Aging, which is generally accepted as an inevitable state of organ and tissue declines, and one frequently associated with one or more chronic health conditions, commonly induces feelings of anxiety, depression, fear and beliefs in limitations, rather than perceptions of confidence and control in many older adults. However, the idea that one can still not only engage early on in life in health protective behaviors, but can actively pursue the idea of aging ‘successfully’ or a state where life quality, autonomy, self-efficacy, and feeling purposeful can be maintained, improved or optimized appears to be gaining support. Indeed, a considerable body of psychology as well as medical research has examined and tested not only whether thoughts can be changed, especially among older adults, often believed to hold intractable views, but whether those who are more optimistic than not can experience more rather than less healthful aging states, including a better coping capacity, and a reduction in perceived stress and stressors.

Given the growing need for health providers to assist older adults to avoid preventable illnesses and to enable them to cope effectively with chronic illnesses, and find meaning and purpose in life, which are positive features of ‘successful aging’, it appears there is some merit to examining if a focus on positive aspects of their experiences, rather than the negative or unchangeable issues will be more helpful than not. In particular, and in light of the severe impact of excessive reactive anxiety and depression on overall motivation, as well as health seeking, autonomy, self-perceptions, adherence, and ultimately on physical health, overcoming or mitigating remediable factors underpinning depression and anxiety appears highly desirable 1. Moreover, psychological strategies that can improve one’s ability to foster a state of resilience, rather than a negative downward spiraling state of health and well-being 2 may have immense health implications for both the aging adult, as well as the practitioner.

In this regard, this mini review elected to selectively focus on establishing if there is some evidence to support the view that one or more possible benefits are likely to be evidenced in response to persistent active efforts to apply strategies that engender positive thoughts as opposed to the sole use of pharmacologic approaches to alleviate age associated negative mental health states. While other modes of intervention such as cognitive behavioral therapy or group therapy, or community based education may be helpful in this respect 3, it is possible that some cases of severe chronic mood conditions need to be overcome first by more direct interventions such as those produced by a change or modification of the individual’s thought processes at the outset. In other cases, travel, service, and mobility restrictions should not impede the application of efforts to foster optimally successful aging. Since quality of life may be severely jeopardized by chronic mood disorders, as well as associated with emergent cognitive challenges such as anxiety, sadness, and sorrow that emerge with age, and that these emotional states may be prevented, attenuated or reversed, it was believed line of inquiry would prove fruitful to examine.

Indeed, this idea is not novel, and has been proposed for some time by Seligman 4 and others. In addition, the idea does not only pertain to cognitively alert older adults, as is sometimes believed. Evidence concerning one European research initiative for example, illustrates the progressive awareness of the benefit of such non-pharmacological approaches in the prevention of dementia and the relevance of taking into account the psycho-affective dimension in endeavoring to improve mental health and well-being of older adults 5. Benefits are also not dependent on the presence of complete physical or cognitive health attributes as shown by van Leeuwen et al. 6. In many cases, cognitive based attributes such as feeling proud, feeling valuable, feeling positive, making the best out of life, being able to accept unchangeable situations, having peace of mind, feeling happy, and having faith are some favorable attributes that can be employed to alter or nullify or counter balance one or more associated negative emotional or reactive responses, despite any prevailing harsh realities.

In light of the importance of achieving optimal health for all, and enhancing wellness opportunities for older populations, this mini review sought to establish, if in an age of high uncertainty and enormous post COVID-19 health and economic challenges, whether the application of positive psychology is plausible, and if so, whether this approach can help to mitigate some of the excess health burden that is being evidenced among the elderly in all parts of the post pandemic globe environments.

A parallel aim was to establish whether the attributes of resilience, autonomy, acceptance, the ability to cope to achieve personally valued goals, and perceived self-efficacy for coping with life are likely to be strengthened through the application of one or more positive psychology approaches, regardless of the older adult’s physical health and socioeconomic status.

By 2030, the numbers of older adults in the United States and elsewhere will soar. However, not all will age successfully, even if they have no distinctive co-morbid health condition. On the other hand, this rapidly increasing number of older adults will probably have high rates of chronic diseases, which may be barriers to the achievement of a fully functional life, even though this is not evidenced by some. However, without some tools that can be applied universally, at low cost, and with no side effects, the principle and vision of ‘successful aging’ for all is likely to fail. Approaches that look at the glass as half full, plus those that heighten acceptance and self-image, and perceived control are likely to be more advantageous than not in this regard in our view.

To examine the aforementioned premises, we attempted to locate salient data housed on PUBMED, PsycINFO, Medline (Ebsco), Web of Science, and GOOGLE SCHOLAR using the key terms, Positive Psychology and Healthy/Successful Aging. All modes of publication were deemed acceptable in this regard if they addressed one or more of the topics of interest noted above in some way and there were no yearly or methodological restrictions. The most salient articles, book chapters, or books, related to the current theme were duly downloaded and examined and those deemed noteworthy are highlighted here in narrative form. All modes of application employed in the various research studies were accepted as valid, as were all definitions of anxiety and depression and positive psychology. Moreover, since the article was designed to serve as a general one to introduce the topic, rather than a systematic review, it did not consider any of the currently reported research endeavors in depth, but rather the goals was to present a snapshot of the prevailing trends in this realm and the potential of this modality for clinical purposes.

The term positive psychology was largely employed to examine interventions, treatment methods or intentional activities aimed at cultivating positive feelings, positive behaviors, or positive cognitions believed to enhance well-being and ameliorate depressive symptoms 7 as opposed to the hypothesized negative scenario depicted in Figure 1 below.

While aging is inevitable, increasing evidence suggests aging as a negative state does not have to be a foregone ordained experience of downward spiraling events and perceptions. This review explored the degree to which positive psychology a broad term applied to encompass approaches that draw on positive thoughts and beliefs regardless of negative situations can serve as a primary as well as a secondary and tertiary preventive tool in the context of efforts to attain a state of successful aging as discussed by Pandey and Garb 63. As such, evidence appears to imply that regardless of age and health condition, a more positive outlook involving active efforts on behalf of the aging adulthas a sufficiently strong bearing on their ability to attain an optimally healthy aging state, high energy levels, overall satisfaction, and motivation. In this regard, one or more positive thoughts applied on a regular basis may help to improve overall mental and physical health attributes, while mitigating damage attributable to persistent unrelenting or adverse negative/stressful health situations and others 63. Since this is an important goal of many practitioners as well as aging adults themselves, fostering older adults to adopt a positive frame of mind as far as possible is likely to foster greater overall life satisfaction and productivity than not 4664. Moreover, those who ‘feel good’, will tend to have higher health benefits all factors considered, when compared to those who focus solely on negative emotions 65.

In sum, as discussed by Araujo et al.66 the study of aging through the lens of positive psychology as proposed initially by Seligman 4 appears to allow both the practitioner or provider, as well as the client, to look beyond the decline normally associated with advancing age and to consider rewarding experiences and strategies that can help to promote a meaningful aging state, rather than one of despair, distress, despondency, and mood disorders. Moreover, addressed sooner rather than later, early interventions may not only help to ably preserve an optimal mental health status and well-being among aging adults, but may extend longevity 6768, enhance compassion 69 along with increased feelings of love, closeness, or trust, while reducing negative feelings of stress, nervousness, and being overwhelmed, a finding also supported by Hodgetts et al. 70 and Barton et al 71. Smith et al. 72 note that among older adults, a greater ability to savor positive experiences and higher resilience also predicted greater happiness, lower depression, and greater life satisfaction. Indeed, research shows that positive psychology offers a fertile ground for exploration and application, but that even a small change in one dimension affecting life quality positively might have a considerable impact on others that can foster health vicariously speaking 6.

That is, rather than focusing on the older person's weaknesses or future anticipated weaknesses, for example, frailty, depression, anxiety, or fears, activating their strengths and reserve capacities 3 by harnessing one or more attributes of positive psychology, an umbrella term for the application of various positive emotions, appears to be a highly promising complementary approach to advancing the idea of ‘successful aging’. A growing number of well controlled studies imply positive psychology as a global strategy does tend to produce favorable measureable outcomes in multiple spheres, including important psychological, physical, and cognitive spheres of well-being 73. Indeed, altering an older adult’s health beliefs and stance from a maladaptive reactive one in the face of their aging challenges, to a more strengths and asset based adaptive stance, may markedly help them to counter any aging related fears, anxieties, and negative beliefs. Older adults pursuing these varied positively oriented approaches may also be expected to experience less stress, a more productive, creative, meaningful aging process, and a happier healthier one. Moreover, applied in a customized way, elder depression and death associated anxiety may decline, while longevity may increase, as may the older adult’s ability to cope effectively with new stressors and/or unanticipated events, for example COVID-19 pandemic lockdowns and isolation 19. Continual efforts to consider these current ideas both in practice as well as well as broadening the scope and nature of the research to include mixed methods case and single sample study designs may provide even further insights into this potential for positive thoughts and actions to advance optimal health, even late in life, and in the face of multiple health challenges, that may otherwise be overlooked in the context of either controlled trials, or systematic analyses or both. More diverse, as well as longitudinal examination of the impact of early life adoption of positive perspectives and which approaches can be applied most successfully also warrants careful study of this perspective in light of the current burden experienced by most aging cognitive adults, in a world where change is the normal, but interventions to preserve calm and dignity, and foster resilience that might be harnessed are few. These include but are not limited to. Box 1

The application of positive psychology attributes offers a highly promising, safe, and potentially efficacious cost-effective approach for promoting health protection efforts and for harmonizing the negative and aversive complications of aging.

Applied alone, or in combination with other approaches, implied benefits of positive psychology approaches, include greater joy, contentment, and life quality, regardless of aging.

To be effective, an empathetic and skilled provider, and one who believes in the potential of positive psychology can potentially enable their older clients to achieve more effective states of pain control, heightened longevity, less depression, and dependence. Other outcomes that can be anticipated are enhancements in:

1. Life quality/adaptation

2. Improved relationships

3. Happiness

4. Health status and immunity

5. Life satisfaction

6. Long-term behavioral maintenance/skills for generating them

7. Positive affect increases

8. Possible functional improvements

9. Resilience

10. Retention of dignity and personal identity

11. Stress control

12. Stronger will to live 57304867717277