Role for Psychiatry in Enhancing Successful Ageing

In a new study the negative view of ageing, which has been viewed as a period of progressive decline in physical, cognitive and psychosocial functioning, has been busted.

In a comprehensive study of 1,006 older adults in San Diego, researchers from the University of California, San Diego School of Medicine and Stanford University took a 25-minute phone interview, followed by a comprehensive mail-in survey.

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"While there is a growing public health interest in understanding and promoting successful ageing, until now little published research has combined measures of physical health with cognitive and psychological assessments, in a large and randomly selected sample," principal investigator Dilip V. Jeste said.

The Successful Ageing Evaluation (SAGE) study included adults between the ages of 50 and 99 years, with a mean age of just over 77 years.

In addition to measures which assessed rates of chronic disease and disability, the survey looked at more subjective criteria such as social engagement and participants' self-assessment of their overall health.

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"Sometimes the most relevant outcomes are from the perspective of the subjects themselves," Jeste said.

The study concludes that resilience and depression have significant bearing on how individuals self-rate successful ageing, with effects that are comparable to that of physical health.

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"Even though older age was closely associated with worse physical and cognitive functioning, it was also related to better mental functioning," co-author Colin Depp said.

After adjusting for age, a higher self-rating of successful ageing was associated with higher education, better cognitive function, better perceived physical and mental health, less depression, and greater optimism and resilience.

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Participants were asked to rate the extent to which they thought they had "successfully aged", using a 10-point scale and using their own concept of the term.

The study found that people with low physical functioning but high resilience, had self-ratings of successful ageing similar to those of physical healthy people with low resilience.

Likewise, the self-ratings of individuals with low physical functioning but no or minimal depression had scores comparable to those of physically healthy people with moderate to severe depression.

"It was clear to us that, even in the midst of physical or cognitive decline, individuals in our study reported feeling that their well-being had improved with age," Jeste said.

This counterintuitive increase in well-being with ageing persisted even after accounting for variables like income, education and marriage.

Jeste suggests there's a take-away message for clinicians, which is that an optimistic approach to the care of seniors may help reduce societal ageism.

"There is considerable discussion In public forums about the financial drain on the society due to rising costs of healthcare for older adults - what some people disparageingly label the 'silver tsunami.' But, successfully ageing older adults can be a great resource for younger generations," he said.

The findings point to an important role for psychiatry in enhancing successful ageing in older adults.

"Perfect physical health is neither necessary nor sufficient," Jeste said.

"There is potential for enhancing successful ageing by fostering resilience and treating or preventing depression," Jeste added.

The study has been published online issue in the American Journal of Psychiatry.

Source-ANI