Successful aging: implications for oral health.

The past few years have seen a growing emphasis in gerontology on the concept of "successful" or "robust" aging. This represents a major paradigm shift in the field from a focus on declines in physical and social functioning, assumptions of the aging process as a downward spiral, and studies on how to manage these declines. Leading the way toward this new perspective on aging, the MacArthur Studies of Successful Aging asked the fundamental question: "What genetic, biomedical, behavioral, and social factors are crucial to maintaining health and functional capacities in the later years?" These studies examined longitudinally a large cohort of independent elders on several physical, cognitive, emotional, and social parameters. Other researchers have focused on the theme of robust aging; however, common predictors have emerged, such as remaining active physically and cognitively, maintaining social contacts, and avoiding disease. This research is timely, given the expanding population of the oldest old, and with successive cohorts demonstrating the "compression of morbidity" phenomenon. Such a paradigm shift is critical in geriatric dentistry as well, where successful aging is evident in the growing number of older adults who have retained their natural dentition into advanced old age. This presentation draws parallels between successful aging at the systemic and oral health levels, with illustrations from epidemiologic studies that demonstrate trends in improved health and quality of life among newer cohorts of older adults.