Abstract
Reflecting the theme of the 2015 Gerontological Society of America (GSA) Annual Scientific Meeting, “Aging as a Lifelong Process,” this paper examines intersections between aging processes and their environmental context, develops theory regarding constructive developmental processes and their environmental context, and considers potential implications for conceptualizing and creating aging-friendly communities. The first section examines the primary goals of aging-friendly communities, that is, promoting elder well-being. The second section explores the role of environmental pathways in fostering well-being throughout the lifecourse. The third section presents a new Process Model of Constructive Aging that identifies key developmental processes at the intersection of individual and environmental pathways. The final section considers potential implications for creating aging-friendly communities, including ways in which cities and towns can promote the ability of community members to live fully throughout their lives, and identifies some key conceptual and empirical challenges affecting the future of the field.
The past decade has witnessed substantial attention to the development of aging-friendly communities, including major initiatives by the World Health Organization (WHO), International Federation on Aging, American Association of Retired Persons (AARP), American Society on Aging, American Planning Association, National Association of Area Agencies on Aging (N4A), and Grantmakers in Aging (GIA), among others. As of this writing, more than 300 cities and towns around the world have joined the WHO Network of Age-Friendly Cities and Communities, and more than 100 U. S. communities are part of the AARP Network of Age-Friendly Communities. These efforts reflect growing recognition of the importance of physical and social environments for healthy well-being at all ages, and especially in later life. However, the conceptual and empirical basis for such efforts is not well developed. Of particular concern is the lack of connection to seminal work on adult development and environmental gerontology, including the substantial body of literature on the processes by which individuals and environments change over time.
This paper attempts to address this gap by examining intersections between individual aging processes and the environments within which aging unfolds, developing theory regarding constructive developmental processes and their environmental context, and considering potential implications for conceptualizing and creating aging-friendly communities. In doing so, this paper reflects the theme of the 2015 Gerontological Society of America (GSA) Annual Scientific Meeting, “Aging as a Lifelong Process.” With this developmental perspective in mind, I utilize the term “aging friendliness” rather than the more common “age friendliness.”
In the first section of the paper, I review a number of existing approaches for conceptualizing healthy aging, typically considered the primary purpose of aging-friendly communities. In the second section, I examine environmental pathways, drawing upon environmental gerontological principles to consider ways in which physical and social contexts can affect optimal functioning and well-being among older persons and other community members. In the third section, I present a new, integrative Process Model of Constructive Aging, which identifies key developmental processes at the intersection of individual and environmental pathways. In the final section, I consider potential implications of this integrative model for creating aging-friendly communities, including future research and theory development regarding the mechanisms by which aging-friendly communities might influence individual well-being and population health. I also discuss some key challenges affecting the future of this field. This paper extends and further refines prior work by myself and my colleagues regarding the characteristics of aging-friendly communities (e.g., Lehning, Chun, & Scharlach, 2007; Scharlach, 2016; Scharlach & Diaz-Moore, 2016; Scharlach & Lehning, 2015).
Individual Processes
Efforts to create aging-friendly communities typically identify their primary purpose as the well-being of older community members, typically described as “healthy aging” (AARP, 2016; n4a, 2007; WHO, 2002). However, such efforts have given relatively little critical attention to how healthy aging is conceptualized and operationalized, nor how it is affected by specific community characteristics. In this section, I examine three major perspectives on well-being in later life: (a) functional perspectives; (b) phenomenological perspectives; and (c) adaptational perspectives.
Functional Perspectives
Functional perspectives conceive the aging process primarily as embodied in observable manifestations of physical, mental, and social functioning, as reflected in terms such as “successful aging” or “active aging” (Rowe & Kahn, 1998; WHO, 2002). The Rowe–Kahn conceptualization of successful aging, for example, posits three interrelated functional criteria: (a) avoidance of disease and disability; (b) maintenance of high levels of physical and cognitive functioning as one ages; and (c) active engagement in social and productive activities (Rowe & Kahn, 1998). Similarly, the European Year for Active Ageing and Solidarity Between Generations promoted “growing old in good health and as a full member of society, feeling more fulfilled in our jobs, more independent in our daily lives and more involved as citizens” (Europa, 2012, p. 1).
Although endorsed for their positive view of aging, functional perspectives also have been criticized on a number of grounds, including the following: that they reflect cultural biases regarding the importance of functional independence and productivity; that they impose restrictive criteria that reserve “successful aging” primarily for the privileged few; that they reinforce lifelong patterns of power and privilege by ignoring cumulative advantage and disadvantage processes that contribute to increased illness and functional limitations in later life; that they promote ageist stereotypes by equating normal signs of aging with failure; and finally, that they ignore the complexity of human experience, including elders’ own subjective perspectives (Hank, 2011; Holstein & Minkler, 2003; Martinson & Berridge, 2015; McLaughlin, Connell, Heeringa, Li, & Roberts, 2010; Strawbridge, Wallhagen, & Cohen, 2002). Recent conceptual expansions, such as Successful Aging 2.0 (Rowe & Kahn, 2015), recognize the importance of societal factors such as institutional and structural barriers to successful aging, but still tend to overlook the potential influence of physical and social environments, or the subjective perspectives of elders themselves.
Phenomenological Perspectives
Older adults’ personal perspectives on successful aging and similar constructs have been examined using individual interviews, focus groups, and other qualitative methods. Emergent themes generally include some functional aspects of aging (e.g., good health and high levels of physical, cognitive, and social functioning), as well as a number of interpersonal and attitudinal factors that are not captured by a functional perspective.
Harmonious interpersonal relationships emerge as a common theme in many studies, including positive family relationships, family support, interdependence, and meaningful social connections (e.g.,Knight & Ricciardelli, 2003; Tate, Lah, & Cuddy, 2003; Torres, 2003). Another common theme is having an impact on one’s social environment, including helping others, transmitting experience-based knowledge and wisdom, ensuring family and societal continuity by preserving traditions, and receiving recognition and respect (e.g., Romo et al., 2013; Torres, 2003; Troutman, Nies, Small, & Bates, 2011). Autonomy, self-determination, and the ability to make choices about oneself and one’s life are also mentioned frequently in a number of studies, as is personal growth (e.g., Duay & Bryan, 2006; Knight & Ricciardelli, 2003; Tate et al., 2003). Finally, life satisfaction, the ability to maintain a positive outlook and a general appreciation for life in the face of aging-related changes in one’s self and one’s environment, is frequently identified as an essential component of a good old age (e.g., Knight & Ricciardelli, 2003; Laditka et al., 2009; Tate et al., 2003). Indeed, “getting a maximum of satisfaction out of life” is widely considered to be the first definition of successful aging, appearing more than 50 years ago in the inaugural edition of The Gerontologist (Neugarten, Havighurst, & Tobin, 1961, p. 8).
Adaptational Perspectives
Finally, aging can be understood as a process of ongoing adaptation to age-related challenges and opportunities across the life span (Marsiske, Lang, Baltes, & Baltes, 1995; Ryff, 1989), rather than as a set of specific characteristics or goals achievable only by a subset of older persons. Positive psychological characteristics, such as a sense of coherence, life purpose, autonomy, personal growth, environmental mastery, positive relationships, and self-acceptance, have been associated with improved outcomes when confronted with life challenges (Antonovsky, 1985; Eriksson & Lindström, 2006; Ryff, 2014). Selection, optimization, and compensation (SOC) processes (Baltes & Baltes, 1990), in particular, have been associated with greater life satisfaction and overall psychological well-being, after controlling for age, health, and personality characteristics (Freund & Baltes, 2002). Finally, proactive coping strategies designed to reduce the likelihood, intensity, or impact of future stressors (e.g., health promotion activities, financial planning, skills acquisition, investing in long-term relationships) are linked to better quality of life, concurrently and prospectively (Kahana, Kelley-Moore, & Kahana, 2012; Prenda & Lachman, 2001).
Adaptive processes in later life are apt to differ from those of earlier adulthood as a result of age-related changes in abilities and priorities. Utilization of constructive compensation, optimization, and proactive coping strategies, for example, tends to decline in later life, most likely due to a decrease in available internal and external resources for responding to increasing life demands (Lang, Rieckmann, & Baltes, 2002). At the same time, novel adaptive processes may be needed in response to age-related physical, cognitive, social, and environmental changes. The SOC model, for example, conceptualizes successful development as an ongoing process of adaptation between individuals and their physical, social, and cultural environment (Freund & Baltes, 2007). As noted by Paul and Margret Baltes, “optimal aging refers to … aging under development-enhancing and age-friendly environmental conditions” (Baltes & Baltes, 1990, p. 8). The nature of these environmental conditions, however, has received only limited attention from lifespan developmental theorists such as these.
Environmental Pathways
In this section, I examine environmental conditions that are likely to promote healthy aging, including compensatory and enabling processes, interrelationships between individual and environmental characteristics, age-related changes in environmental attributes and their salience, and the subjective nature of person-environment interactions as they evolve over time.
Ecological Model of Aging
The ecological model of aging (Lawton, 1982) provided an early framework for considering the environmental context within which aging occurs. This model proposed that behaviors and outcomes are a function of interactions between individual competence and environmental press, where either too much press or too little press induces maladaptive behavior and negative affect.
Environments can be seen not only as sources of press, but also as offering resources and opportunities that are either compensatory or enabling. Compensatory processes promote older adults’ sense of stability and security in the face of declining abilities, as reflected in the environmental functions of maintenance and support proposed by Lawton (Lawton, 1982). The maintenance function is postulated to assist older adults to preserve their sense of identity and experience the benefits of place attachment, including the predictability that accrues from a familiar home and neighborhood. Environmental stability, furthermore, is presumed to allow older adults to focus more of their energy on skills and activities rather than navigating their environment (Lawton, 1982). Support reflects a reduction in environmental demand in order to preserve personal well-being in the face of age-related reductions in capacity, in accordance with the competence-press model (Lawton, 1982).
Enabling processes, as reflected in Lawton’s third component of person-environment fit, stimulation (Lawton, 1982), involve environmental demands designed to promote enhanced physical and social functioning. Mental and social stimulation, whether in-person or electronically-mediated, for example, can be especially beneficial for sedentary older individuals, including those at advanced ages who spend much of their time at home (Baltes, Maas, Wilms, Borchelt, & Little, 1999; Lawton, 1982). Such processes are reflected in the European Community’s focus on promoting “active ageing,” defined as “helping people stay in charge of their own lives for as long as possible as they age and, where possible, to contribute to the economy and society” (European Commission, n.d.). A dual focus on both compensatory and enabling processes is consistent with a number of recent conceptualizations of aging friendliness, including Alley and colleagues’ definition of an elder-friendly community as “a place where older people are actively involved, valued, and supported with infrastructure and services that effectively accommodate their needs” (Alley, Liebig, Pynoos, Banerjee, & Choi, 2007).
Intersectionalities
Factors affecting individuals and their environments are interrelated, and are impacted by macro-economic forces and structural inequities. Independent mobility, for example, is affected not only by the accessibility of one’s residence but also the presence of well-maintained sidewalks, meaningful destinations within walking distance, publicly-supported transportation options, and a crime-free environment. Individual risk factors (e.g., being poor, 75 and older, female, living alone due to widowhood, having less than a high school education), furthermore, are more likely to be found among persons living in less healthy environments, and vice versa (Golant, 2008). Similarly, neighborhoods with an especially high density of such persons may be associated with greater social and economic instability. Circumstances such as this might contribute to older adults being “stuck in place” (Erickson, Call, & Brown, 2012), lacking the personal and social resources needed to move to a more salutary living environment.
Developmental Effects
The aging process is apt to require continual adaptation in response to age-related changes in individual competence and environmental press, with the influence of environmental conditions tending to increase with age (Lawton & Nahemow, 1973). To some extent, increased environmental influence is attributable to increases in the social and psychological salience of the immediate environment, as reflected in the concept of place attachment (Rowles, 1983). Long-term residence, for example, may convey a sense of physical, social, and autobiographical insideness (Rowles, 1983). Physical insideness, including familiarity with environmental details, can allow individuals to navigate their immediate environment, even with reduced functional capacity. Social insideness, associated with physically and emotionally close social bonds, can promote feelings of belonging as well as assistance when needed. Autobiographical insideness can provide older adults with a greater sense of meaning for their own lives as well as their community’s past, present, and future. Older adults’ greater emotional investment in immediate physical and social environments may also be attributable in part to cohort differences, reflecting greater geographical stability and sense of community among today’s older adults compared with subsequent cohorts (Phillipson, Scharf, Kingston, & Smith, 2001).
Age-related increases in environmental influence also may be due to a reduction in elders’ activity space, as a result of restricted mobility associated with physical limitations combined with built environments designed for younger persons (Burns, Lavoie, & Rose, 2012; Schonfelder & Axhausen, 2003). The amount of time spent at home or nearby is likely to increase, as the spatial distribution of regular destinations constricts (Forrest & Kearns, 2001). In part because older adults are more geographically bound, their social space may constrict as well, inducing greater dependence on geographically-proximate social ties. In contrast, younger adults’ social networks tend to be more geographically dispersed, and are more likely to be based on work associations or common interests (Forrest & Kearns, 2001; Guest & Wierzbicki, 1999). Furthermore, as individuals and environments evolve over time, the effects of adequate or inadequate person-environment fit tend to accumulate, with earlier individual and environmental characteristics helping to shape future person-environment fit (Scheidt & Windley, 2006). Over the life course of a neighborhood, for example, physical infrastructure may be improved or replaced or left to deteriorate, and resident characteristics may change markedly.
Ecological Framework of Place
Aging-related changes in individual abilities and motivations, social networks, social institutions, and physical environments suggest the importance of a lifecourse perspective that examines the changing interaction among individuals and their environments. One model that adopts a developmental perspective for understanding the interface between individuals and their environments is the ecological framework of place (EFP) (Diaz Moore, 2014). The EFP conceives individuals and places as active partners in a dynamic process of ongoing negotiations designed to promote person–environment fit and enhance socially meaningful experiences.
The environment includes not only the objective characteristics of the physical setting but also the activities that are made possible thereby and the socially shared expectations that affect how those activities are understood and evaluated. Individuals, moreover, bring to their environments a unique set of competencies, intentions, desires, and needs, based on a lifetime of experiences. From this perspective, a community is simultaneously a physical space (e.g., neighborhood), a social space (e.g., social boundaries and norms), and a set of social bonds (e.g., a sense of community), interacting and interpenetrating to imbue spaces with meaning (Diaz Moore, 2014).
This suggests a more nuanced and dynamic conceptualization of individual and environmental aging processes, and their potential implications for conceptualizing aging friendliness. Transcending the assumed static nature of individuals and their environments, EFP and similar models consider the potential influence of time (i.e., aging) on individuals (P), physical and social contexts (E), processes used to negotiate the interface between individuals and contexts (P × E), and the purposes of those negotiations (e.g., goals, preferences, priorities, etc.). From this perspective, individuals can be thought of not only as a set of competencies, but also as having intentions reflecting age as well as cohort influences. In addition to the various ways in which physical and social environments affect individuals, EFP suggests that environments are themselves shaped by the motivations, goals, and abilities of the individuals who design, modify, select, and occupy them (Diaz Moore, 2014).
A Process Model of Constructive Aging
In an effort to integrate these various perspectives, my colleagues and I have developed the concept of constructive aging, reflecting an ongoing process of individual and environmental adaptation. Constructive aging is conceptualized as having six interrelated components: Constructive aging involves six interrelated processes, as displayed in Figure 1: (a) self-construct preservation in the face of personal and environmental threats (continuity); (b) behavioral and psychological adaptation to age-related challenges (compensation); (c) preservation of perceived self-efficacy (control); (d) meaningful constructive interpersonal relationships (connection); (e) generativity in public and private spheres (contribution); and (f) stimulation and growth in multiple domains of functioning (challenge). The conceptual basis of each of these processes, program examples, and potential benefits are described below, and summarized in Table 1. Communities can be considered aging-friendly to the extent that they facilitate these six constructive aging processes.
Process Model of Constructive Aging.
Constructive Aging Processes, Their Conceptual Basis, Program Examples, and Potential Benefits.
| Developmental process | Conceptual basis | Program examples | Potential benefits |
|---|---|---|---|
| Continuity | Continuity theory (Atchley, 1989); Personality stability (McCrae & Costa, 1990) | Universal design; Complete streets; Age-friendly business certification | Self-construct preservation; Minimal age-related limitations |
| Compensation | Competence-press model (Lawton, 1982); SOC (Baltes & Baltes, 1990) | Assistive devices; Environmental modifications; Semiautonomous vehicles; Dementia-friendly communities | Basic safety and security; Reduced uncompensated disabilities; Minimal unmet needs |
| Control | Control theory (Schulz & Heckhausen, 1996); Sense of coherence (Antonovsky, 1985) | Web-based service access; Consumer- directed care; Village model | Sense of mastery; Self-efficacy; Sense of meaning |
| Connection | Socioemotional selectivity theory (Carstensen, 1993); Attachment theory (Parkes et al., 2006) | Friendly visiting; Visitable housing design; Intergenerational programs | Meaningful relationships; Emotional gratification; Social support |
| Contribution | Productive aging (Morrow-Howell, 2010); Civic engagement (Hinterlong & Williamson, 2006); Prosocial behavior (Kahana, Midlarsky, & Kahana, 1987); Social capital theory (Lin, 1999) | Supported employment; Volunteer opportunities; TimeBanking; Leadership development | Sense of purpose; Positive self- construct; Social capital |
| Challenge | Competence-press model (Lawton, 1982); Hormesis theory (Cook & Calabrese, 2006); Resilience theory (Staudinger, Marsiske, & Baltes, 1993) | Health promotion; Exercise programs; Community roles and responsibilities | Optimal physical, psychological, and social functioning; Hardiness |
| Developmental process | Conceptual basis | Program examples | Potential benefits |
|---|---|---|---|
| Continuity | Continuity theory (Atchley, 1989); Personality stability (McCrae & Costa, 1990) | Universal design; Complete streets; Age-friendly business certification | Self-construct preservation; Minimal age-related limitations |
| Compensation | Competence-press model (Lawton, 1982); SOC (Baltes & Baltes, 1990) | Assistive devices; Environmental modifications; Semiautonomous vehicles; Dementia-friendly communities | Basic safety and security; Reduced uncompensated disabilities; Minimal unmet needs |
| Control | Control theory (Schulz & Heckhausen, 1996); Sense of coherence (Antonovsky, 1985) | Web-based service access; Consumer- directed care; Village model | Sense of mastery; Self-efficacy; Sense of meaning |
| Connection | Socioemotional selectivity theory (Carstensen, 1993); Attachment theory (Parkes et al., 2006) | Friendly visiting; Visitable housing design; Intergenerational programs | Meaningful relationships; Emotional gratification; Social support |
| Contribution | Productive aging (Morrow-Howell, 2010); Civic engagement (Hinterlong & Williamson, 2006); Prosocial behavior (Kahana, Midlarsky, & Kahana, 1987); Social capital theory (Lin, 1999) | Supported employment; Volunteer opportunities; TimeBanking; Leadership development | Sense of purpose; Positive self- construct; Social capital |
| Challenge | Competence-press model (Lawton, 1982); Hormesis theory (Cook & Calabrese, 2006); Resilience theory (Staudinger, Marsiske, & Baltes, 1993) | Health promotion; Exercise programs; Community roles and responsibilities | Optimal physical, psychological, and social functioning; Hardiness |
Note: SOC = Selection, optimization, and compensation.
Constructive Aging Processes, Their Conceptual Basis, Program Examples, and Potential Benefits.
| Developmental process | Conceptual basis | Program examples | Potential benefits |
|---|---|---|---|
| Continuity | Continuity theory (Atchley, 1989); Personality stability (McCrae & Costa, 1990) | Universal design; Complete streets; Age-friendly business certification | Self-construct preservation; Minimal age-related limitations |
| Compensation | Competence-press model (Lawton, 1982); SOC (Baltes & Baltes, 1990) | Assistive devices; Environmental modifications; Semiautonomous vehicles; Dementia-friendly communities | Basic safety and security; Reduced uncompensated disabilities; Minimal unmet needs |
| Control | Control theory (Schulz & Heckhausen, 1996); Sense of coherence (Antonovsky, 1985) | Web-based service access; Consumer- directed care; Village model | Sense of mastery; Self-efficacy; Sense of meaning |
| Connection | Socioemotional selectivity theory (Carstensen, 1993); Attachment theory (Parkes et al., 2006) | Friendly visiting; Visitable housing design; Intergenerational programs | Meaningful relationships; Emotional gratification; Social support |
| Contribution | Productive aging (Morrow-Howell, 2010); Civic engagement (Hinterlong & Williamson, 2006); Prosocial behavior (Kahana, Midlarsky, & Kahana, 1987); Social capital theory (Lin, 1999) | Supported employment; Volunteer opportunities; TimeBanking; Leadership development | Sense of purpose; Positive self- construct; Social capital |
| Challenge | Competence-press model (Lawton, 1982); Hormesis theory (Cook & Calabrese, 2006); Resilience theory (Staudinger, Marsiske, & Baltes, 1993) | Health promotion; Exercise programs; Community roles and responsibilities | Optimal physical, psychological, and social functioning; Hardiness |
| Developmental process | Conceptual basis | Program examples | Potential benefits |
|---|---|---|---|
| Continuity | Continuity theory (Atchley, 1989); Personality stability (McCrae & Costa, 1990) | Universal design; Complete streets; Age-friendly business certification | Self-construct preservation; Minimal age-related limitations |
| Compensation | Competence-press model (Lawton, 1982); SOC (Baltes & Baltes, 1990) | Assistive devices; Environmental modifications; Semiautonomous vehicles; Dementia-friendly communities | Basic safety and security; Reduced uncompensated disabilities; Minimal unmet needs |
| Control | Control theory (Schulz & Heckhausen, 1996); Sense of coherence (Antonovsky, 1985) | Web-based service access; Consumer- directed care; Village model | Sense of mastery; Self-efficacy; Sense of meaning |
| Connection | Socioemotional selectivity theory (Carstensen, 1993); Attachment theory (Parkes et al., 2006) | Friendly visiting; Visitable housing design; Intergenerational programs | Meaningful relationships; Emotional gratification; Social support |
| Contribution | Productive aging (Morrow-Howell, 2010); Civic engagement (Hinterlong & Williamson, 2006); Prosocial behavior (Kahana, Midlarsky, & Kahana, 1987); Social capital theory (Lin, 1999) | Supported employment; Volunteer opportunities; TimeBanking; Leadership development | Sense of purpose; Positive self- construct; Social capital |
| Challenge | Competence-press model (Lawton, 1982); Hormesis theory (Cook & Calabrese, 2006); Resilience theory (Staudinger, Marsiske, & Baltes, 1993) | Health promotion; Exercise programs; Community roles and responsibilities | Optimal physical, psychological, and social functioning; Hardiness |
Note: SOC = Selection, optimization, and compensation.
Continuity
Reflecting subjective perspectives on successful aging, personal goals and values tend to maintain their importance throughout the adult life span (e.g., Kaufman, 1986) and major personality characteristics change remarkably little (e.g., McCrae & Costa, 1990). Consistent with functional and phenomenological perspectives, aging friendliness involves minimizing age-related personal and environmental limitations, so as to maintain as much consistency as possible between current activities and those that have been important in the past. As Lawton noted, maintenance activities that preserve one’s sense of personal identity and continuity of self-construct may become especially important in later life, in the face of a variety of internal and external forces that threaten to undermine one’s sense of self and disconnect a person from much that previously had given their life meaning. Elders’ focus on familiar activities and beliefs also may be an adaptive response to a disabling environment in which physical, social, and attitudinal barriers limit opportunities for meaningful new experiences, highlighting the importance of minimizing age-related environmental barriers. At the same time, age-related increases in the salience of familiar places can accentuate a desire to age in place.
An aging-friendly community, therefore, is one in which individuals are able to continue personally and societally meaningful activity patterns as they age, with no unnecessary barriers to doing so, consistent with Lawton’s maintenance function of the environment (Lawton, 1982). For example, instead of “Peter Pan” housing apparently designed for individuals who do not age (Pynoos, Sabata, & Choi, 2005), aging-friendly housing includes universal design features that can accommodate to the diverse needs of individuals of various ages, abilities, and life circumstances (Pynoos, Caraviello, & Cicero, 2009). Similarly, automobiles and roads could be better designed to accommodate expectable age-related changes in sensation and mobility, including enhanced visibility, larger signage, infrared sensors, dedicated left-turn lanes, and adjustable crosswalk timers (Satariano, Scharlach, & Lindeman, 2014). Another example is age-friendly business certification, using volunteers to assess community businesses regarding the presence of aging-friendly features such as larger signage, accessible shelves, seating, and human assistance (Action for Older Persons, 2014).
Compensation
Adaptation and ecological perspectives suggest that external and internal compensation processes are likely to be required in the face of age-related physiological, social, and environmental discontinuities and dislocations. In accordance with the supportive function of environments hypothesized by Lawton, successful adaptation to age-related personal and social declines is apt to require adequate, appropriate, accessible, and affordable environmental supports and accommodations to enable older persons to continue to achieve meaningful goals and meet basic health and social needs (Baltes & Baltes, 1990; Lawton, 1982). Compensation can include external assistance with tasks that can no longer be performed safely or easily, including personal assistance, assistive devices, environmental modifications, or other sources of support. Internal compensation efforts include adjusting aspirations and reference standards, becoming more selective about the range of activities pursued to achieve one’s goals, maximizing one’s capacities, and identifying alternative means of achieving one’s goals, as reflected in the concept of selective optimization with compensation (Baltes & Baltes, 1990; Romo et al., 2013).
Compensation-oriented initiatives designed to enhance support with aging-related deficits include assistive technologies, remote sensor and monitoring systems, biomedical devices of various kinds (Satariano et al., 2014), semi-autonomous vehicles that compensate for sensory and functional limitations (Bartolini & McNeill, 2012), dementia-friendly community initiatives (Lin, 2016), and extension of Americans with Disabilities Act (ADA) provisions to reflect functional limitations more likely to be experienced by older adults (e.g., balance problems requiring cane use, limited stamina, reduced vision and hearing) rather than the more acute and localized limitations targeted by ADA provisions (e.g., lower-body injuries resulting in wheelchair use, blindness, deafness) (Sterns, & Miklos, 1995).
Control
Opportunities to exert control over one’s self and one’s environment may be especially important in the context of physical and social environments that pervasively undermine autonomy and self-control in later life (Schulz, Heckhausen, & O’Brien, 1994; Schulz & Heckhausen, 1996), as hypothesized by adaptational and ecological perspectives. At a time when declining personal capacity and dependency-inducing physical and social contexts can foster subjective experiences of marginalization, purposelessness, and helplessness, meaningful and agentic activities can reinforce a greater sense of mastery, personal control, and self-efficacy, along with a renewed sense of meaning and purpose. Primary control processes typically involve active attempts to manipulate the physical or social environment to attain one’s goals, as proposed by EFP. Secondary control processes include internal psychological adaptations designed to preserve a sense of self-efficacy even when primary control efforts are ineffective (Schulz & Heckhausen, 1996).
Employing primary control strategies has been associated with better health and well-being (Schulz, et al., 1994; Seeman & Lewis, 1995), protection against disease (Marmot et al., 1997), enhanced cognitive functioning (Seeman et al., 1993), and lower mortality rates (Seeman & Lewis, 1995), although the importance and potential salutary impact of individual personal control is likely to vary across cultural contexts (Steptoe, Hamer, & Chida, 2007).
Control-oriented initiatives include a variety of approaches for enhancing older residents’ sense of self-efficacy and self-determination. For example, mobility control can be enhanced through senior-friendly web-based consumer-initiated ride matching services, such as Lift Hero, GoGoGrandparent, and Integrated Transportation Network (Shaheen & Chan, 2016).
Consumer-directed care options include web-based provider matching services, such as Honor and caring.com (Larson & Kao, 2016), as well as publicly supported consumer-directed care options such as Cash & Counseling (Mahoney, Fishman, Doty, & Squillace, 2007). In nearly 200 communities in the United States, older adults are creating their own grassroots, consumer-run supportive service options, such as the Village model (Scharlach, Graham, & Lehning, 2012). Control also can be enhanced through active participation in and responsibility for aging-friendly community planning efforts, such as the Atlanta Regional Commission’s design charrettes (Keyes, Rader, & Berger, 2011) and New York City’s local aging improvement district planning councils (New York Academy of Medicine & Age-Friendly NYC, 2012).
Connection
Positive family and social relationships are mentioned frequently by older adults as an essential aspect of healthy aging, and are essential to physical and psychological well-being (Parkes, Stevenson-Hinde, & Marris, 2006). Emotionally-meaningful human interactions seem to become more important with age, in part because of increased salience of close personal relationships based on a recognition that there is limited time left to live (Carstensen, 1993) and in part because of reductions in activity space. Social integration has been linked to better self-rated health, fewer depressive symptoms, and a decreased risk of mortality (Holt-Lunstad, Smith, & Layton, 2010). Social isolation, on the other hand, is associated with impaired immune system functioning, increasing the risk of heart problems, infections, and other life-threatening illnesses (Steptoe, Shankar, Demakakos, & Wardle, 2013). Peer support can play a particularly important role in helping cope with age-related physical and social losses, reducing the likelihood of negative psychological repercussions, health problems, or undesired residential relocations (Giles, Glonek, Luszcz, & Andrews, 2007; Greenfield & Marks, 2004).
Personal and environmental barriers, however, can undermine elders’ efforts to remain socially engaged, resulting in decreases in discretionary social contact in later life (Ertel, Glymour, & Berkman, 2009). Health problems and disabling conditions, for example, can restrict mobility and interpersonal communication, making social interaction more difficult. At the same time, there is apt to be a decrease in opportunities for discretionary social contact due to depletion of social networks because of death, illness, and retirement, coupled with ageist and disablist norms that contribute to social isolation by fostering feelings of inadequacy and invisibility, and unsupportive physical environments that can limit mobility and restrict access.
Social engagement requires a supportive physical and social infrastructure that provides opportunities for meaningful interpersonal connections, without restrictions based on age or disability. Communities can promote social engagement through friendly visiting and telephone reassurance programs (Dickens, Richards, Greaves, & Campbell, 2011), by encouraging reciprocal social exchanges that foster interdependence rather than inequity and disempowerment (Seyfang, 2003), by reducing mobility barriers that limit social engagement (Dickens et al., 2011), by promoting multi-generational housing (Fry & Passel, 2014), and by including older residents as key partners in all aspects of community life (Hinterlong & Williamson, 2006).
Contribution
There is substantial evidence regarding the potential personal and societal benefits of prosocial behavior in later life, consistent with functional and phenomenological perspectives, the purposeful nature of person-environment transactions, and the “contributory orientation” attributed to adult psychosocial development (Kahana, Midlarsky, & Kahana, 1987). Contributory activities can help to sustain a positive self-concept in the face of threats caused by changing capacity, lack of clearly-defined role structures, and an ageist society that devalues individuals based on their age and ability. Volunteering and other contributory activities are associated with greater life satisfaction, reduced anxiety, and lower rates of depression (Hao, 2008; Musick & Wilson, 2003), as well as fewer functional limitations, decreased mortality, and reduced health care services use (Gottlieb & Gillespie, 2008; Luoh & Herzog, 2002). Helping others also can strengthen social bonds, increase social capital, and enhance other social and psychological resources (Gottlieb & Gillespie, 2008; Kahana et al., 1987; Lin, 1999).
Communities can promote older adults’ contributory roles in a variety of ways. Paid workforce participation can be fostered through supported employment programs, flexible working conditions, ergonomically-appropriate physical environments, and opportunities for seasonal and part-time employment (McMullin & Shuey, 2006). Communities can promote meaningful social participation by offering a range of formal volunteer opportunities through charitable organizations, religious or cultural institutions, and social or athletic clubs, along with adequate transportation and other supports and incentives to overcome age-related barriers to participation (Morrow-Howell, 2010). Engagement in civil society can also be fostered through informal community leadership roles, along with leadership development and advocacy training, as offered by the California Senior Leaders Alliance (Romero & Minkler, 2005) and the Minnesota Vital Aging Network (Hively, n.d.). Communities can also provide recognition and support for grandparent care and other meaningful family roles and responsibilities, or promote development of elder-inclusive intentional informal helping networks, such as time banking (Seyfang, 2003). Finally, communities can assure older adult representation in civic governance structures, such as advisory committees, planning councils, and other formal decision-making bodies (Hinterlong & Williamson, 2006).
Challenge
Adequate environmental stimulation may be essential for optimal physical, cognitive, and psychological functioning, as postulated by adaptational perspectives and the competence-press model (Lawton, 1982). Although overly-demanding environmental conditions can impair functioning, smaller intensity environmental demands can stimulate resilience and hardiness through a process of strength conditioning (Cook & Calabrese, 2006). Structured exercise activities (e.g., walking for exercise, exercise classes, weightlifting), for example, can contribute to muscle mass, mobility, executive function, reduced risk for congestive heart disease and breast cancer, and enhanced psychological well-being (Etkin, Prohaska, Harris, Latham, & Jette, 2006; Rolland, van Kan, & Vellas, 2010). Appropriately challenging mental and social tasks (e.g., reading, socializing, playing bridge, playing board games) are associated with improvements in working memory and social functioning, delays in cognitive decline, and enhanced quality of life (Wilson, Segawa, Boyle, & Bennett, 2012; Woods, Aguirre, Spector, & Orrell, 2012).
Communities can promote age-appropriate stimulation in a variety of ways: by facilitating neighborhood-based health promotion initiatives, such as walking groups, Tai Chi, yoga, and other low-impact exercise programs (Smith, 1988); by offering evidence-based fitness programs that combine exercise, strength-building, balance training, and other potentially beneficial physically-challenging activities, such as Be Well, Fit and Strong! (Hughes et al., 2004) and A Matter of Balance (Peterson, 2002); by making environmental improvements to increase neighborhood walkability (Satariano et al., 2012); by encouraging fitness facilities to provide programs and equipment designed for older bodies (Bethancourt, Rosenberg, Beatty, & Arterburn, 2014); and by encouraging elder participation in a wide range of meaningful and potentially challenging social roles and activities (Morrow-Howell, 2010).
Implications for Aging-Friendly Communities
The dynamic person-environment processes presented here can provide a useful complement to the relatively static environmental conditions that typically serve as the focus of many prominent aging-friendly initiatives, such as AARP’s Livable Communities initiative (AARP Public Policy Institute, 2005), WHO’s Ageing and Life Course Programme’s Global Age-Friendly Cities project (World Health Organization, 2007), and the National Association of Area Agencies on Aging’s Aging in Place initiative (National Association of Area Agencies on Aging, 2011), among others. The WHO project, for example, focuses on eight domains of age friendliness within three overarching areas: (a) physical infrastructure (outdoor spaces and buildings, transportation, housing); (b) social opportunities (social participation, civic participation, respect and social inclusion); and, (c) supportive services (communication and information, community and health services). Here, I examine each of these areas in terms of its potential association with the six constructive aging processes identified above.
Physical Infrastructure
Aging-friendly physical infrastructures include personally-meaningful destinations (e.g., shopping, personal grooming, religious settings, social connections, contributory roles), accessible locations (e.g., mixed-use zoning, co-located housing and services, safe walkways), a range of mobility options for getting there (e.g., volunteer drivers, driving companions, semi-autonomous vehicles, paratransit), a reduction in physical barriers, and limited reliance on automobile use. Safe and barrier-free outdoor spaces and accessible buildings, for example, can enable older adults to maintain familiar activities (continuity), have places to sit when fatigued (compensation), require less assistance with out-of-home tasks (control), see longstanding friends and acquaintances (connection), participate more actively in community affairs (contribution), and get more exercise (challenge) (Clarke & George, 2005; Schutzer & Graves, 2004). Road and vehicle modifications that allow older adults to continue to drive independently rather than rely on other mobility options can make it easier for them to get where they need and want to go (continuity), improve access to doctor’s offices and other life-sustaining destinations (compensation), avoid feelings of helplessness (control), reduce social isolation (connection), and enhance participation in work and volunteer activities (contribution, challenge) (Curl, Stowe, Cooney, & Proulx, 2014; US GAO, 2004). Universal housing design and associated home modifications can enable older adults to continue to live in familiar surroundings (continuity), do so comfortably and safely (compensation), require less human assistance (control), and retain propinquitous social ties (connection).
Social Engagement
Aging-friendly social opportunities include the ability to maintain meaningful social interactions and social participation, as well as options for developing new social roles and relationships. The AARP Public Policy Institute, for example, considers “the high level of engagement of [its] residents with one another and with the life of the community itself” to be a prerequisite for a livable community (AARP Public Policy Institute, 2005, p. 20). Lui and colleagues note, “A supportive context with positive social relations, engagement and inclusion is a core prerequisite for ageing well” (Lui, Everingham, Warburton, Cuthill, & Bartlett, 2009, p. 120).
Senior centers and other structured social participation programs can foster meaningful personal relationships (connection), enhance self-efficacy (control), engage participants in leadership and peer support roles (contribution), and offer new educational opportunities (challenge) (Aday, Kehoe, & Farney, 2006). Age-friendly universities and other programs that engage older adults in meaningful activities can foster autonomy (control), contribute to a sense of belonging (connection), provide opportunities for knowledge sharing (contribution), and stimulate new ways of thinking (challenge) (Talmage, Mark, Slowey, & Knopf, 2016). Intergenerational programs and other inclusionary initiatives can help to alleviate helpless-inducing personal and societal attitudes (control), promote meaningful cross-generational bonds (connection), provide opportunities for cross-generational knowledge transmission (contribution), and stimulate new ways of thinking (challenge) (Manheimer, 1998).
Supportive Services
Aging-friendly health and social supports include services designed to ensure basic safety and security, promote multidimensional health and well-being, and reduce the impact of aging-related diseases. Age-friendly information and communication channels can enable elders to obtain needed services (compensation), reduce the need for human assistance (control), stay connected with family members and friends (connection), overcome physical barriers to contributory activities (contribution), and experience intellectual and social stimulation (challenge) (Satariano et al., 2014). Finally, access to a wide range of health and social services can help older adults to age in place (continuity), reduce the potential impact of age-related disabilities (compensation), maintain independence (control), enhance social support (connection), and foster capacity and opportunities for new experiences (challenge) (Centers for Disease Control and Prevention, 2013).
Implications for Research and Theory Development
The Process Model of Constructive Aging presented here is intended as a heuristic tool, and will require further empirical validation. Future research is needed regarding the operationalization and assessment of the six developmental processes, the extent to which they are conceptually and empirically distinct, the extent to which they are of particular salience in later life, interpersonal and cross-situational variations in their salience and expression, their ability to predict a variety of positive outcomes for individuals and communities, their plasticity, and their responsiveness to specific intervention approaches.
More generally, there is a lack of theory development overall in the literature on aging-friendly communities. In particular, there is a need for increased conceptual and empirical development regarding the construct of aging friendliness, its operationalization, its assessment, and the effectiveness of intervention efforts on the developmental processes associated with individual health and well-being. Numerous programs have been launched in recent years designed to foster aging-friendly communities or promote aging-in-place (e.g., WHO, AARP, Community Innovations for Aging in Place, Community Partnerships for Older Adults, AdvantAge Initiative). However, evidence regarding the effectiveness of such initiatives is extremely limited. Additional research is needed regarding the impact of aging-friendly interventions on the well-being of communities and their residents, including their ability to activate enabling and compensatory processes that have potential for promoting constructive person-environment transactions over time.
Specific targets of intervention and evaluation might include outcomes such as community elder friendliness, livability, proactivity, and engagement. Community elder friendliness might be assessed by examining the extent to which physical structures and programs are appropriate to the unique needs, preferences, and capabilities of the current cohort of older community members, including fostering constructive aging processes. Community livability is evidenced by efforts to promote the health and well-being of everyone in the community, regardless of age (n4a, 2007), as reflected in the World Health Organization’s (WHO) description of a healthy city as “continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and developing to their maximum potential” (WHO, 1998, p. 13). Community proactivity is evidenced by efforts to promote optimal adaptation to expectable future personal and environmental changes. Finally, community engagement is evidenced by the involvement of a wide range of community residents in efforts to promote community well-being, including systems and activities that enhance social capital, as reflected in the concept of aging in community (Thomas & Blanchard, 2009).
Conclusion
The Process Model of Constructive Aging presented here substantially extends current conceptualizations of healthy aging, with the intention of stimulating additional theory building regarding the environmental pathways through which aging-friendly communities might promote individual and community well-being. Rooted in adult developmental theory and environmental gerontology, this model incorporates lessons from functional approaches to healthy aging, phenomenological perspectives, adaptational strategies, and ecological frameworks. Furthermore, the model reflects a dynamic conceptualization of person-environment fit that considers transactional adaptational processes among individuals and their environments as these evolve over time. In so doing, the model provides a stronger conceptual basis for research on community aging friendliness, including the mechanisms by which environments may influence individual well-being, the physical and social environmental modifications likely to foster constructive aging processes, and the effectiveness of particular programmatic and policy interventions. Conceptual developments such as this are essential for the creation of effective aging-friendly community change strategies designed to promote constructive personal-environmental processes as individuals and their communities change over time, thereby enhancing the potential of community members to live more full and meaningful lives throughout the life course, consistent with their aging-related developmental needs and priorities.
Acknowledgments
An earlier version of this article “Aging in Context: Individual and Environmental Pathways” was presented as the 2015 Maxwell A. Pollack Award lecture on November 20, 2015 at the 68th Annual Scientific Meeting of the Gerontological Society of America, Orlando, Florida. The ideas presented in this article include important contributions from Amanda Lehning, Keith Diaz-Moore, and numerous other colleagues and students.
References
Author notes
Address correspondence to Andrew E. Scharlach, School of Social Welfare, University of California, 120 Haviland, Berkeley, CA 94720. E-mail: scharlach@berkeley.edu
Decision Editor: Rachel Pruchno, PhD
