[Happiness in the elderly: an epidemiological approach in the ISA-Camp 2008 study]

Factors associated with happiness among community-dwelling older adults: a systematic review

OBJECTIVES

To identify factors associated with self-reported happiness among community-dwelling older adults.

METHODS

A systematic review of the literature was conducted. Searches were conducted in the PsycInfo, Web of Science, Scopus and Pubmed databases for relevant articles published in English, Spanish or Portuguese using the following search strategy and Boolean operators: (happiness*) AND (elder* OR (old adult*)). No restriction was imposed with regards to year of publication. This review was registered in PROSPERO (CRD42018107302).

RESULTS

Forty-six articles met the eligibility criteria and were included in the review. Economic, social and health-related factors were associated with happiness among community-dwelling older adults. The sociodemographic characteristics of older adults, such as the female sex, being married, an older age, a higher level of schooling and having a religion, were also associated with happiness.

CONCLUSIONS

The articles included in the present systematic review demonstrate that social, economic and health-related aspects have an association with happiness in community-dwelling older adults.

A Path Analytic Model Exploration of Determinants of Happiness of Older Adults in Abu Dhabi

The objective of the study was to identify the factors associated with the subjective well-being of older adults in Abu Dhabi when happiness is taken as the dependent variable. In the present research, a framework based on theoretical models was developed in which older adult’s happiness was seen in a synergistic relationship and was associated with many other variables related to various domains in the social system. The sample consisted of 1,004 older adults aged 60 and above, who participated in the First Abu Dhabi General Social Survey administered in 2018. Many subjective well-being variables were considered. Path analysis was used to develop a model that incorporated the five following variables directly affecting the happiness of older adults: housing satisfaction, satisfaction with family life, satisfaction with friendships, life satisfaction, satisfaction with surrounding environment, and some psychological feelings. The study highlighted all direct and indirect associations. Further analysis of variance revealed the associations of gender, marital status, and education attainment. Implications of the study were highlighted along with future research directions.

Prevalence and factors associated with underweight among Brazilian older adults

The aim of this study was to estimate the prevalence of underweight among older adults according to socio-demographic characteristics in different regions of Brazil as well as determine associated contextual and individual factors. Cross-sectional population-based study with older adults (≥ 65 years) interviewed by telephone survey in 2014. The body mass index was calculated based on weight and height. Associations were determined using Pearson's chi-square test, considering a 5% significance level. Adjusted prevalence ratios were estimated using multilevel Poisson regression. Mean age was 73.3 years and the prevalence of underweight was 15.6% (95%CI: 14.1-17.1%). Higher prevalence rates of underweight were found among women, individuals aged ≥ 80 years, smokers and those who reported the regular consumption of beans. The prevalence rate of underweight was lower among those who reported abusive alcohol intake and those with a medical diagnosis of hypertension. The northern region of the country had the highest prevalence of underweight after adjusting for associated individual factors. The findings demonstrate the subgroups with higher prevalence rates of underweight that demand greater attention from the health services in terms of recovering of an adequate nutritional status.

Factors associated with happiness in the elderly persons living in the community

OBJECTIVE

The aim of the present study was to evaluate factors associated with happiness in a sample of Brazilian older adults.

METHODS

A study was conducted with 263 elderly people in the area of coverage of a family health unit located in the state of São Paulo, Brazil. The Subjective Happiness Scale was used to measure happiness, the final score of which determined one of three outcomes: not happy, intermediate, and happy. Disability, sociodemographic characteristics, and psychological, cognitive, and physical factors were considered for the multinomial logistic regression analysis.

RESULTS

Statistically significant differences were found among the three groups regarding satisfaction with life, disability, social phobia, anxiety, depression, and frailty (p≤0.05). In the multinomial regression analysis, being "not happy" was significantly associated with satisfaction with life (RRR: 0.53), depression (RRR: 1.46), social phobia (RRR: 1.24), and age (RRR: 1.06).

CONCLUSION

The present findings indicate that psychological factors and age influence the levels of happiness in older adults living in the community. Furthermore, better screening, diagnosis, and treatment of mental health disorders could increase the feeling of happiness among older adults.

Happy life expectancy among older adults: differences by sex and functional limitations

OBJECTIVE

To evaluate if the happy life expectancy in older adults differs according to sex and functional limitations.

METHODS

Life expectancy was estimated by Chiang method, and happy life expectancy was estimated by Sullivan method, combining mortality data with the prevalence of happiness. The questions on happiness and limitations came from a health survey, which interviewed 1,514 non-institutionalized older adults living in the city of Campinas, SP, Southeastern Brazil. The happy life expectancy was estimated by sex, age, and functional limitations. Based on the variance and standard error of the happy life expectancy, we estimated 95% confidence intervals, which allowed us to compare the statistical differences of the number of happy years lived among men and women.

RESULTS

Differences by sex in happy life expectancy were significant at ages 60, 65, and 70. In absolute terms, women live more years happily. But, in relative terms, older men could expect to live proportionally more years with happiness. Happy life expectancy decreased significantly with increasing age in both men and women. Among older people living without functional limitation, differences by sex were statistically significant in all age groups, except at age 80. In the group with limitations, no significant differences by sex were found. Significant differences between the group without and with functional limitations were seen in both men and women.

CONCLUSIONS

Older men could expect to live a greater proportion of their lives happily in comparison to same-aged women, but women show more years with happiness than men. Functional limitations have a significant impact on happy life expectancy for both sexes.

In the choice between health and money, health comes first: an analysis of happiness among rural Chilean elderly

We studied the relationship between happiness and individual socio-demographic context and health and dietary variables by interviewing 389 elderly individuals (age 60-90 years) living in rural areas in the Maule Region of Central Chile. The Lyubomirsky & Lepper (1999) subjective happiness scale was used. Ordinal logistic regression models were estimated. The discrete dependent variable was level of happiness. The following variables were significantly associated with happiness: (1) individual socio-demographic variables like age and satisfaction with the economic situation; (2) health variables like independence in activities of daily living, common activities, and self-rated health; and (3) dietary variables such as life satisfaction related to food and the frequency with which the elders shared dinner with others. The study results suggest more efficient efforts at healthy eating for the elderly in rural areas.

Indoor second-hand smoking could mediate the associations of foods and adult happiness: Scottish Health Survey, 2012

There has been literature on the relationship of food and happiness, but the role of second-hand smoking is less understood. Therefore, the aim of the present study was to examine if second-hand smoking might mediate the associations of food consumption and subjective happiness in a country-wide and population-based setting. Data was retrieved from the Scottish Health Survey, 2012. Information on demographics, frequency of consuming certain foods and subjective happiness was obtained by household interview. Chi-square test and survey-weighted logistic regression modelling were performed. Of the included Scottish adults aged 16-99 (n = 4815), 15.4 % (n = 677) reported that they were unhappy. It was observed that eating lots of potatoes, some meat, some oily fish and some pastries were inversely associated with unhappiness. People who consumed vegetables and fruits on the day before the health interview were also found to be less unhappy, compared to their counterparts. However, the protective effect from fruits disappeared after additionally adjusting for indoor second-hand smoking while the protective effects from other foods mentioned above have also been lessened. In addition, cumulatively people who consumed more "happy foods" (mentioned above) were more likely to report subjective happiness, compared to those who did not consume any of those. For future research, longitudinally monitoring on the associations among food, household environment and psychological well-being and both the short-term and long-term effects would be suggested. For policy implications, Removal of indoor second-hand smoking to retain the protective effects from happy foods on well-being should be encouraged.

Individual and social determinants of self-rated health and well-being in the elderly population of Portugal

This article aims to identify the main determinants of self-rated health and well-being in the elderly Portuguese population, using a set of dimensions including demographic and socioeconomic indicators, characteristics of interpersonal networks and social activities, health, sexual activity, representations of aging, and feeling of happiness. Taking socioeconomic, behavioral, and attitudinal predictors into account to analyze the explanatory value of the interrelated dimensions and weights for each factor, the author argues that social capital, activities associated with active aging, and greater optimism towards aging can contribute greatly to better self-rated health and wellbeing among the elderly, partially offsetting the effect of socioeconomic factors and illness associated with age.

Gender differences in healthy life expectancy among Brazilian elderly

BACKGROUND

This study examined gender differences in healthy life expectancy (HLE) and unhealthy life expectancy (UHLE) among people aged 60 years or older living in a large Brazilian city.

METHODS

Based on Chiang method, abridged life tables were constructed for men and for women. To calculate HLE, the Sullivan method was applied. Estimates of the prevalence of self-rated health and self-reported functional disability (global, mild/moderate, and severe) were obtained from a population-based household survey carried out in 2008, which involved non-institutionalized individuals.

RESULTS

Findings showed that women live longer and these extra years would be spent in good self-rated health. For example, women aged 60 would live, on average, 4 more years in good health in comparison to men. In terms of global limitations and mild/moderate limitations, no gender differences were detected for HLE. However, UHLE was statistically higher among women than among men at all ages in the global limitations and mild/moderate limitations (except for the age 80). Women at age 60, for instance, could expect to live 3.1 years longer with mild/moderate limitations compared to men. Gender differences were identified for severe limitations for either HLE or UHLE. In comparison to men, women at age 60, for example, would expect to live 2.5 and 2.0 more years without and with severe limitations.

CONCLUSIONS

By showing that the advantage of longer life expectancy among women is not necessarily accompanied by worse health conditions, these findings add some evidence to the debate about male-female health-survival paradox. Policy efforts are necessary to reduce gender differences in the quantity and quality of years to be lived, providing equal opportunities to women and men live longer with quality of life, autonomy, and independence.