About the feature picture. The feature picture shows the 3 Rowe and Kahn objective criteria of successful ageing at the individual level: 1-Minimise risk of disease and disability, 2-Maintain physical and cognitive function, and 3-Continued engagement with life. https://keystoneeldercare.com/successful-aging-what-does-it-mean-to-you/
Introduction
The origin of the successful ageing model came from the MacArthur Foundation. [1] In the mid-1980s, it established an interdisciplinary Network of scholars to embark on theoretical and empirical work to define the then nebulous concept of “Successful Ageing”. The 12 member team of demographers, epidemiologists, geneticists, social and behavoural scientists, economists and a geriatrician.
1-Successful Ageing Model at the Individual Level
The group articulated and published general theoretical paper in 1987 [2], and a detailed specific model in 1997[3] both by JW Rowe and RL Kahn. At the individual level, using the Rowe and Kahn model there are three objective criteria of successful ageing as shown in the feature picture.
2-Successful Ageing Model at the Societal Level
The next development in the understanding of successful ageing is at the societal level. The MacArthur Foundation created a second major effort in ageing termed the Research Network on an Ageing Society in the 2006 onwards. A major product of this network is the development of a multi-dimensional index that measures the degree of adaptation of society to ageing published in 2018. This index has 5 principal domains [1] and [4]. They are:
- 1-Productivity and engagement, including volunteerism and paid work
- 2-Well-being, including disability free life expectancy
- 3-Equity in the distribution of assets across the older population
- 4-Inter-generational relations — both within families, and across society age cohorts, and
- 5-Security, including financial well being and personal safety.
The initial successful ageing model at the individual and next at the societal level, taken together provide a comprehensive framework for understanding concepts of ageing successfully and policy development across countries.
3-Overall Performance in the Ageing Society Index
The ageing society index across countries ranged from 65 for Norway which is the highest, to 23 for Hungary, the lowest. Two Nordic countries, Norway and Sweden, had the highest index. The United States ranked third across all countries, and Japan ranked fifth. The majority of the central and eastern European countries had the lowest indices.
4-Successful Ageing in China, Korea, Japan, and Singapore
Heterogeneity in successful ageing exist across countries. How do east Asian countries (China, Korea, Japan) and Singapore compare? Using the Rowe and Kahn model, comparison among China, Korea, and Japan, the average prevalence of successful aging was 17.6%. The odds of ageing successfully were highest in Japan, and lowest in China.[5]
The prevalence of successful ageing in Singapore was 25.4%. Older adults with education levels, who had no formal education (OR 0.2), some schooling but did not complete primary education (OR 0.4) or only primary education (OR 0.6), had lower odds of ageing successfully compared to those who had tertiary education. [6]
5-Singapore launches its 2023 Action Plan for Successful Ageing
The Singapore 2023 Action Plan for Successful Ageing focuses on 3 Cs in the elderly — Care of older adults, Connectedness, and Contribution to Society. Ageing requires a societal response aimed at preventing frailty. The video clip from Channel News Asia has more. https://www.youtube.com/watch?v=Rbl2ci-Szrs
6-Take home messages
- 1-The Rowe and Kahn model of successful ageing provides the 3 objective criteria for successful ageing at the individual level.
- 2-The 5 multidimensional domain index by Chen et al provide a index for comparison of countries’ adaptation to societal ageing — Norway and Sweden top the list with Japan in the fifth place.
- 3-The prevalence for successful ageing in Singapore was 25.4% Older adults in Singapore have much more active engagement with life as compared to their counterparts in other countries.
- 4-The Singapore 2023 Action Plan for Successful Ageing will further enhance the successful ageing rates of its older adults in the years to come.
References
1-Rowe, J.W. Successful Aging : Evolution of a Concept. J Nutr Health Aging 27, 194–195 (2023). https://doi.org/10.1007/s12603-023-1098-1
2-Rowe JW, Kahn RL. Human aging: usual and successful. Science. 1987 Jul 10;237(4811):143-9. doi: 10.1126/science.3299702. PMID: 3299702. https://pubmed.ncbi.nlm.nih.gov/3299702/
3-Rowe JW, Kahn RL. Successful aging. Gerontologist. 1997 Aug;37(4):433-40. doi: 10.1093/geront/37.4.433. PMID: 9279031. https://pubmed.ncbi.nlm.nih.gov/9279031/
4-Chen C, Goldman DP, Zissimopoulos J, Rowe JW; Research Network on an Aging Society. Multidimensional comparison of countries’ adaptation to societal aging. Proc Natl Acad Sci U S A. 2018 Sep 11;115(37):9169-9174. doi: 10.1073/pnas.1806260115. PMID: 30154160; PMCID: PMC6140517. https://pubmed.ncbi.nlm.nih.gov/30154160/
5-Nakagawa T, Cho J, Yeung DY. Successful Aging in East Asia: Comparison Among China, Korea, and Japan. J Gerontol B Psychol Sci Soc Sci. 2021 Jun 8;76(Suppl 1):S17-S26. doi: 10.1093/geronb/gbaa042. PMID: 32324214; PMCID: PMC8495754. https://pubmed.ncbi.nlm.nih.gov/30154160/
6- Subramaniam M, Abdin E, Vaingankar JA, Sambasivam R, Seow E, Picco L, Chua HC, Mahendran R, Ng LL, Chong SA. Successful ageing in Singapore: prevalence and correlates from a national survey of older adults. Singapore Med J. 2019 Jan;60(1):22-30. doi: 10.11622/smedj.2018050. PMID: 29774358; PMCID: PMC6351696. https://pubmed.ncbi.nlm.nih.gov/29774358/
7- MOH Singapore. Launch of the 2023 Action Plan for Successful Ageing. 2023 Jan 30. https://www.moh.gov.sg/news-highlights/details/launch-of-the-2023-action-plan-for-successful-ageing
7A-Channel News Asia. Singapore launches 2023 action plan for successful ageing. 2023 Jan 30. Video. https://www.youtube.com/watch?v=Rbl2ci-Szrs
7B-MOH. Living Life to the Fullest. 2023 Action Plan for Successful Ageing. Seven Chapters. https://www.moh.gov.sg/docs/librariesprovider3/action-plan/2023-action-plan.pdf
Acknowledgments
Thanks are due to Channel News Asia for the video clip on the 3 Cs action plan for successful aging, 2023 Jan 30 and to keystone elder.com for the feature picture of Rowe and Kahn successful ageing(1997) .
Dr LG Goh
Dr GOH Lee Gan is a retired Associate Professor in the Department of Family Medicine, National University Health System. He has an interest in learning and teaching how we can age well everyday (AWE).
