Subjective well-being among the rural elderly population

The purpose of this study was to investigate the relationship between psychosocial factors and subjective well-being among rural elderly persons. A broad range of psychosocial factors (such as mastery, social support, and perceived health) and measures of well-being (such as positive and negative affect and life satisfaction) were employed in bivariate correlation, canonical correlation, and multiple regression analysis. The findings show significant relationships between subjective well-being measures and psychosocial factors that are concomitant with other populations, both elderly and general.     

Socio-cognitive skills as a determinant of life satisfaction in aged persons.

The purpose of this study was to explore the viability of a revised model of elderly life satisfaction, specifically evaluating the contribution of socio-cognitive skills. The role of such skills in relation to life satisfaction among aged persons has not been explored in research to date. Pilot data gathered from 60 community-living aged individuals indicated that numerous variables (e.g., subjective/objective health, education, financial satisfaction, role participation, subjective integration) significantly correlated with life satisfaction. However, the combined effects of two variables, persons' feelings of loneliness and isolation from their families and a measure of socio-cognitive skill, accounted for 49 percent of the variability in elderly life satisfaction. The effects of each on life satisfaction were unique however. Implications of these data and possible interventions for increasing elderly persons' life satisfaction are discussed.     

Social integrations related to institutionalized and noninstitutionalized forms of care of elderly people

This is a report about a research project analyzing costs and effectiveness of institutionalized and ambulatory care of older people. For this analysis economic factors as well as social factors are considered. On the sociological part multiple objective conditions (e.g. state health, financial situation and family relations) were correlated with subjective factors as feelings of well-being and various personal attitudes. To this purpose approximately 900 elderly persons (3 samples: 1. inhabitants of homes of the aged, 2. ambulant served (meals on wheels, home help and community nurses), 3. random sample of persons living at their own home. The 3 samples were taken in an urban, semiurban and rural area. Some remarkable differences between the 3 samples could be shown referring to the general physical and mental status and rate of impairment, in the state of care, familiar situation, social integration and subjective attitude (e.g. demonstrating that the inhabitants of homes for the aged were less socially integrated and less satisfied.     

Some determinants of attrition in prospective studies on aging

Demographic measures, psychosocial variables, and objective and subjective measures of physical impairment were assessed in elderly men twice at intervals of 12 to 18 months. Canonical discriminant function analysis of the relationship between these predictor variables on the first testing and whether participants (a) returned for retesting, (b) did not return because of apparent disinterest, or (c) did not return because of illness or death, revealed two significant canonical variates. The first, characterized by decreased mental and physical capacity, discriminated between the deceased/ill group and the other two groups. The second was characterized by decreased social interaction and life satisfaction, and increased life events, and distinguished between the disinterested group and the other two groups. However, both groups that failed to return for retesting showed evidence of impaired physical health and a general disengagement from social and personal activities, compared to the retested group.     

Living conditions as predictor of elderly residential satisfaction. A cross-European view by poverty status

Although there is an extensive body of literature on the use of residential satisfaction to measure the impact of housing conditions on well-being in later life, less is known about differences and similarities between sub-populations and national contexts. By means of a cross-European analysis (EU15), this study aims to examine how objective and subjective factors of living conditions shape the perceptions of older Europeans about the adequacy of their residential environment. Two patterns of housing quality are explored: (1) international heterogeneity of the EU15 countries, and (2) intra-national heterogeneity, where we distinguish between households at risk of poverty and those not at risk in the elderly population of these countries. Data were drawn from the 2007 wave of the European Union Statistics on Income and Living Conditions survey, providing a sample of more than 58,000 individuals aged 65 years and older. The housing characteristics surveyed were reduced using tetrachoric correlations in a principal component analysis. The resulting predictors, as well as control variables (including gender, age, health status and tenure), are assessed using multiple linear regression analysis to explore their association with a high or low level of residential satisfaction. Despite a generally positive assessment by older Europeans of their living space, major geographic and household income differences existed in the factors that explained residential satisfaction. Identifying factors associated with residential satisfaction in different household income groups and national contexts may facilitate the development of EU policies that attempt to make ‘ageing in place’ a viable and suitable option for older Europeans.     

The impact of differences between subjective and objective social class on life satisfaction among the Korean population in early old age: Analysis of Korean longitudinal study on aging

BackgroundSeveral previous studies have established the relationship between the effects of socioeconomic status or subjective social strata on life satisfaction. However, no previous study has examined the relationship between social class and life satisfaction in terms of a disparity between subjective and objective social status.ObjectiveTo investigate the relationship between differences in subjective and objective social class and life satisfaction.MethodsData from the Korean Longitudinal Study of Aging with 8252 participants aged 45 or older was used. Life satisfaction was measured by the question, “How satisfied are you with your quality of life?” The main independent variable was differences in objective (income and education) and subjective social class, which was classified according to nine categories (ranging from high-high to low-low). This association was investigated by linear mixed model due to two waves data nested within individuals.ResultsLower social class (income, education, subjective social class) was associated with dissatisfaction. The impact of objective and subjective social class on life satisfaction varied according to the level of differences in objective and subjective social class. Namely, an individual’s life satisfaction declined as objective social classes decreased at the same level of subjective social class (i.e., HH, MH, LH). In both dimensions of objective social class (education and income), an individual’s life satisfaction declined as subjective social class decreased by one level (i.e., HH, HM, HL).ConclusionOur findings indicated that social supports is needed to improve the life satisfaction among the population aged 45 or more with low social class. The government should place increased focus on policies that encourage not only the life satisfaction of the Korean elderly with low objective social class, but also subjective social class.     

Perceived control and adaptation in elder caregivers: development of an explanatory model.

Perceived control has been implicated in the adaptation and well-being of older adults and may be especially relevant to elder caregivers. However, few studies have investigated perceived control within the individual's unique personal, social, and environmental context. This study tested a model representing the hypothesis that perceived control, defined as the perception that salient or valued aspects of one's life are manageable, mediates the objective and subjective aspects of caregiving and caregiver adaptation. Sixty elderly caregivers ranging in age from sixty to eighty-four (M = 69.4) were interviewed. Perceived control had a direct relationship with life satisfaction and depression, and an indirect relationship with subjective symptoms of stress. Wishful thinking coping behavior had a negative relationship with all adaptation variables. Findings are discussed in relation to further refinement and development of a theoretical approach to caregiver research and intervention studies in light of the obtained path model.     

What influences self-perception of health in the elderly? The role of objective health condition, subjective well-being and sense of coherence

The study examines in what way objective health-related variables interfere with psychic health and personality factors in explaining self-perception of health in the elderly. Two hundred and sixty-one patients aged 60 and older of an internal medicine hospital previously examined between 1994 and 1997 were once more contacted five years later. One hundred and sixty-four patients could not be included in the present investigation because of death, dementia, or severe physical illness. Of the 97 patients eligible for this second investigation, 74 agreed to participate. They were investigated extensively by means of psychometric scales and diagnostic interviews. A positive selection effect could be found for the sample of the present investigation with regard to age and health-related variables. Subjective evaluation of health correlated highly with the self-evaluation scales that recorded subjective well-being (life satisfaction, anxiety, and depression), and with the sense of coherence, but not substantially with objective health-related variables. A backward regression resulted in an adjusted R2 = 0.33 for the three retained variables "subjective physical complaints", "sense of coherence" and "self-evaluated depression" which rendered the same variance clarification of subjective health as did the model including all variables. Since the elderly represent the majority of patients treated in general hospitals and as subjective health and subjective physical complaints influence frequency of medical consultations and health care utilization, this is an important issue for consultation-liaison-psychiatry and health policy.     

SATISFACTION WITH LIFE IN RESIDENTIAL CARE: THE ROLE OF PRE-ENTRY FACTORS

The study examines the role of psychological factors in the satisfaction of old people living in long-term-care residences for the elderly. Two hundred people living in hostels and nursing homes participated in the study. Data were collected on their pre-entry attitudes and involvement with the relocation process, perception of the stressors and uplifts in the environment, health, finance, social support and perception of control. Both objective and subjective measures of well-being and happiness were used as outcome variables. Regressional analyses indicated that the best predictors of outcomes include pre-entry factors and perception of stressors/conflict in the environment.     

A comparison of physical health and psychosocial variables as predictors of reaction time and serial learning performance in elderly men

Choice reaction time and serial learning tasks were studied in three groups of elderly men (aged 65 to 85), including (a) hospitalized veterans, (b) veteran outpatients, and (c) nonhospitalized veteran volunteers. Demographic variables, life satisfaction, and attitudes toward aging, as well as objective and subjective measures of physical impairment, were assessed in each group. The three groups differed on both reaction time and serial learning measures. Multivariate analysis revealed that objective physical health assessments were the best predictors of reaction time performance, whereas subjective assessments best predicted serial learning performance. More negative attitudes and life satisfaction were associated with impaired physical health, but these psychosocial measures were poor predictors of behavioral performance.     

Evaluation of subjective happiness in the elderly using a visual analogue scale of happiness to analyze the effect of life style and neurobehavioral function on subjective happiness]

The effects of activity of daily living (ADL), physical conditions, social environmental factors and neurobehavioral functions on subjective happiness were investigated in 313 elderly subjects. The degree of subjective happiness was measured using visual analogue scale of happiness (VAS-H). There was significant relationship between VAS-H and ADL. The VAS-H score had weak but significant correlation with physical conditions and neurobehavioral functions. The social environmental factors, especially economical conditions, family relationships and group behavior had a significant correlation with VAS-H. In conclusion, in apparent healthy elderly people, the subjective degree of happiness was not related to ADLs, but to social environment and information physical conditions.     

Social support and well-being: preliminary indicators based on two samples of the elderly

The structure of social support and its relation to health, affect, and life satisfaction are compared for two samples of the elderly. The first is a national representative sample; the second is a distressed sample from South Miami Beach. Although there are similarities in the structure of social support across the two groups, those in the Miami Beach sample report fewer support figures, and far fewer within geographic proximity, than do those in the national sample. This comparative network impoverishment is particularly marked for male respondents and is accentuated by a high number of isolates in this group. In addition, stronger relationships are found between support network size and affect, and among affect, life satisfaction, and health in the South Miami Beach sample. Older men in poor health and without supportive relationships are targeted as a particularly high risk subgroup. The discussion includes a focus on personal, situational, and life span differences related to variations in support and well-being and a consideration of implications for more recent waves of elderly sun-belt migrants.     

Socio-economic factors and health care system characteristics related to cancer survival in the elderly. A population-based analysis in 16 European countries (ELDCARE project)

The ELDCARE study aims to investigate, at the ecological level, the relationships between socio-economic variables and cancer survival in patients aged 65 years and over. Survival data for patients diagnosed during the period 1985-1989 and followed up to 1994 were provided by 43 European Cancer Registries in 16 countries participating in the EUROCARE 2 project. Relative survival was computed by Hakulinen's methods. Data on socio-economic factors were collected by national statistics offices for the years around 1991. Pearson's correlation was used to study the relationships between cancer survival and socio-economic factors. We selected four groups of variables. The first group included macro-economic variables (such as Gross Domestic Product, GDP; Total Health Expenditure, THE); the second, the main characteristics of national health care systems; the third, demographic factors; and the fourth, variables on labour market organisation. The countries with the largest proportions of elderly populations, in Northern and Western Europe, spent more on health than the less affluent countries of Eastern Europe. GDP was strongly related to THE but a very high variability in Computed Tomography Scanners (CTS) among countries with similar THE was observed. Indeed, those countries with THE around US 1500 dollars per capita had survival rates for breast cancer ranging from 67 to 82%. Cancer survival in elderly patients in Europe was most strongly related to GDP and THE, especially for good prognosis cancers. Survival was strongly correlated with health care technologies, particularly CTS, but not with health employment. Survival was positively correlated with proportion of married elderly people (and negatively with widowed elderly), suggesting a role played by social support in influencing the prognosis of elderly patients. These results highlight how health outcomes in the elderly are a complex phenomenon, not determined only by GDP and THE, but affected by social organisation and life habits as well as economic development conditions.     

Trajectories and covariates of life satisfaction among older adults in Taiwan

The goals of this study were to identify different life satisfaction trajectory groups among the Taiwanese elderly and to explore the relationships between life satisfaction and time-varying physical, mental, social, health, and economic variables. The data used herein were from five waves of a longitudinal study conducted from 1993 to 2007. Those who completed at least three waves were included in the analysis, for a total of 2584 participants. A group-based trajectory model was used to analyze the data. Time-constant variables and time-varying covariates were used as the moderators of changes in life satisfaction trajectories. Four life satisfaction trajectories were identified: low (21.8%), middle (39.7%), increasing (25.9%), and high-declining (12.5%). Having more education and better physical and psychological health, social support, and economic satisfaction were predictors of a higher life satisfaction trajectory, and maintaining good physical and emotional health, having a spouse, and having better economic satisfaction were associated with an increase in life satisfaction over time.     

Impact of psychosocial factors on health outcomes in the elderly. A prospective study

One hundred and thirty-five initially healthy men and women older than 65 years of age were studied prospectively to identify factors associated with health outcomes. At study onset, measures of personality, social interaction, and health locus of control were obtained while participants were still healthy. A reliable health outcome measure was developed, based on the annual objective coding of morbidity. Correlations between variables showed significant associations between age, a less independent personality trait, and poor health outcomes. Anxiety and low levels of social interaction were associated with poor health after 8 years. Gender and health locus of control were not significantly related to health outcomes. A path analysis showed significant direct paths between age and trait anxiety and 8-year health outcomes, and indirect paths between anxiety and extroversion and 8-year health, by way of social interaction. There was no evidence that social interaction mediated the effects of either anxiety or extroversion on health. The structure of psychosocial characteristics of the healthy elderly sample was revealed in the pattern of correlations between personality, social interaction, and locus of control.     

Relationship between subjective social status and measures of health in older Taiwanese persons

OBJECTIVES: To compare the association between subjective ladder ranking and health measures with the association between objective indices and health measures in older Taiwanese men and women. DESIGN: Cross-sectional study. SETTING: A population-representative sample of elderly and nearly elderly men and women in Taiwan. PARTICIPANTS: The study included 991 participants from the Social Environment and Biomarkers of Aging Study in Taiwan. MEASUREMENTS: The information collected included demographic characteristics; subjective ladder score of SES; objective measures of SES, including education, income, and occupation; health behaviors; health-related variables such as self-rated health, basic activity of daily living difficulties, instrumental activity of daily living (IADL) difficulties, and physical activity difficulties; and depression score. RESULTS: Low ladder score was associated with poorer self-rated health and more reported IADL and physical activity difficulties, even after adjustment for objective measures of SES and other covariates. The multiply adjusted odds ratio for a one-quartile difference in ladder score and worse self-rated health was 1.19 (95% confidence interval=1.06-1.33). The associations between subjective ladder ranking and health status were generally stronger in those who had 6 years or less of education than in those who received more education. CONCLUSION: A simple subjective assessment of one's ranking on the social hierarchy was associated with self-rated health and physical functional status in an older ethnic Chinese population. The associations were independent of the effects of traditional objective measures of SES, such as education, income, and occupation.     

Social support and depression among elderly Chinese people in Hong Kong.

This study examines the association between social support and depressive symptomatology in a representative community sample of 1106 Chinese people in Hong Kong aged sixty years or older. Significant bivariate relationships were found between depression and all dimensions of social support including social network size, network composition, social contact frequency, satisfaction of social support, instrumental/emotional support, and helping others. Using multiple regression models, the authors found that at least one measure of these six dimensions of social support was associated with depressive symptomatology, even after controlling for socio-demographic, and functional disability. We found that social support from family is important for elderly Chinese people in Hong Kong, and satisfaction with support is a more important predictor of depression levels than other objective measures of network relationships. Lastly, it was found that material aid and instrumental support is more important in preventing depression for elderly individuals in Hong Kong than emotional support.     

The social determinants of depression in elderly Korean immigrants in Canada: does acculturation matter?

Depression in old age significantly decreases the quality of life and may lead to serious consequences, such as suicide. Existing literature indicates that elderly Korean immigrants may experience higher levels of depression than other racial ethnic group elders. The purpose of this exploratory study was to investigate factors that influence depression among older Korean immigrants in Toronto. A total of 148 participants, ages 60 years or older (mean age = 74.01, SD = 8.24), completed face-to-face interviews in Korean language. Hierarchical regression analyses were conducted by adding variables in three steps: (1) demographic variables; (2) acculturation variables (years of immigration and English proficiency); and (3) social determinants (social integration variables, physical health, and financial satisfaction). Results showed that acculturation factors were not associated with depression. Instead, social determinants variables, including lower physical health status and lower financial status, living alone, and lower level of social activity, predicted higher level of depressive symptoms, along with lower education. The final regression model explained about 37% of variance of depression in the sample. These results suggest that social determinants, not acculturation, are important factors explaining the levels of depression in Korean immigrant elders living in a metropolitan city in Canada. Implications for practice are discussed.