Why do some people cope better than others with getting old? Sociologist Eva Kahana, director of the Elderly Care Research Center at Case Western Reserve University, offers some clues.
Is there a secret to ageing well?
There are a few. I've been studying how older people cope with the stressors of later life — the physical decline and loss of friends and relatives that often result in adverse psychological and social outcomes. It turns out that the people who age best engage in two kinds of adaptation. The first is preventive behaviours, such as physical exercise and healthy diet. Helping others and holding altruistic attitudes also seem to improve happiness in late life — that's a phenomenon I'm investigating now with my collaborator on all this work — my husband Boaz Kahana, a psychologist at Cleveland State University.
The other type of adaptation comes into play after the stressors have arisen. In a study published in May 2012, we found that actively asking for help and planning ahead for purchases or trips are important predictors of maintaining psychological well-being and social connectedness1. In other words, the people who do best still try to make the most of their future.
Your observations have led to your theory of 'successful ageing'. Isn't that a loaded term?
Successful ageing is a slippery concept, but most gerontologists use it. A lot of early models assumed that you have to be healthy, wealthy and wise to age successfully. Today, the term is in flux. Some people say it's subjective — if you think you're ageing successfully, then you are. Others say that if you're sick and depressed with no social support then you are not ageing very successfully — and self-perception is neither here nor there.
Our view is that people are dealt different hands in life. As long as they do the best they can to make their lives better they can have a place at the table of successful ageing.
On what research do you base these ideas?
Much of it comes from a long-term project, the Florida Retirement Study. It started in 1989 with 1,000 people who had relocated to a large retirement community in Florida. We hypothesized that if you're far from your previous social supports, such as your children, you will have more problems facing the stressors of old age.
Every year, we interviewed each resident about their lives, leisure pursuits, aspirations, health, well-being and social relationships. We followed the same group for 20 years, by which time we were down to fewer than 100 people. It's one of the longest studies of its kind.
We found that the progression of frailty identified by many studies did occur, but slowly. These people led active, leisure-oriented lives, and maintained good health and functioning for a long time. We also found that they enjoyed living among older people, which many gerontologists thought was not beneficial. On average they scored high2 on measures of happiness and life satisfaction, despite being far from their families. Many of them said: “Our grandchildren visit at Christmas. We're happy to see them come, and we're even happier to see them go.”
Did that surprise you?
I wouldn't want to live in an age-segregated retirement community, far away from my children and grandchildren, so I presumed these people would not be very happy or healthy. But, much to our surprise, they were flourishing. That's the wonderful thing about science — you don't always find what you expected.
There are great differences among individuals, and people who choose to enter agesegregated communities or move away from the younger generation can do just fine.
Has your own ageing changed your approach to this research?
I'm 71. Studying ageing while ageing is wonderful because I find that many of my ideas come from my experience. For instance, as my husband and I have encountered our own health challenges, I have become acutely aware of the importance of advocacy in obtaining good healthcare. We now have a study teaching disadvantaged older people at senior centres to communicate with their doctors, for example, to prepare questions in advance of an appointment, or to take somebody along who can listen in case they don't catch something. That way, they can advocate for themselves and not just be passive healthcare consumers.
Has life informed your research in other ways?
When my late mother, who was a Holocaust survivor, was admitted to the hospital, I fought unsuccessfully to get her a private room. But then she told me she didn't want a private room. She said: “If there's another person in the room, then nobody will mistreat me.” I was shocked, and I began to think about it. Why do we assume that everybody wants the same thing? That led to my theory of person–environment fit3, a model for understanding how living environments affect older people's well-being.
Gerontologists tend to look for universal solutions and say something is good or harmful for everybody. But as we found with the Florida study, that's not always the case. Even though it's been 30 years, this theory of person–environment fit remains my most cited work.
Kahana, E. et al. Aging Mental Health 16, 438–451 (2012).
Kahana, E. et al. Psychosomat. Med. 64, 382–394 (2002).
Kahana, E. A. in Theory Development in Environment and Aging (eds Windley, P. G., Byerts, T. O. & Ernst, F. G.) 181–217 (Wiley, New York, 1975).
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Kessler, R. Q&A Eva Kahana: Ageing proactively. Nature 492, S9 (2012). https://doi.org/10.1038/492S9a