Am J Psychiatry 158:839-847, June 2001
© 2001 American Psychiatric Association
Successful Aging
George E. Vaillant, M.D., and
Kenneth Mukamal, M.D.
OBJECTIVE: Until now, prospective studies of aging have begun with 50–60-year-olds, not adolescents. Premature death, childhood variables, and alcohol abuse have been often ignored, as has successful aging. METHOD: The authors reviewed the existing literature on health in late life in order to highlight that, increasingly, successful aging is not an oxymoron. The present study followed two cohorts of adolescent boys (237 college students and 332 core-city youth) for 60 years or until death. Complete physical examinations were obtained every 5 years and psychosocial data every 2 years. Predictor variables assessed before age 50 included six variables reflecting uncontrollable factors: parental social class, family cohesion, major depression, ancestral longevity, childhood temperament, and physical health at age 50 and seven variables reflecting (at least some) personal control: alcohol abuse, smoking, marital stability, exercise, body mass index, coping mechanisms, and education. The six outcome variables chosen to assess successful aging at age 70–80 included four objectively assessed variables (physical health, death and disability before age 80, social supports, and mental health) and two self-rated variables (instrumental activities of daily living and life enjoyment). RESULTS: Multivariate analysis suggested that "good" and "bad" aging from age 70–80 could be predicted by variables assessed before age 50. More hopeful still, if the seven variables under some personal control were controlled, depression was the only uncontrollable predictor variable that affected the quality of subjective and objective aging. CONCLUSIONS: One may have greater personal control over one’s biopsychosocial health after retirement than previously recognized.
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