New research outlines factors linked to optimal aging

Aging is a natural phenomenon. From birth, individuals begin to grow, change and mature. From the term ‘growing’ and ‘maturing’ in the younger years, individuals progress to ‘aging’ later in life. Although many fear aging, as this event is often associated with suffering from one or multiple diseases, this does not have to be the case. 

Around the world, many organisations, including the World Health Organization (WHO) and Pan American Health Organization (PAHO) [1], are redefining aging. 

What is healthy aging? 

According to PAHO [1], healthy aging “is a continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout life.” 

Independent and healthy older adults contribute to the well-being not only of their families but also of their communities. Hence, it is a myth to portray older people as passive healthcare and social services recipients. Currently, many countries across the world are experiencing an aging population. It is feared that the increasing number of older people might overburden the social and healthcare system. However, this should not be the case if early interventions are implemented to promote healthy aging. 

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What is optimal aging? 

Optimal aging does not mean that an older adult does not have health challenges. Instead, this is the ability of an older individual to live the best life each day and flourish amidst challenges. It is a process of continually optimizing individual experiences and evolving. For the individual, this means living well while feeling good about oneself and functioning effectively. 

Maintaining an optimal range of functioning even when experiencing age-related decline and loss in the following categories is essential to optimal aging: 

  • Intellectual (growing, thinking, learning, communicating new knowledge and ideas, creating) 
  • Physical (eating well, exercising, relaxing, and playing) 
  • Social (enjoying companionship with friends, neighbours, and relatives) 
  • Emotional (expressing diverse feelings and responding to these feelings without harming others) 
  • Spiritual (developing a sense of connectedness and a sense of self) 

A new study [2] published in the Environmental Research and Public Health and conducted by researchers at the University of Toronto provided further information on healthy aging. Researchers recruited two groups of participants: Canadian-born older adults and immigrants. 

The study, which Mabel Ho leads, identified several characteristics associated with successful aging, which is geared towards a wellness orientation instead of a disease-free one. 

According to Ho, successful aging means that older adults can carry out their daily functions regardless of whether they are experiencing a chronic illness. Ho’s definition of successful aging is similar to PAHO’s healthy or optimal aging. 

The study by Ho defined healthy aging as follows: 

  • Freedom from chronic pain that is disabling 
  • Sufficient social support 
  • The ability to accomplish daily activities or the ADLs (Activities of Daily Living) 
  • Freedom from memory problems and mental illness 
  • Self-reported perceptions of optimal physical health and happiness 
  • Ability to achieve the IADLs or instrumental activities of daily living 

The WHO and PAHO’s definition of healthy aging is consistent with Mabel Ho’s definition of successful aging. The traditional concept of successful aging, devoid of any diseases, is no longer accepted as accurate. Instead, many healthcare practitioners and researchers recognized that healthy or optimal aging is a continuum and process and does not mean an individual is disease-free. 

Findings of the study 

Investigators examined data from 7,651 individuals who participated in the Longitudinal Study on Aging (CLSA). All participants were 60 years and older when they started the longitudinal study. This study follows a group of patients or individuals through time and examines factors that might influence diseases during aging and other factors that contribute to healthy aging. Of the 7,651 participants, 1,446 respondents had migrated to Canada. The health status and characteristics associated with healthy aging were compared between immigrant Canadians and those who lived in Canada throughout their lives. 

Mabel Ho and her colleagues identified several characteristics that were known to be associated with optimal or healthy aging. The authors also identified individuals who had the following elements at the start of the longitudinal study: 

  • Participated in physical activities (i.e. moderate to strenuous exercise) 
  • Did not have cardiovascular disorders or autoimmune disorders 
  • Were not smokers 
  • Did not experience or suffer from insomnia and other sleep issues 
  • Had normal weight 
  • Belonged to higher income groups 
  • Were married 
  • Belonged to the younger group at the beginning of data collection 

The study’s findings revealed that those born in Canada had a slightly higher prevalence of achieving successful aging compared with immigrant Canadians. After adjusting 18 additional factors, immigrant status remained a significant factor for successful aging. 

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Among immigrants, factors that were associated with successful aging include the following: having a higher income; being younger; not being obese; being married; never smoking; not being obese; not having sleeping problems; engaging in moderate or strenuous physical activities and being free of heart disease or arthritis. 

Compared with Canadian-born peers, older immigrant adults tend to have a lower prevalence of successful aging. Notably, the study found that even respondents who aged successfully may experience a decline in health during the final follow-up. 

Meanwhile, those who started as less than successful agers at baseline and the first follow-up may enjoy better health and successful aging through engaging in activities that promote mental and psychological wellness, physical wellness, and social wellness. This showed that engaging in activities that promote overall health and well-being could be critical to successful aging. 

Limitations of the study 

There are some significant limitations to the study that should be considered when applying findings to local healthcare practice. 

Canadian minorities were under-represented in the sample population. Hence, it is difficult to determine if the same factors related to healthy aging could influence successful aging in minority groups. 

The population-based study failed to ask essential questions that capture the respondents’ sense of well-being, mental state, and spiritual perspectives. Responses to these critical questions could help elucidate important quality-of-life indicators. 

At the time of the study, the participants recruited had high levels of education. Most were well-educated, which does not represent the average older Canadian adult. As stressed by the authors, an average older adult in Canada would only have half of the educational level attained by the respondents in the study. Education is one of the critical factors associated with better health and well-being among older adults [1]. 

Results showed that Canadian immigrants tend to have less successful aging than their Canadian-born counterparts. The study was conducted in English and French, and the questionnaires were not translated into other languages. This might be an issue during the recruitment process as immigrants who do not speak French or English well might have been excluded from the study. 

What is the secret to healthy aging? 

Healthy aging can result from a combination of multiple factors, including genetics, environment, lifestyle, and access to affordable healthcare. 

A review [3] published in 2016 argues that social inequalities influence healthy aging. Older adults with higher education are wealthier, have better access to good healthcare services, and tend to age successfully compared with those with lower education levels, lower social status and poor access to health and social care services. As stressed in the review, addressing social determinants of health and inequities is necessary for promoting optimal and healthy aging for all older adults. 

The World Health Organisation is crucial in empowering healthcare systems worldwide in providing equitable access to health and social care services and ensuring that older adults’ mental, physical, spiritual and social healthcare needs are addressed. This would also require governments’ participation in providing a healthy environment for older adults. 

Finally, successful aging is within reach if individuals, families, communities, and the government work hand in hand to promote a healthy environment and reduce health inequities for all older adults. 

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The information included in this article is for informational purposes only. The purpose of this webpage is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.