Life Satisfaction and Frailty Among Older Adults

The effect of research on life satisfaction in middle-aged and older adults: physical disability and physical activity as a parallel and serial mediation analysis

BACKGROUND AND OBJECTIVE

Maintaining the life satisfaction of frail middle-aged and older adults when they experience physical disability, lower activity status, or complex conditions that are related to each other is now an urgent issue. Therefore, the purpose of this study was to provide evidence for the impact of frailty in middle-aged and older adults on life satisfaction under the simultaneous occurrence and correlation of physical disability and physical activity status.

METHODS

Data from the 2015 Taiwan Longitudinal Study in Ageing (TLSA) were analyzed by PROCESS in SPSS to explore three different mediation models (N = 4,421). The first was a parallel mediation model for exploring life satisfaction in middle-aged and older adults with frailty through physical disability or physical activity. The second was a serial mediation model for examining physical disability and physical activity in causal chains linked with a specific direction of flow and to test all combinations. The third was a moderated mediation model for testing whether the indirect effect of frailty status on life satisfaction through physical disability or physical activity was moderated by age stratification.

RESULTS

Physical disability and physical activity partially mediated the relationship between frailty status and life satisfaction (IE_OVERALL = -0.196, 95% CI: -0.255 to -0.139). The causal path with the highest indirect effect was found to be that between frailty and physical disability; increased frailty led to higher physical disability, which in turn affected physical activity, leading to lower life satisfaction (IE = 0.013, 95% CI: 0.008 to 0.019). The different stratifications by age significantly increased the mediating effect of physical activity (Index of Moderated Mediation = -0.107, SE = 0.052, 95% CI: -0.208 to -0.005) but did not reduce the mediating effect of physical disability.

CONCLUSION

This study provides evidence that physical activity and physical disability influence the development of frailty. It also has a significant impact on the life satisfaction of middle-aged and older adults.

Types of household headship and associated life satisfaction among older adults in India: findings from LASI survey, 2017-18

BACKGROUND

Household headship with decision-making power may have a positive influence on life satisfaction in older adults. This study examines the associations of several types of household headship with life satisfaction among older adults in India.

METHOD

The study utilized the data from the Longitudinal Ageing Study in India (2017-18). The effective sample size for the study was 31,464 adults aged 60 years or older. Ordered logistic regression model was employed to find the association of life satisfaction with household headship status after adjusting for selected socioeconomic and demographic factors.

RESULTS

It was found that about 1.3% of older male and 1.5% of older females had nominal headship status in their household. Higher percentage of older males (42%) and females (48.3%) who had nominal headship status had low life satisfaction. In multivariable analysis, older adults who practiced nominal headship had significantly higher odds of low life satisfaction in reference to older adults who practiced functional headship [Adjusted odds ratio (AOR): 1.87; confidence interval (CI): 1.45,2.42]. Interaction model reveals that older men who practised nominal headship had significantly higher odds of low life satisfaction in reference to older men who practised functional headship [AOR: 2.34; CI: 1.59,3.45]. Similarly, older women who practised nominal headship had 55% significantly higher likelihood to have low life satisfaction in reference to older men who practised functional headship [AOR: 1.55; CI: 1.09, 2.18].

CONCLUSION

The recognition of older individuals as active agents of the households they belong to, and giving them the value they deserve may help boosting their mental well-being. As a direct driver of subjective well-being, headship status and decision making power deserve a more prominent role and future studies are required on the mechanisms of functional and nominal headship statuses that have impact on successful aging.

Global and domain-specific life satisfaction among older adults with long-term spinal cord injury

OBJECTIVE

Although life expectancy after spinal cord injury (SCI) has increased, knowledge of life satisfaction and associated factors among older adults with long-term SCI is still very limited. The objective of this study was, therefore, to assess global and domain-specific life satisfaction among older adults with long-term SCI and investigate the association with sociodemographics, injury characteristics and secondary health conditions.

DESIGN

Cross-sectional cohort study. Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS).

SETTING

Community settings in southern Sweden.

PARTICIPANTS

Seventy-eight individuals (32% women, injury levels C1-L3, American Spinal Injury Association Impairment Scale (AIS) A-D) mean age 68 years, mean time since injury 31 years.

INTERVENTIONS

Not applicable.

OUTCOME MEASURES

The Life Satisfaction Questionnaire (LiSat-11).

RESULTS

The participants were at least rather satisfied with most of the 11 life domains. They rated the lowest satisfaction with sexual life, activities of daily living and somatic health. Having a partner and being vocationally active was associated with greater satisfaction with life as a whole and with several other life domains. Participants with AIS D injuries were less satisfied with their somatic health than those with tetraplegia AIS A-C and paraplegia AIS A-C injuries. More secondary health conditions were negatively associated with satisfaction in five life domains.

CONCLUSION

Life satisfaction can be affected many years after SCI. The social context, participation in meaningful activities and minimizing secondary health conditions seem to be important for maintaining life satisfaction in older adults with a long-term injury.

Factors Associated with Life Satisfaction in Older Adults with Chronic Pain (PainS65+)

Background

Chronic pain in later life is a worldwide problem. In younger patients, chronic pain affects life satisfaction negatively; however, it is unknown whether this outcome will extend into old age.

Objective

This study examines which factors determine life satisfaction in older adults who suffer from chronic pain with respect to socio-demographics, lifestyle behaviors, pain, and comorbidities.

Methods

This cross-sectional study recruited a random sample of people ≥65 years old living in south-eastern Sweden (N= 6611). A postal survey addressed pain aspects and health experiences. Three domains from the Life Satisfaction Questionnaire (LiSat-11) were used to capture the individual’s estimations of overall satisfaction (LiSat-life), somatic health (LiSat-somhealth), and psychological health (LiSat-psychhealth).

Results

Respondents with chronic pain (2790, 76.2±7.4 years old) rated lower on life satisfaction than those without chronic pain, with medium effect size (ES) on LiSat-somhealth (r = 0.38, P < 0.001) and small ES on the other two domains (r < 0.3). Among the respondents with chronic pain, severe pain (OR 0.29–0.59) and pain spreading (OR 0.87–0.95) were inversely associated with all three domains of the LiSat-11. Current smoking, alcohol overconsumption, and obesity negatively affected one or more domains of the LiSat-11. Most comorbidities were negatively related to LiSat-somhealth, and some comorbidities affected the other two domains. For example, having tumour or cancer negatively affected both LiSat-life (OR 0.62, 95% CI 0.44–0.88) and LiSat-somhealth (OR 0.42, 95% CI 0.24–0.74). Anxiety or depression disorders had a negative relationship both for LiSat-life (OR 0.54, 95% CI 0.38–0.78) and LiSat-psychhealth (OR 0.10, 95% CI 0.06–0.14).

Conclusion

Older adults with chronic pain reported lower life satisfaction but the difference from their peers without chronic pain was trivial, except for satisfaction with somatic health. Pain management in old age needs to consider comorbidities and severe pain to improve patients’ life satisfaction.

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Effect of a care process programme on frail older people's life satisfaction

AIM

The aim of this study was to analyse the effects of a full-scale implementation of a care process programme on life satisfaction among frail older people, as compared with those receiving usual care.

DESIGN

The study includes participants from a full-scale care process programme (N = 77) and participants from a historical control group (N = 66). The care process programme establishes a comprehensive continuum of care through components including case management, interprofessional teamwork and care-planning meetings in the older people's own homes.

METHODS

Questionnaires were used and data were collected at baseline, with follow-ups at three, six and 12 months.

RESULTS

The implementation of the full-scale care process programme had a positive effect on life satisfaction among frail older people. From 6-month-12-month follow-ups, a higher proportion of participants in the care process programme had positive life satisfaction outcomes, as compared with the historical control group.

Daily Life Satisfaction in Older Adults as a Function of (In)Activity

Objectives

This 14-day daily diary study tested the between-person and within-person associations between sedentary behavior, physical activity, and life satisfaction in community-dwelling older adults.

Method

Older adults (n = 100) wore ActivPAL3 activity monitors for 14 days and, at the end of each day, answered questions regarding their health behaviors and life satisfaction.

Results

Separate multilevel models were tested for self-reported and objectively measured behavioral data. In the model using objectively measured behavioral data, life satisfaction was (a) negatively associated with sedentary behavior at the within-person level and unassociated with sedentary behavior at the between-person level and (b) unassociated with physical activity at either the between-person or within-person level. In the model using self-reported behavioral data, life satisfaction was (a) unassociated with sedentary behavior at either the between-person or within-person level and (2) positively associated with physical activity at the within-person, but not at the between-person, level.

Discussion

Results indicated that daily deviations in objectively measured sedentary behavior and self-reported physical activity have implications for older adults' well-being. Interventions designed to enhance well-being and quality of life in older adults should consider targeting daily changes in total sedentary behavior and daily changes in the volume or frequency of physical activity.

Effects of a continuum of care intervention on frail elders’ self-rated health, experiences of security/safety and symptoms: A randomised controlled trial

We aimed to evaluate effects of the intervention on self-rated health, experiences of security/safety and symptoms. A non-blinded controlled trial was performed with participants randomised to either the intervention group or a control group, with follow-ups at 3, 6 and 12 months. The intervention involved collaboration between a nurse with geriatric competence at the emergency department, the hospital wards and a multi-professional team for care and rehabilitation of older adults, with a case manager from the municipality as the hub. Older people who sought care at the emergency department at Sahlgrenska University Hospital/Mölndal and who were discharged to their own homes in the Mölndal municipality were asked to participate. Inclusion criteria were age 80 years and older, or 65 to 79 years with at least one chronic disease and dependency in at least one activity of daily living. Analyses were conducted on the basis of the intention-to-treat principle. Outcome measures were self-rated health, experiences of security/safety and symptoms. These were analysed using Svensson’s method. Of 161 participants, 76 were allocated to the control group and 85 to the intervention group. Positive effects of the intervention were observed for frail older adult’s symptoms and self-rated health.

The Impact of Socioeconomic Conditions, Social Networks, and Health on Frail Older People's Life Satisfaction: A Cross-Sectional Study

It has been shown that frailty is associated with low levels of well-being and life satisfaction. Further exploration is needed, however, to better understand which components constitute life satisfaction for frail older people and how satisfaction is related to other life circumstances. The aim of this study was to examine relationships between frail older people’s life satisfaction and their socioeconomic conditions, social networks, and health-related conditions. A cross-sectional study was conducted (n=179). A logistic regression analysis was performed, including life satisfaction as the dependent variable and 12 items as independent variables. Four of the independent variables made statistically significant contributions: financial situation (OR 3.53), social contacts (OR 2.44), risk of depression (OR 2.26), and self-rated health (OR 2.79). This study demonstrates that financial situation, self-rated health conditions and social networks are important components for frail older people’s life satisfaction. Health and social care professionals and policy makers should consider this knowledge in the care and service for frail older people; and actions that benefit life satisfaction – such as social support – should be promoted.

Urban and rural factors associated with life satisfaction among older Chinese adults

OBJECTIVE

This study compared urban and rural factors associated with life satisfaction among older adults in mainland China.

METHOD

Study data were extracted at random from 10% of the Sample Survey on Aged Population in urban/rural China in 2006 for 1980 participants aged 60 and older, including 997 from urban cities and 983 from rural villages.

RESULTS

In this study, 54.6% of urban older adults and 44.1% of rural older adults reported satisfaction with their lives. Binary logistic regression analysis showed that financial strain, depressive symptoms, filial piety, and accessibility of health services were significantly associated with life satisfaction for both urban and rural participants, but age and financial exchange with children were only associated with life satisfaction among urban older adults.

CONCLUSION

Findings are consistent with some previous studies that indicated the importance of financial strain, depressive symptoms, filial piety, and accessibility of health services to life satisfaction among the older adults in both urban and rural areas. This study also demonstrated the importance of age and family financial exchange to the life satisfaction of urban older adults.