ABSTRACT

This chapter introduces the model of developmental adaptation, an extension of the adaptation model used in the Georgia Centenarian Study. The focus of this model is to combine distal experiences and past achievements as important predictors of well-being and adaptation in later life. Modeling results suggest that distal events have a direct effect on adaptation, proximal events have a direct effect on adaptation, and that the effect of distal variables on adaptation is mediated by proximal resources. Illustrations of the developmental adaptation model will be given. For example, results suggest that education and life-time negative events (as distal variables) predict mental health with competence (a proximal resource) as a mediator. The implications for understanding well-being in old-old age will be discussed.

INTRODUCTION

Very old individuals face a number of uniquely demanding life challenges. For those persons entering the 9th, 10th, and 11th decades of life, negotiating increasingly restrictive functional limitations and rapidly shrinking social-support networks becomes a dominant life concern and activity (Martin, Poon, Kim, & Johnson, 1996). How do older adults adapt to these changes? The purpose of this chapter is to introduce a model of developmental adaptation that incorporates distal and proximal influences in the prediction of longevity and adaptation in later life. In the first section of this chapter, we review a number of common adaptation models. This section is followed by an overview of studies based on the Georgia adaptation model.

ABSTRACT

Very old adults have experienced many events in their lives, some many years ago, some more recently. This chapter highlights events perceived as the most important ones in the lives of centenarians. Domain-specific events are also considered in this chapter, including health events, family events, and work events. Finally, the impact of life events on the overall well-being of the oldest-old adults is considered. The evidence suggests that positive cumulative (“lifetime”) events reduce levels of negative affect, whereas cumulative (“lifetime”) negative events promote negative affect. When proximal events (i.e., those experienced in the past 20 years) and distal events (i.e., those experienced more than 20 years ago) are considered, proximal events are more likely to reduce levels of positive affect and enhance levels of negative affect. Distal events, on the other hand, are more likely to enhance overall feelings of positive affect.

INTRODUCTION

Individuals who have lived for a long time can look back on a life filled with many experiences. Formative life events can go back as far as early childhood, spread over the adolescent and adult years, and continue to occur very late in life. The effect of these events on physical and mental health, as well as on ways of coping and adaptation has been demonstrated in many studies. For example, a meta-analysis of 25 studies (Kraaij, Arensman, & Spinhoven, 2002) suggested that older adults in general may be at greater risk of depression because they have experienced an accumulation of many stressful events and daily hassles.

ABSTRACT

The relationship of nutrition-related factors with well-being in people 80 and older has received little attention. Therefore, this chapter explores the relationships of depression and depressive symptoms, as a measure of well-being, with appetite, body weight changes, underweight, and obesity as measures of nutritional status. The sample is from the Georgia Centenarian Study (aged 80 to 89 and 98+ years, see Chapter 9). In bivariate analyses, centenarians with depression consistently had the highest prevalence of underweight when compared to centenarians without depression and all octogenarians (23% to 33% vs. 0% to 16%). When controlled for other demographic factors, clinically relevant depressive symptomatology was associated with appetite loss, while a current diagnosis of depression was associated with recent changes in body weight. However, taking antidepressant medications was not associated with any of the nutrition-related measures. Demographic factors emerged as important predictors of nutritional status. Living in a skilled nursing facility compared to living in the community was associated with a lower risk of appetite loss and higher risk of weight gain; being a centenarian or being female was associated with underweight; and being Black (vs. White) was associated with obesity. Thus, risk factors for poor nutritional status in the oldest may be related to depression as well as to specific demographic factors including age, gender, race, and residence in a skilled nursing facility.

ABSTRACT

This chapter integrates and summarizes our collective thinking on well-being among the old-old by answering five central questions: 1) What is old-old age?; 2) What is well-being in old-old persons?; 3) What affects well-being in old-old age?; 4) What theory, if any, is appropriate for old-old age?; 5) What interventions, if at all, are needed to enhance well-being in old-old age? It is hoped that our discourse will generate new research and directions toward well-being among old-old at the end stage of life.

INTRODUCTION

We began this volume with a road map to increase our knowledge on well-being among the oldest old. We designed this volume to include different views on well-being, the impact of experiences and trauma accumulated over the lifetime, mediating and moderating influences, and measurement issues.

At the end of this journey of inquiry, we are able to summarize and integrate our effort. As a scientific endeavor, this book both answers questions and raises others. The book aims to answer questions about the essence of well-being in very old age and the predictors of such status. Some findings repeat and are consistent across populations and studies, whereas some of the chapters present diverse and conflicting points of view. To integrate the results of the different chapters and focus the discussion, we concentrate on five questions that traverse the chapters:

1. What is old-old age?

2. What is well-being in old-old persons?

3. What affects well-being in old-old age?

4. What theory, if any, is appropriate for old-old age?

5. What interventions, if at all, are needed to enhance well-being in old-old age?

ABSTRACT

This chapter provides a road map to address the dearth of information and the central theme of this volume: well-being among the oldest old. A reality among the oldest old is the increasing variability in both subjective and psychological well-being found within an individual owing to variations in cumulative experiences and differences in strategies to survive into very old age. This chapter outlines the strategies in addressing the central theme by describing four different views on well-being among the oldest old (Section I), the influence of experiences and trauma on well-being at the end stage of life (Section II), examination of moderating and mediating influences (Section III), measurement issues (Section IV), and conclusions (Section V).

INTRODUCTION

The life course is marked by individuality and diversity. An individual's life is a process that, if scrutinized at a singular instance, would yield incorrect assumptions about its trajectory. Instead, the gradual accumulation of events in a person's life provides perspective into how that person arrived at his or her present state of well-being. This chapter provides a road map of the contents in this edited volume on the well-being of the oldest old. Although the age of the oldest-old cohort is continually increasing as a result of the rectangularization of the population pyramid, this volume defines the oldest old as those individuals older than 75 years of age. This cohort deserves its own conception of well-being because of its distinctiveness in comparison with younger generations.

ABSTRACT

This chapter clarifies and differentiates changes in cognitive functioning among the oldest old at the group and individual levels. Cross-sectionally, the oldest old demonstrate normative differences of being more physically and cognitively frail compared to younger groups. More variation and successful aging is observed at the individual level. Some oldest-old individuals can perform at the same levels as adults 20 to 40 years younger. Recent literature has recognized that the concept of cognitive vitality transcends the absence of dementia or dementing processes. We seek to clarify the concept of cognitive vitality because it has not been well defined in the literature either theoretically or operationally. This chapter addresses the following questions: 1) What is cognitive vitality and how does it contribute to the well-being of older adults? 2) What factors or resources contribute to cognitive vitality among the oldest old? and 3) What new directions can be identified for future research?

COGNITIVE FUNCTIONING AND VITALITY AMONG THE OLDEST OLD: IMPLICATIONS FOR WELL-BEING

Lay people and professionals alike fall prey to aging stereotypes and myths (Ory, Hoffman, Hawkins, Sanner, & Mockenhaupt, 2003), namely that cognitive decline is inevitable and there is nothing we can do about it. Empirical research has focused on comparing the cognitive performance of younger and older adults, often noting “deficits” in older adults' abilities without taking into account context and potentially meaningful qualitative differences in older adults' approaches to cognitive problems (e.g., Marsiske & Margrett, 2006).