Cross-cultural comparability of the Philadelphia Geriatric Center Morale Scale: an American-Japanese comparison

Factors related to a sense of economic insecurity among older adults who participate in social activities

Japan has the highest life expectancy worldwide. Older adults who experience economic insecurity may refrain from seeking medical consultation or using long-term care insurance, and these behaviors may increase the incidence and progression of frailty. This study conducted a cross-sectional survey to identify factors related to a sense of economic insecurity among older adults who participate in social activities, and identified support measures. In total, 1,351 older adults aged ≥65 years who had participated in social activities voluntarily completed an anonymous self-administered questionnaire. The questionnaire encompassed their physical, cognitive, social, and psychological conditions, and economic insecurity. We performed univariate analysis considering a sense of economic insecurity as the dependent variable, and conducted multiple logistic regression analysis (forced entry method) considering the independent variables with p<0.1 as the covariates. Among the 872 filled questionnaires, 717 were analyzed as they had no missing data with respect to the responses to survey questions (valid response rate was 53.1%). Analysis results showed that 43.6% of the older adults had a sense of economic insecurity, which was most common among those aged 75-84 years, accounting for 47.3%, followed by those aged 65-74 years accounting for 44.1%, and those aged ≥85 years accounting for 31.5% (p<0.05). The sense of economic insecurity was not associated with physical conditions, subjective symptoms of dementia, or social conditions; however, it grew with increased loneliness (OR: 1.71, 1.002-2.92, p = 0.049) and decreased with an increased subjective sense of well-being (OR: 0.86, 0.81-0.92, <0.001). Economic insecurity among older adults was not associated with physical, cognitive, or social aspects, as reported in previous studies. The survey respondents constituted older adults who participate in social activities. Maintaining interactions within the community, even in old age, may prevent loneliness and improve subjective health.

Health-Related Quality of Life With Trastuzumab Monotherapy Versus Trastuzumab Plus Standard Chemotherapy as Adjuvant Therapy in Older Patients With HER2-Positive Breast Cancer

PURPOSE

We report findings on quality of life (QoL) in the RESPECT trial, which compared adjuvant trastuzumab monotherapy with trastuzumab plus chemotherapy in older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC).

PATIENTS AND METHODS

Patients age 70-80 years with human epidermal growth factor receptor 2-positive surgically treated breast cancer were randomly assigned to receive trastuzumab (T) or trastuzumab plus chemotherapy (T + C). QoL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G), Philadelphia Geriatric Center Morale Scale, Hospital Anxiety and Depression Scale, Patient Neurotoxicity Questionnaire, and Tokyo Metropolitan Institute of Gerontology Index of Competence at baseline and after 2, 12, and 36 months. Comparisons were based on individual changes from baseline and were performed by Fisher's test or mixed-model repeated-measures.

RESULTS

Among 275 patients in the parent study, 231 (84%) (average age: 74 years) were included in the analysis. At 2, 12, and 36 months, 198, 177, and 178 patients completed surveys, and the mean FACT-G scores at each survey point were 78.9, 80.4, 82.7, and 79.1 in group T and 79.5, 74.5, 78.4, and 78.5 in group T + C. Compared with group T + C, the proportion of patients showing QoL deterioration (≥ 5 points decrease from baseline in FACT-G) was significantly lower at 2 months (31% v 48%; P = .016) and 12 months (19% v 38%; P = .009). In group T, the Hospital Anxiety and Depression Scale score (P = .003) and the proportion of severe sensory peripheral neuropathy (P = .001) were significantly lower at 2 months, and Philadelphia Geriatric Center Morale Scale and Tokyo Metropolitan Institute of Gerontology Index of Competence scores were significantly higher (P = .024, .042) at 12 months. At 36 months, there were no significant differences in any QoL items.

CONCLUSION

Detrimental effects of adjuvant chemotherapy on global QoL, morale, and activity capacity lasted for at least 12 months but were not observed at 36 months.

Scaling Down the PGCM Scale to Assess Views on Ageing More Efficiently: Finding a New Alternative

The aim of the study is to present a new and efficient way of measuring the quality of life among older populations, with special attention to morale, positive outlook on life and ageing. The measure is based on the Philadelphia Geriatric Center Morale Scale (PGCM), originally consisting of 22 items. The growing numbers and proportions of older people among European populations has increased the need to obtain more reliable data on their needs, values, life experiences and overall quality of life. Using data from six surveys conducted in the Czech Republic, we have formulated a three-item positive outlook on life and ageing (POLA) scale. Our analyses are divided into three steps: (1) constructing the scale and testing its internal consistency; (2) testing the scale's external validity using mean comparisons and correlation coefficients; and (3) determining the factors affecting a positive outlook on later life, such as gender and education. We have confirmed that the three-item approach to measuring positive outlook on ageing as a part of morale is highly applicable to surveys, producing compelling results in assessing important quality-of-life sub-concepts, such as subjective health, subjective age, and loneliness.

Benefits of Grandparental Caregiving in Chinese Older Adults: Reduced Lonely Dissatisfaction as a Mediator

Objective

The purpose of the present study is twofold: (1) to investigate the differences in terms of physical and mental health between those who provide grandparental care and those who do not and (2) to explore the mechanism that connects grandparental caregiving and health-related outcomes.

Methods

Two studies (a cross-sectional and a short-term longitudinal follow-up) were conducted. The cross-sectional study (Study 1) examined 148 older adults who provided grandparental care and another 150 older adults who did not. A small longitudinal follow-up study (Study 2) was conducted among 102 older adults randomly selected from Study 1, of which 52 were older adults who provided grandparental care, and another 50 older adults were those who did not. Health status (measured by SF-36), lonely dissatisfaction (measured by Lonely Dissatisfaction Subscale of PGC-MS), and cognitive functions (measured by subscales of WAIS) as well as demographics were measured in both studies.

Results

Results of both the cross-sectional and longitudinal studies showed that, compared with older adults who did not provide grandparental care, those providing grandparental care had significantly better physical and mental health as well as reduced lonely dissatisfaction. Further path analysis showed that lonely dissatisfaction mediated the association between providing grandparental care and enhancement in functions such that providing grandparental care could reduce lonely dissatisfaction, which, in turn, could improve their physical and mental health even after controlling for their cognitive functions.

Discussion

These results suggest that providing grandparental care can improve older adults’ physical and mental health through reduced lonely dissatisfaction.

Subjective well-being in centenarians: a comparison of Japan and the United States

OBJECTIVE

The present study examined the cultural differences and similarities in the levels and predictors of subjective well-being in Japanese and American centenarians.

METHOD

We analyzed data on cognitively intact Japanese (N = 59) and American (N = 125) participants from the Tokyo and Georgia Centenarian Studies, respectively. The Philadelphia Geriatric Center Morale Scale was used to measure subjective well-being, while sociodemographic, social, and health resources were assessed as potential predictors.

RESULTS

The American participants reported higher scores on well-being (satisfaction with social relations and psychological comfort). However, cultural differences in the levels of well-being disappeared after we controlled for its predictors. The regression models revealed that health resources (cognitive function, hearing problems, and activities of daily living) were strong predictors of well-being in both countries. Social resources (living with others) were strongly associated with one dimension of well-being (attitude toward one's aging) among the Japanese participants.

DISCUSSION

The findings support the existing lifespan and cross-cultural literature, indicating that declines in health impose certain limitations on adaptive capacity in oldest-old age irrespective of cultures, and that social embeddedness is valued in Eastern cultures. The authors speculate that cultural values, i.e. personal autonomy versus relational harmony, play an important role for well-being in oldest-old age.

Social Support and Attitudes to Aging in Later Life

Negative attitudes to aging are a risk factor for poor health and well-being. The current study sought to examine satisfaction with social support as a potentially modifiable factor that might facilitate the development of more positive attitudes to aging. A convenience sample of 501 older respondents (M_age = 72.06) reported on frequency of social support and their satisfaction with it, as well as completing a rating of attachment (model of the self and others), a measure of attitudes to aging, and a number of background measures. Results indicated that better subjective health, younger age, and greater satisfaction with social support were all significant predictors of more positive attitudes to aging, while frequency of social support was not. Model of the self accounted for some variation in satisfaction with social support. Interventions to increase satisfaction with social support in later life, recognizing individual differences and attachment styles, may improve attitudes to aging and further support health and well-being.

A longitudinal analysis of the impact of family support on the morale of older parents in Japan: does the parent's normative belief in filial responsibilities make a difference?

Japan presents a unique social laboratory in which to examine how family support impacts on older adults’ psychological wellbeing. This is because of its cultural climate where distinctively different expectations of old-age independence and the traditional norm of filial piety coexist. This study investigated how structural and functional dimensions of the family support of older Japanese parents influence their psychological morale, and whether the impacts of family support on parents’ morale vary depending on the parents’ belief in the traditional cultural norm of filial piety. Four waves of data from the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA) collected in 1999, 2001, 2003 and 2006 were analysed. Combining the two- or three-year span of longitudinal data between each wave (N=3,882), an ordered logistic regression analysis was undertaken. The results reveal that although parents who were widowed or received emotional support from a child tended to report a lower level of morale, the negative influences of such support tended to be mitigated if the parent agreed with the traditional cultural norm of filial responsibilities. These results imply that the meaning and benefit of family support may differ depending on the degree to which Japanese older parents support the traditional norm of filial responsibilities.

Comparisons of the prevalence of and risk factors for elderly depression between urban and rural populations in Japan

BACKGROUND

The aim of the present study was to investigate the differences in the prevalence of and risk factors for elderly depression between urban and rural areas in Japan and to further understanding of the features of elderly depression.

METHODS

A multistage, random sampling procedure and mailing method were used in urban and rural areas in Kumamoto Prefecture. A total of 2,152 participants aged 65 years and older were evaluated for depression using the Geriatric Depression Scale (GDS). Factors associated with depression were also examined. In order to assess the relationship between risk factors and subjective happiness, the Philadelphia Geriatric Center Morale Scale (PGC-MS) was used.

RESULTS

Depressive symptoms were associated with living alone, being unemployed, chronic illness, sleep disturbance, suicidal ideation, financial strain, and poor social support; the risk factors for elderly depression were almost the same in the two areas. Although three factors (financial strain, work status, and PGC-MS) were significantly associated with depression in both areas on logistic regression analysis, sleep disturbance was significant only for the urban area, and poor social support was significant only for the rural area.

CONCLUSIONS

Although factors related to depression did not differ markedly between urban and rural elderly people, some risk factors differed between the two areas. Effective intervention programs for elderly depression should pay more attention to regional differences.

Effects of a 12-month multicomponent exercise program on physical performance, daily physical activity, and quality of life in very elderly people with minor disabilities: an intervention study

BACKGROUND

Although studies suggest that exercise training improves physical performance and health-related quality of life (HRQOL) among elderly people, most of these studies have investigated relatively healthy persons. The objective of the present study was to determine the effects of a 12-month multicomponent exercise program on physical performance, daily physical activity, and HRQOL among very elderly people with minor disabilities.

METHODS

The subjects consisted of 65 elders (median age: 84 years) who were certified to receive long-term care in the form of support only or Level 1 care (the lowest level of care required); 31 were allocated to the intervention group and 34 to the control group. The intervention group participated in supervised exercises once a week for 12 months and in home-based exercises. The exercise program consisted of various exercises related to flexibility, muscle strength, balance, and aerobic performance.

RESULTS

After 12 months of exercise training, the intervention group had significant improvements in lower-limb strength and on the sit-and-reach test; these effects were not observed in the control group. The control group had significant decreases in grip strength, 6-minute walking distance, walking speed, and stride length; these decreases were not observed in the intervention group. No clear differences in HRQOL measurements or changes in physical activity were detected between groups.

CONCLUSIONS

The 12-month multicomponent exercise program may effectively improve and maintain the physical performance of very elderly individuals with minor disabilities.

A creative reminiscence program for older adults with severe mental disorders: results of a pilot evaluation

OBJECTIVE

Older adults with severe mental disorders experience major dissatisfaction with conditions of life that are connected with aging. To assist them in developing a coherent, meaningful life-story and to improve their life satisfaction, we conducted a pilot evaluation of a creative reminiscence program called Searching for meaning in life.

METHODS

One week before and one week after the intervention 36 participants from three psychiatric hospitals and one sheltered housing program were interviewed. Life satisfaction was measured with the Manchester Short Assessment of Quality of Life (MANSA) and the Philadelphia Geriatric Center Moral Scale (PGCMS). At follow-up questions were also asked about the intervention.

RESULTS

About 78% of the participants completed the course. Most of them were satisfied with the course (74%). The overall sample showed significantly more life satisfaction after the intervention. Participants with a psychotic disorder also improved significantly in life satisfaction but at the same time their depressive symptoms increased significantly. Participants with a moderate to high level of depressive symptoms at baseline had relatively favorable outcomes. Their life satisfaction had improved significantly and they especially had a better attitude toward their aging.

CONCLUSION

The program is feasible and acceptable for adults with severe mental illness and it has potential benefits for them. More research is needed to find out what explains the increase of depressive symptoms for participants with psychotic disorders.

Stability of the Philadelphia Geriatric Center Morale Scale: A Multidimensional Item Response Model and Rasch Analysis

The purpose of this study was to explore the longitudinal structural and measurement invariance of the 17-item Philadelphia Geriatric Center Morale Scale (PGCMS) using a multidimensional item response model and the unidimensional Rasch model in contrast to prior work employing classical test theory. Participants ( n = 177) were assigned to three interventions and assessed at three time points. The structural analyses found that a 3-factor model fit better than a 1-factor or a 2-factor model using the Akaike information criterion (AIC) and Schwartz’s Bayesian information criterion (BIC) though not with the AICPC or the BIC PC. With respect to item fit, differential item functioning (DIF) and correlation of item logit positions, the PGCMS was quite stable. However, Items 4 and 5 were problematic in terms of fit. The internal consistency reliabilities of three factors were also relatively lower than desirable at one point and adequate at others.

Gender-associated differences in dyspnoea and health-related quality of life in patients with chronic obstructive pulmonary disease

BACKGROUND AND OBJECTIVES

Recent studies have reported several gender-associated differences among patients with COPD, but gender-associated differences in health-related quality of life (HRQoL) in patients with COPD have not yet been clarified. This study evaluated gender differences in dyspnoea and HRQoL in patients with COPD.

METHODS

Study participants were 156 patients with COPD (men 117, women 39); men were individually matched to women by age and FEV(1)% predicted to give a ratio of 3:1 (male : female). Study participants were evaluated for dyspnoea and completed HRQoL questionnaires. An oxygen cost diagram (OCD) was used to assess the degree of dyspnoea and Morale Scale was used to assess subjective well-being. St. George's Respiratory Questionnaire (SGRQ) and SF-36 were used for HRQoL evaluation. The findings in the male and female groups were compared.

RESULTS

The OCD and Morale Scale showed significantly lower values for female patients with COPD. Disease-specific HRQoL assessed by SGRQ was significantly worse, except for symptoms, in female patients with COPD. Generic HRQoL assessed by SF-36 was also significantly worse, except for general health and social functioning. Stepwise multiple regression showed OCD, Morale Scale and 6-min walking distance to be significantly associated with total SGRQ score in the male group, and Morale Scale and 6-min walking distance were significant associations in the female group.

CONCLUSIONS

Gender differences exist in dyspnoea and HRQoL in patients with COPD. These need to be considered when designing treatment strategies for COPD patients.

Association between subjective well-being and sleep among the elderly in Japan

OBJECTIVE

The purpose of this study was to examine the association between sleep and subjective quality of life in an elderly Japanese population.

METHODS

Elderly people aged 70 years or more (n=1,769) were selected randomly from all areas of Japan. They were visited and interviewed in November 2003. Subjective well-being of the subjects was assessed using the Philadelphia Geriatric Center (PGC) Morale Scale. A logistic regression analysis was performed using sleep-related factors as explanatory variables.

RESULTS

A positive linear association was observed between subjective sleep sufficiency and the mean PGC Morale Scale score. The crude and adjusted odds ratios for sleep disorders such as difficulty initiating sleep, excessive daytime sleepiness, and restless legs syndrome were significantly low. The mean score was highest for a sleep duration of 7-8h and became lower at sleep durations of <6 and 9h (inverted U-shaped association). However, the adjusted odds ratio for sleep duration did not show a significant reduction.

CONCLUSIONS

In order to improve the subjective well-being of the elderly, better subjective sleep sufficiency and alleviation of sleep disorders are necessary. Different mechanisms may reduce subjective well-being in individuals who sleep less than 6h or who sleep 9h or more.

The relationship between characteristics of supported housing and the quality of life of older adults with severe mental illness

This study examined whether group living (as opposed to single living), staff availability and degree of personal freedom are associated with the quality of life of older adults with severe mental illness. A cross-sectional study was carried out in 18 supported living programmes in residential homes for the elderly that differed in terms of these three characteristics. The study included 35 patients with a psychotic disorder and 38 with an anxiety or mood disorder. Quality of life was assessed with the Philadelphia Geriatric Centre Morale Scale (PGCMS) and the Manchester Short Assessment of Quality of Life (MANSA). No association was found between group living and quality of life. Availability of psychiatrically trained staff was associated with life quality only for patients with a psychotic disorder, and perceived amount of personal freedom was associated with life quality only for patients with a non-psychotic disorder. Both differences were seen only on the PGCMS Agitation subscale. Older people with psychotic disorders appear to have relatively high needs for professional psychiatric support, and those with non-psychotic disorders for control over their daily lives. Further research is needed in other settings for older people with severe mental illness, preferably using longitudinal designs.

Population science is science only if you know the population

BACKGROUND

Cancer control efforts have had limited effect in reducing the inequities for minorities and the medically underserved. One factor is the lack of theory-based conceptualization of the terms used to define race, ethnicity, and culture.

METHOD

Guidelines are provided to develop more accurate use of the terms race, ethnicity, and culture to determine standards of comparability across studies of cancer incidence, survival, and quality of life in diverse populations rather than stereotypes.

RESULTS AND CONCLUSIONS

Our ability to use theoretically based criteria to differentiate groups of people could increase our ability to more effectively eliminate these disparities.

Examination of the Philadelphia Geriatric Morale Scale as a Subjective Quality-of-Life Measure in Elderly Hong Kong Chinese

PURPOSE

We examine the psychometric properties of the Philadelphia Geriatric Morale Scale (PGMS) in an elderly Chinese population in Hong Kong.

DESIGN AND METHODS

The study consisted of two cohorts: (a) 759 participants aged 70 years and older living in the community who were recruited as part of a territory-wide health survey and interviewed in 1993-1994; and (b) 388 participants living in long-term-care institutions in 1995-1996. Participants who were cognitively impaired (Abbreviated Mental Test score less than 7) or who could not answer questions for other reasons were excluded. The 15-item PGMS was administered. The Rasch dichotomous model was used to assess the validity of the PGMS, and the 15-item Geriatric Depression Scale, previously validated in Chinese, was also administered to examine the concurrent validity.

RESULTS

A confirmatory factor analysis identified three underlying factors similar to findings among Caucasians; however, not all the goodness-of-fit indices were acceptable. An exploratory factor analysis using principal axis factoring and promax rotation revealed two underlying factors that explained 35% of the total variance: reconciled aging and unstrained affect. Some items were redundant when applied to the institutional sample. Concurrent validity was demonstrated by the good correlation between the reconciled aging and unstrained affect domains and the Geriatric Depression Scale (r = -0.72 and r = -0.56 respectively). Female gender, older age, and residence in institutions were associated with lower morale.

IMPLICATIONS

The PGMS is a valid quality-of-life measure in elderly Hong Kong Chinese persons, but its psychometric properties are slightly different from those for Caucasians.

Usefulness of a linear analog scale questionnaire to measure health-related quality of life in elderly patients with chronic obstructive pulmonary disease

OBJECTIVES

To examine the validity, discriminatory ability, and responsiveness of health-related quality-of-life (HRQoL) questionnaires using a linear analog scale (Quality of Life (QOL) scale) for chronic obstructive pulmonary disease (COPD).

DESIGN

Cross-sectional and longitudinal.

SETTING

Outpatient.

PARTICIPANTS

One hundred two elderly subjects with mild to severe COPD.

MEASUREMENTS

Scores on the QOL scale, the St. George's Respiratory Questionnaire (SGRQ), and the 36-item Short-Form Health Survey questionnaire (SF-36) and various clinical parameters were recorded. The correlations between these QOL questionnaires and various clinical parameters were then examined. The responses of 31 elderly COPD patients to the QOL scale and the SGRQ before and 3 months after the completion of a comprehensive pulmonary rehabilitation program were compared longitudinally.

RESULTS

On cross-sectional study, the QOL scale showed a significant correlation with the total score and three components of the SGRQ. The QOL scale correlated significantly with all components of the SF-36, but the total SGRQ score correlated with only six components of the SF-36, excluding vitality and the mental health index. Both the QOL scale and the total score of the SGRQ correlated significantly with the oxygen cost diagram (OCD), Morale scale, 6-minute walking distance (6MWD), forced expiratory volume in 1 second, and instrumental activities of daily living (IADL) score. When subjects were divided into three groups according to disease severity (mild, moderate, severe) using American Thoracic Society guidelines, the total SGRQ score discriminated between the three groups. The QOL scale could not discriminate between mild and moderate or moderate and severe. On longitudinal study, 3 months after finishing the comprehensive pulmonary rehabilitation program, the QOL scale, the SGRQ, 6MWD, and OCD all showed significant improvement. The difference in the QOL scale after the comprehensive pulmonary rehabilitation program showed a significant correlation with changes in the SGRQ total score and the OCD but not with the 6MWD.

CONCLUSION

The QOL scale is similar to more-complex questionnaires such as the SGRQ in terms of validity and responsiveness for evaluating disease-specific HRQoL in elderly COPD patients. In clinical settings, the QOL scale, as a simple questionnaire, may be useful for disease-specific HRQoL assessments in elderly COPD patients.

Cross-cultural comparability of the Geriatric Depression Scale: comparison between older Koreans and older Americans

It is becoming increasingly clear that, in order to better understand the implications of global aging, more cross-cultural research is needed. In the present study, the structure and validity of the Geriatric Depression Scale-Short Form (GDS-SF) was examined in Korean and US samples of older adults. The participants included 153 older adults living in Korea (mean age=65.9 years) and 459 older adults from Florida (mean age=72.4 years). All participants completed the original or translated versions of the GDS-SF, as well as additional demographic and health-related measures. The results indicated that the GDS-SF exhibited good reliability in both samples. However, the results of a principal components analysis indicated that the structure was not well replicated across the two samples. In general, the present study suggests that, despite great efforts to make the questionnaires equivalent in the two cultures, the concept of depression for older adults may vary greatly in Korea and the USA. Possible explanations for cross-cultural differences are discussed, as well as implications.

Item bias in self-reported functional ability among 75-year-old men and women in three Nordic localities

The purpose of this article is to analyse item bias in a measure of self-reported functional ability among 75-year-old people in three Nordic localities. The present item bias analysis examines whether the construction of a functional ability index from several variables results in bias in relation to geographical locality and gender. Information about self-reported functional ability was gathered from surveys on 75-year-old men and women in Glostrup (Denmark), Göteborg (Sweden) and Jyväskylä (Finland). The data were collected by structured home interviews about mobility and Physical activities of daily living (PADL) in relation to tiredness, reduced speed and dependency and combined into three tiredness-scales, three reduced speed-scales and two dependency-scales. The analysis revealed item bias regarding geographical locality in seven out of eight of the functional ability scales, but nearly no bias in relation to gender in the combined data. The conclusion is that only one tiredness-scale (Lower Limb-T), one reduced speed-scale (Lower Limb-S) and the two dependency-scales (PADL-H and Mob-H) can be proposed for use in comparisons between the three localities (with removal of one or more items).

An outlook on subjective well-being in older Israeli adults: a unified formulation

The present study explored the factorial structure of the combined item pool of the Life Satisfaction Index A (LSIA) [1] and the Philadelphia Geriatric Center Morale Scale (PGCMS) [2], two prominent instruments for assessing subjective well-being (SWB) and formulating its structure among the elderly. The sample consisted of 830 older Israeli adults, randomly divided into two groups for cross-validating purposes. The exploratory factor analysis yielded five substantial factors labeled Reconciled Aging, Unstrained, Affect, General Contentment, Present Happiness, and Past Self-fulfillment. The emerging structure was subjected to a confirmatory factor analysis by LISREL, indicating the fit of Liang's model [3, 4] that postulates a second-order factor of SWB. Correlations between the factor scales and other SWB indices provided evidence of convergent validity. The current formulation, which awaits further replication and validation, demonstrated that while each measure does contain unique components, they both contribute to a superordinate construct. The integrative approach employed here might facilitate the delineation of basic psychological themes as well as generate a broader perspective for the assessment of SWB in old age.

Subjective well-being measures: reliability and validity among Spanish elders

The Philadelphia Geriatric Center Morale Scale, Life Satisfaction Index, and Affect Balance Scale were translated into Castilian Spanish and Catalan. Responses to these scales were obtained by interviews with 151 elderly persons living in Spain. Reliability estimates for the Life Satisfaction Index and the Affect Balance subscales were comparable to those for English-speaking samples, while reliability estimates for the Philadelphia Geriatric Center Morale Scale were somewhat lower. Validity estimates among these scales were consistent with previous research and previously reported factor structures were found to fit the present data reasonably well, although factor loadings were lower than those previously reported. English and translated versions of the scales are provided in Appendix A.

The structure of the Life Satisfaction Index A in elderly Israeli adults

Neugaraten et al.'s Life Satisfaction Index A (LSIA) is a widely used instrument for measuring subjective well-being among elderly adults, and the generalizability of its structure in different cultural contexts should be established [1]. The present study investigated the structure of the LSIA in older Israeli adults by exploratory and confirmatory factor analyses. Exploratory factor analyses in Sample 1 (N = 267) yielded three factors of Zest, Mood Tone, and Congruence. Unlike previous studies in the United States, Zest emerged in alternate forms, labeled Zest-Via-Time and Zest-Via-Interest. Confirmatory factor analyses were conducted in Sample 1 and Sample 2 (N = 154) according to Liang's [2] model specifications, assuming a second-order factor. When previously suggested factorial compositions were tested, Liang's [2] and Hoyt and Creech's [3] three-factor models fit the data, while Adams' [4] model did not. Hoyt and Creech's [3] four-factor model provided no improvement on the two, three-factor models. When the present factorial compositions were tested, a three-factor model with Zest-Via-Interest best fit Sample 1, while an alternate three-factor model with Zest-Via-Time best fit Sample 2. A four-factor model with both forms of Zest provided no improvement on the best fitting three-factor models. The results support the generalizability of a three-factor structure with a second-order factor but suggest two different variations of Zest. Cross-cultural as well as other implications concerning subjective well-being in elderly adults are discussed.

Subjective well-being and its domains across different age groups: an Israeli sample

Subjective well-being (SWB) across the life span was studied in a representative Israeli sample by a national survey of 1183 subjects, ranging from 18 to 80 years of age. Subjects were given "life scales", on which they rated their SWB in their present life, as well as their satisfaction regarding health, relations with friends, family, work, economic status, sense of personal achievement, and sense of control. The results indicate that: (a) SWB is negatively correlated with chronological age; (b) the relative strength of most of SWB domains changes in the different age groups; (c) SWB is best explained by different sets of domains in different age groups; and (d) economic status is the strongest domain, accounting for SWB in 6 out of 8 age groups. Explanations for these results confronted the developmental view of changing tasks across the life span vs cohort-based differences between the age groups. The decreasing number of domains that account for SWB variance with progressing age, as well as some unexpected findings with regard to the oldest age group (71-80) are also discussed.