Defining “Healthy Aging”

The concept of “successful aging,” as coined by gerontologists Rowe and Kahn, has been influential in gerontology and has advanced scholarly understanding of healthy aging. This definition states that individuals are successfully aging if they are: free of disease; can function at a high physical and cognitive level; are socially engaged; and are productive. Critics of this model have noted that this standard of health aging is only attained by a small minority of individuals, and that a more widely attainable model might be useful for gerontologists. An article in The Gerontologist compares the Rowe and Kahn model with three alternate definitions of healthy aging to see how changes in the model affect the prevalence and validity of the healthy aging concept.

The researchers used data from the Health and Retirement Study (HRS), in which an evolving cohort of older adults in the United States are surveyed every two years. The researchers used four definitions of healthy aging with varying levels of strictness. These were:

  • Rowe and Kahn’s model;
  • Level I: Like Rowe and Kahn’s model but with less-strict definitions of disease avoidance and cognitive function;
  • Level II: A less-strict definition of disease avoidance than Level I; the same definition of cognitive function as Level I
  • Level III: No definition of disease avoidance; the same definition of physical and cognitive functioning as Levels I and II.

The researchers then assessed each model based on predictive validity—which was based on the subsequent mortality of the HRS sample—and concurrent validity—based on self-reported health status. The researchers also looked at differences in likelihood of attaining each definition of healthy aging based on age, gender, race/ethnicity, and education.

As would be logically expected, the Level III definition labeled the greatest number of individuals as experiencing healthy aging (35.5 percent of the HRS sample), and the Rowe and Kahn model the lowest (3.3 percent). However, each model had similar predictive validity (odds of mortality were between 60 and 73 percent lower for individuals considered healthy by each of the models) and concurrent validity (odds of reporting poor or fair health were 86 percent to 93 percent lower for all models). This analysis suggests that a more inclusive, less rigid definition of successful, healthy aging may be useful for gerontologists.

Source:

McLaughlin SJ, Jette AM, Connell CM (2012). An examination of healthy aging across a conceptual continuum: prevalence estimates, demographic patters, and validity. J Gerontol A Biol Sci Med Sci, e-pub ahead of print.

Also cited:

Rowe KW, Kahn RL, (1987). “Successful aging.” The Gerontologist 37(4):433-440.

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