6. Reflections on ageing and future directions

‘Reflections on ageing and future directions’ considers some of the new directions in geriatric research and clinical practice; exciting developments in healthcare and technology, including personalized medicine; and new, promising models of aged care, such as the Green House nursing homes in the USA and Small Group Living homes in the Netherlands. It also looks at what we are learning from the growing number of supercentenarian studies. The very end of life, with attendant fears about death and dying, as well as potential positive gains to be made through cognitive training and other ‘brain games’, are also considered.

4. Social and interpersonal aspects of ageing

How we interact with others, with the physical and social environment, as well as how well we cope with life events, role changes, and positive and negative stresses all affect how we age. Later life is also intimately connected to, and affected by, circumstances and decisions earlier in life. Social support and engagement are critical for physical and emotional well-being. ‘Social and interpersonal aspects of ageing’ explores ageing in a social and societal context. The ways in which older adults engage with younger cohorts and their contribution to their family, communities, and society more broadly have changed over time and have also been affected by social and technological advances.

3. The psychology of ageing

Psychological theories of ageing encompass mental health and emotional well-being as well as changes in these states, at individual as well as interpersonal levels, associated with increasing age. ‘The psychology of ageing’ reviews different ways of studying changes in functioning: cross-sectional, longitudinal, and sequential study designs; the varying psychological theories of ageing, including the disengagement theory, activity theory, continuity theory, socioemotional selectivity theory, convoy theory, and social identity theory; and the cognitive aspects of ageing, including changes in thinking and behaviour as a result of both primary and secondary ageing. It also considers how personality and emotions are expressed in later life and the treatment of mental disorders.

1. Ageing, a brief history

How has the construct of ageing, and attitudes towards it, changed over time? How have human beings from various historical epochs, cultures, and perspectives viewed ageing? What impact have these views about ageing had on individuals and our broader society? ‘Ageing, a brief history’ considers these questions and shows that from the ancient world to the modern there have been conflicting views on ageing. It examines historical trends in longevity and lifespan, and factors influencing life expectancy and ageing. We are now at a point in history where the number of individuals over the age of 65 will surpass those aged 5 and under, across the developed and developing world.

5. Positive and successful ageing

‘Positive and successful ageing’ examines how, as a society, we can promote positive and successful ageing in terms of physical, mental, and social well-being in later life. It addresses current findings and directions in research, interventions, and social policy, which have focused more strongly on health and well-being, rather than disease and disability, in the last few decades. Attention is paid to the contributions of the environment, lifestyle factors, meaning and engagement in life, resilience, and wisdom that support a successful move through the latter stages of life. Successful ageing is now the subject of policy frameworks, lifespan theories of development, and actions—large and small—affecting older adults globally.

2. Physical and biological aspects of ageing

‘Physical and biological aspects of ageing’ considers influences on longevity and the physical disorders commonly experienced at the end of life. It describes primary and secondary ageing and different biological theories of ageing—error and programme theories. Error theories (e.g. wear and tear theory, free radical theory, and somatic DNA damage theory) postulate that ageing and death are the result of environmental damage to the body over time. Programme theories (e.g. endocrine theory, immunological theory, and genetic theory (programmed longevity)) postulate that lifelong growth and development is genetically programmed to follow a pre-determined timeline. The ageing brain and body, and disease trajectories later in life are also considered.