co.uk/health-information/brain-nervous-system/migraine
- Havighurst, R. J. (1961). Successful aging. The Gerontologist, 1(1), 8-13.
- Health Research Funding. (n.d.). The activity theory of aging explained. Retrieved from https://healthresearchfunding.org/disengagement-theory-of-aging-explained/
- The Irish Longitudinal Study on Ageing (TILDA). (2016, January 27). You’re only as old as you feel [Press release]. Retrieved from https://tilda.tcd.ie/news-events/2016/1603-ageing-perceptions-attitudes/
- Jivraj, S., Nazroo, J., Vanhoutte, B., & Chandola, T. (2014). Aging and subjective well-being in later life. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 69(6), 930-941.
- Johnson, K. J., & Mutchler, J. E. (2014). The emergence of a positive gerontology: From disengagement to social involvement. The Gerontologist, 54(1), 93-100.
- Karasawa, M., Curhan, K. B., Markus, H. R., Kitayama, S. S., Love, G. D., Radler, B. T., & Ryff, C. D. (2011). Cultural perspectives on aging and well-being: A comparison of Japan and the United States. The International Journal of Aging and Human Development, 73(1), 73-98.
- Lindau, S. T., & Gavrilova, N. (2010). Sex, health, and years of sexually active life gained due to good health: Evidence from two US population based cross sectional surveys of ageing. British Medical Journal, 340.
- Martin, P., Kelly, N., Kahana, B., Kahana, E., Willcox, B. J., Willcox, D. C., & Poon, L. W. (2015). Defining successful aging: A tangible or elusive concept? The Gerontologist, 55(1), 14-25.
- Miller, K. (2017). How socially assistive robots positively affect aging-in-place, the healthcare worker shortage, and solve the long-term care crisis. Unpublished manuscript.
- Ministry of Social Development. (2001). The positive ageing strategy – background. Super Seniors. Retrieved from http://www.superseniors.msd.govt.nz/about-superseniors/office-for-seniors/positive-ageing-strategy.html
- Ministry of Social Development. (2014). 2014 Report on the positive ageing strategy. Wellington, New Zealand: Office for Senior Citizens. Retrieved from https://www.superseniors.msd.govt.nz/documents/msd-17470-2014-ageing-strategy-summary-final.pdf
- Nashiro, K., Mather, M., Gorlick, M. A., & Nga, L. (2011). Negative emotional outcomes impair older adults’ reversal learning. Cognition & Emotion, 25(6), 1014-1028.
- Park, D. C., & Bischof, G. N. (2013). The aging mind: Neuroplasticity in response to cognitive training. Dialogues in Clinical Neuroscience, 15(1), 109-119.
- Pauwels, L., Chalavi, S., & Swinnen, S. P. (2018). Aging and brain plasticity. Aging, 10(8), 1789-1790.
- Pew Research Center. (2018, February 5). Social Media Fact Sheet. Retrieved from http://www.pewinternet.org/fact-sheet/social-media/
- Positive Ageing. (n.d.). What is positive ageing? Retrieved from http://positiveageing.org.uk/
- Positive Psychology Institute. (n.d.). Positive ageing. Retrieved from https://www.positivepsychologyinstitute.com.au/positive-ageing
- Poulain, M., Herm, A., Pes, G. (2013). The Blue Zones: Areas of exceptional longevity around the world. Vienna Yearbook of Population Research, 11, 87-108.
- Robertson, D. A., & Kenny, R. A. (2016). Negative perceptions of aging modify the association between frailty and cognitive function in older adults. Personality and Individual Differences, 100, 120-125.
- Rowe, J. W., & Kahn, R. L. (1997). Successful aging. The Gerontologist, 37(4), 433-440.
- The Royal Society for Public Health. (n.d.). That age old question. Retrieved from https://www.rsph.org.uk/uploads/assets/uploaded/a01e3aa7-9356-40bc-99c81b14dd904a41.pdf
- Suh, E. M., & Choi, S. (2018). Predictors of subjective well-being across cultures. In E. Diener, S. Oishi, & L. Tay (Eds.), Handbook of well-being (pp. 1-13). Salt Lake City, UT: DEF Publishers.
- Thompson, W. K., Charo, L., Vahia, I. V., Depp, C., Allison, M., & Jeste, D. V. (2011). Association between higher levels of sexual function, activity, and satisfaction and self‐rated successful aging in older postmenopausal women. Journal of the American Geriatrics Society, 59(8), 1503-1508.
- World Health Organization (WHO). (2005). The health for all policy framework for the WHO European region: 2005 Update. Copenhagen, Denmark: WHO Regional Office for Europe.
- World Health Organization (WHO). (2016, September 29). Discrimination and negative attitudes about ageing are bad for your health. Retrieved from https://www.who.int/en/news-room/detail/29-09-2016-discrimination-and-negative-attitudes-about-ageing-are-bad-for-your-health
- World Health Organization (WHO). (2020, October 26). Ageing: Healthy ageing and functional ability. Retrieved from https://www.who.int/westernpacific/news/q-a-detail/ageing-healthy-ageing-and-functional-ability.
- Yotsumoto, Y., Chang, L. H., Ni, R., Pierce, R., Andersen, G. J., Watanabe, T., & Sasaki, Y. (2014). White matter in the older brain is more plastic than in the younger brain. Nature Communications, 5(1), 1-8.
- Zhou, B., Liu, X., & Yu, P. (2018). Toward successful aging: The Chinese health criteria for the elderly. Aging Medicine, 1(2), 154-157.