Life satisfaction in older people

Objective:   Factors influencing life satisfaction were studied in a cohort study.
Methods:   Life satisfaction was measured using the Philadelphia Geriatric Center (PGC) morale scale. Two thousand one hundred and fifty-one older people, approximately 99% of all older people (2165 subjects) in a rural town, Tashiro, Akita prefecture responded to the questionnaire and, after eliminating 455 for incomplete answers, 1710 subjects (79% of all older people) were entered into the present study. Approximately 10% were self-care dependent older people.
Results:   Female self-care independent older people showed lower morale scores than men. Morale scores in self-care independent older people decreased with age in both women and men. Morale scores of self-care independent men were higher when they were healthy, had an occupation and took part in social activities in the community; morale scores of self-care independent women were higher when they were healthy and had hobbies. Family composition, self-care dependency, income and habits for health promotion were also factors of morale scores, while education was not.
Conclusions:   Healthy older persons with some gender specific lifestyles had the higher morale scores. With advanced age, lifestyles do not determine the morale scores.     

Dispositional hope and life satisfaction among older adults attending lifelong learning programs

BackgroundThe aim of this study is to explore the indirect effects of dispositional hope in the life satisfaction of older adults attending a lifelong learning program at the University of Valencia, Spain. We examine the mediating impact of dispositional hope regarding its ability to impact life satisfaction while considering affective and confidant social support, perceived health and leisure activities, consciousness and spirituality as predictors.MethodsAnalysis were based on survey data (response rate 77.4%) provided by 737 adults 55 years old or more (Mean age = 65.41, SD = 6.60; 69% woman). A structural model with latent variables was specified and estimated in Mplus.ResultsThe results show the ability of just a few variables to sum up a reasonable model to apply to successful aging population. All these variables are correlated and significantly predict hope with the exception of health. The model additionally includes significant positive indirect effects from spirituality, affective support and consciousness on satisfaction. The model has a good fit in terms of both the measurement and structural model. Regarding predictive power, these comprehensive four main areas of successful aging account for 42% of hope and finally for one third of the life satisfaction variance.ConclusionsResults support the mediating role of dispositional hope on the life satisfaction among older adults attending lifelong learning programs. These findings also support the MacArthur model of successful aging adapted to older adults with high levels of functional, social and cognitive ability. Dispositional hope, perceived health, and social support were the strongest predictors of satisfaction with life.     

Life satisfaction of older people in six European countries: findings from the European Study on Adult Well-Being

The European Study on Adult Well-being (ESAW), funded by the European Union, was conducted during 2002 and 2003 in Austria, Italy, Luxembourg, The Netherlands, United Kingdom and Sweden. The aim of the interdisciplinary study was the conceptual clarification and the identification of factors contributing to life satisfaction for older people. Five key components were included in the study: (1) physical health and functional status; (2) self-resources; (3) material security; (4) social support resources; and (5) life activity. A representative population of adults aged 50–90 years living independently (not institutionalised) was selected in each participating country, and the actual sample size came very close to the target of 2,000, ranging from 1,854 to 2,417. The total European sample comprised 12,478 respondents. In this paper, mean differences in general and domain-specific life satisfaction between the six countries including age groups and gender are reported and discussed with respect to contextual national characteristics. In general the findings showed a high level in all chosen indicators of life satisfaction across the six countries. National differences depended on the domain under consideration, but the results showed in general that The Netherlands, United Kingdom, Luxembourg and Austria had higher values of life satisfaction compared to Sweden and Italy.     

Correlates of loneliness in older persons living with HIV

ABSTRACT

Loneliness poses a significant risk for morbidity and mortality in the context of older adulthood. Research shows that older persons living with HIV (PLWH) often face increased and complex vulnerability in terms of physical and psychosocial needs which may promote loneliness. The current study sought to identify correlates of loneliness in a sample of 146 older PLWH (age ≥50) recruited from an outpatient HIV clinic in Atlanta, GA. Participants completed a survey on loneliness, depression, HIV-related stigma, social network size, HIV-disclosure status, disease burden, and demographics. HIV biomarkers were abstracted from electronic medical records. Participants were predominantly male (60%) and African American (86%). Twelve percent (n?=?17) reported past homelessness/unstable housing. Multivariable modeling revealed that depression and HIV-related stigma explained 41% of the variance in loneliness, above and beyond the effects of past homelessness/unstable housing and disease burden (R ^2?=?0.41, F(7, 138)?=?13.76, p?<?.001). Findings suggest that targeting HIV-related stigma and depression may reduce loneliness in older PLWH, but more studies are needed to elucidate causal pathways. A greater understanding of the mechanisms by which loneliness affects health among older PLWH could help better inform efforts to improve health in this patient population.     

Life satisfaction among Chinese elderly in Beijing

The present study examined correlates of life satisfaction among 350 Chinese elderly aged 65 or older. Subjects consisted of a clinic sample (n = 200) and a randomly selected community sample (n = 150) recruited from the same area in Beijing. Linear regression analysis was performed, using health, financial status, and family support as independent variables. Results showed that the regression model explained 38 percent of the variance in life satisfaction in the total sample, 34 percent and 43 percent of the variance respectively in the clinical and community samples. Life satisfaction was significantly predicted by health and financial status among community elderly and by health, financial status, as well as family support among outpatient elderly. Findings suggest that the socio-cultural context has exerted important impacts on the Chinese elderly's life satisfaction.     

Association between higher levels of sexual function, activity, and satisfaction and self-rated successful aging in older postmenopausal women

OBJECTIVES: To determine whether measures of successful aging are associated with sexual activity, satisfaction, and function in older postmenopausal women. DESIGN: Cross‐sectional study using self‐report surveys; analyses included chi‐square and t‐tests and multiple linear regression analyses. SETTING: Community‐dwelling older postmenopausal women in the greater San Diego region. PARTICIPANTS: One thousand two hundred thirty‐five community‐dwelling women aged 60 to 89 participating at the San Diego site of the Women's Health Initiative. MEASUREMENTS: Demographic information and self‐reported measures of sexual activity, function, and satisfaction and successful aging. RESULTS: Sexual activity and functioning (desire, arousal, vaginal tightness, use of lubricants, and ability to climax) were negatively associated with age, as were physical and mental health. In contrast, sexual satisfaction and self‐rated successful aging and quality of life remained unchanged across age groups. Successful aging measures were positively associated with sexual measures, especially self‐rated quality of life and sexual satisfaction. CONCLUSION: Self‐rated successful aging, quality of life, and sexual satisfaction appear to be stable in the face of declines in physical health, some cognitive abilities, and sexual activity and function and positively associated with each other from age 60 to 89.     

Postoperative incision scars and cosmetic satisfaction of living liver donors

Cosmetic appearance is a major concern for living donors. However, little is known about the impact of a surgical scar on body image changes in living liver donors. The aim of this study was to identify potential factors that cause displeasing upper midline incision scar, and to evaluate the overall satisfaction regarding body image and scarring after living donor hepatectomy.Donors who underwent right lobe hepatectomy were recruited. Exclusion criteria included reoperation, refusal to participate, and lost follow-up. All donors were invited to complete the Vancouver Scar Scale (VSS) and the body image questionnaire. According to the VSS results of upper midline incision scar, donors were divided into 2 groups: good scarring group (VSS ≤4) and bad scarring group (VSS >4). we compared the clinical outcomes, including the demographics, preoperation, intraoperation, and postoperation variables. The study also analyzed the results of the body image questionnaire.The proportion of male donors was 48.9%. The bad scarring group consisted of 63% of the donors. On multivariate analysis, being a male donor was found to be an independent predictor of a cosmetically displeasing upper midline incision scar with statistical significance. The results of body image questionnaires, there were significant differences in cosmetic score and confidence score among the 2 groups.The upper midline incision and male donors have higher rates of scarring in comparison with the transverse incision and female donors. Donors who reported having a higher satisfaction with their scar appearance usually had more self-confidence. However, the body image won’t be affected. Medical staff should encourage donors to take active participation in wound care and continuously observe the impact of surgical scars on psychological changes in living liver donors.     

Global sleep satisfaction of older people: the Jerusalem Cohort Study

OBJECTIVES: To describe the nature of global sleep satisfaction (GSS) of older people and the factors associated with it. DESIGN: A 7-year follow-up of an age-homogenous cohort. SETTING: Community based. PARTICIPANTS: Two hundred ninety subjects aged 70 at baseline and 77 at follow-up. MEASUREMENTS: Self-reported sleep domains and a comprehensive assessment of health variables, including psychosocial, physical, and functional factors, at ages 70 and 77. RESULTS: GSS was found to be poor in 25% of subjects at ages 70 and 77, with an estimated average annual remission rate of 7% and an annual incidence of 2.4%. Poor GSS at ages 70 and 77 was significantly associated with difficulty falling asleep, awakening feeling tired, two or more nocturnal awakenings, and taking sleeping tablets. Significant cross-sectional associations were found at age 70 and 77 between poor GSS and poor self-rated health, general fatigue, depression, dependence in one or more activities of daily living, and low level of physical activity. In a regression analysis, risk factors at age 70 for subsequent poor GSS were loneliness, depression, poor self-rated health, economic difficulties, back pain, obesity, and prior poor GSS. The only significant long-term association was between poor GSS and poor self-rated health. GSS did not influence mortality data. CONCLUSION: Poor GSS in older people is common and chronic. Its chief determinants are loneliness, depression, poor self-rated health, economic difficulties, back pain, and obesity. It predicts poor self-rated health but not increased mortality.     

Anemia and recovery from disability in activities of daily living in hospitalized older persons

OBJECTIVES: To evaluate the predictive value of hemoglobin levels upon hospital admission on recovery from activity of daily living (ADL) disability during hospital stay in older patients. DESIGN: Longitudinal observational study. SETTING: Geriatric and internal medicine acute care units. PARTICIPANTS: Data are from 5,675 patients aged 65 and older enrolled in the Italian Group of Pharmacoepidemiology in the Elderly Study with ADL disability upon hospital admission. MEASUREMENTS: ADL disability was defined as inability to perform or need for assistance in performing one or more ADLs. Recovery from ADL disability was defined as independence in ADLs upon hospital discharge. Anemia was defined according to the World Health Organization criteria. Sociodemographic and clinical characteristics were considered as potential confounders. RESULTS: Mean age was 80.5 years; 57.7% of subjects were female. Prevalence of anemia was 46.8%. A total of 536 (9.4%) participants regained independence in all six ADLs at hospital discharge. Patients with anemia had a lower rate of recovery from ADL disability than those with normal hemoglobin levels (7.0% vs 11.6%; P<.001). Adjusted analyses confirmed that anemia was inversely associated with the likelihood of ADL recovery (odds ratio=0.71, 95% confidence interval=0.57-0.88). The probability of ADL recovery in anemic patients was higher at higher hemoglobin concentrations. CONCLUSION: In older hospitalized patients, anemia is inversely associated with the likelihood of regaining ADL independence during a hospital stay.     

Factors associated with social deprivation among older persons living with HIV

Aging persons living with HIV may develop multiple health problems, including comorbidities, and altered physical and mental health, earlier than non-infected people. They may also experience social deprivation. We assessed the prevalence of social deprivation and its relationship with health indicators in older persons living with HIV. An 18-month, multicenter, cross-sectional study was carried out between 2013 and 2014 focusing on patients ≥50-years of age followed-up in 12 dedicated HIV medical hospital units located in the South of France and involved the VISAGE study group. Social deprivation was measured with the EPICES (Evaluation of Deprivation and Inequalities in Health Examination Centers) score (ES) and defined as ES ≥30.17. The following data were recorded: health indicators (gender, age, body mass index), comorbidities, frailty markers, socioeconomic, behavioral and age-related variables. Among 509 patients recruited, 494 completed the ES social deprivation evaluation. Mean age was 58.5?±?7.0 years and 72.9% were male. The prevalence of social deprivation was 49.0%. Multivariable logistic regression analysis showed that higher social deprivation was significantly linked to alcohol consumption (OR?=?4.07 [95%CI: 1.23–13.48]), risk of depression (OR?=?3.59 [95%CI: 2.26–5.70]), chronic obstructive pulmonary disease (OR?=?3.10 [95%CI: 1.36–7.09]), hepatitis C (OR?=?1.96 [95%CI: 1.10–3.52]), and chronic pain (OR?=?1.11 [95%CI: 1.01–1.21]). Social deprivation was not related to HIV status. Our study showed that not only did older patients with HIV suffer from social deprivation, but they also received little support from social workers. Physicians should be aware of this situation and should systematically evaluate social deprivation in order to provide comprehensive targeted care involving global, social, and psychological support to reduce the burden of social deprivation.     

Age,stress, and isolation in older adults living with HIV

People living with HIV (PLWH) have increasingly longer life spans. This age group faces different challenges than younger PLWH, which may include increased stress and social isolation. The purpose of this study was to determine whether the age and sex of PLWH are associated with measures of physiologic stress, perceived stress, and social isolation. In this cross-sectional study, we enrolled 102 PLWH equally into four groups divided by age (younger or older than 50 years) and gender. Participants completed well-validated survey measurements of stress and isolation, and their heart rate variability over 60 minutes was measured by Holter monitor. The mean (SD) Perceived Stress Scale score was 17.4 (6.94), mean Visual Analog Stress Scale score was 3.51 (2.79), and mean Hawthorne Friendship Scale score, a measure of social isolation, was 17.03 (4.84). Mean heart rate variability expressed as the SD of successive N–N intervals was 65.47 (31.16) msec. In multivariable regression models that controlled for selected demographic variables, there was no relationship between the Perceived Stress Scale and age (coefficient = ?0.09, p =?0.23) or female gender (coefficient = ?0.12, p = 0.93); however, there was a modest relationship between female gender and stress using the Visual Analog Stress Scale (coefficient = 1.24, p = 0.05). Perceived Stress was negatively associated with the Hawthorne Friendship score (coefficient = ?0.34, p = 0.05). Hawthorne Friendship score was positively associated with younger age (coefficient = 0.11, p = 0.02). Age was the only independent predictor of physiologic stress as measured by heart rate variability (coefficient = ?1.3, p < 0.01). Our findings suggest that younger PLWH may experience more social isolation; however, age-related changes in heart rate variability do not appear to be related to perceived stress or social isolation. Future longitudinal research is required to more thoroughly understand this relationship and its impact on the health of PLWH.     

Oxidative stress is associated with greater mortality in older women living in the community

OBJECTIVES: To determine whether oxidative stress, as implied by oxidative damage to proteins, is associated with greater mortality in older women living in the community. DESIGN: Longitudinal. SETTING: Women's Health and Aging Study I, Baltimore, Maryland. PARTICIPANTS: Seven hundred forty-six moderately to severely disabled women, aged 65 and older, with baseline measures of serum protein carbonyls. MEASUREMENTS: Serum protein carbonyls, which consist of chemically stable aldehyde and ketone groups produced on protein side chains when they are oxidized, were measured using enzyme-linked immunosorbent assay. Multivariate logistic regression was used to adjust for potential confounders. RESULTS: During 5 years of follow-up, 202 (27.1%) participants died. Geometric mean serum protein carbonyls were 0.091 nmol/mg in women who died and 0.083 nmol/mg in those who survived (P=.02). Log(e) protein carbonyls (nmol/mg) were associated with greater risk of mortality (hazards ratio=1.34, 95% confidence interval=1.01-1.79, P=.04) in a multivariate Cox proportional hazards model adjusting for age, current smoking, and body mass index. CONCLUSION: Greater oxidative stress, as indicated by elevated serum protein carbonyl concentrations, was associated with greater risk of death in older women living in the community who were moderately to severely disabled. Prevention of oxidative stress may reduce the risk of mortality.     

Assessing resident satisfaction and its relationship to staff satisfaction in residential aged care

Objective: To describe a method for assessing the views of residents in aged care facilities and present the results of modelling the relationships between resident satisfaction and factors related to the staff, the residents and the facilities. Methods: The first stage involved focus groups and interviews with over 400 residents, with staff and management, and consultations with relevant groups. The self‐complete resident satisfaction instrument developed was then administered, in conjunction with other instruments, in a total of 70 aged care facilities. Results: Whilst satisfaction with staff care was found to have a significant positive impact on all aspects of resident satisfaction, staff satisfaction was found to have more influence on resident satisfaction than actual care hours provided, adjusting for resident dependency. Conclusion: Increasing the satisfaction of residents in aged care facilities appears to be particularly related to attending to the factors which influence staff satisfaction, such as status and pay.