INTRODUCTION

Since publication of the article Geriatrics by I. L. Nascher, M.D., almost a century ago in The New York Medical Journal, the field continues to evolve in its view of the concept of aging. In 1909, Dr. Nascher coined the word geriatrics from the Greek words geras, old age, and iatrikos, relating to the physician. The field of geriatrics has since explored aging, successful aging, healthy aging, productive aging, usual aging, homeostenosis (the depletion of physiological reserves resulting from aging), frailty, and senescence. For the purposes of this chapter, we will use the word ‘successful’ interchangeably with optimal and healthy. As individuals age, how can the process of aging occur in a manner viewed as successful or healthy continues to be a topic of interest to individuals and cultures alike. The concept of successful aging implies that some age successfully whereas others do not. How one defines successful aging varies greatly by person, physician, and researcher. As Thomas Glass notes, we know little about how older people define successful aging and what they value in the quality of their life and death. Review of the literature on successful aging reveals no clear consensus as to the definition of successful aging. Although different types of aging are denoted, one finds all three descriptors used widely in the literature to represent similar ideas. Now 100 years after Dr. Nascher wrote his article, geriatricians researching this topic typically present a philosophical discussion about the interplay of aging, disease, pathology, and senescence.