Envejecimiento saludable: un primer acercamiento a la revisión de indicadores subjetivos de salud en zonas urbanas y rurales en Costa Rica / Healthy aging: An initial review of subjective health indicators in urban and rural areas in Costa Rica

Resumen En este artículo se presentan los resultados de una primera aproximación al análisis del efecto moderador del contexto social, cultural y geográfico en indicadores subjetivos del envejecimiento saludable en personas mayores de 46 años residentes en territorios con características diferenciadas en Costa Rica. Se trabajó con una muestra de 305 personas residentes en tres áreas geográficas: una urbana, una semiurbana y una tercera principalmente rural. La diferenciación de las tres zonas se basó en criterios de densidad poblacional, infraestructura y acceso a bienes y servicios. Los indicadores subjetivos del envejecimiento saludable analizados fueron: participación social, apoyo social, salud percibida, espiritualidad, autoeficacia, comportamientos de autocuidado, bienestar subjetivo (satisfacción con la vida y bienestar psicológico) y estado de ánimo; todas las variables fueron condicionadas por zona de residencia, edad y sexo. Para analizar los indicadores subjetivos se estimó un análisis de covarianza (ANCOVA) o un análisis multivariado de covarianza (MANCOVA), dependiendo del número de variables dependientes analizadas. En general, se identificaron indicadores subjetivos de envejecimiento saludable altos en las personas participantes del estudio, quienes reportaron altos niveles de participación social, satisfacción con la vida y estados de salud y ánimo positivos. Se encontraron diferencias por edad entre los grupos. Sin embargo, no se evidenciaron diferencias estadísticamente significativas en los indicadores subjetivos analizados según la zona de residencia o el sexo. En síntesis, este estudio encontró que los indicadores subjetivos de envejecimiento saludable analizados eran muy similares en residentes de tres zonas geográficas con características distintas. Estos hallazgos iniciales se discuten desde una perspectiva cultural y geográfica y en relación con los modelos de envejecimiento saludable.

Abstract This review exposes the results of a first approximation to the analysis of the moderator effect of the geographical, social, and cultural context on subjective indicators of healthy aging in the Costa Rican context. Costa Rica is a middle-income democratic country that is in an advanced demographic changing process; this phenomenon makes it one of the aged countries in the Latin American region. Therefore, studying healthy aging becomes relevant in the context of population demographic change in the present and future aging societies. The study compared several subjective indicators of healthy aging among people older than 46 who resided in three different geographical areas in the country. Participants were 305 healthy people from three locations: one urban (Heredia Central City), one semi-urban (Santa Ana Central City), and one mainly rural (Nicoya). Participants completed standardized assessment scales to evaluate social participation, social support, perceived health, spirituality, self-efficacy, self-care behaviors, and subjective well-being (life satisfaction and psychological well-being). All variables were conditioned by geographical zone (urban, semi-urban, and mainly rural), age, and gender. Either Analysis of Covariance (ANCOVA) or Multivariate Analysis of Covariance (MANCOVA) were estimated depending on the number of dependent variables analyzed to test the effect of the zone of residence, gender, and age, over the subjective indicator of healthy aging studied. In general, participants evidenced high scores on subjective indicators such as self-care, social support, spirituality, life satisfaction, and psychological well-being, which have been associated with health and well-being during the aging process. Participants reported high levels of social participation and perceived that they received adequate support for their daily life needs. Likewise, participants evidenced a general state of well-being, a positive state of health, high levels of self-efficacy, and positive moods. Differences were found among the groups by comparing age. However, no significant differences were found in the variables studied related to geographical areas of residence and sex, suggesting invariant comparison evidence by zone of residence and sex. Nevertheless, the results indicate that the subjective indicators of healthy aging studied are key to promoting healthy aging at the national level. It is considered necessary to improve opportunities for social participation aimed at older adults, to strengthen community and family social networks, to promote socio-economic support such as financial and instrumental support for activities of daily living, and finally emotional support such as listening, empathy and advice. Although the differences among geographical areas of residence of the people studied were not statistically significant in this study, the evidence suggested a trend of high well-being indicators mainly in the rural areas studied, and particularly more in males than in females. As this study only reached preliminary data, further research must obtain conclusive evidence, as previous research had suggested older people living in rural areas with high longevity indicators in Costa Rica might enjoy unusual environmental characteristics and personal protective factors that could be absent in most of the urban areas in the country. On the other hand, it will be necessary to include the historical and socio-cultural determinants focusing on context-specific review analyses in the mainstream research on healthy aging, even more in aged countries like Costa Rica. The findings are discussed within the inter-cultural emphasis and healthy aging models in order to contribute to a better understanding of how the context (physical-constructed and social/cultural) influences the differences, although subtle, in the study´s variables and participants, and how the process of aging might be different according to the multiple contextual conditions in which people live and adapt their capacities and abilities for coping with daily life demands.

Envejecimiento exitoso y calidad de vida en personas mayores institucionalizadas del norte de colombia

Objetivo: Determinar relación entre Envejecimiento exitoso y Calidad de vida de personas mayores institucionalizadas. Material y Método: Estudio descriptivo y correlacionai con muestreo intencional; previo consentimiento informado, participaron 14o personas mayores asistentes a un hogar del municipio de Montería, Colombia. Se incluyeron a personas de 6o y más años; sus características sociodemográficas fueron identificadas por una cédula de datos. La Calidad de vida se midió con WHOQOL-bref y el Envejecimiento exitoso con Successful Aging Inventory (SAI). Los datos recolectados por enfermeras/os, se procesaron en SPSS v22 y analizados con estadística descriptiva, normalidad con Kolmogorov Smirnov y corrección de Lilliefors; como no hubo distribución normal, el objetivo se respondió con correlación de Spearman. Resultados: Existe relación negativa y significativa entre Envejecimiento exitoso global (p= ,012), Desempeño funcional (p= ,025) y Proposito y satisfacción con la vida (p= ,012) con la dimensión Social de la Calidad de vida; se observo relación negativa y significativa (p= ,013) entre el Propósito y satisfacción con la vida con la dimensión Ambiental de la Calidad de vida. Conclusiones: la mayoría de las personas mayores presentaron un envejecimiento exitoso y tienen su Calidad de vida global y Percepción de su salud altas. Existe relación negativa y significativa entre Envejecimiento exitoso, Desempeño funcional y Propósito y satisfacción con la dimensión Social de la Calidad de vida; existe relación negativa y significativa entre el Propósito y satisfacción con la vida con la dimensión Ambiental de la calidad de vida. No hay relación entre los puntajes globales de Envejecimiento exitoso y Calidad de vida.

Objective: To determine the relationship between successful aging and quality of life among institutionalized elderly people. Materials and Methods: Descriptive and correlational study using intentional sampling. It was carried out, after prior informed consent, with 140 elderly people who attended a nursing home in the city of Monteria, Northern Colombia. People over 60 years and older were included and their sociodemographic characteristics were recorded in a data sheet. The quality of life was measured with the WHOQOL-bref questionnaire and the Successful aging was measured with the Succesful Aging Inventory (SAI). Data collected by nurses were processed in SPSS v22 and analyzed with descriptive statistics, Kolmogorov-Smirnov test for normality and Lilliefors correction. As there was no normal distribution, the Spearman's correlation was applied. Results: There is a negative and significant relationship between the overall successful aging (p= .012), functional performance (p= .025) and life purpose and satisfaction (p= .012) with the social dimension of quality of life; a negative and significant relationship (p= .013) was also observed between life purpose and satisfaction with the environmental dimension of quality of life. Conclusions: Most of the elderly people showed successful aging and had a high overall quality of life and health perception. There is a negative and significant relationship between successful aging, functional performance, as well as life purpose and satisfaction with the social dimension of quality of life; there is a negative and significant relationship between life purpose and satisfaction with the environmental dimension of quality of life. There is no relationship between the overall scores of successful aging and quality of life.

Objetivo: Determinar a relação entre envelhecimento bem-sucedido e qualidade de vida de pessoas idosas institucionalizadas. Material e Método: Estudo descritivo e correlacional com amostragem intencional. O estudo foi realizado, após consentimento informado prévio, com 140 idosos que frequentaram um asilo na cidade de Montería, no norte da Colômbia. Foram incluídas pessoas de 60 anos ou mais e suas características sociodemográficas foram registradas em uma ficha de dados. A qualidade de vida foi medida com o questionário WHOQOL-bref e o inventário Successful Aging Inventory (SAI) foi usado para medir o envelhecimento bem- sucedido. Os dados coletados pelos enfermeiros e enfermeiras foram processados por meio do programa SPSS versão 22 e analisados com estatísticas descritivas e teste Kolmogorov-Smirnov para normalidade e correção de Lilliefors. Como não houve distribuição normal, foi aplicada a correlação do Spearman. Resultados: Existe uma relação negativa e significativa entre o envelhecimento geral bem-sucedido (p= ,012), desempenho funcional (p= ,025) e propósito de vida e satisfação (p= ,012) com a dimensão social da qualidade de vida; uma relação negativa e significativa (p= ,013) também foi observada entre o propósito de vida e satisfação com a dimensão ambiental da qualidade de vida. Conclusões: A maioria dos idosos demonstrou um envelhecimento bem- sucedido e teve uma alta percepção geral de qualidade de vida e saúde. Há uma relação negativa e significativa entre o envelhecimento bem-sucedido, desempenho funcional, bem como propósito de vida e satisfação com a dimensão social da qualidade de vida; há uma relação negativa e significativa entre proposito de vida e satisfação com a dimensão ambiental da qualidade de vida. Não há relação entre as pontuações gerais do envelhecimento bem-sucedido e a qualidade de vida.

El impacto de la soledad y la fragilidad en el bienestar de los mayores europeos / The impact of loneliness and frailty on the well-being of older Europeans

Resumen Introducción: El bienestar es un constructo importante cuyos determinantes asociados deben ser identificados para comprender con mayor profundidad los procesos para envejecer de forma saludable. El estudio del impacto de la fragilidad en el bienestar de las personas mayores requiere incorporar los dominios físico, psicológico y social. Así, el adulto mayor frágil puede definirse a partir de la fragilidad física, junto con la soledad como fragilidad social. Este estudio propone un modelo para estudiar el impacto de la fragilidad física y la soledad sobre el bienestar de las personas mayores, diferenciando entre control, autonomía, placer y autorrealización. Método: Se realizó un estudio de carácter transversal con una muestra de 13569 personas mayores provenientes de la encuesta SHARE, para estimar un modelo de ecuaciones estructurales en el que se contemplaban los efectos de la fragilidad y la soledad en el bienestar (cuestionario CASP), controlado por el género, la edad y la salud percibida. Resultados: El modelo final contemplaba el efecto del género sobre el indicador de fuerza de prensión de fragilidad. Los resultados mostraron un ajuste adecuado del modelo a los datos y consiguieron explicar un 80.1% de la varianza de control, un 48.6% de la de autonomía, un 43.6% de la de placer y un 61.3% de la varianza de autorrealización. Conclusiones: La soledad y la fragilidad presentaron efectos diferenciales en función del componente de bienestar. Se discuten las implicaciones de dichos efectos en el desarrollo de intervenciones.

Abstract Introduction: Well-being is an important construct whose associated determinants must be identified in order to further understand the processes for healthy aging. The study of the impact of frailty on older people's wellbeing requires the incorporation of physical, psychological and social domains. Hence, frail older adults can be defined from physical frailty, together with loneliness as social frailty. This study proposes a model to study the impact of frailty and loneliness on well-being of older adults, differentiating among control, autonomy, pleasure and self-realization. Method: A cross-sectional study was carried out with a sample of 13569 older adults from the SHARE project was employed in order to estimate a structural equation model in which frailty and loneliness affected well-being (CASP questionnaire), while controlling for gender, age and perceived health. Results: The final model additionally contemplated the effect of gender on the grip strength frailty indicator. Results showed a good fit of the model to the data and could explain 80.1% of the variance of control, 48.6% of autonomy's, 43.6% of pleasure's and 61.3% of the variance of self-realization. Conclusions: Loneliness and frailty showed differential effects on the different components of well-being. Implications of these effects on intervention development are discussed

COVID-19 y vulnerabilidad frente a vejez exitosa y salud mental / COVID-19 and vulnerability vs. successful aging and mental health / COVID-19 e vulnerabilidade à velhice bem-sucedida e saúde mental

RESUMEN Introducción: La COVID-19 y las medidas generadas para proteger a los adultos mayores han marcado mucho más la vulnerabilidad de este grupo, incrementando factores de riesgos psicosociales como la desvinculación, el maltrato, la ansiedad, lo que demandó examinar patrones de vejez exitosa que generan y garantizan salud mental en personas de esta edad. Objetivo: Caracterizar aquellos indicadores de una vejez exitosa que promueven salud mental, a través de su expresión concreta en un paciente. Método: Enfoque cualitativo, privilegiando el estudio de caso único de carácter crítico. Para evaluar los criterios de salud mental y vulnerabilidad, se utilizó una entrevista semiestructurada. Para la caracterización de la vejez se trabajó con método biográfico y la técnica de historia de vida durante los meses de agosto a noviembre de 2021. Resultados: Se identificaron criterios de vulnerabilidad como la viudez y la soledad, pero predominaron fortalezas a nivel individual, micro y macrosocial, lo que se consolida con un estado mental saludable que se expresó en evidente funcionamiento y bienestar psicológico. Se presentaron en la paciente, todos los indicadores de vejez exitosa que se definieron, garantizando el tránsito satisfactorio por la etapa. Conclusiones: La paciente con una vejez exitosa posee redes de integración, activación y trascendencia que le permiten reestructurar su campo de acción en un contexto como el que ha implicado la COVID-19, garantizando autovaloración y sentido de vida, expresados de forma desarrolladoras para favorecer su salud mental y su desarrollo psicológico.

ABSTRACT Introduction: COVID-19 and the measures generated to protect older adults have marked much more the vulnerability of this group, increasing psychosocial risk factors such as disengagement, mistreatment, anxiety; which required examining patterns of successful old age that generate and guarantee mental health in the elderly. Objective: To characterize those indicators of a successful old age that promote mental health, through its concrete expression in a patient. Method: Qualitative approach, favoring the single critical case study. To assess the mental health and vulnerability criteria, a semi-structured interview was used. For the characterization of old age, we worked with the biographical method and the life history technique, from August to November 2021. Results: Vulnerability criteria such as widowhood and loneliness were identified, but prevailed micro and macrosocial strengths at an individual level, which is consolidated with a healthy mental state that was expressed in evident functioning and psychological well-being. All the indicators of successful aging that were defined were presented in the patient, guaranteeing satisfactory transit through the stage. Conclusions: The patient with a successful old age has networks of integration, activation and transcendence that allow him to restructure his field of action in a context such as COVID-19; guaranteeing self-assessment and a sense of life, expressed in a developing way to favor their mental health and psychological development.

RESUMO Introdução: A COVID-19 e as medidas geradas para proteger os idosos marcaram muito mais a vulnerabilidade desse grupo, aumentando fatores de risco psicossociais como desengajamento, maus-tratos, ansiedade, o que exigiu examinar padrões de velhice bem-sucedida que geram e garantem a saúde mental em pessoas desta idade. Objetivo: Caracterizar os indicadores de uma velhice bem-sucedida que promovem a saúde mental, por meio de sua expressão concreta em um paciente. Método: Abordagem qualitativa, privilegiando o estudo de caso único crítico. Para avaliar os critérios de saúde mental e vulnerabilidade, foi utilizada uma entrevista semiestruturada. Para a caracterização da velhice, trabalhou-se com o método biográfico e a técnica de história de vida durante os meses de agosto a novembro de 2021. Resultados: Foram identificados critérios de vulnerabilidade como viuvez e solidão, mas prevaleceram as forças no nível individual, micro e macrossocial, que se consolidou com um estado mental saudável que se expressou em evidente funcionamento e bem-estar psicológico. Todos os indicadores de envelhecimento bem-sucedido que foram definidos foram apresentados no paciente, garantindo um trânsito satisfatório pelo estágio. Conclusões: O paciente com velhice bem-sucedida possui redes de integração, ativação e transcendência que lhe permitem reestruturar seu campo de ação em um contexto como o que a COVID-19 implicou, garantindo autoavaliação e sentido de vida, expressa de forma crescente para favorecer sua saúde mental e desenvolvimento psicológico.

Achieving successful aging through exercise: intrinsic logic and path selection / 中华老年医学杂志

Physical exercise helps promote successful aging, meaning that physical exercise can promote the physical health of the elderly and achieve healthy aging.It can also improve the mental health of the elderly and help achieve active aging.In addition, it can enhance social participation of the elderly and help achieve productive aging.To take advantage of the benefits of exercise for successful aging, the selection of paths should follow the principles of evidence-based exercise and scientifically proven exercise to avoid ineffective exercise or other negative effects of exercise, give priority to the natural environment to maximize exercise benefits, consider harmonious integration into social situations to improve the sense of social participation of the elderly, and formulate specific exercise plans to offer customized exercise prescriptions to realize the best results.

Los nuevos modelos sociales e identitarios de los adultos mayores profundizando el concepto de vejez exitosa / Os novos modelos sociais e identitários dos idosos aprofundando o conceito de envelhecimento bem-sucedido / The new social and identitary models of elderly people deepening the concept of successful aging

Cada vez surge más evidencia en la literatura especializada que indica que la figura del adulto mayor como decrépito e inactivo comienza a ser substituida por la figura de un adulto mayor saludable y capaz de emprender nuevos proyectos de vida. El objetivo de la revisión integradora bibliográfica que se propone es analizar en las evidencias disponibles en la literatura, algunas delas implicaciones psicosociales, confrontacionales y familiares en lo que se denomina "envejecimiento de éxito" o "successful aging". Para la selección delos artículos fueron consultadas las bases de datos electrónicos Google Scholar, Crossref, Medline, ISI. Fueron seleccionados trece estudios para la realización de la revisión sistemática utilizando el descriptor "successful aging" y "envejecimiento activo" y a partir de los mismos se profundizó interdisciplinariamente el descriptor utilizado utilizando conceptos psico-sociales y vinculares. En las conclusiones se indica que existe suficiente evidencia proveniente del campo interdisciplinario de la gerontología para poder indicar que nuevos procesos de envejecimiento se van imponiendo en las generaciones actuales de adultos mayores.(AU)

Há evidências crescentes na literatura especializada de que a figura do idoso como decrépito e inativo está começando a ser substituída pela figura de um idoso saudável, capaz de empreender novos projetos de vida. O objetivo da revisão bibliográfica integrativa proposta é analisar nas evidências disponíveis na literatura, algumas das implicações psicossociais, confrontacionais e familiares no que é chamado de "Successful Aging". Para a seleção dos artigos, consultamos os bancos de dados eletrônicos Google Scholar, Crossref, Medlinee ISI. Treze estudos foram selecionados para realizar a revisão sistemática usando o descritor "Envelhecimento com Sucesso" e, a partir deles,o descritor usado foi aprofundado interdisciplinarmente usando conceitos psico-sociais e de união. Nas conclusões se indica que há evidências suficientes provenientes do campo interdisciplinar da gerontologia para indicar que novos processos de envelhecimento estão sendo impostos às gerações atuais dos idosos.(AU)

There is more and more evidence in the specialized literature that indicates that the figure of the older adult as decrepit and inactive is beginning to be replaced by the figure of a healthy older adult capable of undertaking new life projects. The objective of the proposed inte grative bibliographic review is to analyze in the available evidence in the literature, some of the psychosocial, confrontational and family implications in what is called "successful aging". For the selection of the articles, the electronic databases Google Scholar, Crossref, Medline, and ISI were consulted. Thirteen studies were selected to carry out the systematic review using the descriptor "Successful Aging" and from them the descriptor used was deepened interdisciplinaryly using psycho-social and bonding concepts. In the conclusions, it is indicated there is enough evidence from the interdisciplinary field of gerontology to indicate that new processes of aging are being imposed on the current generations of older adults.(AU)

Enjoying Life and Health Status among Young Adults and Elderly: A Comparative Study in Light of the Globalization Effects on the Human Being of the 21st Century

The enjoying life and health status, consider one of the determinants of active adulthood and successful aging. Hence the importance of this study represented in investigate these variables, especially in the light of globalization, which left its negative effects clearly on the individual of this century as deep scarves, which positive psychology seeking to strengthen the positive and treat the negative aspects to achieve well-being. This descriptive study aimed to examine the relationship between enjoying life and health status among adults and the elderly, and to detect the differences in enjoying life and health status due to age, education, and sex. The sample consisted of 380 adults and elderly persons selected randomly. Data were collected by enjoying life scale and health status questionnaire which prepared by researchers in this study. The results showed that there was a significant statistical relationship between enjoying life and health status, and there were significant statistical differences in enjoying life and health status due to age, education, and sex. Level of enjoying life and health status was high in participants who are elderly, educated and females. These findings emphasized the importance of developing the enjoying life among young adults and the elderly to enjoy with health status and to achieve active adulthood and successful aging.

Aging, Resilience and Vulnerability of Selected Faculty and Staff (55 years old and above) in an Academic Community in the Philippines

Introduction@#A demographic shift towards population aging is evident worldwide. This presents challenges particularly to low-income and middle-income countries like the Philippines. Understanding perceptions of aging, resilience, vulnerability, and gender identity will help prepare the health care system and social services in addressing the needs of the Filipino older population. @*Objective@#To describe gender identity, perceptions of active aging, successful aging, resilience, and vulnerability among faculty and staff (working, retired) in an academic community in the Philippines.@*Methods@#Survey and focus group discussions were conducted among working and retired faculty and staff aged 55 years old and above. @*Results, Analysis, and Discussion@#Almost all respondents had the same gender identity as their biological sex. There were differences in the respondents’ perceptions of active aging and successful aging and in their sources of strength and worries. Compared with retired respondents more working respondents believed that active aging meant being strong and physically active or being involved in sports. Female respondents thought that being socially active in their community and church was indicative of active aging. In contrast, male respondents equated being physically healthy with active aging. More working respondents and females (than retired and male respondents) thought that successful aging meant participating in community-based activities. In terms of vulnerability, differences were noted in the respondents’ sources of strength and worries. In general, retired respondents and female respondents said they got their strength from their grandchildren and from their religion. In contrast, working respondents and male respondents relied on their families for strength. It was also noteworthy that more retired respondents did not have any old agerelated worries compared with working respondents. Female respondents worried about their families while male respondents worried about death. Subjective nuances of being an older working or a retired employee in an academic community surfaced in the FGDs. The importance of context was evident in shaping the informants’ perceptions of active aging and frailty, and in their sources of worries and happiness. Overall, this paper adds to the body of knowledge about aging in the Philippines by studying a group of older Filipinos in an academic community. It showed that particular aspects of Filipino culture such as gender roles, religion, and close family ties permeate one’s life until he or she reaches old age. The results can help academic communities in policy formulation and program development to ensure that their older employees — throughout their life course — can adequately address vulnerability and resiliency needs to achieve active and successful aging.

Successful Aging and Personal Well-Being Among the Chilean Indigenous and Non-Indigenous Elderly / Envejecimiento exitoso y bienestar personal en adultos mayores chilenos indígenas y no indígenas / Envelhecimento bem-sucedido e bem-estar pessoal em idosos chilenos indígenas e não indígenas

ABSTRACT Objective: The aim of this research was to analyse the association between successful aging (SA) and subjective well-being (SWB) in different domains. Method: The study is quantitative and cross-sectional, with a sample consisting of 800 older people, including 569 indigenous (Aymara and Mapuche) participants living in northern and southern Chile. Results: Domains associated with SA are satisfaction with health, satisfaction with social relationships, satisfaction with future security, and satisfaction with spiritual and religious experiences. SA is also positively associated with being a woman, being young, and not being indigenous. Conclusion: The research has two main practical implications. First, SWB domains may be incorporated into socio-health interventions as they relate to elements that can be changed or improved (health, social inclusion, security, and beliefs). Second, this study suggests a situation of risk among older indigenous Chileans, confirming the premise that the life paths of indigenous Chileans at social risk give rise to a more socially unequal old age with; therefore, it is important to analyse positive aspects that promote better old age.

RESUMEN Objetivo: el objetivo de esta investigación consistió en analizar la asociación entre envejecimiento exitoso (SA) y bienestar subjetivo (SWB) en sus diferentes dominios. Metodología: se trata de un diseño cuantitativo y transversal, con una muestra compuesta por 800 adultos mayores, incluidos 569 indígenas (aymaras y mapuches), que viven en el norte y sur de Chile. Resultados: muestran que los dominios asociados con la SA son satisfacción con la salud, satisfacción con las relaciones sociales, satisfacción con la seguridad futura y satisfacción con las experiencias espirituales y religiosas. La SA también se asocia positivamente con ser mujer, ser joven y no ser indígena. Conclusión: la investigación tiene dos implicaciones prácticas principales. Primero, estos dominios del SWB pueden incorporarse a las intervenciones sociosanitarias, ya que se relacionan con elementos que se pueden cambiar o mejorar (salud, inclusión social, seguridad y creencias). En segundo lugar, este estudio sugiere una situación de riesgo entre los chilenos indígenas mayores, lo que confirma la premisa de que las trayectorias de vida de los indígenas chilenos que han enfrentado más riesgo social dan lugar a una vejez con más desigualdad social, por lo que es importante analizar aspectos positivos que promuevan un mejor envejecimiento.

RESUMO Objetivo: analisar a associação entre envelhecimento bem-sucedido e bem-estar subjetivo em seus diferentes domínios. Método: trata-se de um desenho quantitativo e transversal, com uma amostra composta por 800 idosos, incluídos 569 indígenas (aymaras e mapuches), que habitam no norte e no sul do Chile. Resultados: os domínios associados com o envelhecimento bem-sucedido são satisfação com a saúde, satisfação com as relações sociais, satisfação com a segurança futura e satisfação com as experiências espirituais e religiosas. Além disso, associa-se de forma positiva com ser mulher, jovem e não indígena. Conclusão: esta pesquisa tem duas implicações práticas principais. Na primeira, esses domínios do bem-estar subjetivo podem ser incorporados às intervenções sociossanitárias, já que estão relacionados com elementos que podem ser mudados ou melhorados (saúde, inclusão social, segurança e crenças). Em segundo lugar, este estudo sugere uma situação de risco entre os idosos chilenos indígenas, o que confirma a hipótese de que as trajetórias de vida dos indígenas chilenos que enfrentaram mais risco social levam a uma velhice com mais desigualdade social, razão pela qual é importante analisar aspectos positivos que promovam um melhor envelhecimento.

Envelhecer com sucesso: contributos da educação / Age successfully: education contributions / Envejecer con éxito: contribuciones de la educación

O fenómeno1 do envelhecimento tem vindo a tornar-se objeto de grande interesse no âmbito da investigação educativa, devido ao facto de ser, hoje, consensualmente aceite a ideia de que a intervenção educativa na e com a terceira idade constitui um poderoso instrumento no processo do envelhecimento bem-sucedido. O nosso trabalho apresenta os resultados de um projeto de investigação/intervenção desenvolvido com pessoas idosas em contexto institucional, cuja finalidade se centrou na promoção do envelhecimento bem-sucedido. Com base nas metodologias intrínsecas ao paradigma qualitativo interpretativo-hermenêutico, e seguindo as diretrizes do método de investigaçãoação-participativa, a nossa intervenção baseou-se na dinamização de quatro oficinas favorecedoras do processo de educação/aprendizagem dos participantes. Os resultados evidenciaram uma incontornável relação entre educação e envelhecimento bem-sucedido. Entre os resultados positivos podemos salientar como estratégias favorecedoras de um processo de envelhecimento bem-sucedido, a aquisição de novas aprendizagens e a promoção do convívio e da relação interpessoal.

Aging has become an object of great interest in educational research because it is now widely accepted that educational intervention in and with the elderly is a powerful instrument in a successful aging process. This text presents the results of an investigation/intervention project developed with elderly people. It aimed at the promotion of successful aging in a specific institutional context and, by following participatory actionresearch guidelines, was based on the dynamization of four workshops that favored the education / learning process of the participants. The data collected was analyzed according to an interpretive-hermeneutic qualitative methodology. The results showed an inescapable relationship between education and successful aging. Among other positive results, the analysis revealed the construction of new learning and the promotion of social interaction and interpersonal relationship as strategies favoring a successful aging process.

El fenómeno del envejecimiento se ha convertido en un objeto de gran interés en el ámbito de la investigación educativa, debido al hecho de que actualmente se acepta generalizadamente la idea de que la intervención educativa en y con la tercera edad representa un poderoso instrumento en el proceso de envejecimiento exitoso. Nuestro trabajo representa los resultados de un proyecto de investigación/intervención desarrollados con personas mayores en el contexto de una institución, cuya finalidad se centró en la promoción del envejecimiento exitoso. A partir de las metodologías del paradigma de investigación cualitativa hermenéutico-interpretativa, y las directrices del método de investigación-acción-participativa, nuestra intervención se basó, en la dinamización de cuatro talleres favorecedores del proceso de educación/aprendizaje de los participantes. Los resultados evidenciaron una relación inevitable entre educación y el envejecimiento exitoso. Entre los resultados positivos podemos destacar como estrategias favorecedoras del proceso de envejecimiento exitoso, la adquisición de nuevos aprendizajes, la promoción de la convivencia y de la relación interpersonal.

Risk Factors And Changes In Successful Aging Among Older Individuals In Indonesia

@#Successful aging is a universal goal, but it is a challenge owing to declining physical, psychological, and social conditions that occur with increasing age. The aim of this study was to analyze risk factors and changes in successful aging among older individuals (≥ 60) in Indonesia. This longitudinal study (2000 to 2014) used data from the Indonesia Life Survey (IFLS). Successful aging was defined with physical, mental and social health based on the available questionnaire. The univariate analysis and chi-square- test was used in this study. Of the 801 individuals followed up, 588 (93.2%) were found to have unsuccessful aging and 43 (6.8%) older person showed a change from unsuccessful to successful aging. The proportion of older persons mental and social unhealthy were higher than physical. Factors significantly relating to unsuccessful aging included female sex (p < 0.001), living in rural areas (p < 0.05) or movement from rural to urban areas (p < 0.05), unemployed (p < 0.001), movement from employed to unemployed (p < 0.001), unmarried (p < 0.001) and underweight (p < 0.05). Older individuals who are not categorized as successful aging at the age of ≥ 60 years can still change for better success in aging at ≥ 74 years of age. Maintaining mental and social health of older individuals can be achieved through their empowerment by providing opportunities for social activity and work productivity in the community.

Cross-cultural adjustment of successful aging scale and its reliability and validity in urban elderly / 中华行为医学与脑科学杂志

Objective@#To revised the Taiwan version successful aging inventory (SAI), and verify its reliability and validity in urban elderly in mainland China.@*Methods@#SAI was adjusted by culture and revised by pre-test to form a formal questionnaire. A sample of 600 elderly people in Guangzhou was chosen for a face-to-face questionnaire survey through convenient sampling. Half of the sample (n=300) was randomly selected for exploratory factor analysis, and the other was used to confirm the structural validity of SAI.@*Results@#Exploratory factor analysis extracted six common factors, including health autonomy, economic security, life adaptation, society and relative relationship, study and family. The cumulative contribution rate of six common factors was 65.366%. The fitting indexes of confirmatory factor analysis were χ2/df=1.861, CFI=0.930, IFI=0.930, TLI=0.923, GFI=0.823, RMSEA=0.054, RMR=0.073. There were significant ceiling effects in the four dimensions of health autonomy, economic security, life adaptation, and family. The internal consistency coefficient (Cronbach's α) of SAI was 0.930, and the test-retest reliability was 0.943. An average score of SAI ≥ 3.95 points was considered successful aging.@*Conclusion@#Reliability and validity of SAI are good, which can be used to measure the successful aging status of Chinese elders and track the effectiveness of health promotion measures.

Psychosocial characteristics of successful agers among Filipino senior citizens in six districts of Quezon City From June-October 2017

Objectives@#To describe the socio-demographic and psychological characteristics of self-rated successful agers among seniors 60 years old above in Quezon City Philippines.@*Methodology@#The sample (N=346) was obtained from a random sampling of voluntary attendees invited to a mental health screening program scheduled in six districts spanning from June to October of 2017. Proposed psychosocial factors of healthy aging were assessed through demographics and the following scales:1)-Montreal Cognitive Assessment Test in Pilipino (MOCA-P), 2) Hospital Anxiety and Depression scale in Pilipino (HADS-P), 3) Connor-Davidson Resilience Scale (CDR-10) and 4) World Health Organization Quality of Life using (WHOQOLBREF). Successful Agers were defined as participants who scored themselves seven or above (:2:7) in the Self-Rated Successful Aging (SRSA) scale. @*Results@#Seventy percent (70%) of the respondents (N=238) considered themselves as successful agers. Among the demographic variables, being female and the frequency of social visits were related to successful aging. Self-reported successful agers (SRSA) had no dementia with (MOCA-P mean of 21). They were not depressed (HADS-D mean 1.8) or anxious (HADS-A mean 3.4); had good quality of life (WHOQOL mean 3.4) and positive perceived health (WHOQOL mean3.3). Successful Quezon City Filipino agers were not as resilient (CD-RISC) with a mean of 27.@*Conclusion@#Like most studies in successful aging, quality of life and perceived health and strong family support were related to self-rated successful aging in this group of Filipino senior citizens. There was no relationship with cognitive function and resilience, which may be due to the exclusion of cognitively impaired participants and the lack of a validated cut-off score for the Filipino translated resilience scale used.

Cross-cultural adjustment of successful aging scale and its reliability and validity in urban elderly / 中华行为医学与脑科学杂志

Objective To revised the Taiwan version successful aging inventory (SAI),and verify its reliability and validity in urban elderly in mainland China.Methods SAI was adjusted by culture and revised by pre-test to form a formal questionnaire.A sample of 600 elderly people in Guangzhou was chosen for a face-to-face questionnaire survey through convenient sampling.Half of the sample (n=300) was randomly selected for exploratory factor analysis,and the other was used to confirm the structural validity of SAI.Results Exploratory factor analysis extracted six common factors,including health autonomy,economic security,life adaptation,society and relative relationship,study and family.The cumulative contribution rate of six common factors was 65.366％.The fitting indexes of confirmatory factor analysis were x2/df=1.861,CFI =0.930,IFI =0.930,TLI =0.923,GFI =0.823,RMSEA =0.054,RMR =0.073.There were significant ceiling effects in the four dimensions of health autonomy,economic security,life adaptation,and family.The intemal consistency coefficient (Cronbach's α) of SAI was 0.930,and the test-retest reliability was 0.943.An average score of SAI ≥ 3.95 points was considered successful aging.Conclusion Reliability and validity of SAI are good,which can be used to measure the successful aging status of Chinese elders and track the effectiveness of health promotion measures.

Identification of dietary patterns associated with characteristics of successful aging

@# Introduction: This study aimed to identify dietary patterns (DPs) and their association with successful aging (SA). Methods: A comparative cross-sectional study was conducted among 579 elderly subjects recruited from four states in Malaysia through a multistage random sampling method. SA was defined as having no chronic illnesses, no functional limitation, normal global function, no depression, a good quality of life and good self-perceived health. Information on dietary intake was obtained using a diet history questionnaire. Cognitive functions were assessed using the Mini Mental State Examination (MMSE), depressive symptoms using Geriatric Depression Score-15 items (GDS-15) and a question regarding their perceived health and quality of life. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to determine functional status. DPs were obtained using the principal component analysis (PCA) approach. An ordinal logistic regression model was used to examine associations between DP scores and SA. Results: Five DPs were identified namely ‘sweet foods-beverages’, ‘meat-vegetablesrice and noodles’, ‘local snacks-fish and seafood-high salt foods’, ‘fruits-legumes’, and ‘tropical fruits-oats’. A higher score for ‘tropical fruits-oats’ DP was associated with SA [Adjusted OR=1.59 (95% CI: 1.08-2.32)]. However, the association diminished when the model was adjusted for education level. Further analysis indicated that this DP increased the chance of SA among those with secondary education and above [Adjusted OR=2.43 (95% CI: 1.09–5.42)]. Conclusion: Tropical fruits-oats’ DP is associated with SA among elderly with secondary education and above. There is a need to investigate DPs among those with lower education.

Envelhecimento bem-sucedido e autoeficácia: Uma revisão da literatura / Self-efficacy and successful aging: a literature review / Envejecimiento exitoso y autoeficacia: una revisión de la literatura

O envelhecimento bem-sucedido não apresenta uma definição consensual, porém é representado por idosos ativos. A autoeficácia é um autorregulador de capacidades próprias para a execução de ações, visando a determinadas realizações. O objetivo do estudo foi realizar uma revisão da literatura sobre o envelhecimento bem-sucedido e a autoeficácia. A literatura oferece indícios de que a autoeficácia seja um dos determinantes para uma velhice bem-sucedida.

Successful aging does not have a conceptual definition, however it is represented by active seniors. The self-efficacy is a high regulator of their own capacities for the execution of actions aiming at certain realizations. The objective of this study was to conduct a review of the literature on successful aging and self-efficacy. The literature offers evidence that self-efficacy is one of the determinants of successful old aging.

El envejecimiento exitoso no tiene una definición consensuada, pero está representado por personas mayores activas. La autoeficacia es un autorregulador de sus propias habilidades para realizar acciones, con el objetivo de ciertos logros. El objetivo del estudio fue revisar la literatura sobre envejecimiento exitoso y autoeficacia. La literatura proporciona evidencia de que la autoeficacia es uno de los determinantes de la vejez exitosa.

Sixteen-year predictors of successful aging from a Southern Brazilian cohort: the PALA study / Preditores do envelhecimento bem-sucedido após 16 anos de seguimento de uma coorte do sul do Brasil: estudo PALA

ABSTRACT Successful aging (SA) is a current positive aging-related perspective and it is important to determine the variables associated with this concept. Most longitudinal population-based studies on predictors of SA were carried out in developed countries. Objective: This investigation evaluated which baseline characteristics predicted successful aging in 16 years of follow-up in a southern Brazilian cohort - the Porto Alegre Longitudinal Aging study. Methods: At baseline, 345 community-dwelling healthy independent individuals aged 60 or older were assessed for medical and psychiatric conditions, memory, orientation, judgment and problem solving, functioning in the community and at home, and hobbies. SA, according to Rowe and Kahn's definition, was the outcome assessed in the last evaluation at a maximum 16-year follow-up. All baseline variables were evaluated as potential predictors for the outcome SA. Results: Of the 345 individuals evaluated at baseline, 32 (9.3%) participants were classified as successful agers in the follow-up. Younger age (OR=0.926, 95%CI=0.863-0.994), female gender (OR=0.226, 95%CI=0.072-0.711) and higher MMSE (OR=1.220, 95%CI=1.031-1.444) were predictors of SA for the 16-year follow-up in a logistic regression model. Conclusion: In contrast with our previous hypothesis, the impact of the socioeconomic and socio-environmental characteristics was small, as was the baseline classification into successful and normal aging.

RESUMO Envelhecimento bem sucedido (EBS) é uma perspectiva positiva sobre o envelhecimento, sendo importante determinar as variáveis associadas a esse conceito. A maioria dos estudos longitudinais de base populacional sobre preditores do EBS foi realizada em países desenvolvidos. Objetivo: Este estudo avaliou quais características da linha de base predisseram o envelhecimento bem sucedido em 16 anos de seguimento de uma coorte do sul-brasileira - o Estudo Longitudinal de envelhecimento de Porto Alegre (Porto Alegre Longitudinal Aging - PALA - study). Métodos: No início do estudo, 345 indivíduos da comunidade, saudáveis e independentes, com 60 anos ou mais foram avaliados para condições médicas e psiquiátricas, memória, orientação, julgamento e solução de problemas, funcionamento na comunidade, em casa e passatempos. EBS, segundo Rowe e Kahn, foi o desfecho obtido na última visita em um máximo de 16 anos de seguimento. Todas as variáveis da linha de base foram avaliadas como potenciais preditoras para o desfecho EBS. Resultados: Dos 345 indivíduos avaliados na linha de base, 32 participantes (9,3%) foram classificados como idosos com envelhecimento bem sucedidos em 16 anos de seguimento. No modelo de regressão logística, menor idade (OR=0,926; 95%CI=0,863-0,994), gênero feminino (OR=0,226; 95%CI=0,072-0,711) e MEEM mais elevado (OR=1,220; 95%CI=1,031-1,444) foram preditores de EBS para o seguimento de 16 anos. Conclusão: Em contraste com nossa hipótese prévia, o impacto das características socioeconômicas e socio-ambientais foi pequeno, bem como o da classificação inicial de envelhecimento normal e bem sucedido.

O museu como contexto de educação comunitária: um projeto de promoção do envelhecimento bem - sucedido / Museum as context of community education: the case of a project of successful ageing

A intervenção aqui descrita resultou de um trabalho de investigação intervenção desenvolvido com população idosa que frequenta uma oficina de educação de adultos num museu, cuja finalidade se centrou na promoção do envelhecimento ativo através da animação sociocultural. Abrangeu um grupo de 37 participantes com idades compreendidas entre quarenta e noventa anos. Recorrendo ao paradigma interpretativo-hermenêutico, foi desenvolvido um trabalho de investigação-ação participativa utilizando as técnicas de animação sociocultural, enquanto metodologias que fomentam a motivação e participação da população-alvo do projeto. Partindo dos interesses, necessidades e potencialidades dos participantes, foram desenvolvidos quatro ateliers: a) Atividades Físicas; b) Desenvolvimento Interpessoal; c) (In)Formação e d) Expressão Artística, nos quais foram dinamizados diversos tipos de atividades a nível físico, cognitivo, lúdico, social e afetivo, que permitiram desenvolver as capacidades funcionais do idoso (mobilidade, memória, criatividade, reflexão crítica), fomentar o convívio e as relações interpessoais. A intervenção teve resultados positivos dado que na avaliação final os participantes destacaram os benefícios do projeto, nomeadamente, aos níveis do bem-estar físico e psicológico, do relacionamento interpessoal e da aquisição de novas aprendizagens. Este projeto reiterou a importância da animação sociocultural como intervenção promotora de aprendizagens, do bem-estar e da qualidade de vida junto da população idosa. (AU)

The intervention here described resulted from a research/intervention work developed with the elderly who attended an adult education workshop in a museum, which purpose was to promote active aging by means of sociocultural animation. It involved a group of 37 participants aged between forty and ninety years. The authors developed a participatory action-research, applying the interpretive-hermeneutic paradigm and resorting to sociocultural animation techniques-methodologies that usually foster motivation and participation on the target population. Based on the interests, needs and potential of the participants, four workshops were developed: a) Physical Activities; b) Interpersonal Development; c) (In)formation and d) Artistic Expression. Various types of activities (physical, cognitive, recreational, social and emotional) were fostered, which allowed the development of the elderly's functional abilities (e.g. mobility, memory, creativity, critical reflection), the fostering of interactional and interpersonal processes. The intervention had positive results as the final evaluation revealed: the participants highlighted the benefits of the project, in particular, the levels of physical and psychological well-being, the augment of the quality of their relationships with others and the occurrence of new apprenticeships. This project reiterated the importance of social and cultural activities regarding the elderly's learning processes, welfare and quality of life. (AU)

A study on the current situation and correlation between the Successful Aging of the elderly in community and the Constitution Types of Traditional Chinese Medicine / 中国实用护理杂志

Objective To understand the present situation of Successful Aging (SA) and its Constitution Types of Traditional Chinese Medicine (CTTCM) in the elderly,exploring on the correlation between SA and CTTCM. Methods Totally 198 old adults from community service center were investigated with Chinese-version Successful aging Inventory (C-SAI) and TCM physique type scale. Results The mean score of SA was(56.90±10.01), the physical types of the elderly are mostly biased. The results of one-way variance analysis of Constitution Types of Traditional Chinese Medicine showed that there were differences in the SAI scores of old people with different physique types (F=21.180, P<0.05). Multiple linear regression analysis showed SA scores were statistically significant in terms of educational level, living styles, dietary habits, sleep quality and participation in social activities (t=-4.969-4.257, P<0.05). Conclusions The SA in our study was at a moderate level, the constitution types of the elderly are mainly biased. The Constitution Types of Traditional Chinese Medicine could influence the old adults′ SA. By providing individualized Chinese medicine intervention for the elderly to correct biased physique, and improve the level of successful aging in future.

Predictores socioemocionales y cognitivos: su papel en la comprensión del envejecimiento con éxito en el contexto costarricense / Socio-Emotional and Cognitive Predictors: Its Roll on the Comprehension of the Successful Aging in Costarica's Context

RESUMEN Tomando en cuenta las teorías del envejecimiento con éxito, este estudio se orientó hacia la identificación y el análisis de las características que presentan personas adultas mayores con altos niveles de actividad y participación social residentes en Costa Rica. El estudio contó con 191 participantes con edades entre 55 y 87 años (M = 68.5, DE = 6.9) que habitan en el área metropolitana y participan en programas dirigidos a personas mayores en cursos de computación, idiomas, actividad física, arte, entre otros. Mediante modelos lineales, se evidenció la importancia de las condiciones sociales, emocionales y cognitivas como las mejores variables predictoras del nivel de actividad en la muestra estudiada: a) variables emocionales como autoeficacia percibida, emociones positivas, satisfacción con la vida, control personal, adecuadas redes de apoyo; b) características cognitivas como funciones ejecutivas preservadas; c) percepción subjetiva de salud y d) características sociodemográficas como nivel educativo e ingresos. El estudio permite funcionar como línea base, a nivel teórico y metodológico, del envejecimiento con éxito en Costa Rica. Describe los estilos de vida activos en la vejez de los participantes costarricenses, caracterizados primordialmente por la participación en relaciones sociales y ocio, más que por actividades de tipo cognitivas y físicas o vinculadas al logro personal.

ABSTRACT The present study was aimed at identifying and analyzing the characteristics of older people with high levels of activity and social participation living in Costa Rica, from perspectives like the Successful Aging approach. It also addresses the classical criteria of successful aging theories and their scope in Costa Rican culture. 191 participants between the ages of 55 and 87 (M = 68.5, SD = 6.9) who live in the metropolitan area and participate in programs of the Costa Rican Gerontological Association and the Program for the older people at the University of Costa Rica (in computer courses, languages courses, physical activity, art, among others). Linear models analysis has shown that social, emotional and cognitive factors are the best predictors of the level of activity in the analyzed sample. The variables combined to better predict social participation in leisure activities, physical activities, cognitive activities, instrumental functionality and productivity in old age are: a.) Variables of emotional stability as self-efficacy, positive emotions, life satisfaction, personal control, adequate support networks b.) executive functions, c.) perceived subjective health and d.) sociodemographic characteristics such as level of education and income. The study can serve as a baseline for theoretical and methodical descriptions of successful aging in Costa Rica, characterized by a strong orientation to give more importance to social participation and leisure activities rather than cognitive and physical activity or personal achievement.