OBJECTIVE: Although prior research has identified racial/ethnic and gender differences in successful aging (SA), heterogeneity within groups has been little examined. We consequently explore the variety of aging experiences among older Black women.
METHODS: We used the 2010/2012 U.S. Health and Retirement Study, limiting analyses to Black women who completed the Psychosocial Leave-Behind Questionnaire (N = 1,186). We conducted latent class analysis (LCA) using indicators of physical health, psychological well-being, social support/strain, and social engagement.
RESULTS: Six SA latent classes were identified and labeled according to their distinctive characteristics: infirm, isolated, taxed, independent, vivacious, and robust. The infirm class had uniformly poor health, while the isolated class was in poor physical health but also lacked social relations. Although both had average physical health and psychological well-being, the taxed class experienced high levels of social support and social strain compared to the high support (and unpartnered) independent class. The vivacious and robust classes exhibited high physical health and psychological well-being, high social support/low social strain, and high social engagement, but vivacious women (23% of respondents) were unpartnered and robust women (16% of respondents) were partnered. The robust class had the highest physical and psychological well-being, and best social relations across all classes.
CONCLUSIONS: Using nationally representative data, we reveal significant heterogeneity in Black women\'s aging experiences. Although many face difficult aging experiences, 39% of older Black women fit the SA framework well. Future work should recognize that Black women\'s aging experiences are not homogenous.

OBJECTIVE: The aging experiences of military veterans provide critical insights into what successful aging is and means for later life contexts constrained by distinct health and social needs. Can veterans \'successfully\' age when they are exposed to so many stressors with serious health and social consequences for later life? Veterans can offer valuable lessons for developing comprehensive approaches to refining successful aging, ensuring inclusivity of different older populations. Building on Rowe and Kahn\'s idea of successful aging, we utilize the complementary concept of \'active aging\' to explore if there are unique factors, characteristics, and interventions that support active aging in veterans, compared to non-veteran populations.
METHODS: A rapid review and evidence synthesis was conducted across 9 databases in medicine, psychology, anthropology, sociology, and public health to search for peer-reviewed articles and research reports.
RESULTS: Findings suggest that programs linking health and social dimensions can support the active aging of veterans, namely interventions promoting active physical and cognitive lifestyle as well as social connectedness and engagement. Such programs and interventions help prevent and combat mental and physical health decline and increase quality of life and well-being.
CONCLUSIONS: Findings have implications for veteran and non-veteran populations more broadly, as people can actively age even when they have unique health and social needs.

Computerized cognitive training (CCT) is a rapidly developing area of cognitive rehabilitation at the intersection of information technology and healthcare, the constantly updated results of which can be successfully translated into practical application in clinical medicine and in particular in gerontology. The basis of CCT, as a non-invasive method of influencing the functional activity of the brain and the processes of neuroplasticity, is software for stimulating cognitive functions in order to improve their productivity. The level of scientific and practical interest in CCP technology is growing rapidly. The article reports on the current state of research on the use of CCT aimed at correcting cognitive impairment. The purpose of this work is to systematize the available scientific data in this area, as well as to promote further integration of research in the field of information technology into clinical practice, in particular, to study the potential of CCT as a promising therapeutic tool in the paradigm of successful aging and prevention of the progression of cognitive impairment. This noninvasive intervention may improve global cognitive function in patients with clinically defined impairments and during normal aging in cognitively healthy older adults. However, new studies with fully comparable protocols are needed to evaluate in more detail the duration of the effect and the effectiveness of CCT in preventing cognitive decline in the long term.
Компьютеризированный когнитивный тренинг (ККТ) представляет собой быстро развивающееся направление когнитивной реабилитации на пересечении информационных технологий и здравоохранения, постоянно обновляемые результаты которого возможно с успехом транслировать в сферу практического применения в клинической медицине и, в частности, в геронтологии. Основу ККT, как неинвазивного метода воздействия на функциональную активность мозга и процессы нейропластичности, составляет программное обеспечение для стимуляции когнитивных функций с целью улучшения их продуктивности. Научный и практический интерес к технологии ККТ растет быстрыми темпами, и в определенной степени он даже больше, чем к некоторым другим областям реабилитации, ориентированным на здоровое старение. В статье сообщается о современном состоянии исследований применения ККТ, направленного на коррекцию когнитивных нарушений. Цель настоящей работы — не только систематизировать имеющиеся научные данные в этой области, но также способствовать дальнейшей интеграции быстро развивающихся исследований в области информационных технологий в клиническую практику. В частности, необходимо изучить потенциал ККТ как перспективного терапевтического инструмента в парадигме успешного старения и профилактики прогрессирования когнитивных нарушений. Проведенный анализ показывает, что такое вмешательство может улучшить глобальные когнитивные функции у пациентов с клинически установленными нарушениями и в процессе нормального старения у когнитивно-здоровых людей пожилого возраста. Однако необходимы новые исследования с максимально сопоставимыми протоколами, чтобы более детально оценить длительность эффекта и результативность ККТ для предотвращения снижения когнитивных функций в долгосрочной перспективе.

This study aims to determine the prevalence of successful aging (SA) and examine the association of changes in the indicators of SA and variations in SA status between 2016 and 2020. The study included 548 participants recruited for the Korean Frailty and Aging Cohort Study (KFACS). Compared to participants who achieved SA in 2016 (N = 393, 71.7%), the number of older adults with SA decreased by 7.8% in 2020. Among older adults preserving SA (SA→SA group, 54%), there were relatively small numbers of older adults who successfully maintained indicators, including chronic diseases (no→no, 9.5%), employment (yes→yes, 12.2%), and volunteer activities (yes→yes, 2.9%). Our findings suggest that interventions to strengthen the physical and psychological function of older adults are needed, and social support needs to be guaranteed to improve social engagement for older adults.

OBJECTIVE: Successful aging is a mainstay of the gerontological literature, but it is not without criticism, including the often-limited way that it is studied and measured as well as the exclusion of older adults\' voices in its formulation and understanding. This study sought to address these issues through a qualitative investigation across multiple countries.
METHODS: This was a mixed-methods, cross-sectional, exploratory study, using an online survey. Nations that received the survey included Australia, New Zealand, the United Kingdom, Ireland, Canada, and the Unites States. Participants aged 65 and older were asked to describe what successful aging means to them in an open-ended survey item. Summative content analysis was utilized to examine the responses.
RESULTS: Successful aging was defined by 1,994 participants, and six themes along with 20 subthemes were found. In contrast to conception that successful aging is solely or predominantly related to the absence of disease and decline, the most prominent theme in this study was \"active, independent, and engaged\" as the hallmark of success.
CONCLUSIONS: While health and health maintenance were present in other themes, these findings support a multidimensional definition of successful aging that promotes the perspectives of older people. Future research should seek to further investigate the ways in which person-in-environment factors influence definitions of successful aging, including culture, gender and gender identity, race and ethnicity, and socioeconomic background.

OBJECTIVE: For the first time in human history, older adults will outnumber children and a substantial and growing proportion will live alone and lack one or more nuclear family tie. Such unprecedented shifts require a reevaluation of existing models of \"successful aging\", particularly in terms of long-term care policies.
METHODS: This paper draws on country-level data from multiple publicly available sources (e.g., World Bank, Organization for Economic Cooperation and Development, Our World in Data, and the World Values Survey) to examine cross-national patterns of development, health, demography, resources and policies, and cultural values in low-, middle-, and high-income countries.
RESULTS: Although there exists substantial heterogeneity across countries, country-level patterns illustrate the economic privilege of living alone and the dominance of \"successful aging\" opportunities in high income countries. Cultural values about family reflect standard patterns of economic development, yet friendship emerges as a particularly consistent global value. At the country-level, living alone and health are associated in higher income countries with lower within-country inequality.
CONCLUSIONS: Aging \"alone\" is a risk factor in some contexts, yet a marker of privilege in others. Models of \"successful aging\" are largely unobtainable in lower income countries or high inequality countries, and therefore require a thorough incorporation of global realities, or final abandonment in favor of more nuanced structural perspectives. Long-term care policies that assume the presence of family will yield increasing risk over time across all global contexts and represent a key vulnerability in the future of healthy aging policy.

Comorbidities due to aging and the COVID-19 pandemic together are expected to cause death anxiety among older adults. This study aimed to assess the prevalence of death anxiety and its impact on psychological well-being and successful aging of older adults with chronic illness. A cross-sectional correlational survey was conducted on 79 older adults with chronic illness, drawn with a stratified random sampling method. Self-report measures were used to assess death anxiety, psychological well-being, and successful aging. A high prevalence of death anxiety was reported among older adults. Psychological well-being and successful aging in these older adults were significantly and negatively associated with death anxiety. Further, death anxiety showed substantial predictive valence for psychological well-being and successful aging of older adults with chronic illness. Findings strongly advocate and call for timely intervention programs for chronically ill older adults to reduce their death anxiety for enhanced psychological well-being and promote successful aging.

OBJECTIVE: To investigate the determinants of resilience phenotype in aging, operationalized as the maintenance of cognitive, physical, and psychological health in very old individuals (80+), we investigated the structure and interrelated impact of the main resilience-enhancing factors, which are usually studied in separate research fields.
METHODS: Participants were older adults without dementia recruited for the fifth wave of the InveCe.Ab population-based cohort study (aged 83-87 years). Multidimensional evaluation comprised blood sampling, social and lifestyle survey, geriatric and neuropsychological assessment. We classified resilient individuals as displaying normal cognition, functional independence, and mental health. First, we performed exploratory factor analysis (EFA) to examine the underlying structure of the relevant cognitive, lifestyle, physical, and psychological resilience-enhancing factors. The factors obtained were included as predictors of the resilience phenotype in the logistic regression model, controlling for sociodemographic and cumulative exposure to physical and psychosocial stressors, including COVID-19 infection.
RESULTS: Among the 404 enrolled participants, 153 (38%) exhibited the resilience phenotype. EFA resulted in the identification of 6 factors (59% of variance): cognitive reserve, affective reserve, insecure attachment, current lifestyle, physical reserve, and avoidant attachment. Among these factors, cognitive reserve, affective reserve, and current lifestyle significantly and independently predicted resilience status, controlling for cumulative exposure to age-related stressors and COVID-19 infection.
CONCLUSIONS: Our findings showed that, even in very old age, both early and late life modifiable factors affect individuals\' ability to adapt to the aging process, thus confirming the importance of a life-course approach to improve health outcomes in the aged population.

Successful cognitive aging is often thought to result from resistance to the accumulation of pathology, resilience to the effects of pathological accumulation, or some combination of the two. While evidence for resilience has been found in typical aging populations, the oldest-old provide us with a unique window into the role of pathological accumulation in impacting cognition. Here, we aimed to assess group differences in measures of amyloid and tau across older age groups using data from the Alzheimer\'s Disease Neuroimaging Initiative (ADNI age: 60-89) and The 90+ Study (age: 90-101). Additionally, using the ADNI dataset, we performed exploratory analyses of regional cingulate AV-45 SUVRs to assess if amyloid load in particular areas was associated with Top Cognitive Performance (TCP). Consistent with the literature, results showed no group differences in amyloid SUVRs both regionally and in the whole cortex. For tau with AV-1451, we also observed no differences in Braak composite SUVRs. Interestingly, these relationships persisted in the oldest-old. This indicates that Top Cognitive Performance throughout aging does not reflect resistance to amyloid and tau burden, but that other mechanisms may be associated with protection against amyloid and tau related neurodegeneration.

Understanding the relationship between functional connectivity (FC) of higher-order neurocognitive networks and age-related cognitive decline is a complex and evolving field of research. Decreases in FC have been associated with cognitive decline in persons with Alzheimer\'s disease and related dementias (ADRD). However, the contributions of FC have been less straightforward in typical cognitive aging. Some investigations suggest relatively robust FC within neurocognitive networks differentiates unusually successful cognitive aging from average aging, while others do not. Methodologic limitations in data processing and varying definitions of \'successful aging\' may have contributed to the inconsistent results to date. The current study seeks to address previous limitations by optimized MRI methods to examine FC in the well-established SuperAging phenotype, defined by age and cognitive performance as individuals 80 and older with episodic memory performance equal to or better than 50-to-60-year-olds. Within- and between-network FC of large-scale neurocognitive networks were compared between 24 SuperAgers and 16 cognitively average older-aged control (OACs) with stable cognitive profiles using resting-state functional MRI (rs-fMRI) from a single visit. Group classification was determined based on measures of episodic memory, executive functioning, verbal fluency and picture naming. Inclusion criteria required stable cognitive status across two visits. First, we investigated the FC within and between seven resting-state networks from a common atlas parcellation. A separate index of network segregation was also compared between groups. Second, we investigated the FC between six subcomponents of the default mode network (DMN), the neurocognitive network commonly associated with memory performance and disrupted in persons with ADRD. For each analysis, FCs were compared across groups using two-sample independent t-tests and corrected for multiple comparisons. There were no significant between-group differences in demographic characteristics including age, sex and education. At the group-level, within-network FC, between-network FC, and segregation measurements of seven large-scale networks, including subcomponents of the DMN, were not a primary differentiator between cognitively average aging and SuperAging phenotypes. Thus, FC within or between large-scale networks does not appear to be a primary driver of the exceptional memory performance observed in SuperAgers. These results have relevance for differentiating the role of FC changes associated with cognitive aging from those associated with ADRD.