I May Be Frail But I Ain’t No Failure

The terms “successful aging” and “the frail elderly” are now commonly used in aging research, but biomedical researchers may be unaware of the possible unintended negative consequences of their use. A commonly used operational definition of successful aging (high cognitive and physical function, low probability of disease, and active engagement with life) reflects values not necessarily shared by other cultures or even by older persons in our own culture. Other definitions for “a good old age” have been proposed. The adjective “successful” implies that those who do not meet its definition are unsuccessful or a failure. Labels such as “frail” predispose the person described to the phenomenon of identity spread, whereby the label becomes the master identity. Labels encourage us to regard someone as “other”. Yet only 10–15% of us will die without a significant period of disability. Research has demonstrated that older persons internalize stereotypes of aging, which can have important short- and long-term effects. The language and theories of social scientists can be poorly understood by those outside of their field, yet biomedical clinicians and researchers should be aware of this literature so that unnecessary suffering is not unintentionally inflicted on our patients and our future selves.