The transition from adulthood to old age is often perceived as a process of loss, physiologically and psychologically (Birren, 1958; Gould, 1972). However, it is as yet unclear just how much of this change is biologically determined and how much is a function of the environment. The ability to sustain a sense of personal control in old age may be greatly influenced by societal factors, and this in turn may affect one's physical well-being.

Typically the life situation does change in old age. There is some loss of roles, norms, and reference groups, events that negatively influence one's perceived competence and feeling of responsibility (Bengston, 1973). Perception of these changes in addition to actual physical decrements may enhance a sense of aging and lower self-esteem (Lehr & Puschner, Note 1). In response to internal developmental changes, the aging individual may come to see himself in a position of lessened mastery relative to the rest of the world, as a passive object manipulated by the environment (Neugarten & Gutman, 1958). Questioning whether these factors can be counteracted, some studies have suggested that more successful aging— measured by decreased mortality, morbidity, and psychological disability—occurs when an individual feels a sense of usefulness and purpose (Bengston, 1973; Butler, 1967; Leaf, 1973; Lieberman, 1965).