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Ageing well for self and for others

Sik Hung Ng (伍錫洪 )City University of Hong Kong

CADENZA Symposium 2008: Successful Ageing10-11 October, 2008, Hong Kong SAR

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PART I: Background

By 2025, more than half of the world’s elders will be in Asia as its huge middle-aged population live to older adulthood.

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In doing ageing research in Asia, we should not forget our mid-agers. Instead we should rediscover midlife in “ageing” research.

Further we should shift our research focus from negative to positive ageing, to discover ways of ageing well rather than to remain preoccupied solely with deficits and diseases of old age, important though they are.

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Successful aging (Havighurst,1961)

Active aging (World Health Organisation, 2002)

Vital aging (Erikson et al., 1986)

Productive aging (Morrow-Howell et al., 2001)

Positive aging (Minichiello & Coulson, 2005)

New Gerontology (Holstein & Minkler, 2003)

Need for multi-cultural global research (Fry et al., 1997)

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PART II: Concepts and measurement

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Positive Ageing (PA) Components(1) Avoiding disease (health)

pain, medication, mobility, overall(2) Physical and cognitive functioning (functional independence)

energy, sleep, memory, cognitive mastery(3) Engagement with life

(3a) social-emotional contributions (love)family, relatives, neighbours, friends, overall(3b) instrumental-productive contributions (work)work/career, family, society, NGO/community

5-point response format (higher score = more positive)

Rowe & Kahn (1998); Chou & Chi (2002); Hsu & Chang (2004); Chong et al. (2005); Bowling (2006)

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Table 1. Sample in 2004 and its follow-up in 2005 stratified by age

2004(n = 2,970)

2005(n = 2,120)

Age (years)

40-49 873 609 (70%)*

50-59 811 584 (72%)*

60-69 771 553 (72%)*

70-74 515 374 (73%)*

* Retention rate

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Confirmatory factor analysis (2004) Established goodness of fit: chi square (98) = 512, RMSEA = .038, SRMR = .027, CFI = .959

Confirmatory factor analysis (2005)Replicated the goodness of fit:chi square (98) = 480, RMSEA = .043, SRMR = .029, CFI = .952

Validation (2006)Against known groups and Cantril’s (1965) ladder measure of QoL

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Figure 1. Changes in overall PA from 2004 to 2005

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Figure 2. PA Components across Age Groups in 2004

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Figure 3. PA Components across Age Groups in 2005

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Preliminary conclusions

1. Factor structure of positive ageing

The structure is similar, though not identical, between Hong Kong Chinese and Western populations.

2. Variability across PA components

Personal ageing (health and functioning independence) is stronger than social ageing (love and work), indicating the primacy of personal concerns.

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3. Variability from mid-agers to older adults Health declines more steeply than functioning. Work declines more steeply than love. Switch-over year is around 60.

4. Implications Life after 60 years has to cope with greater losses in

health and work, but functional decline remains small and love refuses to fade out.

Retirement, which occurs mostly around 60 years, plays a big part in the pattern of variability across age groups.

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PART III: Explaining variabilities

Demographics: age and sex

Social:

network availability

quality of network

Psychological:

sense of humour (Martin & Lefcourt, 1983)

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Table 2. Sample in 2007 stratified by age

Years

15-39 454

40-59 464

60-79 252

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Confirmatory factor analysis of PA personal and PA social model (2007)

Goodness of fit: chi square (104) = 505, RMSEA = .057, SRMR = .052, CFI = .922

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PA personal PA social beta t beta t Age group -.282 -10.32** -.021 -0.81 Female -.054 -1.97* .033 1.28 Social network size -.015 -0.522 .211 8.04** Social network quality .167 5.71** .237 8.60** Humour .130 4.55** .252 9.33** R2 = .146 R2 = .241

Table 3. Standardized effects of predictors on

PA personal and PA social

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2.5

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3.5

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4.5

15-39 40-59 60-79

Age Group

Positive ageing

PA personal

PA social

Fig 4. Ageing well personally and socially

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Vol. work

Soc. participation

PA personal -.032

.093

PA social .201 .255

Table 4. Correlations of PA personal and PA social with voluntary work and other forms of social participation (n=1,170)

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Overall conclusions1. Ageing well for self and for others

Ageing well is not solely maintaining personal health and functional independence, but also loving others and continuing to be a useful member of society.

“Successful aging (is viewed) as involving a foundation of health and security, along with

attitudes and adaptive behaviors that can compensate for difficulties with that foundation and

enable engagement in meaningful activity and stimulation.” (Reichstadt et al., 2007, p. 2007)

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Overall conclusions (cont’d)

2. Effects of age and sex Old age and being a woman affect personal ageing negatively, but have little effect on social ageing, implicating adaptational processes in the latter.

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Overall conclusions (cont’d)

3. Effects of social network

Whereas social network size affects personal ageing only, quality of social network enhances both aspects of ageing. As the quality of interpersonal relations needs time to cultivate and maintain, midlife plays a pivotal role here.

4. Effects of humour

This (cheap) psychological variable is the most powerful predictor of social ageing, and also plays a significant part in personal ageing. Sadly, humour is not in the cultural blood of Chinese.

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Overall conclusions (cont’d)

5. Correlations with voluntary work and social participation

Social ageing, but not personal ageing, is correlated with voluntary work and social participation in organisations. The causal path is probably bidirectional; and if so, policy emphasis on active and participatory ageing will promote social ageing overall.

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Thank you

Acknowledgements to CADENZA for the invitation, to City University of Hong Kong for research funds, and to Jean Woo, Alex Kwan, Alice Chong, T. Wing Lo, K.K. Leung, Tina Rochelle, and many others for

research collaboration.