Trajectories of Life Satisfaction and their Predictors among Korean Older Adults

Using machine learning to explore the predictors of life satisfaction trajectories in older adults

Life satisfaction is vital for older adults' well-being, impacting various life aspects. It is dynamic, necessitating nuanced approaches to capture its trajectories accurately. This study aimed to explore the diverse trajectories and predictors of life satisfaction among older adults in China using longitudinal data from the China Health and Retirement Longitudinal Study. Latent class growth modeling and growth mixture modeling were employed to identify distinct trajectories of life satisfaction. Machine learning (ML) models were developed to predict different trajectories and identify important predictors of different trajectories. Four distinct trajectories of life satisfaction were identified, showcasing nuanced patterns of life satisfaction that changed over time. ML models, especially random forest, effectively predicted these trajectories. Emotional experiences (particularly the frequency of happiness and loneliness), body mass index, and self-report health emerged as significant predictors of different life satisfaction trajectories. Our finding revealed the importance of focusing on individuals or groups with consistently low life satisfaction and paying more attention to mental and physical health predictors. Our models might guide future targeted preventative treatments.

Life Satisfaction Trajectories and Associated Factors in Middle-Aged and Older Mexican Adults

BACKGROUND

Given the importance of understanding psychosocial well-being as part of aging characteristics and processes, the present study aimed to describe life satisfaction among middle-aged and older adults in Mexico, according to sociodemographic, economic, psychosocial, and health factors.

METHODS

Data were obtained from the Mexican Health and Aging Study (MHAS), a longitudinal, nationally representative survey of adults aged 50 years and older. Data from the 2012, 2015, and 2018 waves were analyzed for this study. Life satisfaction in the MHAS is assessed using the Spanish version of the Satisfaction with Life Scale (SWLS). For the construction of the trajectories over six years of follow-up, quartiles of the scale were calculated for each wave. Multinomial regression models were then estimated to determine significant factors associated with each trajectory.

RESULTS

A total of 8,376 individuals aged 50 years and older met our study criteria for complete data in the three follow-up waves. Four life satisfaction trajectories were identified over six years of follow-up: high-constant, high-low, low-high, and low-constant. Subjective or psychosocial characteristics such as depressive symptoms, self-reported health, and functional ability were highly significant factors associated with life satisfaction trajectories, while multimorbidity was not significant.

CONCLUSIONS

This research contributes to the understanding of psychosocial well-being in Mexican older adults by exploring life satisfaction trajectories and their associated factors. The study shows that psychosocial and economic factors, along with functional abilities, have a much greater impact on life satisfaction, beyond the presence of comorbidity.

Mobile Internet Use and Life Satisfaction Among Older Adults: The Moderating Effect of Living Alone

This study, informed by the principle of the Conservation of Resources (COR) theory, evaluated the relationships between mobile internet use frequency, living arrangement, and life satisfaction in older adults. We used data from the 2021 Digital Divide Survey in South Korea, conducting a secondary analysis on 2105 participants aged 65 or above who accessed the internet in the last month. Multiple linear regression models were performed. Compared to the older adults who lived with others, those living alone showed a stronger positive association between their use of the mobile internet for daily services, information production and sharing, social participation, and life satisfaction. These findings align with the principle of the COR theory, suggesting that older adults living alone due to a loss in resources are more likely to benefit from mobile internet use, indicating the potential effectiveness of promoting mobile internet use as a strategy to enhance their life satisfaction.

Social participation, loneliness and well-being among older adults in Hong Kong: a longitudinal examination

The present study adopts a longitudinal design to examine the relationship between loneliness, social participation, life satisfaction and social networks among older adults in Hong Kong. The study also explores the mediating effects of social network and social participation on the relationship between loneliness and life satisfaction. A community sample of 200 older adults (153 female) ranging in age from 65 to 93 years (Mage = 76.03) were recruited from 20 elderly centres and NGOs across Hong Kong. The model of loneliness as a predictor of life satisfaction, sequentially mediated by network importance and social participation was significant and explained a total of 21% of the variance in life satisfaction. The present study highlights the importance of social networks and social participation in contributing to the life satisfaction of older adults in Hong Kong.

Association Between Social Frailty and Life Satisfaction Among Older Adults: The Role of Functional Limitations and Depressive Symptoms

The current study aimed to identify life satisfaction depending on the degree of social frailty and explore the mediating role of functional limitations and depressive symptoms between social frailty and life satisfaction. A secondary analysis of a cross-sectional survey was used. Data of 6,479 older adults were selected from the 2020 National Survey of Older Koreans. Of all participants, 2,595 (40.1%) and 1,605 (24.8%) had social prefrailty and frailty, respectively. Life satisfaction of participants with social frailty was significantly worse than those without social frailty. Social frailty negatively influenced life satisfaction. Functional limitations and depressive symptoms serially mediated the association between social frailty and life satisfaction. This mediation model provided evidence of the associations among social frailty, functional limitations, depressive symptoms, and life satisfaction in older adults. In community care settings, nurses should recognize the assessment of social frailty to enhance the subjective well-being of older adults. [Research in Gerontological Nursing, 16(6), 291-300.].

Effects of tai chi on postural balance and quality of life among the elderly with gait disorders: A systematic review

BACKGROUND

Tai Chi is good for improving the physical fitness of older adults. But few studies have reported the effects of Tai Chi on the postural balance and quality of life of older adults with gait disorders.

OBJECTIVE

This review aimed to assess the influence of tai chi on postural stability and quality of life in older adults with abnormal gait.

METHOD

According to the literature retrieval principles, the works published from the inception date to May 2023 were retrieved, including the following databases: PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, EBSCOhost, and Google Scholar. Subsequently, literature screening and quality assessment were performed.

RESULTS

A total of 16 randomized controlled trials were included in this study, Tai Chi intervention can affect populations with Parkinson's disease (PD), no exercise, mild cognitive impairment (MCI), chronic stroke, sedentary, fear of falling, or history of falling. Postural instability is associated with balance, gait, the Unified Parkinson's Disease Rating Scale Motor Subscale 3 (UPDRS III), mobility, lower body strength, and falls. Only two articles looked at quality of life. The Yang style is the most commonly used in the intervention. Nonetheless, most studies were performed on female participants, hence, more research on older male populations is needed.

CONCLUSION

Tai Chi intervention benefits postural balance in patients with gait disorders. 12 weeks is the most common intervention period for patients with gait disorders. The frequency of intervention is seven articles twice a week, and the intervention time is about 60 minutes. The Tai Chi intervention methods in this study involve Yang Style, Sun Style, Taoist Tai Chi, and Health Qigong Tai Chi, but the Yang Style Tai Chi intervention is the most widely used.

Trajectories of Physical Function and Behavioral, Psychological, and Social Well-Being in a Cohort of Swedish Older Adults

Background and Objectives

Successful aging has been described as a multifactorial and dynamic process. The aims of the study were to detect aging trajectories of physical function and behavioral, psychological, and social well-being; and to explore the correlations between functional versus well-being trajectories by age group.

Research Design and Methods

Data were gathered from the Swedish National Study on Aging and Care in Kungsholmen (N = 1,375). Subjects' physical function was assessed through walking speed and chair-stand tests, behavioral well-being through participation in mental and physical activities, psychological well-being through life satisfaction and positive affect, and social well-being through social connections and support. All exposures were standardized (z-scores). Linear mixed models were used to estimate trajectories of physical function and well-being over a 12-year follow-up.

Results

The steepest declines were seen for physical function (relative change [RC] in z-scores across ages; RC = 3.01), followed by behavioral well-being (RC = 2.15), psychological well-being (RC = 2.01), and social well-being (RC = 0.76). Correlations between physical function and the different well-being domains were weak, especially for slopes. Stronger intercept correlations were observed among the oldest-compared to the youngest-old, especially with behavioral (r = 0.39 vs r = 0.24) and psychological (r = 0.33 vs r = 0.22) well-being.

Discussion and Implications

Physical function declines the fastest throughout aging. The different well-being domains decline at a slower rate, which may be a possible sign of compensation against age-related functional decline, especially among the youngest-old, for whom discordances between physical function and the different well-being domains were more common.

Developmental trajectories of successful aging among older adults in China: Evidence from the China Health and Retirement Longitudinal Study

This study aimed to identify potential trajectory groups of successful aging in older adults and to explore the influencing factors of each trajectory group. We used four waves of longitudinal data from the China Health and Retirement Longitudinal Study from 2011 to 2018, which involved 1,949 older adults. The developmental trajectories were determined using growth mixture modeling (GMM), and the influencing factors of each trajectory group were identified using multinomial logistic analysis. We identified three different groups of successful aging trajectories: high level-declining group (45%), medium level-declining group (39%), and low level-steady group (16%). Gender, education, marital status, place of residence, self-rated health, life satisfaction, and retirement pension were the influencing factors for the high level-declining group. Influencing factors for the medium level-declining group included gender, education, self-rated health, life satisfaction, and retirement pension. Healthcare professionals should formulate targeted measures according to different trajectory categories to promote successful aging in older adults.

The Individual and Combined Effects of Social Networks and Loneliness on Life Satisfaction among Community-Dwelling Residing Older Adults: A Longitudinal Study

Social networks and loneliness are correlates of life satisfaction in old age. However, the evidence of the combined effects of social isolation and loneliness on life satisfaction is lacking; therefore, this study also aimed to investigate the combined effects of social networks and loneliness on life satisfaction in Malaysian older adults. Data from two waves of the "Neuroprotective Model for Healthy Longevity among Malaysian Older Adults" study were extracted. The first wave of data collection was completed in February 2013, while the second wave was conducted three years after the first wave. The main statistical analysis used was multivariable logistic regression. For individual effect, social networks (B = 0.375, p = 0.007), but not loneliness (B = -0.178, p = 0.368) significantly determined life satisfaction. Increasing social network size causes increasing life satisfaction. For combined effects, those in "the lone farmers" group (B = 0.279, p = 0.044) and "the majority" group (B = -0.413, p = 0.004) were linked to life satisfaction. Social engagement in older people is important for wellbeing in later life. Therefore, community programs and investing in a quality relationship should be encouraged to obtain adequate support and ultimately promote higher life satisfaction.

The role of marriage in the life satisfaction and mortality association at older ages: age and sex differences

OBJECTIVES

Although life satisfaction (LS) could reduce mortality risk of older adults, whether the LS-mortality link is consistent in older adults with different marital status is largely unknown. In this study, we examine (1) how the LS-mortality association at older ages varies by marital status and marital quality, and (2) whether the role of marriage in the LS-mortality link differs between young-old (ages 65-79) and oldest-old (ages 80+) ages and between men and women in mainland China.

METHODS

We used five waves of data from a nationally representative survey in mainland China and applied the multilevel random effect of survival analysis to examine the LS-mortality association in Chinese older adults by marital status, controlling for a wide set of covariates.

RESULTS

First, the protective effect of LS on mortality was valid in older men regardless of their marital status, whereas the protective effect was only valid in currently-not-married older women. Second, for a good marriage, LS significantly reduced mortality risk irrespective of gender and age, while for a poor marriage, LS had no significant association with mortality of older adults. Third, the LS-mortality association seemed to be stronger in the oldest-old than in the young-old irrespective of their marital status.

CONCLUSION

Given the pivotal role of spouse in daily life, the society should create an age-friendly social environment for re-marriage among older adults who wish to get re-married, while highlighting and advocating the importance of good marriage in determining healthy aging, and design various policies to improve the LS of older people to reduce their mortality risk.

Supplemental data for this article is available online at.

Optimizing future well-being with artificial intelligence: self-organizing maps (SOMs) for the identification of islands of emotional stability

In this article, we present a deep learning model of human psychology that can predict one’s current age and future well-being. We used the model to demonstrate that one’s baseline well-being is not the determining factor of future well-being, as posited by hedonic treadmill theory. Further, we have created a 2D map of human psychotypes and identified the regions that are most vulnerable to depression. This map may be used to provide personalized recommendations for maximizing one’s future well-being.

Development and Assessment of the Validity and Reliability of the Short-Form Life Satisfaction Index (LSI-SF) among the Elderly Population

Background: Elderly care should focus on not only prolonging life but also satisfaction with elderly life. Our study investigated the reliability and validity of the Short-Form Life Satisfaction Index (LSI-SF). Method: Data were drawn from the 2015 Taiwan Longitudinal Study on Aging. Internal consistency reliability was used to confirm that the items measured the targeted characteristics. Construct validity was established by confirmatory factor analysis (CFA). Criterion-related validity was examined with the WHO-5 Well-Being Index as an indicator of quality of life. Known-group validity was determined from the difference between frailty stage and quality of life. Results: The high consistency reliability supported the reliability of the LSI-SF. Rigorous CFA validated the construct validity of the LSI-SF. Perfect convergent and discriminant validity supported the validity of the LSI-SF. In addition, there was a significant correlation between the LSI-SF and the WHO-5 Well-Being Index. The LSI-SF appears to be a reliable measure of quality of life in the elderly. We found that frailty status was associated with lower life satisfaction, which supported the known-group validity. Life satisfaction was highest in the non-frailty stage and lowest in the frailty stage. Conclusions: The LSI-SF appears to be a valid and reliable measure of satisfaction with elderly life.

Effect of Brisk Walking on Health-Related Physical Fitness Balance and Life Satisfaction Among the Elderly: A Systematic Review

BACKGROUND

Although the elderly frequently engages in brisk walking as a form of exercise, little has been reported in the literature about the effect of brisk walking on health-related physical fitness, balance, and overall life satisfaction.

OBJECTIVES

The purpose of this systematic review is to determine the effect of brisk walking on the elderly's health-related physical fitness, balance, and life satisfaction.

DESIGN

We conducted a comprehensive search from the PubMed, Web of Science, Scopus, and SPORTDiscus databases from January to September 2021. We selected studies through PICOS and conducted a systematic literature review according to the PRISMA guidelines.

RESULTS

Thirteen studies met all criteria; 11 were classed as low risk of bias, while two were classified as high risk of bias. Generally, brisk walking has been shown to improve cardiorespiratory fitness, muscular strength, and body composition. Limited evidence was presented on flexibility, muscular endurance and development and life satisfaction, and there was conflicting evidence on balance. Moreover, evidence of restriction proves that high-intensity (80-85%) brisk walking is more effective than moderate-intensity (60-75%) brisk walking on the aerobic capacity of the elderly. Furthermore, there was less research conducted on males.

CONCLUSION

Brisk walking has been shown to improve cardiorespiratory fitness, muscular strength, and body composition. Other outcomes (balance, flexibility, muscular endurance, and life satisfaction) and the impact of the intensity of brisk walking on the elderly should be confirmed. Therefore, there remains insufficient research on brisk walking, while single brisk walking cannot meet requirements of elderly in terms of their health-related physical fitness, balance, and life satisfaction. Future research should aim to examine the effectiveness of combining several types of exercises to promote general health in the elderly, as the World Health Organization recommends. Unintelligible FITT (frequency, intensity, time, type) principles of brisk walking training should be trenched for the results of scientific and effective physical exercise.

Relationships among mental health, social capital and life satisfaction in rural senior older adults: a structural equation model

BACKGROUND

Literature about life satisfaction in rural senior older adults is scarce. The aim of this research was to examine the relationships among mental health, social capital and life satisfaction in rural senior older adults.

METHODS

This was a cross-sectional study. From July to October 2017, 245 senior older adults from 14 villages of Jinhua City in China were recruited. The Satisfaction with Life Scale (SWLS), the Chinese Version of the 12-item General Health Questionnaire (GHQ-12), the Social Capital Questionnaire (SCQ) and a self-designed questionnaire was administered to the participants. Structural equation modelling was implemented to analyse the relationships between mental health, social capital and life satisfaction in rural senior older adults.

RESULTS

The structural equation model was fitting adequately (χ2/df = 1.785, P < 0.001; RMSEA = 0.059; CFI = 0.963). Life satisfaction was positively affected by income (β = 0.243, P = 0.01). Likewise, community canteen services improved life satisfaction (β = 0.288, P = 0.001). Social capital had direct positive prediction on life satisfaction (β = 0.342, P = 0.003) and indirectly improved life satisfaction through mental health (β =0.183, P = 0.007). Life satisfaction was impaired by poor mental health among senior older adults (β = - 0.395, P < 0.026).

CONCLUSIONS

Life satisfaction among rural senior older adults is a multifaceted well-being construct affected by income, community canteen services, social capital and mental health. The presented model highlights the positive effect of income, community canteen services, social capital and mental health. Appropriate home-based aged care, programs and policies are needed.

Estabilidade e mudança em medidas prospectivas de satisfação com a vida em idosos: Estudo Fibra

Resumo Objetivo Investigar a incidência e variáveis associadas à estabilidade e à mudança da satisfação com a vida (SV) em medidas de linha de base (LB) e seguimento (SG) realizadas a um intervalo de nove anos, em idosos recrutados na comunidade. Método Estudo longitudinal prospectivo com dados da LB (2008-2009) e do SG (2016-2017) do Estudo Fragilidade em Idosos Brasileiros, envolvendo 360 idosos com 71,7±5,0 anos na LB (68,9% mulheres). Foram calculadas associações entre variáveis sociodemográficas, indicadores objetivos e subjetivos de saúde e variáveis psicossociais em LB e a incidência de estabilidade e mudança em SV no SG. Resultados Nove anos depois da LB, foram observadas: maior incidência de estabilidade (61,1%) do que de piora (26,4%) ou melhora (12,5%) da SV; menor incidência de piora no grupo de 80 anos e mais do que no de 70 a 79; maior incidência de mudança do que estabilidade da SV entre os idosos com multimorbidades e com pontuação > 6 em sintomas depressivos; maior incidência de piora da SV entre os idosos com baixos níveis de autoavaliação de saúde (risco relativo; RR=2,26) e de satisfação com a memória (RR=2,33). Conclusões A incidência de estabilidade em SV em idosos foi mais frequente do que a de piora ou melhora. Indicadores subjetivos de saúde física e satisfação com a memória podem ser sinalizadores de deterioração em bem-estar no tempo e sintomas depressivos de instabilidade nas avaliações, possivelmente acompanhando a redução ou o aumento da SV. Foi observada considerável heterogeneidade nas manifestações de SV entre idosos.

Stability and change in prospective measures of life satisfaction in older adults: Fibra Study

Abstract Objective The purpose of this study was to identify the incidence and variables associated with stability and change in life satisfaction (LS) between baseline and 9-year follow-up, in community-dwelling-older adults. Method A prospective longitudinal study of baseline (BL; 2008-2009) and follow-up (FW; 2016-2017) data from the Frailty in Elderly Brazilians Study involving 360 individuals aged 71.7±5.0 years at BL, 68.9% women, was conducted. Associations of sociodemographic and psychosocial variables, and objective and subjective health indicators measured at BL with the incidence of stability and change in LS between BL and FW were investigated. Results Nine years after the BL collection, the following results were observed: higher incidence of stability (61.1%) than of worsening (26.4%) or improvement (12.5%) in LS; lower incidence of worsening of LS in the ≥80 age group than in the 70-79 years group; higher incidence of change than stability of LS among the participants with multimorbidities and scores > 6 for depressive symptoms; higher incidence of LS worsening among participants with low self-rated health (relative risk; RR=2.26) and low satisfaction with memory (RR=2.33). Conclusions The incidence of stability in LS was more frequent than that of worsening or improvement. Subjective indicators of physical health and satisfaction with memory may serve as indicators of deterioration in wellbeing over time and the presence of depressive symptoms may suggest instability in self-assessments, possibly accompanying a reduction or increase in LS over time. There was considerable heterogeneity in the manifestations of LS among the older adults assessed.

Environment-Stratified Age-Period-Cohort Effects on the Prevalence of Walking Among Older Adults

Walking promotes active aging; however, walking prevalence changes among older adults by age and environmental conditions remain unclear. Age-period-cohort (APC) differences in walking trends among Korean older adults were examined. Data included adults aged ≥ 65 years (n = 592,235) from the nationally representative Korean Community Health Survey. Regional units examined were metropolitan cities, small- and medium-sized cities, and rural areas. Environment-stratified APC modeling was applied for walking prevalence (walking days/time during the past week). From 2008 to 2017, the walking prevalence gap between regional units widened. Decreasing trends were most apparent in rural areas, including by birth year. In all areas, walking decreased with increased age. No distinct period effects were found. Each effect's magnitude was larger in rural areas than cities. Differential APC effects by environmental conditions likely influence walking prevalence changes among older adults. Walking promotion for older adults should consider APC effects and environmental conditions.

Mediators of the socioeconomic status and life satisfaction relationship in older adults: a multi-country structural equation modeling approach

OBJECTIVES

Socioeconomic status (SES) relates to life satisfaction in old age, although the underlying mechanisms remain unclear. Health and subjective social status have shown to be related to both SES and life satisfaction. This study aims to test the mediating role of health and subjective social status in old age, and to analyze if these potential mediations vary among three European countries with different socioeconomic characteristics and welfare regimes.

METHOD

The sample comprised 7,272 participants aged 50+ from COURAGE in Europe study, a household survey carried out in 2011-2012 on nationally representative samples from Finland, Poland, and Spain. A Multiple Indicators, Multiple Causes approach based on multi-group Structural Equation Modeling was implemented to test mediating effects.

RESULTS

The structural invariance model showed an adequate fit (CFI = 0.971, RMSEA = 0.061). Health and subjective social status invariantly mediated the relationship between SES and life satisfaction across countries with different socioeconomic characteristics and welfare regimes. SES direct effects explained 0.83-0.85% of life satisfaction variance, whilst indirect effects explained 2.29-2.36% of life satisfaction variance via health, 3.30-3.42% via subjective social status, and 0.06% via both mediating variables.

CONCLUSION

Policies aimed at increasing the SES of the older adults may entail multiple benefits, resulting in better subjective social status, health, and life satisfaction outcomes, thus fostering healthy aging of the population.

Trajectories of Depression and Their Predictors in a Population-Based Study of Korean Older Adults

The aim of this study was to determine trajectories of depression in older adults and to identify predictors of membership in the different trajectory groups. A total of 3983 individuals aged 65 or older were included. Latent class growth models were used to identify trajectory groups. Of 3983 individuals, 2269 (57%) were females, with a mean baseline age of 72.4 years (SD = 6 years). Four depression trajectories were identified across 8 years of follow-up: "low-flat" (n = 3636; 86.6%), "low-to-middle" (n = 214; 9.2%), "low-to-high" (n = 31; 1.3%), and "high-stable" (n = 102; 2.9%). Compared to the low-flat depression group, high-stable depression group members were more likely to be female, have three or more chronic diseases, and were more likely not to own a home. Our findings will assist health policy decision-makers in planning intervention programs targeting those most likely to experience persistent depression in order to improve psychological well-being in the elderly.

Sociodemographic Determinants of Health and Well-Being Among Adults Residing in the Combined Kaiser Permanente Regions

CONTEXT

Kaiser Permanente commissioned a health and well-being (HWB) survey of adult members and nonmembers in its 8 Regions.

OBJECTIVE

To estimate the prevalence of HWB indicators and evaluate differences in prevalence of excellent/very good (E/VG) health and thriving overall in life (thriving) by race/ethnicity, age group, sex, education, and financial situation.

DESIGN

Cross-sectional survey conducted by email and phone during Winter 2016-2017 with a racial/ethnic group-stratified quota sample. Participants (N = 26,304) provided sociodemographic characteristics and ratings for 6 HWB indicators. Using population-weighted data, we estimated the prevalence of HWB indicators and used logistic regression models to test for differences in E/VG health and thriving by sociodemographic factors.

MAIN OUTCOME MEASURES

Overall health and overall life evaluation.

RESULTS

Of adults, 52% were in E/VG health and 63% were thriving. Blacks were less likely to be in E/VG health than whites, Hispanics, and Asian/Pacific Islanders, but there was little racial/ethnic variation in those who were thriving. E/VG health and thriving varied significantly by level of education and financial situation. Across all racial/ethnic groups, large differences in percentages were observed in E/VG health and thriving between the lowest and highest levels of education and financial situation but little racial/ethnic variation within education and financial situation strata.

CONCLUSION

Differences in health status and life evaluation are associated very strongly with financial situation and educational attainment, and these social determinants partially explain racial/ethnic disparities in HWB. The lack of strong correlation of health status and life evaluation suggests these are different domains of well-being.

How Do Time Use and Social Relationships Affect the Life Satisfaction Trajectory of Korean Adolescents?

This study investigated the life satisfaction trajectory of Korean adolescents, and factors associated with changes in life satisfaction. Specifically, we focused on how changes in time use and social relationships were associated with changes in life satisfaction. Using three waves of the Korean Children and Youth Panel Survey, we conducted a series of multilevel growth curve modeling analyses. The results indicate that Korean adolescents’ life satisfaction decreased over a three-year period, and that time spent on leisure and sleeping were both significant predictors of changes in life satisfaction. Life satisfaction decreased at a slower rate for adolescents whose relationships with peers and teachers positively increased over time. Findings highlight the importance of ensuring adequate amount of sleep and providing various opportunities for leisure activities in improving Korean adolescents’ life satisfaction. Furthermore, social relationships, specifically with teachers and peers should be the focus of prevention and intervention for adolescents to maintain and improve their level of life satisfaction.

Psychological correlates of multimorbidity and disability accumulation in older adults

BACKGROUND/OBJECTIVES

attitudes toward life and health are emerging as important psychological contributors to health heterogeneity in ageing. We aimed to explore whether different psychological factors were associated with the rate of chronic disease and disability accumulation over time.

DESIGN

population-based cohort study between 2001 and 2010.

SETTING

Swedish National study on aging and care in Kungsholmen.

SUBJECTS

adults aged 60 and older (N = 2293).

METHODS

linear mixed models were employed to study the association of life satisfaction, health outlook, resistance to illness, sickness orientation, and health worry with the rate of accumulation of chronic diseases and impaired basic and instrumental activities of daily living. Models were adjusted for demographic, clinical, social, personality and lifestyle factors. Analyses were repeated after excluding individuals with multimorbidity or disability at baseline.

RESULTS

high life satisfaction and positive health outlook were consistently associated with a lower rate of accumulation and progression of multimorbidity (β -0.064 95% confidence interval [CI] -0.116, -0.011; β -0.065 95% CI -0.121, -0.008, respectively) and disability (β -0.063 95% CI -0.098, -0.028; β -0.042 95% CI -0.079, -0.004, respectively) over time. This was true even for people without multimorbidity or disability at baseline and after adjusting for all covariates.

CONCLUSIONS

positive attitudes toward life in general and health in particular may be especially important in old age, when the cumulative effects of biological and environmental deficits lead to accelerated health decline. These findings should encourage researchers to use measures of psychological well-being to better understand the multifactorial and diverse process of ageing.

Does social capital and a healthier lifestyle increase mental health resilience to disability acquisition? Group-based discrete trajectory mixture models of pre-post longitudinal data

Poor mental health is strongly associated with disability acquisition. Social capital and healthier lifestyles pre-disability onset may help promote mental health resilience (i.e. a state of seemingly being unaffected by the event), or the capacity to 'bounce back', post-acquisition. This paper used a novel methodology (discrete trajectory mixture models) to examine discrete trajectories in mental health before and after disability acquisition in the Household Income Labour Dynamics in Australia (HILDA) survey. Group membership in association with pre-onset social capital and healthy lifestyles were then examined using multinomial logistic regressions. Four discrete trajectory groups were identified in 2904 Australians reporting onset of ongoing disability, with about 28.4% demonstrating mental health resilience. Three other groups were identified, each demonstrating increasingly severe reductions in mental health. No clear 'bounce back' group was observed. Group membership was associated with participants who felt they had 'no-help from others' prior to disability acquisition. Pre-disability acquisition measures of social capital and unhealthy behaviours moderated the association between disability acquisition and mental health trajectories. Social capital was protective only for the respondents who had poorer mental health before disability onset and had less resilience after onset, and long working hours and less resilience were positively associated. Public policies that help to enhance levels of social capital and reduce unhealthy behaviours at a population level may help to promote mental health resilience to adversities such as the acquisition of disability.

Determinants of Successful Aging in a Cohort of Filipino Women

This study describes a multidimensional measure of successful aging (SA) and examines the relationship with chronic disease status and self-reported health. Using data from the 2015 Cebu Longitudinal Health and Nutrition Survey of 1568 Filipino women, we created a four domain measure of SA (physiological, mental health, cognitive, sociological). We explored age-stratified associations of each domain and total SA with various health behaviors, chronic disease status, and correlations with self-reported health measures. Both age groups reported aging well, but younger women had higher mean SA scores. Association patterns between domain and total SA and sociodemographic and health behaviors were similar across age groups. Physiological score was associated with hypertension for all ages, and with diabetes in younger women. Total SA was moderately correlated with self-reported health measures. Participants reported aging successfully despite chronic disease status. Future studies should use a multidimensional definition of SA which incorporates elders’ perspective.

Health behaviors influencing depressive symptoms in older Koreans living alone: secondary data analysis of the 2014 Korean longitudinal study of aging

BACKGROUND

Geriatric depression is a societal problem, specifically in those living alone in Korea. This study aims are to investigate (1) how sociodemographic factors, health status, and health behaviors are differently associated with depressive symptoms in older Koreans living alone compared to those living with others and (2) how living arrangements attenuated or strengthened the associations between four types of health behaviors and depressive symptoms.

METHODS

This secondary data analysis was conducted using data from the 2014 Korean Longitudinal Study of Aging. A structured survey assessing sociodemographic factors, health status, and health behaviors was conducted with people aged 65 or older who lived alone (n = 1359) and living with others (n = 2864). A multiple linear regression with interaction terms was conducted between mean-centered health behaviors and the status of living alone. All statistical analyses were performed using SPSS Statistics 23.0, and the two-tailed level of significance was set at 0.05.

RESULTS

Those living alone reported higher levels of depressive symptoms than those living with others (Mdiff = 2.129, SE = 0.005, p <  0.001). The variance of depressive symptoms explained by 13 variables was 18.1% for those living alone compared to 23.7% for those living with others. Compared to health behaviors, sociodemographic factors and health status more explained depressive symptoms, specifically with psychiatric disorders, pain, and impaired functionality as risk factors. Smoking, alcohol abstinence, physical inactivity, and social inactivity were associated with more depressive symptoms. Living arrangements moderated the association between depressive symptoms and each health behavior, except for physical inactivity (all p values < 0.001).

CONCLUSIONS

Older Koreans living alone were exposed to different risk factors for depressive symptoms compared to those living with others. Non-modifiable sociodemographic and health status factors were highly associated with depressive symptoms relative to health behaviors; thus, it is important to conduct early assessment and classification of vulnerable subgroups regarding geriatric depression. Specific assessment instruments should be prepared in practice according to living arrangements among older Koreans. Targeted interventions are essential to addressing living arrangements and modifying health behaviors to reduce smoking, alcohol consumption, and social inactivity, specifically in those living alone.

Associations between Perceived Neighborhood Walkability and Walking Time, Wellbeing, and Loneliness in Community-Dwelling Older Chinese People in Hong Kong

This study examined the cross-sectional associations between perceived neighborhood walkability and walking time, physical activity, wellbeing, and loneliness, and examined which components of walkability were most strongly associated with better wellbeing and less loneliness in older adults. Participants were community-dwelling Chinese adults aged 60+ (n = 181). Walkability was measured using nine items selected from the Chinese version of the abbreviated Neighborhood Environment Walkability Scales (NEWS) and NEWS for Chinese Seniors. Outcomes were walking time, physical activity, wellbeing (life satisfaction, happiness, sense of purpose and meaning in life), and loneliness. The mean age of the participants was 71.7 ± 7.8 years. Walkability was positively associated with walking time (p = 0.001, p for trend <0.001) but not with physical activity. After adjusting for socio-demographic characteristics, health conditions, lifestyle, and negative life events, those who perceived their neighborhoods as walkable had higher scores for life satisfaction (p = 0.002) and happiness (p = 0.002), and lower scores for loneliness (p = 0.019), compared with those who perceived their neighborhoods as less walkable. However, perceived neighborhood walkability was not associated with sense of purpose and meaning in life. Among components of walkability, land use mix-access, infrastructure and safety for walking, and traffic safety showed the strongest associations with the measures of wellbeing. The results of this study support the importance of neighborhood walkability for health behavior and wellbeing of older adults. The wellbeing of older adults may be enhanced through the improvement of land use mix-access, infrastructure for walking, and traffic safety.