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Successful Aging in the Oldest Old
Who Can Be Characterized as Successfully Aged?
Margaret von Faber, MA;
Annetje Bootsma–van der Wiel, MD;
Eric van Exel, MD;
Jacobijn Gussekloo, MD, PhD;
Anne M. Lagaay, MD, PhD;
Els van Dongen, MA, PhD;
Dick L. Knook, PhD;
Sjaak van der Geest, MA, PhD;
Rudi G. J. Westendorp, MD, PhD
Arch Intern Med. 2001;161:2694-2700.
Background Successful aging is a worldwide aim, but it is less clear which indicators
characterize elderly persons as successfully aged. We explored the meaning
of successful aging from 2 perspectives.
Methods Analysis of data from the first cross-sectional part of the longitudinal
Leiden 85-plus Study, conducted in Leiden, the Netherlands. All inhabitants
of Leiden aged 85 years were eligible. Data were obtained from 599 participants
(response rate, 87%). Successful aging from a public health perspective was
defined as a state of being. All participants were classified as successful
or not successful based on optimal scores for physical, social, and psychocognitive
functioning and on feelings of well-being, using validated quantitative instruments.
Qualitative indepth interviews on the perspectives of elderly persons were
held with a representative group of 27 participants.
Results Although 45% (267/599) of the participants had optimal scores for well-being,
only 13% (79/599) had optimal scores for overall functioning. In total, 10%
(58/599) of the participants satisfied all the criteria and could be classified
as successfully aged. The qualitative interviews showed that most elderly
persons viewed success as a process of adaptation rather than a state of being.
They recognized the various domains of successful aging, but valued well-being
and social functioning more than physical and psychocognitive functioning.
Conclusions If successful aging is defined as an optimal state of overall functioning
and well-being, only a happy few meet the criteria. However, elderly persons
view successful aging as a process of adaptation. Using this perspective,
many more persons could be considered to be successfully aged.
From the Section of Gerontology and Geriatrics, Department of General
Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
(Ms von Faber and Drs Bootsma–van der Wiel, van Exel, Gussekloo, Lagaay,
Knook, and Westendorp); and Division of Medical Anthropology, University of
Amsterdam, Amsterdam, the Netherlands (Ms von Farber and Drs van Dongen and
van der Geest).
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