The concept of "successful aging" has become widely accepted in gerontology, yet continues to have no common underlying definition. Researchers have increasingly looked to older individuals for their lay definitions of successful aging. The present analysis is based on responses to five questionnaires administered to surviving participants of the male Manitoba Follow-up Study cohort (www.mfus.ca) in 1996, 2000, 2002, 2004, and 2006 (n = 2,043 men were alive at a mean age of 78 years in 1996). One question on each survey asked: "What is YOUR definition of successful aging?" Applying content analysis to the 5,898 narratives received over the 11 years, we developed a coding system encompassing 21 main themes and 86 sub-themes defining successful aging. We quantitatively analyzed trends in prevalence of themes of successful aging prospectively over time. Our findings empirically support colleagues' past suggestions to shift from defining successful aging in primarily biomedical terms, by taking lay views into account.
In the absence of a universally agreed-upon definition of successful aging, researchers increasingly look to older adults for layperson views of aging and definitions of successful aging. To use lay definitions in studies of aging, however, researchers must address the definitions' consistency. In 2004, surviving members of the Manitoba Follow-up Study male cohort (mean age: 83 years) were asked twice for their definition of successful aging. A consistency category was assigned based on the similarity of themes in each of 654 pairs of definitions. At least half of the main themes were similar in 70 per cent of the definition pairs; 80 per cent of respondents repeated at least one theme. Positive or negative health events in the four-week interval between definitions and specific respondents' characteristics did not vary across consistency categories. This evidence for consistency supports our continued reliance on lay definitions of successful aging.
Background
The Hutterite Brethren are a communal group of Anabaptists who live in the Western regions of North America, predominantly in the Western Canadian provinces. Due to a founder effect, Hutterites have a high rate of cystic fibrosis (CF) with genotypes limited to only two CFTR mutations. One‐third of Hutterite patients with CF are pancreatic sufficient. Previously we found an unexplained younger age at death in Hutterites compared with nonHutterites homozygous for the common F508del mutation. The present study expanded the data collection and analysis for confirmation and further exploration.
Methods
Anonymized information, based on Hutterite surnames, was extracted from the Canadian CF Registry. Summary data on nonHutterite patients with CF homozygous for F508del served as control. Statistical analyses explored the effects of genotype within Hutterites and compared nutritional status, lung function, and microbiologic findings between the groups.
Results
The younger average age at death in Hutterites compared with controls was confirmed, but there was no suggestion of a generally shortened life expectancy. While the nutritional status in Hutterite children was better than that of controls, their lung function was slightly but significantly lower. Staphylococcus aureus was more frequent in Hutterites while there was no difference between the groups regarding Pseudomonas aeruginosa.
Conclusions
Despite less pancreatic insufficiency, better nutrition, communal life in socioeconomic stability, and without exposure to environmental tobacco smoke, the clinical course of CF appears to be more severe in a significant number of Hutterites. Investigations of gene‐environment interactions and of CF disease gene modifiers may help to explain this conundrum.
Nutritional screening programs for community-dwelling older men are warranted as two-thirds of the study participants were at nutritional risk. Identifying older men at nutritional risk is a critical step in the process of nutritional assessment, and subsequent nutrition interventions and follow-up are required to prevent further health decline.
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