Development in old and very old age

Despite population projections estimate that over 3 million individuals will reach age 100 in 2050 worldwide, centenarians represent an underserved and understudied population. As centenarians have mostly been investigated in the context of demographic and medical studies, there is a striking lack of research with respect to describing the challenges very old individuals and their families encounter as well as the quality of life at age 100 and its determinants. In 2010, we started a series of international centenarian studies with the goal to investigate life conditions of centenarians including their difficulties (e.g., health issues), their social support system (e.g., informal care), their psychological strengths (e.g., meaning in life), as well as well-being indicators (e.g., well-being). Besides considering the personal resources and risks of the centenarians, we also investigate the relationship with their immediate social context, specifically, with their children who are most involved in their care. Furthermore, we consider the societal and cultural context by comparing centenarians from different countries. Using population based samples, quantitative as well as qualitative assessment, and parallel design and measures across countries, we aim at gaining a more differentiated view on very old age in order to create a more realistic picture of this very advanced age, to determine cultural and societal characteristics involved in shaping life at very old age, and to identify positive potential for development in old age and successful aging. So far, our network of centenarian studies includes the Second Heidelberg Centenarian Study (Heidelberg, Germany; Jopp, Rott, Boerner & Kruse), the Fordham Centenarian Study (New York, USA) as well as the Oporto Centenarian Study (PI: Profs. Oscar Ribeiro, Constanza Paul and colleagues, UNIBAS Oporto). Other collaborations involve Japan (Prof. Yasuyuki Gondo, Osaka University) and China (Prof. Yuan Zhao, Prof. Hong Fu, Nanjing Normal University, and Dr. Danan Gu, United Nations). A new study is planned for Switzerland. The long-term goal of our studies is to develop culturally sensitive models of successful aging in very old age as well as prevention and intervention efforts that help individuals and their families to optimally handle the challenges of very old age.

The breathtaking acceleration of the average life expectancy is a global issue. In particular, the very old represent the fastest growing population group in industrialized countries worldwide. This trend in population aging gives rise to a new phenomenon: family members reach (old and) very old age together. Specifically, about two thirds of the very old have children who have reached old age themselves. Since most very old persons have outlived spouses and friends, children are likely to become their primary social contact. Yet there is virtually no research on this specific relationship constellation, very old parent with advanced-age child. Given the importance of close social relationships for well-being and health, with protective effects of high-quality and the potential harm of low-quality relationships, investigation of the very old parent-child constellation is imperative. Besides addressing the effects that the involvement of their children has for the life of the very old parent, it is also important to consider that many advanced age children have health issues and may feel particularly burdened due to compromised goals and prolonged caregiving. Furthermore, as research documents physical and mental health difficulties associated caregiving including enhanced mortality risk, the children of the very old may be at risk. Together with Prof. Kathrin Boerner (University of Massachusetts, Boston), we have examined the relationship between very old individuals and advanced age children in the context of the Second Heidelberg Centenarian Study and the Fordham Centenarian Study. More recently, we have started investigating this phenomenon also in Switzerland, with the support of Fondation Leenaards (Quality of Life in Older Adults Award 2015, in the category Exploratory Study; together with Profs. Joelle Darwiche and Dario Spini [University of Lausanne] and Prof. Heining Cham [Fordham University, New York]). Since September 2016, we have been able to extend this study with the support of National Research Center of Excellence LIVES (2016-2018). In September 2017, we started a new study on this topic in the USA funded by the US National Institute on Aging, which will be conducted at University of Massachusetts, Boston under the lead of Prof. Kathrin Boerner.

Throughout the lifespan, individuals attempt to actively influence their development and to achieve positive developmental outcomes such as high functioning or quality of life. This effort is challenged when they are confronted with critical life events, illness and age-related losses. Our research aims at identifying psychological mechanisms that enable individuals to cope with and overcome these difficulties. In particular, we investigate the role of individual’s basic (a) resources (e.g., education, cognition, health, social network), which set the stage for development, as well as “psychological strengths”; (b) strategies that are used to solve problems or reach goals (e.g., coping and life-management strategies); and (c) beliefs that provide the motivation necessary to engage in effortful and persistent action (e.g., control beliefs and attitudes towards life, disease, and aging). Our studies demonstrates that resources and psychological strengths play an important role for general (e.g., well-being, positive adaptation to loss) and specific (e.g., memory functioning) developmental outcomes, and that taking into account the interrelations among these constructs explains more about positive development than when considered alone.

Of particular interest is very old age, presenting a “testing-the-limits” situation for the human capacity of adaptation. More specifically, reaching very old age usually is accompanied by multiple losses, including health issues, loss of loved ones, and increasing restrictions in activities that give meaning to life. Despite these losses and limitations, very old individuals seem to be rather happy and satisfied with their lives. Which mechanisms contribute to this “well-being paradox” is unknown. One potential group of factors are psychological strengths (e.g., self-efficacy, optimistic outlook, meaning in life) which we study in the context of our centenarian studies. Ongoing research also investigates adaptation to divorce and bereavement within a LIVES study on partner loss in the second half of the life-span (with Profs. Pasqualina Perrig-Chiello and Hans-Joerg Znoj, University of Berne). In this context, team member Dr. Claudia Meystre investigates the role of professional psychological support as a means of overcoming partner loss.

Active engagement in life represents a key factor for successful development and aging. Of particular importance are leisure activities, and these have been found to be associated with beneficial outcomes across the life-span. Our research investigates to what extent being active is associated to objective aspects, including health and cognitive functioning, as well as quality of life, including well-being and depression. In that context, we also address the role of psychological aspects, such as self-referent beliefs (e.g., control beliefs) about memory or cognitive functioning. We furthermore investigate activities in relation to the social cure hypothesis, that is to what extent the feeling of being a member of a social group has additional benefits, for example after critical life events such as divorce or bereavement, in collaboration with Prof. Dario Spini (University of Lausanne). Moreover, team member Charikleia Lampraki is investigating activity patterns in middle, old and very old age and the motives behind activity selection, as part of her doctoral thesis under the supervision of Prof. Daniela Jopp and Prof. Dario Spini. An additional focus of this research also focuses on how social group memberships can promote identity processes, i.e. self-continuity, in the context of critical life events. 

Although many studies investigate successful aging, there are ongoing discussions among aging researchers about what successful aging means. Despite the lack of scientific consensus, only few studies have addressed what lay persons conceive as successful aging. As it can be problematic to communicate and to develop successful interventions when both scientific and lay perspectives of aging well do not match, our studies explore in more detail laypersons’ ideas about successful aging and to what extent they  are reflected in theories on successful aging. More recently, we have started investigating how individuals develop their views on aging. This is of particular importance as societal views on aging are dominated by negative stereotypes, which have been found to negatively influence not only how individuals experience their own aging, but also the actual aging process. Thus, gaining a better understanding of how individuals may adopt positive views on aging that counteract these negative stereotypes is of particular importance. One mechanism could be role models of successful aging which we investigate in several ongoing studies. Furthermore, we investigate to what extent the family context, including the quality of the relationship to parents, determines how younger individuals experience their own aging. 

Our research also addresses a new psychological disorder, which we have identified in a series of recently published studies – maladaptive daydreaming (MD). Apparently, there are individuals who have the gift of being able to create very rich and detailed fantasy worlds in their heads, yet for some of them, this ability turns into a serious problem. In collaboration with Jayne Bigelsen and Jonathan Lehrfeld (Fordham University, New York) and Prof. Eli Somer (University of Haifa), we found that people suffering from maladaptive daydreaming spend an average of 60% of their waking time in an imaginary world which they themselves have created. They get lost in this imaginary world, which develops into an addiction, and 97% of them feel restricted in their everyday life. Although not recognized as a condition of clinical relevance as of now, several thousand individuals document their daily struggle of not being able to limit their daydreaming activities on webpages and internet forums and do not get help by health professionals. On the basis of a set of papers using qualitative and quantitative approaches, our team has accumulated substantial information about the condition. After having developed a short questionnaire assessing MD, the Maladaptive Daydreaming Scale, our ongoing research includes the development and validation of a French and a German version of the MDS as well as the more in-depth investigation of this under-acknowledged and under-researched condition (in collaboration with Profs. Christine Mohr and Rémy Amouroux, University of Lausanne).