How Do Older Adults Define Successful Aging? A Scoping Review

Abstract

Successful aging is a prominent theory that describes the aging process and the expected activities and behaviors older adults should engage in or exhibit to age successfully. Although this theory is used to gauge the extent to which older adults are aging successfully, older adults’ experiences and perspectives of what successful aging means to them are missing from the theory. A five-step scoping review framework was used to explore and synthesize the existing research that investigated older adults’ perspectives on successful aging. Twelve main themes were found and ranged from the importance of social relationships and interactions to having a good death. Findings indicated older adults do not define successful aging as strictly as is found in the literature. Old age and the aging process from the views of older adults provide future directions for theory development and research.

Keywords

aging successful aging older adults scoping review aging theory

Aging is a socially constructed phenomenon and how it is perceived and experienced is influenced by culture, societal expectations, and individuals’ lived experiences (Brooks, 2010; Chonody & Teater, 2018). Old age has historically been defined through governmental policies by establishing a specific chronological age to denote an “older person” and is used to determine eligibility for particular services (e.g., age 67 to receive Social Security benefits in the United States if born after 1960). Likewise, expectations and explanations of behaviors of people who are classified as “older” adults have been presented through sociological, psychological, and gerontological theories, including disengagement theory (Cumming & Henry, 1961), productive ageing (Bass, Caro, & Chen, 1993), activity theory (Havighurst, 1961), healthy ageing (White House Conference on Ageing, 2015), successful ageing (Rowe & Kahn, 1997), and active aging (World Health Organization, 2002). However, over the past 15 to 20 years, successful aging has become a prominent aging paradigm in the substantive literature, yet a close examination of successful aging reveals that the voices of older adults are missing. This is a significant flaw in theory development in that older adults’ experiences and perspectives play an essential role in understanding and explaining aging. Therefore, this scoping review aims to review the literature to explore and synthesize the existing research that investigated older adults’ views and definitions of successful aging.

Literature Review

Theories and Frameworks of Aging

Historically, the coming of old age was seen as a time associated with disease and disability and as disengagement theory proposed, a period of withdrawal or disengagement from social interactions and activities (Cumming & Henry, 1961). Relatedly, activity theory purports that old age is a time when older adults adjust, redefine, and substitute their roles and activities in an attempt to maintain their sense of self (Havighurst, 1961). Over time, theorists began rejecting these premises, and positive theories of aging that focused on health and activity were proposed. Productive aging is one such theory and argues that older adults needed to remain active and productive through engagement in social activities and through the production of goods and services via paid and volunteer employment, thus reducing their reliance on social services (Bass et al., 1993). The more recent concept of healthy aging, which is defined as “living a long productive, meaningful life and enjoying a high quality of life” (White House Conference on Ageing, 2015), also aims to maximize older adults’ physical, social, and mental well-being to promote independence and reduce burdens on others. Yet, both of these theories fail to consider social and environmental factors that contribute to the extent to which one can age “healthy” (Mendes, 2013).

More current aging theories, such as active aging and successful aging, were developed as a counter response to theories that focused on decline, loss, and disengagement. Active aging is a positive policy framework that focuses on the connection of health and activity through six determinants: health and social services; behavioral; personal; physical; social; and economic, with cross-cutting determinants of culture and gender. Active aging was developed by the World Health Organization (2002) as a policy framework to assist governments in promoting and supporting active aging, which they defined as:

[T]he process of optimizing opportunities for health, participation, and security in order to enhance quality of life as people age [ … ] The word ‘active’ refers to continuing participation in social, economic, cultural, spiritual, and civic affairs, not just the ability to be physically active or to participate in the labor force. […] Active aging aims to extend healthy life expectancy and quality of life for all people as they age, including those who are frail, disabled, and in need of care. (p. 12)

Finally, successful aging is achieved when individuals exhibit the following: (a) low probability of disease and disability, (b) high cognitive and physical functional capacity, and (c) high social activity and engagement in social relationships (Rowe & Kahn, 1997). Many argue that this theory pushed too far in the other direction whereby older adults are being held to unrealistic standards in order to be “successful” (Foster & Walker, 2015; Martinson & Berridge, 2015; Morell, 2003; Rubinstein & de Medeiros, 2015; Teater & Chonody, 2017; Walker, 2009). Furthermore, the focus on remaining free of disease and disability fails to acknowledge the natural changes that occur in an aging body (Teater & Chonody, 2017) and implies “hostility toward ageing bodies” (Morell, 2003, p. 69). In addition, successful aging assumes that “through individual choice and effort” one can age successfully and remain physically and socially active (Rowe & Kahn, 1997, p. 37). This individualist view supports reduction in governmental policies that “provide social and other supports for [older adults] … and, notably, to address the social and structural inequalities that create illness and disability in the first place” (Martinson & Berridge, 2015, p. 63).

Although successful aging aims to take a more positive view of aging by focusing on health promotion, activity, and the positive features of aging, it was developed without the input of older adults’ views and experiences or an evaluation of the extent to which the theory’s principles and premises adequately depict the lived experiences of older adults. Without exploring “how the social meanings ascribed to aging interact with individuals’ lived experiences of the aging process,” aging is being socially constructed and defined by culture instead (Brooks, 2010, p. 238).

Measuring Successful Aging

Successful aging has been used to explain the aging process but has also been used as the basis for determining the extent to which older adults are aging successfully. For example, Kim (2008) developed a 31-item instrument to measure successful aging on a 5-point Likert-type scale (1 = never; 5 = always), which was comprised of items on autonomous life, self-realization, active participation in life, satisfaction with children, self-acceptance, and acceptance of others. Phelan, Anderson, LaCroix, and Larson (2004) developed the successful aging questionnaire where 20 factors of successful aging, consisting of aspects of psychological, social, physical, and functional health, were identified from the existing literature where older adults rated on a 3-point Likert-type scale how important they believed each attribute was to successful aging (1 = not important, 2 = neutral, and 3 = important). The older adults in Phelan et al.’s study reported that health, freedom from disability, life satisfaction, close personal relationships, staying active and involved, maintaining independence, meeting needs, adapting to aging-related changes, self-acceptance, and mastery were most important, which supported the successful aging theory.

Both Kim and Phelan et al.’s studies assessed successful aging by predefining the factors versus asking older adults to define successful aging themselves, which may create an inaccurate picture of reality. Hilton, Gonzalez, Saleh, Maitoza, and Anngela-Cole (2012) highlighted a weakness in Phelan et al.’s study, which is the failure to include financial security and religiosity/spirituality; factors older adults often mention as important to their well-being. The potential incongruence between predefining the factors of successful aging and self-assessment by older adults was underscored in a mixed-methods study where quantitative scores on physical, social, and psychocognitive functions indicated lower levels of successful aging among a group of older adults who qualitatively considered themselves to have aged successfully (von Faber et al., 2001). In addition, Montross et al. (2006) found 92% of community-dwelling older adults aged 60 years and older to perceive themselves as aging successfully despite experiencing a disease or disability. Such studies point to the need for more open-ended measures given that the current views on aging are not informed by older adults’ perspectives but, rather, by what others—often academic researchers—think older adults need (Clarke & Warren, 2007).

The Subjective Experience of Older Adults in Defining Successful Aging

The incongruence found between predefined measures of successful aging and self-assessment may be related to variations among older adults given they are a heterogeneous group. Therefore, theories of aging should incorporate differing views of the aging experience based on gender, culture, health status, and other identities as such dimensions could help or hinder the aging process (Martinson & Berridge, 2015). For example, older adults in non-Western societies may not subscribe to the ideals of successful aging as they may value interdependence and family relations more than the promotion of autonomy, independence, and individual responsibility (Amin, 2017). Moreover, accessibility to resources is not equitable, which can shape how people age. Narrative or life history research may be useful in further capturing how aging is understood among different groups of older adults, and “allow for the examination of how perceptions of aging may vary at different times and across the shifting contexts of people’s lives” (Dionigi, Horton, & Bellamy, 2011, p. 416). Such knowledge allows for a more accurate representation of experiences, referred to as biographical aging, which enables older adults to adapt to or cope with life challenges while also creating alternative meanings of the aging process based on experience and understanding of the self (Chapman, 2005; Dionigi et al., 2011). Acknowledging individual life stories allows for alternative explanations of aging and the aging process that can be valued and accepted among different groups of older adults, thus refuting the belief that all older adults should be held to one standard of “successful” aging.

This scoping review aims to begin this challenge by (a) identifying any existing research that examined the perspectives of older adults on their views of successful aging, (b) summarizing the themes found in this research, (c) comparing older adults’ views and definitions to successful aging, and (d) providing future directions for the conceptualization of old age and the aging process based on the views of older adults.

Methodology

A scoping review framework was used to explore existing research on older adults’ perspectives of successful aging. A scoping review is “a form of knowledge synthesis that addresses an exploratory research question aimed at mapping key concepts, types of evidence, and gaps in research related to a defined area or field by systematically searching, selecting, and synthesizing existing knowledge” (Colquhoun et al., 2014, pp. 1292–1294). The aim of a scoping review is not to critique the methodology of the studies reviewed but rather to synthesize the evidence on a topic of interest (Arksey & O’Malley, 2005).

The five steps in conducting a scoping review were followed as described by Levac, Colquhoun, and O’Brien (2010). The first step is to identify the research question, which was as follows: How do older adults define successful aging?” Given our interest in how participant driven research yields a conceptualization of successful aging, we delimited our research question to exclude researcher-driven ideas of successful aging. The second step in this process was to identify relevant studies. For this review, academic databases (Academic Search Premier; Abstracts in Social Gerontology; Family & Society Studies Worldwide; PsycINFO; Social Work Abstracts) were searched using the following search terms: successful aging, active aging, productive aging, healthy aging, attitudes, older adults. The positive aging theories of active aging, productive aging, and healthy aging were included in the search to review whether the studies were exploring successful aging in addition to these other positive theories, for example, asking older adults to define or provide examples of successful aging (see Lewis, 2013). Articles were limited to those available in English and published from 2002 to 2017. The search of the literature yielded 366 articles.

The third step in a scoping review is to determine whether each of the studies met the inclusion criteria. In addition to the parameters set around publication years and availability in English, the inclusion criteria included research on successful aging from the perspective of older adults through open-ended questions to determine older adults’ definitions, experiences, and perspectives of successful aging (e.g., “What does successful aging mean to you?”; “What is involved in the process of successful aging?”). Articles where the researchers predefined successful aging were excluded, for example, when researchers utilized preexisting measures of successful aging or predefined the possible key elements of successful aging. Both researchers independently reviewed all 366 abstracts identified in the search. Once this process was complete, 56 articles were identified for possible inclusion. The researchers discussed this list together and reviewed the abstracts again to resolve any uncertainties of whether to include or exclude the article. After this process, 42 articles remained, and the full articles were downloaded. Upon reviewing these articles, an additional 12 articles were excluded primarily because upon closer examination, it was found that the researcher versus participants were delineating the definition for successful aging.

The fourth step involved charting the data or findings of the review. For this review, a data extraction form was created to chart the data, which included demographics of the sample, research design, instruments used, questions asked, sampling method, data analysis, and findings. The researchers worked together to develop this form, and then each researcher independently extracted data from the first two articles in the final list. This process helped to determine whether extraction was aligned with the research question (Levac et al., 2010). These extractions were discussed, and then the researchers divided the remaining articles for independent extraction. Once this process was complete, researchers discussed their extractions and once again explored how each article aligned with the purpose of the review. An additional eight articles were found to be slightly off topic; that is, the findings were focused on an element of aging, such as the meaning of death, but participants were not asked to provide their perspective on successful aging. Thus, the final sample of articles used in this review was 22. Table 1 provides a summary of these studies.

Table 1.

A Summary of the Studies Included in the Review.

Author(s)	Demographics	Design/Analyses	Questions	Major Themes (subthemes)
Amin (2017)	7 Males; 5 females Mean age = 71.5 years; range: 60–90 Bangladeshi Community dwelling	Semi-structured interviews (face-to-face or over the phone) Grounded theory; thematic coding strategy	1. When you think about your life, what things do you like least about being the age you are? 2. What would make you satisfied in old age? 3. What do you think it means to age well? 4. What do you think one needs to feel content in old age?	Adaptation to the aging body; financial security; family and intergenerational care; social participation
Chen (2015)	14 Females Mean age = 73.28 years; range: 60–90 Taiwan Community dwelling	Open-ended, in-depth semi-structured interviews Inductive analysis with constant comparative method	Not provided	Being healthy; no financial worries; maintaining connections with family and friends; a good death
Chong, Ng, Woo, and Kwan (2006)	40 Females; 18 males (60+) 20 females; 17 males (middle aged; range: 40–59) Hong Kong Mixture of community dwelling and residential care	Focus groups with 5–8 participants each “Individual units of meaning” were recorded by two members of research team and then compared	“At each focus group, the participants were invited to articulate their notions of positive ageing, to give personal examples, and to identify the factors that would affect how they aged well or positively” (p. 248)	Understanding of positive ageing: good health; having a positive attitude; active participation; having good social and family support; financial security Factors affecting positive ageing: getting an early start; adopting a healthy lifestyle; thinking positively; promoting family and interpersonal relationships; building up financial resources; preferred living arrangements
Collis and Waterfield (2014)	3 Females; 3 males Mean age = 79 years; range: 75–90 England Community dwelling	Interviews Grounded theory-open coding; axial coding interviews;	Explored: 1. What ‘successful aging’ meant to the participants 2. Why they felt they had aged successfully 3. Recollection of painful episodes 4. Methods of coping with pain 5. If and how pain resolved 6. How they thought that pain differs when younger versus than older 7. Current experiences with of pain, if any 8. How their experience of pain compared with that of other older people 9. In the light of their understanding of successful aging, how this might be inhibited by pain	Understanding pain; perceptions of aging (perceptions of others; attitudes of health care professionals; disability; adaptation)
Dionigi et al. (2011)	21 Females Mean age = 83.3 years; range: 75–92 Middle class Caucasians Community dwelling	In-depth interviews Inductive analysis approach; narrative content analysis	Included: 1. Do you have any hobbies or regular activities that you enjoy? Please describe. 2. What does successful aging mean to you? 3. What does the term old mean to you? 4. Please describe your current health status” (406).	Perceptions of being old; definitions of successful aging
Guell, Shefer, Griffin, and Ogilvie (2016)	12 Females; 15 males 10 were 65–69 years old; 7 were 70–74; 10 were 75–80 Norfolk, England Community dwelling	Semi-structured interview; thematic data analysis Open coding synthesized into categories	Explored: everyday activities and motivations; lifestyle opportunities; choice and motivations across the seasons and their life course; aspirations into older age	Aspirations of active living (positive attitude, keeping body and mind active, tension between staying busy and staying active); practices of active living (being out and about, purposeful activities, adaptive activeness); social context of active living (social motivators as facilitators, social limitations as barriers)
Hilton et al. (2012)	38 Females; 22 males Mean age = 61; range: 50–84 Latino(a) Western states in the United States	Face-to-face interviews to fill out questionnaire (mainly close ended questions) Grounded theory; descriptive statistics	Demographics and health status; Phelan’s scale of successful aging; and “When you think about aging well, what comes to mind? Please tell us what successful aging means to you.”	Good health; independence; staying active and involved; family and social relationships; self-care; accepting the aging process; positive attitudes; cognitive functioning; financial well-being; spirituality and transcendence
Horder, Frandin, and Larsson (2013)	9 Females; 15 males Mean age = 81; range: 77–90 Western Sweden Community dwelling	Individual interviews Content analysis	Explored thoughts and feelings related to successful aging; opening question: “Please tell me what successful aging means to you.”(3)	Self-respect through ability to keep fear of frailty at a distance (having sufficient bodily resources for security and opportunity); structures that promote security and opportunities (satisfaction with one’s financial situation; security and opportunities in the closest context); feeling valuable in relation to the outside world (feeling noticed and appreciated in social relations; engagement in activities that provide pleasure or benefit); choosing gratitude instead of worries (chose gratitude for not being as bad as others; denying difficulties; accepting things you cannot change)
Hsu (2007)	48.1% female; 51.9% male (N = 594) 30.3% were 65–69 years; 24.7% were 70–74; 24.8% were 75–79; 20.2% were 80+ Taiwan Community dwelling	Surveys conducted via face-to-face interviews Content analysis; factor analysis	23 predetermined items about successful aging and “What do you think are the essential components of an ideal and satisfactory old-age life?”	Physical health (47.4%); family and social support (28.7%); economic security (17.8%); spiritual well-being (16.9%); environment and social policy (11.7%); engagement with life (7.5%)
Jopp et al. (2015)	N = 291 (151 Americans; 155 Germans); gender was not specified U.S. sample = 21% African American; 7% Asian American; 66% White German sample = 100% White Age range: 15–96 (103 “young people”; 92 “middle-aged”; and 96 “older adults”) Mixture of community dwelling and residential care	Individual interviews; grounded theory Open coding, clustering, and theme identification	1. What is successful aging in your view? 2. What is involved in the process of successful aging?	Health (817%); social resources (65.7%); activities/interests (55.9%); virtues/attitudes/beliefs (51.0%); well-being (49.3%); life management/coping (35.9%); financial resources (31.4%); aging/age as a topic (25.5%); independence (17.6%); meaning in life (14.7%); growth/maturation (14.4%); respect/status (13.7%); education/knowledge (12.1%); microenvironment (9.5%); society/microenvironment (8.2%); other (2.3%)
Laditka et al. (2009)	N = 396 74.9% females Diverse participants, including African Americans, American Indians, Chinese, Hispanic, Vietnamese; White Mean age = 71.0 United States—9 states Community dwelling	42 focus groups Constant comparison methods	Asked to provide a description of “someone who you think is aging well”	Living to advanced age; having good physical health; having a positive mental outlook; being cognitively alert; having a good memory; and being socially involved
Lewis (2011)	16 Females; 10 males 100% Alaskan Natives (AN) Age range: 61–93 6 Bristol Bay Communities (SW Alaska) Community dwelling	Interviews that utilized the “explanatory model interview protocol” Grounded theory, inductive approach; inter-rater reliability checked with Kappa statistic (M = .87)	15 questions covered these topics: “how AN Elders define successful aging; how their aging process affects their emotional, spiritual, and cognitive well-being; and if their community is supportive of them aging successfully”	Four elements were important to eldership (re: successful ageing): emotional well-being; community engagement; spirituality; physical health
Lewis (2013)	16 Females; 10 males 100% Alaskan Natives Age range: 61–93 6 Bristol Bay Communities (SW Alaska) Community dwelling	Interviews that utilized the “explanatory model interview protocol” Grounded theory, inductive approach; inter-rater reliability checked with Kappa statistic (M = .87)	15 questions covered these topics: “how AN Elders define successful aging; how their aging process affects their emotional, spiritual, and cognitive well-being; and if their community is supportive of them aging successfully”	Optimism was the key finding; it was found in each of themes related to eldership; that is, maintain a positive outlook was essential to eldership/successful ageing
Mortimer, Ward, and Winefield (2008)	14 Females Age range: 60–89 Adelaide, Australia Community dwelling	Semi-structured interviews; Thematic analysis with interpretive phenomenological analyses framework	What does successful ageing mean to you?	Personal agency (adaptability; nature; health; life of the mind; finance; spiritual and self-expression); social value (interpersonal; generativity; affiliations; value); quality of life/death (life quality; spirituality; death; autonomy; authenticity)
Nguyen and Seal (2014)	27 Females; 17 males 21 Hmong; 23 Chinese Age range: 60–100 (Chinese), 61–95 (Hmong); Hmong all emigrated from Laos to United States; Chinese were a mix of immigrants and U.S.-born Community dwelling	Interviews with semi-structured narrative inquiry Grounded theory; open coding for emergent themes; Wilcoxon signed rank sum test; chi-square; descriptive statistics	Describe someone you know who you consider to be ageing well; describe some things or people that make you happy; scales for self-reported health, satisfaction with life	Hmong: physical health and mobility; mental health; harmonious relationships; positive family relationships; tangible family support; financial stability; social engagement; religious faith Chinese: physical health and mobility; mental health; positive attitudes; shedding responsibilities; positive family relationships; financial stability; social engagement; religious faith; accomplishments; volunteer work
Nimrod and Ben-Shem (2015)	72% females (N = 207) Mean age = 78.75; range: 65–93 United States Community dwelling	Interviews Constructivists grounded theory and situational analysis	What advice would you give me on how to achieve successful ageing?	Investments made at earlier life stages; preserving qualities contributes to well-being; internal resources that provide coping strategies
Reichstadt, Depp, Palinkas, Folsom, and Jeste (2007)	53% females (N = 72) Age range: 60–99 San Diego, CA Community dwelling	Semi-structured focus groups with “funnel interview design” Grounded theory	How would you define successful ageing? What are the necessary components of successful ageing?	33 Factors were identified with 4 major themes: attitude/adaptation; security/stability; health/wellness; engagement/stimulation
Reichstadt, Sengupta, Depp, Palinkas, and Jeste (2010)	59% females (N = 22) Mean age= 80; range: 64–96 86% White San Diego, CACommunity dwelling	Interviews Grounded theory	How would you define successful ageing? What is important to aging successfully? How have your life experiences influenced the course of your life and how you age? What are your suggestions on how to age well and recommendations for specific interventions to promote healthy ageing?	Self-acceptance/self-contentment (realistic self-appraisal; a review of one’s life; focusing on the present); engagement with life/self-growth (novel pursuits; giving to others; social interactions; positive attitudes)
Romo et al. (2012)	64% females (N = 22) Mean age= 78.3; range: 59–97 23% African American; 32% Chinese; 20% Latino(a); 20% White San Francisco, CA Community dwelling	Semi-structured, open-ended interviews Grounded theory	Researchers have come up with the term “successful aging.” What comes to mind when you hear that term? Do you feel like you have aged successfully? Do you feel old?	Aging means “living in a new reality” (acknowledge this new reality; reject the new reality); successful aging was achieved through adaptation and coping strategies
Rozanova, Noulas, Southwick, and Pietrzak (2015)	96.9% males (N = 2,025) Age range: 60–96 San Francisco, CA Community dwelling veterans	3 open-ended questions on a survey Thematic analysis “rooted in an indicative approach to textual data”	In your view, what factors are most important to successful physical, emotional, and cognitive ageing?	“What you do” (health behaviors; social engagement; maintain good function) was the most prominent theme for each of the three questions; the second most common theme was “who you are” (personality and explanatory style; moral compass; emotional disposition); external factors (e.g., health care) were last common across the domains
Tate, Lah, and Cuddy (2003)	100% males (N = 1,771) Canada Community dwelling WWII Canadian Air Force veteran	Open-ended question on survey Content analysis	What is your definition of successful ageing? Would you say you have successfully aged?	20 Component themes; most frequent themes provided: health and disease; physical, mental, and social activity and were more likely to be found in definitions that included interest; having goals; family; or diet
Tate, Swift, and Bayomi (2013)	100% males (N = 1,745; 5,898 narratives) Canada Community dwelling WWII Canadian Air Force veteran	Open-ended question on survey Content analysis	What is your definition of successful ageing?	21 Themes with 86 subthemes: health—general; health—physical; health—cognitive; health system; attitude; happiness; living and dying; physical activity; leisure activity and interests; lifestyle; being productive or contributing; coping; adjustment; acceptance; adaptation; spirituality/faith; relationships—intimate; relationships—intimate; relationships—family; relationships—companionship; relationships—society; independence; life experience; quality of life

The final fifth step involved collecting, summarizing, and reporting the results. To summarize and synthesize the findings, the researchers each independently reviewed all the data extraction forms and created a list of themes found across the studies. The researchers compared their lists and discussed their findings to ensure that the data were represented and summarized appropriately. Table 2 provides these themes alongside the article author(s).

Table 2.

Themes of Successful Aging.

Themes	Frequency	Authors
1. Social Relationships and Interactions	19	Amin (2017); Chen (2015); Chong et al. (2006); Dionigi et al. (2011); Guell et al. (2016); Hilton et al. (2012); Horder et al. (2013); Hsu (2007); Jopp et al. (2015); Laditka et al. (2009); Lewis (2011); Mortimer et al. (2008); Nguyen and Seal (2014); Nimrod and Ben-Shem (2015); Reichstadt et al. (2007, 2010), Rozanova et al. (2015); Tate et al. (2003, 2013)
2. Positive Thinking, Attitude, and Optimism	17	Chong et al. (2006); Collis and Waterfield (2014), Dionigi et al. (2011); Guell et al. (2016); Hilton et al. (2012); Horder et al. (2013); Jopp et al. (2015); Laditka et al. (2009); Lewis (2011, 2013); Nguyen and Seal (2014); Nimrod and Ben-Shem (2015); Reichstadt et al. (2007, 2010); Rozanova et al. (2015); Tate et al. (2003, 2013)
3. Being Healthy	15	Chen (2015); Chong et al. (2006); Dionigi et al. (2011); Hilton et al. (2012); Horder et al. (2013); Hsu (2007); Jopp et al. (2015); Lewis (2011); Mortimer et al. (2008); Nguyen and Seal (2014); Nimrod and Ben-Shem (2015); Reichstadt et al. (2007); Rozanova et al. (2015); Tate et al. (2003, 2013)
4. Financial Security	13	Amin (2017); Chen (2015); Chong et al. (2006); Hilton et al. (2012); Horder et al. (2013); Hsu (2007); Jopp et al. (2015); Mortimer et al. (2008); Nguyen and Seal (2014); Nimrod and Ben-Shem (2015); Reichstadt et al. (2007); Rozanova et al. (2015); Tate et al. (2003)
5. Acceptance and Adaptation	13	Amin (2017); Collis and Waterfield (2014); Guell et al. (2016); Hilton et al. (2012); Horder et al. (2013); Hsu (2007); Jopp et al. (2015); Laditka et al. (2009); Mortimer et al. (2008); Romo et al. (2012); Rozanova et al. (2015); Tate et al. (2003, 2013)
6. Engagement with Life	13	Chen (2015); Chong et al. (2006); Guell et al. (2016); Hilton et al. (2012); Horder et al. (2013); Hsu (2007); Jopp et al. (2015); Mortimer et al. (2008); Nimrod and Ben-Shem (2015); Reichstadt et al. (2007, 2010); Tate et al. (2003, 2013)
7. Spirituality	11	Amin (2017); Hilton et al. (2012); Hsu (2007); Jopp et al. (2015); Lewis (2011); Mortimer et al. (2008); Nguyen and Seal (2014); Nimrod and Ben-Shem (2015); Rozanova et al. (2015); Tate et al. (2003, 2013)
8. Environment and Social Policy	7	Hsu (2007); Jopp et al. (2015); Mortimer et al. (2008); Nimrod and Ben-Shem (2015); Reichstadt et al. (2007); Rozanova et al. (2015); Tate et al. (2013)
9. Autonomy and Independence	7	Hilton et al. (2012); Jopp et al. (2015); Mortimer et al. (2008); Nguyen and Seal (2014); Nimrod and Ben-Shem (2015); Tate et al. (2003, 2013)
10. Cognitive Health	6	Hilton et al. (2012); Laditka et al. (2009); Nguyen and Seal (2014); Rozanova et al. (2015); Tate et al. (2003, 2013)
11. Physically Active	6	Amin (2017); Dionigi et al. (2011); Guell et al. (2016); Laditka et al. (2009); Tate et al. (2003, 2013)
12. Having a Good Death	2	Chen (2015); Horder et al. (2013)

Findings

As Table 2 illustrates, there were 12 main themes that were identified across the 22 studies exploring older adults’ views and definitions of successful aging. Each of the 12 themes is described in detail later.

Social Relationships and Interactions

Elements of social relationships and interactions were present across 19 of the 22 studies where older adults defined successful aging as consisting of or incorporating the following: maintaining connections with family and friends; having good family and social support; family and intergenerational care; social engagement and participation; social resources; and having status, appreciation, and respect in social relations. In describing the importance of social relationships and interactions, the older adults highlighted the need to have good relationships and engagement with spouses, family, friends, and children (Amin, 2017; Chong et al., 2006; Dionigi et al., 2011; Hilton et al., 2012; Mortimer et al., 2008; Nguyen & Seal, 2014; Rozanova et al., 2015; Tate et al., 2003, 2013) and, for some, friendships were even more indispensable than family (Chen, 2015). The need for help and support from partners/spouses, children, neighbors, and friends as one grows older was highlighted, but also an opportunity to have a sense of belonging and being needed through caretaking, particularly for grandchildren (Amin, 2017) or being taking care of by their children by living with them, having support from them, or receiving frequent visits from them (Hsu, 2007; Nguyen & Seal, 2014). For some older adults, receiving support and feeling loved enabled them to keep from worrying (Horder et al., 2013) and family well-being was viewed as related to their healthy aging experience and good health (Nguyen & Seal, 2014) as well as useful in adjusting to changes in later life (Nimrod & Ben-Shem, 2015).

Social engagements in the community were also important and provided self-satisfaction, an opportunity to gain respect, and social inclusion or belonging (Amin, 2017; Jopp et al., 2015; Lewis, 2011; Mortimer et al., 2008; Reichstadt et al., 2010; Rozanova et al., 2015; Tate et al., 2013). The older adults described having access to social supports and providing social supports to family, friends, and neighbors helped to ward off boredom and loneliness and was a source of encouragement or motivation in staying healthy (Guell et al., 2016; Laditka et al., 2009; Nguyen & Seal, 2014) even when such activities were undertaken because of social expectations (e.g., keeping up the house; watching grandchildren; Guell et al., 2016).

Positive Thinking, Attitude, and Optimism

Elements of positive thinking, attitude, and optimism were present in 17 studies and included maintaining a positive attitude and mental outlook, celebrating and accepting old age, being happy and satisfied with life, choosing gratitude instead of worries, having peace of mind, maintaining emotional well-being, engaging in positive thinking and being optimistic, having self-acceptance and self-contentment, focusing on the present, acknowledging accomplishments, investing in oneself, and engaging in humor and happiness. The older adults described the need to maintain a positive attitude despite changes due to aging, such as not being able to perform the same activities that one could when younger (Chong et al., 2006). When faced with physical changes and challenges, such as illness or chronic pain, the older adults described the need to let go and accept the illness or pain and not let it affect one’s emotions or feel sad about one’s circumstances (Chong et al., 2006; Hilton et al., 2012; Laditka et al., 2009; Nguyen & Seal, 2014). The utilization of coping strategies (Collis & Waterfield, 2014) and taking a “get on with it” approach (Guell et al., 2016) where one looks forward not backwards and experiences contentment, investment in oneself, and celebrates and accepts old age (Dionigi et al., 2011; Nimrod & Ben-Shem, 2015; Reichstadtet al., 2007, 2010; Tate et al., 2013) were important when coping with aging-related changes.

Older adults also described accepting life the way it is, which includes both happiness and sorrow (Horder et al., 2013) and maintaining an optimist outlook (Lewis, 2011, 2013; Reichstadt et al., 2007) and positive attitude to move through grievances and stressful situations (Nguyen & Seal, 2014; Tate et al., 2003). In doing so, one can have peace with oneself, less worry, better health due to less distress when problems arise, and the ability to live fully and enjoy life (Jopp et al., 2015; Lewis, 2011, 2013; Reichstadt et al., 2007). Finally, the older adults reported the importance of acknowledging and reflecting on their accomplishments of the past and feeling a sense of pride (Nguyen & Seal, 2014; Tate et al., 2013) and the importance of keeping a good sense of humor (Nimrod & Ben-Shem, 2015; Rozanova et al., 2015; Tate et al., 2003, 2013).

Being Healthy

Being healthy was described by older adults as contributing to successful aging across 15 of the 22 studies where having good physical and mental health, self-care, sufficient bodily resources for security and opportunities (e.g., mobility), and engaging in healthy behaviors was viewed as important. Being healthy was described as the ability to take care of oneself and everyday life, such as being able to eat, get to places, sleep and to get out of bed, maintain good mobility—even with assistance—maintain a sense of independence, and keeping busy and engaged in life (Chen, 2015; Chong et al., 2006; Dionigi et al., 2011; Horder et al., 2013; Hsu, 2007; Nguyen & Seal, 2014). Being healthy involved making healthy lifestyle choices, such as participating in exercise, eating healthy, maintaining a good weight, stress management, vitamin use, medication management, avoiding the sun, not smoking, and drinking alcohol in moderation (Hilton et al., 2012; Nguyen & Seal, 2014; Nimrod & Ben-Shem, 2015; Reichstadt et al., 2007; Rozanova et al., 2015; Tate et al., 2003, 2013).

It is important to note that some older adults did not equate being healthy with no disease or medical problems (Chen, 2015; Lewis, 2011; Reichstadt et al., 2007) and some form of chronic illness was seen as a natural part of growing older (Nguyen & Seal, 2014). Rather, being healthy meant the ability to adapt and cope with the changes that come with disease, disability, chronic illness, and pain by maintaining a sense of independence and ability to self-care to some degree. Yet, for other older adults, particularly those who were described as being moderately to highly physically active, being healthy did encompass aspects of exercise and regular physical activity as important (Dionigi et al., 2011; Mortimer et al., 2008), and the absence of aches and pains, disease, and major illness (Hilton et al., 2012; Horder et al., 2013; Jopp et al., 2015; Tate et al., 2013), especially when it could significantly impede upon mobility (Nguyen & Seal, 2014) and place a burden on close friends and family (Horder et al., 2013; Hsu, 2007).

Financial Security

Financial security was cited among the older adults as important to successful aging in 13 studies. Financial security included the following: no financial worries; financial resources and well-being; satisfaction with one’s financial situation; economic security, particularly from environmental and social policies; and tangible support from family members. Financial security was particularly important in terms of having enough money through paid employment or retirement/pension, to support oneself in meeting basic needs, meet living expenses, access and maintain health insurance, and maintain a sense of independence (Chen, 2015; Chong et al., 2006; Hilton et al., 2012; Horder et al., 2013; Hsu, 2007; Jopp et al., 2015; Nguyen & Seal, 2014; Nimrod & Ben-Shem, 2015; Rozanova et al., 2015; Tate et al., 2003). There was an exception to this among a group of Hmong older adults who reported the need to have tangible support from family members where they expected their children to provide financial assistance in buying groceries and paying bills (Nguyen & Seal, 2014). Having financial security was reported by the older adults to contribute to one’s ability to have less worries and more a sense of security, to be able to engage in life and participate in activities one enjoys (Horder et al., 2013; Reichstadt et al., 2007), and to have good care in old age (Mortimer et al., 2008).

Acceptance and Adaptation

Elements of acceptance and adaptation as contributing to successful aging was included by older adults across 13 of the 22 studies, which was defined by the following: adapting to the aging body, accepting the aging process, life management/coping, living in a new reality, growth/maturation, and living to advanced age. The older adults stressed the need to adapt to the normal physical changes of the body, such as graying hair, changes to eyesight and hearing, mobility, and chronic diseases (e.g., diabetes, arthritis) without much complaint and being able to take 1 day at a time and accept the new role of “old” with dignity by having realistic expectations (Amin, 2017; Guell et al., 2016; Hilton et al., 2012; Mortimer et al., 2008; Rozanova et al., 2015; Tate et al., 2003, 2013). Even when older adults experienced chronic pain, they discussed being able to age successfully by leading a normal life and accepting that pain is a consequence of aging that one can accept and adjust by making adaptations to lessen the pain or discomfort (Collis & Waterfield, 2014). Adaptations to the physical changes associated with aging could include using assistive devices, engaging in lower impact activities, reducing activities at a gradual level to keep one’s self-respect, and replacing activities all together (Guell et al., 2016; Horder et al., 2013; Tate et al., 2013).

Many older adults also reported the need to continue to live, mature, and work on oneself in old age by setting goals, taking up new challenges, and resolving difficulties (Jopp et al., 2015; Laditka et al., 2009; Rozanova et al., 2015). This involved not viewing age as a punishment, but accepting age and aging and living for many years in a new reality where physical changes occur, but such changes merely require the older adult to perceive situations differently; those who are able to react and adapt were more likely to view aging as successful (Romo et al., 2012; Tate et al., 2013).

Engagement With Life

In 13 studies, older adults mentioned engagement with life as important to successful aging, which included continuing to be productive and contribute to society, being out and about, staying active and involved, engagement in activities that provide pleasure or benefit, and goals. Remaining active in activities that one likes to do, such as hobbies, reading, journaling, writing, philosophizing, and travel, and being involved in the community, such as through volunteering, engagement with cultural activities, church, or senior citizen’s association, or providing child care to grandchildren was viewed as important to successful aging (Chen, 2015; Chong et al., 2006; Hilton et al., 2012; Horder et al., 2013; Hsu, 2007; Jopp et al., 2015; Mortimer et al., 2008; Nimrod & Ben-Shem, 2015; Reichstadt et al., 2007, 2010; Tate et al., 2003, 2013). The older adults reported that being engaged and active did not necessarily mean being physically active, but more getting out of the house and being busy and engaged and trying new things, which could include a combination of physical and sedentary activities (Guell et al., 2016; Reichstadt et al., 2010). Being engaged in life was related to feeling valuable, and being able to contribute gave a sense of satisfaction and a purpose in life (Horder et al., 2013; Nimrod & Ben-Shem, 2015; Reichstadt et al., 2007).

Spirituality

Spirituality, which encompassed spiritual well-being, meaning in life, moral compass, and religious faith, was discussed as an element of successful aging in 11 studies. The older adults defined spirituality as finding peace in later life (Amin, 2017); having spiritual understanding and relying on God (Hilton et al., 2012); celebrating one’s spirit and connecting with something beyond oneself (Mortimer et al., 2008; Tate et al., 2013); and feeling joy, a sense of tranquillity, security, hope, and to be happy and peaceful (Hilton et al., 2012; Hsu, 2007; Nguyen & Seal, 2014; Nimrod & Ben-Shem, 2015; Tate et al., 2003). Some older adults expressed that getting old was a gift from heaven and being involved in church, religion, and spirituality was important, gave meaning or a sense of purpose in life, and helped in preparing for the end of life (Jopp et al., 2015; Lewis, 2011; Rozanova et al., 2015).

Environment and Social Policy

Older adults in 7 of the 22 studies reported the importance of environmental and social policy to successful aging, which included education, security and stability in one’s living environment, nature, housing, health care, and having basic needs provided. Many older adults expressed the importance of the environment in contributing to the extent to which they could age successfully. For example, the importance of quality health care, receipt of free or affordable health care, access to work, governmental pensions to assist in meeting basic needs, and having a good education to help in understanding the world and what it means to be an adult (Hsu, 2007; Jopp et al., 2015; Rozanova et al., 2015; Tate et al., 2013). One’s living environment also contributed to successful aging whereby the environment was safe in terms of design (e.g., no stairs; Nimrod & Ben-Shem, 2015) and gave access to nature (Mortimer et al., 2008), or where supports and resources, such as housekeeping, meals, and activities, were accessible and provided (Nimrod & Ben-Shem, 2015; Reichstadt et al., 2007).

Autonomy and Independence

Older adults mentioned autonomy and independence, including personal dignity and authenticity, as an important element to successful aging across 7 of the 22 studies. Autonomy and independence was described as being able to do things that one likes to do without help, living independently, taking care of oneself without depending on others, and maintaining good mobility and well-functioning motor skills, or if needing assistance with mobility, not being bedbound (Hilton et al., 2012; Jopp et al., 2015; Nguyen & Seal, 2014; Nimrod & Ben-Shem, 2015; Tate et al., 2003, 2013). Autonomy and independence was equated with having a sense of freedom, enabled the older adults to maintain personal dignity, and contributed to the retention of the authentic self (Horder et al., 2013; Mortimer et al., 2008).

Cognitive Health

Cognitive health was mentioned as important aspects of successful aging in six studies, which included good cognitive functioning, being cognitively or mentally alert, and keeping active mentally. Cognitive health was defined as having minimal memory loss, remaining alert, retaining mental activity, and having an active mind (Hilton et al., 2012; Nguyen & Seal, 2014; Tate et al., 2013), including remembering details from the past (Laditka et al., 2009). The older adults reported that maintaining cognitive health required them to engage in certain activities, such as mental exercise, reading, playing games, learning new things, challenges oneself, and engaging in hobbies and creative activities (Rozanova et al., 2015; Tate et al., 2003).

Physically Active

In six of the studies, engaging in physical activity and keeping active as important to successful aging was reported. Some of the older adults described the need to keep physically active by keeping physically fit and working out, such as participating in sports or golf (Tate et al., 2003, 2013). Individuals who were found to be more moderately or highly active described a sense of self-responsibility for their health in older age and believed that keeping physically active by getting out and doing things would delay old age whereas individuals who were found to be inactive did not mention physical activity or exercise as important to successful aging (Dionigi et al., 2011). Keeping physically active was not always necessarily about exercise but, rather, having an engaged and active life where engagement in physical activity was part of socializing, working, or for a purpose, such as walking to get a newspaper (Guell et al., 2016; Laditka et al., 2009).

Having a Good Death

Having a good death was mentioned by older adults in 2 of the 22 studies, which was defined not necessarily as longevity but, rather, as “being able to die at home surrounded by family members in comfort and warmth” (Chen, 2015, p. 224). Older adults not only mentioned their own death but also the threat they experienced by the health, well-being, and death of close relatives and friends and, especially, a spouse (Horder et al., 2013).

Discussion

The results of this scoping review address a gap in the literature by providing a synthesis of the research on older adults’ definitions and descriptions of successful aging. Through a greater understanding of older adults’ lived experiences and perspectives, the basic premises of successful aging can be further evaluated for its ability to capture the aging process. Across the 12 main themes found in the 22 studies included in this review, older people identified both internally and externally controlled elements of aging. That is, older adults relayed their experience of and perspective on successful aging as a combination of social, psychological, physical, financial, environmental, and spiritual aspects. While they included good health and mental, physical, and social well-being, they also acknowledged that getting older comes with changes, such as decreased mobility, sensory impairments, disease, disability, chronic illness, and pain; things that are often beyond one’s control. However, successful aging can still be achieved when positive thinking, spirituality, adaptation, and acceptance are used. Moreover, external resources, such as finances and environmental factors may also help or hinder one’s ability to successfully age. The findings provide a holistic view of older adulthood that encompasses a large number of facets that may be influencing an older person’s individual experience of aging. As we have seen with past theoretical models, reductionism does not facilitate understanding and can promote oppressive thinking, such as the premises of disengagement theory, which suggests that older adults should leave the social and economic arena.

In fact, when comparing this study’s findings to successful aging, a wider range of factors is found than those suggested by the theory, which focuses primarily on what one does. “Success” is denoted by a low probability of disease and disability, high cognitive and physical functioning, and high engagement in social relationships (Rowe & Kahn, 1997), and individual responsibility is placed in high regard as a preventative measure for physical, cognitive, and social decline The older adults in this study do not report that high physical functioning is equated with successful aging, but, rather, engaging in social, cognitive, and physical activities are important while also being realistic and accepting that one will experience changes and challenges to engaging in such activities due to natural changes in the aging body. Therefore, one needs to accept such changes as natural and normal and make adaptations versus merely giving up and concluding they are unsuccessful at aging. Furthermore, the absence of internal factors that facilitate to assist one in coping and accepting challenges and changes that occur in the “natural” and “normal” aging process misses key resilience and protective factors present in older people. This is a limited view of aging and one that also assumes a level playing field in making healthy choices and access to services and resources. This study’s findings highlight this gap in theory in that older adults point out that aging successfully is dependent on external factors, such as financial security, the environment, and social policies to meet basic needs, have safe housing, and gain access to health care. Such external factors influence the extent to which one can engage in social activities, address health concerns and changes, make healthy choice (e.g., purchase healthy meals), and engage in life, including physical activities. The message from the older adults appeared clear in that aging comes with natural changes and difficulties that cannot always be avoided, but aging successfully requires the utilization of their social and psychological supports to adapt, accept, move forward, and maintain a sense of self, pride, and dignity.

Implications for Future Research and Theory Development

This scoping review has highlighted that successful aging is more complex and varied across older adults than has been described through aging theories, which points to several implications for future research and theory development. First, future aging theories should continue to explore the elements of aging that are of importance to older adults and the factors that they have experienced or perceive as contributing factors to aging in a positive way instead of relying on factors identified by theorists and academic researchers. As the findings from this review highlight, there is variation among older adults on the factors that contribute to aging successfully or positively with a strong focus on social relationships and interactions and one’s state of mind over being free of disease and disability and maintaining high levels of social, cognitive, and physical activity. The older adults also acknowledged external factors of financial security and the environment and social policy as factors that mediate one’s ability to age successfully. Future theories should reflect more realistic experiences of aging, including natural changes that will occur, such as graying hair, sensory changes, and decreased mobility, versus viewing successful or positive aging as avoiding or fighting such changes. In addition, theories should reflect how older adults’ access to financial resources, their environments, and social policies help or hinder their ability to age positively versus viewing aging as the sole responsibility of the individual.

Second, future research exploring the experiences and perspectives of older adults should carefully consider the way questions are asked and how this makes a difference to the way in which older adults will respond. For example, Hilton et al. (2012) found:

when asked to describe someone who is aging well, older adults mention things like longevity, how good a person looks for his/her age, good genes in the family, and being able to do things one would not expect of a person that age. Yet, when they were asked about their own aging, older adults describe a different set of more personal characteristics. (p. 197)

Using a biographical approach, such as narrative and life history research that utilizes open-ended questions can encourage older adults to talk about what is important to them. For example, asking questions such as “Can you tell me how you feel about growing older?” (Clarke & Warren, 2007, p. 468) or “Please tell me what successful aging means to you” (Horder et al., 2013, p. 3) would elicit greater depth and allow for discovery of meaningful factors that positively support the aging process.

Third, future research should solicit the experiences and perspectives of older adults among differing groups that explores and highlights intersectionality issues, such as race/ethnicity, nationality, social class, social identity, gender identity, sexual orientation, disability status, health status, and geographical location. The findings from this review demonstrated variations among what older adults found to be contributing factors to, and their definitions of, successful aging based on their demographics and characteristics, and it is important for theory to give voice to those who may be marginalized or vulnerable due social structural barriers. One theory of aging may not be sufficient to adequately explain the aging process or positive aging for all but, rather, several theories across differing groups of older adults may be warranted. Beginning with a theory that incorporates the perspectives and lived experiences of older adults provides a foundation for creating new theory to address intersectionality or apply existing theory (e.g., critical race theory, queer theory) when applicable.

Finally, theorists should consider the naming of aging theories and the explicit and implicit messages they relay. Successful aging is a strengths-based theory of aging, but it also implies particular meanings through its name alone. For example, Jopp et al. (2015) recognizes successful aging combines “aging—typically associated with retirement, reduced activity, and various forms of loss—with success, signifying strength, achievement, and productivity,” which creates “an illusory standard and unrealistically encourage[es] older adults to maintain the achievement orientation of their youth” (p. 92).

Conclusion

Giving voice to older adults and their views on aging elevates theory development and research by creating a context whereby older people are not just written about, but rather, they are included in the process. Old(er) age is a goal that most hope to achieve, and in turn, most would concur that they would like to maintain their ability to self-determine. Part of that self-determination is defining aging in one’s own terms and implementing strategies that help one meet challenges headlong, just as we would do at any other age. The findings from this review suggest that we elevate the strengths and resilience found in older people while also supporting changes that occur during the aging process through progressive approaches to care, support, programing, and policy.

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Barbra Teater is professor of Social Work and MSW Program director at the College of Staten Island and is affiliated with the Graduate Center at the City University of New York.

Jill M. Chonody is associate professor of Social Work and MSW Program director at Boise State University.

References

Amin

(2017). Perceptions of successful aging among older adults in Bangladesh: An exploratory study. Journal of Cross Cultural Gerontology, 32, 191–207.

Arksey

O’Malley

(2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8, 19–32.

Bass

S. A.

Caro

Chen

(Eds.). (1993). Achieving a productive aging society. Westpoint, CT: Greenwood Publishing Group.

Brooks

A. T.

(2010). Aesthetic anti-ageing surgery and technology: Women’s friend or foe? Sociology of Health & Illness, 32, 238–257.

Chapman

S. A.

(2005). Theorizing about aging well: Constructing a narrative. Canadian Journal on Aging, 24(9), 18.

Chen

(2015). Rethinking successful aging: Older female volunteers’ perspectives in Taiwan. Asian Journal of Women’s Studies, 21, 215–231.

Chong

A. M.

Woo

Kwan

A. Y.

(2006). Positive ageing: The views of middle-aged and older adults in Hong Kong. Ageing & Society, 26, 243–265.

Chonody

J. M.

Teater

(2018). Social work practice with older adults: An actively aging framework for practice. Thousand Oaks, CA: SAGE Publications.

Clarke

Warren

(2007). Hopes, fears and expectations about the future: What do older people’s stories tell us about active ageing? Ageing & Society, 27, 465–488.

10.

Collis

Waterfield

(2014). The understanding of pain by older adults who consider themselves to have aged successfully. Musculoskelet Care, 13, 19–30.

11.

Colquhoun

H. L.

Levac

O’Brien

K. K.

Straus

Tricco

A. C.

Perrier

, … Moher

(2014). Scoping reviews: Time for clarity in definition, methods, and reporting. Journal of Clinical Epidemiology, 67, 1291–1294.

12.

Cumming

Henry

(1961). Growing old: The process of disengagement. New York, NY: Basic Books.

13.

Dionigi

R. A.

Horton

Bellamy

(2011). Meanings of aging among older Canadian women of varying physical activity levels. Leisure Sciences, 33, 402–419.

14.

Foster

Walker

(2015). Active and successful aging: A European policy perspective. The Gerontologist, 55, 83–90.

15.

Guell

Shefer

Griffin

Ogilvie

(2016). Keeping your body and mind active: An ethnographic study of aspirations of healthy ageing. BMJ Open, 6, e009973.

16.

Havighurst

R. J.

(1961). Successful aging. The Gerontologist, 1, 8–13.

17.

Hilton

J. M.

Gonzalez

C., A.

Saleh

Maitoza

Anngela-Cole

(2012). Perceptions of successful aging among older Latinos in cross-cultural context. Journal of Cross Cultural Gerontology, 27, 183–199.

18.

Horder

H. M.

Frandin

Larsson

M. E. H.

(2013). Self-respect through ability to keep fear of frailty at a distance: Successful ageing from the perspective of community-dwelling older people. International Journal of Qualitative Studies on Health and Well-Being, 8, 20194.

19.

Hsu

(2007). Exploring elderly people’s perspectives on successful aging in Taiwan. Ageing & Society, 27, 87–102.

20.

Jopp

D. S.

Wozniak

Damarin

A., K.

de Feo

Jung

Jeswani

(2015). How could lay perspectives on successful aging compliment scientific theory? Findings from a U.S. and a German life-span sample. The Gerontologist, 55, 91–106.

21.

Kim

D. B.

(2008). The study on the development of the Korean elderly’s successful aging scale. Korean Journal of Social Welfare, 60, 211–231.

22.

Laditka

S. B.

Corwin

S. J.

Laditka

J. N.

Lui

Tseng

, … Ivey

S. L.

(2009). Attitudes about aging well among a diverse group of older Americans: Implications for promoting cognitive health. The Gerontologist, 49, S30–S39.

23.

Levac

Colquhoun

O’Brien

K. K.

(2010). Scoping studies: Advancing the methodology. Implementation Science, 5, 69.

24.

Lewis

J. P.

(2011). Successful aging through the eyes of Alaska Native elders. What it means to be an elder in Bristol Bay, AK. The Gerontologist, 51, 540–549.

25.

Lewis

J. P.

(2013). The importance of optimism in maintaining healthy aging in rural Alaska. Qualitative Health Research, 23, 1521–1527.

26.

Martinson

Berridge

(2015). Successful aging and its discontents: A systematic review of the social gerontology literature. The Gerontologist, 55(1), 58–69.

27.

Mendes

F. R.

(2013). Active aging: A right or a duty? Health Sociology Review, 22, 174–185.

28.

Montross

L. P.

Depp

Daly

Reichstadt

Golshan

Moore

, … Jeste

D. V.

(2006). Correlates of self-rated successful aging among community-dwelling older adults. American Journal of Geriatric Psychiatry, 14, 43–51.

29.

Morell

C. M.

( ). Empowerment and long-living women: Return to the rejected body. Journal of Ageing Studies, 17, 69–85.

30.

Mortimer

P. M.

Ward

Winefield

(2008). Successful ageing by whose definition? Views of older, spiritually affiliated women. Australasian Journal on Ageing, 27, 200–204.

31.

Nguyen

A. L.

Seal

D. W.

(2014). Cross-cultural comparison of successful aging definitions between Chinese and Hmong elders in the United States. Journal of Cross-Cultural Gerontology, 29, 153–171.

32.

Nimrod

Ben-Shem

(2015). Successful aging as a lifelong process. Educational Gerontology, 41, 814–824.

33.

Phelan

E. A.

Anderson

L. A.

LaCroix

A. Z.

Larson

E. B.

(2004). Older adults’ views of ‘successful aging’: How do they compare with researchers’ definitions? Journal of American Geriatrics Society, 52, 211–216.

34.

Reichstadt

Depp

C. A.

Palinkas

L. A.

Folsom

D. P.

Jeste

D. V.

(2007). Building blocks of successful aging: A focus group study of older adults’ perceived contributors to successful aging. The American Journal of Geriatric Psychiatry, 15, 194–201.

35.

Reichstadt

Sengupta

Depp

C. A.

Palinkas

L. A.

Jeste

(2010). Older adults’ perspectives on successful aging: Qualitative interviews. The American Journal of Geriatric Psychiatry, 18, 567–575.

36.

Romo

R. D.

Wallhagen

M. I.

Yourman

Yeung

C. C.

Eng

Micco

, … Smith

A. K.

(2012). Perceptions of successful aging among diverse elders with late-life disability. The Gerontologist, 53, 939–949.

37.

Rowe

J. W.

Kahn

R. L.

(1997). Successful aging. The Gerontologist, 37, 433–440.

38.

Rozanova

Noulas

Southwick

S. M.

Pietrzak

R. H.

(2015). Perceptions of determinants of successful aging among older U.S. veterans: Results from the national health and resilience in veterans study. The American Journal of Geriatric Psychiatry, 23, 744–753.

39.

Rubinstein

R. L.

de Medeiros

(2015). Successful aging,’ gerontological theory and neoliberalism: A qualitative critique. The Gerontologist, 55, 34–42.

40.

Tate

R. B.

Lah

Cuddy

(2003). Definition of successful aging by elderly Canadian males: The Manitoba follow-up study. The Gerontologist, 43, 735–744.

41.

Tate

R. B.

Swift

A. U.

Bayomi

(2013). Older men’s lay definitions of successful aging over time: The Manitoba follow-up study. The International Journal of Aging and Human Development, 76, 297–322.

42.

Teater

Chonody

(2017). Promoting actively aging: Advancing a framework for social work practice with older adults. Families in Society, 98, 137–145.

43.

von Faber

Bootsma-van der Wiel

van Exel

Gussekloo

Lagaay

A. M.

van Dongen

, … Westendorp

R. G. J.

(2001). Successful aging in the oldest old: Who can be characterized as successfully aged? Archives of Internal Medicine, 161, 2694–2700.

44.

Walker

(2009). Commentary: The emergence and application of active aging in Europe. Journal of Aging & Social Policy, 21, 75–93.

45.

White House Conference on Ageing. (2015). White House conference on aging: Final report. Retrieved from https://whitehouseconferenceonaging.gov/2015-whcoa-final-report.pdf

46.

World Health Organization. (2002). Active ageing: A policy framework. Retrieved from http://www.who.int/ageing/publications/active_ageing/en/