Indiana University       Research & Creative Activity      September 2001 • Volume XXIV, Number 2


Living Long, Aging Well

Challenges for the 21st Century

by Barbara A. Hawkins

Barbara A. Hawkins is director of the Center on Aging and the Aged in the Indiana University School of Health, Physical Education and Reecreation, Bloomington. Photo Heather Hill.

Most of us can identify at least one person who seems ageless, someone who exemplifies a life lived long and a life lived well. More and more, we hear about these people in the news. Strom Thurmond, at 98, is the oldest serving U.S. Senator in history. Helen Nearing, in her 90s, still lives on her family homestead in Harborside, Maine, working the land and writing books much like her husband, Scott, did until his death in his mid-’90s. Maggie Kuhn, who lived to age 90, founded the Gray Panthers, an advocacy group that fights for pension rights and against age discrimination.

At the top of my list is the late Indiana University Chancellor Herman B Wells. About a year before his death in 2000, I was headed across campus one day for a meeting about a global aging project. As I crossed the street in front of a van, I glanced up, and my eyes met the beaming face and twinkling eyes of Chancellor Wells. As he heartily waved at me, I felt an immediate boost, refreshed with new energy. Wells made you feel that way because he was that way—positive, creative, and supportive.

Population aging is a worldwide phenomenon, a reality acknowledged by the United Nations when it declared 1999 as the international year of older persons. In developed countries, people over age 60 represent an increasingly larger sector of the population. Worldwide, one in 10 people is age 60 or older. By 2050, this statistic will change to one in five people. Global life expectancy is 66 years, and by 2050, there will be more than three million centenarians.

Like other developed countries, the United States is no longer a nation of youth. Children under the age of 15 constitute less than 25 percent of the total population; in Indiana, children under age 18 represent less than 24 percent of the state population.

While the picture is somewhat different in developing regions of the world, the pace at which the population is aging in these regions is much faster than in developed countries, making adaptation to older populations one of the great challenges facing developing countries in the first half of the 21st century. Because the tempo of population aging is so much quicker in less- and least-developed nations, what happens in these regions will undoubtedly have a ripple effect on developed countries, economically, socially, environmentally, politically, and culturally. Consider, for example, that about one-third of the world’s population lives in China and India. Migration patterns from these countries alone continue to change the face of American society, as well as that of other developed countries around the world.

Adapting to older pop-ulations is one of the greatest challenges facing developing nations.

Population aging requires dialogue, visionary leadership, and action by politicians and scientists alike. Faculty and staff at the IU Center on Aging and Aged, located at the IUB School for Health, Physical Education and Recreation, are actively studying issues related to population aging. With support from HPER, the IU Center for the Study of Global Change and the Office of International Programs, the Center on Aging and Aged has embarked on a collaboration involving 16 countries to conduct a cross-cultural study of aging and adult well-being. The goal is to fill a critical knowledge gap about factors, both social/environmental and behavioral/psychological, that determine well-being in old age.

All too often, persistent negative myths and stereotypes have characterized older people as ill or disabled and burdensome to society, health care systems, families, and social services. Many existing policies, programs, and social beliefs are rooted in perceptions of the diminished social status and dependence of older persons. These views, along with an overemphasis on the biomedical aspects of disease, have cultivated the idea that older persons are a medical and social problem, often placing them in contentious intergenerational conflict over the distribution of declining or scarce resources.

Aging well is an alternative to the biomedical view of aging. It refocuses our attention on the positive aspects of human development and the conditions that support living long and living well. The concept of aging well embraces the idea that people who live in supportive communities and social environments are able to adapt and maintain healthy, productive, meaningful, and highly satisfying lives. As an integrated, holistic framework, aging well comprises five areas that are crucial to a good old age:
• sustaining social support networks and resources;
• promoting health and functional independence, as well as meeting preventive health care needs, intervention services, restorative care, and/or palliative care;
• promoting mental efficacy and mental well-being;
• safeguarding social welfare, safety, and material security; and
• ensuring the availability of meaningful daily activities and roles.

The aging well perspective on older adulthood is receiving growing attention among researchers on several IU campuses. In this issue, we cover a few researchers who are producing important findings about living long and aging well.

A strong network of friends and family relationships has long been recognized as important to health and well-being in old age. Health and longevity may be compromised by a lonely and socially impoverished life, but as IU Bloomington Chancellors’ Professor Bernice Pescosolido tells us, a life rich in social supports and networks can provide the foundation for health protection and promotion.
Social networks are often tied to one’s roles in life, as the research of sociologist Eliza Pavalko reveals. Multiple roles give men, and particularly women, a sense of empowerment, identity, and connection with others. Pavalko’s findings underscore the need to better understand the importance of sustained roles to adults who are in middle and older adulthood.

It is a well-known fact that poor health in old age is largely due to making poor lifestyle choices earlier in life. Even in older adulthood, however, physical health is influenced by lifestyle. Good health is promoted through nutrition, preventive health care, and regular physical exercise. David Koceja, professor of kinesiology in the IUB School of HPER, has been investigating the role physical activity plays in the ability of aging people to preserve their sense of balance.

The maintenance of health through regular exercise is precisely the focal point of the Adult Fitness Program, run by Janet Wallace, associate professor of kinesiology at IUB. IU boasts of a broad range and depth of research on physical functioning and health on other campuses as well, most notably on the IUPUI campus at the National Institute on Fitness and Sport.

Effective mental functioning is also essential to maintaining independence and well-being in later life. When older persons experience positive mental states, they tend to be able to make the choices necessary to optimize their gains and minimize their sense of loss. John McIntosh, professor and chair of psychology at IU South Bend, investigates the variables and factors that influence mental well-being in later life, particularly among elderly men.

Psychological health and mental efficacy are also much on the mind of today’s nurses, as IUPUI Associate Professor Sara Horton-Deutsch attests. Horton-Deutsch’s research focuses on geropsychiatric nursing, and she is particularly interested in the prevention of depression. Much of what she has found underscores the effectiveness of simply “paying attention” to our older citizens.

Horton-Deutsch is one of several IUPUI Medical School faculty who are engaged in research on mental health and aging, including researchers at the IU Center for Aging Research, directed by Christopher Callahan. IU-CAR focuses attention on health services utilization as well—researchers there are involved in social and behavioral aspects of health and aging.

AGING RESEARCH AROUND IU

As the world's older population expands, so too has researchers’ interest in human aging. As of last year, IU had 125 faculty university-wide conducting research about aging in fields such as anthropology, biology, medicine, optometry, psychology, and sociology. Here’s a sampling of programs and centers around IU that draw together faculty involved aging research

  • Center on Aging and Aged, IU Bloomington. Director: Barbara A. Hawkins, professor of recreation and park administration. The CAA was founded in 1979. To improve the health, education, and welfare of the older population, the CAA sponsors education and training, research, resource development, and community outreach. Located in the School of Health, Physical Education and Recreation, the center has two main projects, an intergenerational learning opportunity for seniors and elementary schoolchildren and the Global Ageing Initiative, an international research project aimed at developing research and curricula related to aging around the world.
  • IU Center for Aging Research, IUPUI. Director: Christopher Callahan, Cornelius and Yvonne Pettinga Scholar on aging research. Founded in 1997, IU-CAR coordinates interdisciplinary research aimed at improving the health of older adults. Researchers at IU-CAR focus on biomedical, behavioral, and social research as well as on diseases and chronic conditions. IU-CAR is a cooperative effort of the IU Schools of Allied Health Sciences, Dentistry, Medicine, Nursing, Optometry, and Social Work.
  • Center for Alzheimer's Disease and Related Disorders, IUPUI. Directors: Hugh C. Hendrie, Albert E. Sterne Professor of psychiatry, and Martin Farlow, professor and vice chairman for research in neurology. This center provides clinical, research, and educational services to individuals and families affected by elderly persons’ memory loss or mood disorders.
  • Indiana Alzheimer's Disease Center, IU School of Medicine. Director: Bernardino Ghetti, Distinguished Professor of medicine. Funded by the National Institute on Aging, the IADC is one of 29 sites in the United States conducting longitudinal research to help identify persons with probable Alzheimer’s disease. The center enrolls approximately 100 subjects per year.
  • Multipurpose Arthritis and Musculoskeletal Diseases Center, IUPUI. Director: Kenneth D. Brandt, professor of medicine. This center pursues biomedical research relevant to rheumatic diseases as well as research concerned with improving the training of personnel involved in treating rheumatic diseases. Outreach programs are also conducted.
  • National Institute on Fitness and Sport, IUPUI. Medical and Research Director: Michael F. Busk, assistant professor of medicine. Established in 1985, the NIFS neighbors the IUPUI Sport Complex. Through a partnership with NIFS, faculty from the IU School of Medicine research health promotion and physical fitness using NIFS members as subject

Like health, material resources are fundamental to aging well. Safe and adequate housing, sustenance, and access to needed goods and services are critical to a secure old age. As the nature of work careers and retirement patterns continue to change throughout the 21st century, researchers will need to address how to adequately support the material and environmental security of an enlarging older adult population. Professor Emeritus George Stolnitz, of IUB, contributes an important perspective on the economic and social consequences of global population aging.

Our lives are only as rich as the lifestyles we create. Meaningful daily activities that enrich our lives are central to aging well. Such activities include productive contributions to family, community, or society (e.g., paid or unpaid work, volunteer activities, or caring for one’s grandchildren) as well as activities that sustain one’s sense of identity, satisfaction, and well-being in later life.

Supporting active retirement, particularly among IU’s retired faculty, is at the center of work being done by Susan Eklund, Byron A. Root Professor in Aging and associate dean of the faculties at IUB. Eklund has studied many programs that provide for active post-retirement lifestyles and promote aging well. She is applying her findings in planning a center that will serve IU’s emeriti faculty by providing office space, resources, and varied programs and services.

The IU community is rich in exemplars of aging well. Within the School of HPER community alone, John Cooper, a professor emeritus of physical education in his late 80s, continues to give lectures at national and international meetings while providing weekly expert horticultural sessions for faculty and staff. Janet R. MacLean, professor emerita of recreation who began her career at IU in 1951, crews a Thistle sailboat with her husband, Bill. Thomas Rillo, professor emeritus of recreation and park administration, leads expeditions in national parks out west as well as fitness classes at the YMCA.

Of course, outside HPER the university community has many more active emeriti faculty. For example, since retirement, Roger Newton, Distinguished Professor emeritus of physics, has distinguished himself further by publishing three books on physics written for the general public. Dorothy Collins, former personal assistant to Herman B Wells and now in her 80s, is an active force in local community affairs. In fact, so many of IU’s 1,230 emeriti faculty exhibit the best of aging well that I could not possibly name them all. This issue provides just a glimpse of IU’s vibrant exemplars in brief profiles of Frank Banta, Phyllis Klotman, Elizabeth Lion, and Henry H. H. Remak. These distinguished colleagues, among many others, provide living proof of the richness that can come with aging. As the poet Robert Browning put it,

Grow old along with me!
The best is yet to be,
The last of life for which the first was made.

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