What is “successful” aging? According to experts at this week’s Gerontological Society of America Annual Scientific Conference, it depends on the lens through which it’s viewed. “Most of our current definitions are applicable to non-Latino white individuals,” said Linda Phillips, Ph.D., R.N., F.A.A.N., from the School of Nursing at the University of California, Los Angeles. “But these definitions may be inappropriate for elders in other ethnic and racial groups.”
For African-Americans, successful aging is directly connected to the life course process, said Kia Skrine Jeffers. “Health is either built or diminished based on social, economic and environmental experiences, that occur throughout life.” Stressors which occur during sensitive periods have significant impact on disease risk, and the cumulative effect, known as weathering, may also affect health-seeking behaviors. “Many racial and ethnic health disparities can be attributed to weathering, to the accumulated experiences of economic and social adversities.”
Jeffers said that “success” in aging should be defined according to the social context of how African-Americans have lived. Additionally, it makes more sense to compare successful aging within groups rather than between groups, since experiences throughout life are so different. Current understanding of the aging process is limited to standardized measures between dissimilar groups who have not faced these life-altering experiences. “So asking African-Americans about their life experiences gives us a good indication of the behaviors that this population engages in to age successfully.”
Successful aging is a term that dates back to Cicero’s time, around 44 BCE, said Michelle Wargo-Sugleris. Today, the term is used in medicine, social sciences, psychology and other disciplines to differentiate between the usual process of physiological and functional decline and the low probability of disease, high cognitive function and engagement in life. “It’s important to draw a distinction between low probability of disease, and no probability of disease,” she said. Successful aging is a multidisciplinary, multidimensional process, that’s “about ability, not disability. It’s about what the elder can do, from a cognitive, psychosocial and physical function view.”
Mere longevity is not necessarily a good indicator of successful aging, according to Sharon Cobb. “We have to consider other factors which are often ignored but influence aging.” Mental health is one such important example. It is a touchy subject among many older African-Americans but has serious impact on successful aging, Cobb said.
“Depression is one of the most prevalent psychiatric diagnoses among the elderly, increasing morbidity, disability, and suicide risk,” she said. “Older black adults suffer more from psychological distress than do whites, due to a lifetime exposure of racism, prejudice, poverty and violence and they have fewer psychological, social and financial resources.” Depression rates among older black Americans range from 10 percent to 30 percent according to recent clinical studies, but research on this topic is limited.
Additionally,“minority groups may show various symptoms of depression depending on their cultural groups and cultural implications,” she said. “This depression may go undiagnosed or untreated due to a lack of cultural awareness among providers.”
Many black elders are reluctant to discuss their mental health issues, Cobb noted. “They are afraid of being stereotyped due to the fear of being stigmatized as a psychiatric patient.” It’s an issue providers and families need to be more aware of and encourage older adults to talk about without fear of being judged.
Families figure strongly in successful aging, especially in African-American cultures. “They are expected to take care of their elders, said Ebere Ume. That means families must also live up to expectations and challenges. “These experiences affect the aging process of caregivers as well as those they care for,” she said. How they cope with cultural beliefs, the impact of their own socio-economics on ability to fulfill a loved one’s wishes can lead to confusion, depression, or guilt.”
It may also deepen their sense of loss after their loved one dies. This in turn, may lead to negative health repercussions. Fatigue, exhaustion, cognitive difficulties, pain and hypertension are not uncommon in caregivers, she said. It’s important for them to remain connected to their community, church, work, and other social support systems during the caregiving process. Unless health professionals are aware of these issues, it will only lead to a downward health spiral until they need care themselves.
