Kaspar Roman, Ehni Hans-Jörg, Schweda Mark, Wahl Hans-Werner
Charlotte Fresenius Hochschule, University of Psychology, Cologne, North Rhine-Westphalia, Germany.
Institute for Ethics and History of Medicine, University of Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany.
Gerontologist. 2024 Dec 13;65(1). doi: 10.1093/geront/gnae117.
Few people who are ages 80+ meet the criteria of successful aging (SA) proposed by Rowe and Kahn. Going beyond the individual-level conceptualization, we argue that SA always operates in multiple contexts and that context may become most critical in advanced old age. However, we are not aware of any previous study providing an empirical test of how contexts for SA unfold across persons 80 years and older, including those living in institutions.
We estimated and compared prevalences of SA based on a classic versus context-enriched understanding of SA in multiple large surveys of older adults, that is, the D80+ study (N = 3.233) and the NRW80+ study (N [baseline] = 1.863). In addition to replication across independent samples, we investigated the stability of context-related SA across time.
Prevalences of SA according to Rowe and Kahn were 9.1% in adults aged 80-84 and 0.7% in persons 90 years or older. However, prevalence rates for those with good contexts at their disposal even if not fulfilling Rowe and Kahn's criteria were much higher across all age groups (80-84 years: 54.9%, 90 years and older: 44.4%). Greater 2-year stability was observed for contextual compared to individual criteria. Notably, positive effects of context on SA were stronger at onset compared to late fourth age.
Our findings support a contextualized understanding of SA and inform policy that furthering SA in the fourth age requires the optimization of multiple contexts at the community level.
很少有80岁及以上的人符合罗和卡恩提出的成功老龄化（SA）标准。超越个体层面的概念化，我们认为成功老龄化总是在多种背景下发生，并且在高龄阶段背景可能变得最为关键。然而，我们不知道之前有任何研究对80岁及以上人群（包括住在养老院的人）成功老龄化的背景如何展开进行实证检验。
在多项针对老年人的大型调查中，即D80 +研究（N = 3233）和北莱茵 - 威斯特法伦州80 +研究（N[基线] = 1863），我们基于对成功老龄化的经典理解与丰富背景理解来估计和比较成功老龄化的患病率。除了在独立样本中进行重复研究外，我们还调查了与背景相关的成功老龄化随时间的稳定性。
根据罗和卡恩的标准，80 - 84岁成年人的成功老龄化患病率为9.1%，90岁及以上人群为0.7%。然而，即使不符合罗和卡恩标准但拥有良好背景的人群在所有年龄组中的患病率要高得多（80 - 84岁：54.9%，90岁及以上：44.4%）。与个体标准相比，背景标准在两年内的稳定性更高。值得注意的是，与高龄后期相比，背景对成功老龄化的积极影响在开始时更强。
我们的研究结果支持对成功老龄化的背景化理解，并为政策提供参考，即在高龄阶段促进成功老龄化需要在社区层面优化多种背景。
