How you age is determined by your genetics, your resources, your lifestyle, and, let’s face it, your luck.
With all those variables, most of us can’t expect to age perfectly. But we can age optimally.
Optimal aging means living the best quality life possible given your circumstances, which might include chronic illness, physical limitation, or cognitive decline. Researchers at Washington State University are working on multiple fronts to ease the effect of such limitations on the lives of older adults.
“Most of us are going to need more support as we age, so we’re looking at how we build in those support structures. We don’t want to make people feel they’re a burden for growing older,” says Cory Bolkan, a professor in the Department of Human Development at WSU Vancouver and codirector of the GATHER Lab (Generating Aging & Translational Health Equity Research).
From left: Raven Weaver and Cory Bolkan
(Courtesy Generating Aging and Translational Health Equity Research Lab)
People often assume technology is the golden ticket to optimal aging, and that might be a solution for some. In-home sensors and smartwatch-type wearables, for example, have been studied extensively by WSU research teams. But technology might not work for someone who wants to grow older in their rural home, or who bristles at the privacy implications of continuous monitoring.
Housing for older people, where it’s located and how that affects health status, is critical. WSU researchers have studied the built environment to see how signage, materials, and systems like thermostats contribute to optimal aging. WSU’s Granger Cobb Institute for Senior Living prepares students to manage a spectrum of senior housing options.
WSU teams are also studying ways to enhance brain health. And across programs and colleges, WSU is working to build the workforce of the future that will serve older people.
Population is aging fast
Optimal aging isn’t a theoretical exercise; the population of the United States is older than it has ever been in the past. In 2022, 17.3 percent of Americans were 65 or older. By 2050, that share is expected to reach 23 percent, or another 24 million people.
About two-thirds of those people want to grow older at home, called aging in place. Doing that will almost assuredly require support, though, and most people haven’t thought through what they’ll need or how they’ll get it, Bolkan says.
A 2022 study led by Bolkan and published in the Journal of Elder Policy found most people don’t think they’ll have future medical or other needs. But that’s not what the data shows, she says. About 95 percent of older adults have at least one chronic condition, and 80 percent have at least two. They may need help with yard work, house cleaning and repair, assistive devices, or accessibility changes.
“Many have very loose plans,” Bolkan says about the people interviewed as part of the study. “They say, ‘Oh, my daughter will do it for me,’ but they’ve probably never had a conversation with their daughter and the daughter has no idea.”
Bolkan and coauthor Raven Weaver, an associate professor in the Department of Human Development, both say a little-known resource in optimal aging is the network of Area Agencies on Aging. These are private or public nonprofits located across the nation that connect people with services to help them age in the place of their choosing. Their services are usually free, and programs are federally funded under the Older Americans Act.
“They’re one of the most underutilized, hidden gems of the aging services network,” says Weaver.
Emotional health is as important as physical health
One established fact in optimal aging is that human connection has a powerful effect on health. Studies at WSU and elsewhere have demonstrated links between social isolation and depression and disease.
The human connection even showed up in a study about smart-home sensors, and how they can help people maintain independence. Roschelle Fritz, a longtime associate professor in the WSU College of Nursing, says the study was successful: the sensors detected changes in patterns that were relevant to a person’s overall health, such as using the bathroom more often or not leaving the house for days.
But participants were most grateful for another aspect of the study: access to a nurse. Study participants talked to a nurse once a week or more, and nearly all of them wanted the study to continue for that reason.
“It was clear that ability to talk to a nurse was very meaningful to them,” says Fritz, who recently joined the University of California, Davis, to work on a project targeting healthy aging in a digital world.
Rural areas offer another kind of human connection. The networks of informal caregivers or community relationships are an underappreciated part of rural life for older adults, Weaver says. Those relationships are balanced against perceived rural deficits like a lack of health care services or access to technology.
When it comes to optimal health, people need support for their physical and functional health plus their emotional and spiritual health, Fritz says. “Loneliness is a big deal,” she says, “and there is a lot of it.”
Living space matters
Housing makes a big difference in optimal aging. A house with stairs? A retirement community? An urban area with few trees? All can have profound effects on mental and physical health.
Solmaz Amiri, a research assistant professor at WSU, led a study published earlier this year that shows a connection between living near nature and better physical and mental health among older adults. Even a 10 percent increase in nearby forest space, trees, water, or trails was associated with better health. Amiri says other studies have shown the reverse, that not having access to green spaces might bring a higher risk of health problems.
Solmaz Amiri (Courtesy WSU Health Sciences)
Researchers at WSU’s Integrated Design & Construction Laboratory have interviewed older people about how easy or difficult it is to function inside a home. Someone whose vision is impaired because of macular degeneration or glaucoma, for example, might have a difficult time seeing things on a speckled countertop. And digital controls were challenging to study participants, no matter how sophisticated or basic those controls were, says Shelby Ruiz, research project manager for the lab. Participants talked about signage, lighting, and storage height, and the frustrations that come with all of those.
“Can we build better buildings for and with the people who are going to be in them?” Ruiz says. “I think the answer is yes, but it takes some careful consideration and actually listening to these folks.”
Start by thinking about the future
Changes like how a building is built, or planting trees in a neighborhood, or whether a patient gets to interact with a nurse, are based on policies. But policies don’t always take the needs of older people into account, says Bolkan.
“As a society we tend to devalue aging and older people, and ageism is a huge problem,” she says.
That also shows up in shortages of health care providers and other workers who serve older populations. Those shortages are expected to get worse, not better.
There are no quick fixes as a society.
But as an individual, there is a place to start, and that’s by acknowledging and embracing aging, and planning for it.
Says Bolkan, “If you’re going to age in place, you need to prepare for that. When you buy your home, is that a home you can live in for the next 30 to 40 years? Are there too many stairs? Is there a bathroom on the first floor? Are you thinking about how accessible it is?
“If you can get people to imagine their future selves, they make better choices.”
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