Successful Ageing: Improving Conceptualisation and Measurement

成功晚年: 改善概念和測量

Student thesis: Doctoral Thesis

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Awarding Institution
Award date30 Aug 2023


Despite successful ageing holding a prominent position in gerontology research throughout the past half-century (Lamb et al., 2017), its definition remains controversial. Among the numerous conceptualisations of successful ageing, one widely adopted model is the biomedical model by Rowe and Kahn (1987, 1997). The model largely reflects American values of self-sufficiency and independence (Katz & Calasanti, 2015; Torres, 1999) and has been widely adopted. However, since its development, this model has been persistently criticised for its over-emphasis on physical functioning and lack of lay perception in defining the constitution of successful ageing (Martinson & Berridge, 2015). Furthermore, the lack of a consensus regarding the definition of successful ageing has resulted in diversified measurements in the field, which have inhibited the advancement of research on successful ageing and limited the comparison of the findings (Cosco et al., 2014a). In addition, it is suggested that successful ageing and selection (elective, and loss-based), optimisation, and compensation (SOC) strategies might be influenced by personal resources. Therefore, it is necessary to identify how personal resources influence SOC strategies and ultimately contribute to successful ageing. Accordingly, in the present project, three studies were conducted (1) to investigate the lay perception of successful ageing among older Hong Kong Chinese adults, (2) to develop and validate a singular multidimensional instrument to measure successful ageing with consideration of the perspectives of both older adults and researchers, and (3) to examine the sustained effects of personal resources and SOC strategies on successful ageing.

Study 1 was conducted with 27 older Hong Kong Chinese adults (Mage = 68.07 years, SD = 7.10, range = 60 – 83; 59.3% female) who participated in either an individual interview or a focus group. The participants were asked with a list of structured interview questions about their personal definitions of successful ageing and how it can be achieved. The findings of Study 1 revealed the following eight major themes concerning the layman definition of successful ageing, including (1) good health; (2) sense of security; (3) positive attitudes toward life; (4) active lifestyle; (5) harmonious family relationship; (6) supportive friendship; (7) continuous learning; and (8) civic awareness and social contribution.

In Study 2, items of the Multidimensional Successful Ageing Scale (MSAS) were initially drafted based on the qualitative findings of Study 1 and the literature reviews of lay perception of successful ageing, and were then refined with inputs from five experts in the field of gerontology. A total of 414 older Hong Kong Chinese adults (Mage = 64.50 years, SD = 4.01, range = 60 – 82; 55.3% female) were recruited and completed the MSAS. Exploratory factor analysis on 25-item MSAS resulted in nine dimensions explaining 64.2% of the variance: (1) harmonious family, (2) active engagement, (3) supportive friendship, (4) adaptive coping, (5) social contribution, (6) living independently, (7) civic awareness, (8) positive attitudes, and (9) perceived constraints. The results revealed satisfactory convergent, divergent, and predictive validity. In addition, results also demonstrated strict measurement invariance across gender, education, and chronic illness groups.

Adopting longitudinal design, Study 3 recruited 552 older Hong Kong Chinese adults and 414 of them (Mage = 68.92 years, SD = 6.64; 59.9% female) completed both the baseline and six-month follow-up assessments (Time 1 and Time 2, respectively; response rate = 75.0%). Confirmatory factor analysis replicated the nine-factor structure of the MSAS found in Study 2. The study further provided evidence of the convergent and predictive validity of the MSAS. In addition, the mediation analysis results first revealed that age and personal resources in Time 1 independently contributed to the use of SOC strategies in Time 2. It also found that the effect of personal resources in Time 1 on successful ageing in Time 2 was partially mediated by loss-based selection in Time 2, but not the use of other SOC strategies.

The present project first reveals the lay perception of successful ageing held by older Chinese adults, which covers more dimensions than the predominant biomedical model by Rowe and Kahn (1987, 1997). This finding highlights the need for more comprehensive theoretical models of successful ageing to better understand of the ageing experiences of older adults, and helps establish a common ground for communication between healthcare professionals, policymakers, and older adults to identify the most appropriate interventions and social policy for maintaining and promoting successful ageing. Second, the project developed and validated the MSAS in two separate samples of older adults. It demonstrated satisfactory reliability and validity and, thus, has the potential to be an appropriate instrument for measuring successful ageing in older Chinese adults. Furthermore, by separating the effects of four types of SOC strategies, the present project showed that personal resources are associated with the subsequent use of all four SOC strategies and successful ageing. In addition, it also clarified that only loss-based selection, but not other SOC strategies, is associated with successful ageing. Thus, the findings of this project will contribute to the fields of health psychology and social work to help practitioners to better understand how the personal resources of older adults may be tied to their ageing experiences, and to design intervention programmes to shape the use of more adaptive strategies to achieve successful ageing.

    Research areas

  • subjective successful ageing, lay conceptualisation, scale development, personal resources, adaptive strategies