Predictors of perceived togetherness in very old men and women: a 5-year follow-up study.

Although a considerable amount of research has been carried out on older adults' social ties, most of it has focused on quantitative aspects and on cross-sectional samples. In this study, the subjective aspect of social interaction is described by the concept of perceived togetherness. The aim of this study was to examine the extent to which different factors predict perceived togetherness in men and women over a 5-year period. It also addresses the question of whether it is possible to identify different subgroups in perceived togetherness. The data were collected with structured interviews and laboratory tests from 225 elderly people at ages 80 and 85. The results showed that the predictors of perceived togetherness partly differed between sexes as well as within the groups of males and females. Predictors common to both genders were contacts with friends, less depressive symptoms, higher education level and better coping with instrumental activities of daily living (IADLs). The findings indicated the importance of friends. Widowhood and self-rated health were predictors in women but not in men. Moreover, there appeared to be two subgroups of women and men in perceived togetherness; these were labeled "socially embedded", "socially isolated", "socially active" and "solitary". The results indicate diversity in perceived togetherness and its predictors. More attention should be paid to individual differences in order to prevent loneliness and to promote older adults' well-being.

Activity as a predictor of mental well-being among older adults.

This eight-year follow-up study examines the roles of physical and leisure activity as predictors of mental well-being among older adults born in 1904-1923. As part of the Evergreen project, 1224 (80%) persons aged 65-84 years were interviewed at baseline (1988), and 663 (90%) persons in the follow-up (1996). Mental well-being factors including depressive symptoms, anxiety, loneliness, self-rated mental vigour and meaning in life were constructed using factor analysis. The predictors of mental well-being included physical and leisure activity, mobility status and number of chronic illnesses. We used a path analysis model to examine the predictors of mental well-being. At baseline, low number of chronic illnesses, better mobility status and leisure activity were associated with mental well-being. Baseline mental well-being, better mobility status and younger age predicted mental well-being in the follow-up. Explanatory power of the path analysis model for the mental well-being factor at baseline was 19% and 35% in the follow-up. These findings suggest that mental well-being in later life is associated with activity, better health and mobility status, which should become targets for preventive measures.

Associations between loneliness, depressive symptoms and perceived togetherness in older people.

This study explores the associations of loneliness with depressive symptoms in a five-year follow-up and describes how the six dimensions of perceived togetherness explain loneliness and depressive symptoms at baseline. The data were collected on 207 residents of Jyväskylä, central Finland, who at baseline in 1990 were aged 80; and 133 residents who at follow-up in 1995 were aged 85. Loneliness was assessed using a questionnaire item with four preset response options, perceived togetherness using the Social Provisions Scale, and depressive symptoms using the CES-D scale. A recursive structural equation model showed that in women but not in men, depressive symptoms predicted more experiences of loneliness. Those who were lonely were more depressed (CES-D score 16 or over) and experienced less togetherness than those who were not. Loneliness was explained by reliable alliance, social integration and attachment; and depressive symptoms were explained by guidance, reassurance of worth, reliable alliance and attachment. A common feature in both loneliness and depressive symptoms was a lower level of perceived emotional togetherness in social interaction.

The association of socio-economic factors with physical and mental capacity in elderly men and women.

The association of socio-economic factors with functional capacity has received less research attention than their association with diseases and mortality. However, functional capacity is an important measure of health and independence in the elderly. This study explores the associations of socio-economic factors with physical and mental capacity as measured in laboratory tests and on the basis of self-report. The data were drawn from the Evergreen project, comprising all persons aged 75 (N=388) and 80 (N=291) in Jyväskylä, central Finland. Women with a higher level of education showed better functional capacity on all indicators, among men higher education was only associated with better vital capacity and cognitive capacity. Better perceived financial situation was associated with better functional capacity in both men and women. The association between socio-economic factors and functional capacity remained even when the number of chronic diseases was controlled for. The results lend support to the assumption that socio-economic factors are associated with physical and mental capacity in elderly people.

Changes in intensity of physical exercise as predictors of depressive symptoms among older adults: an eight-year follow-up.

BACKGROUND: Epidemiological research suggests that regular physical activity may be associated with reduced depressive symptoms. The present study examines the predictive value of physical exercise in relation to depressive symptoms among samples of adults aged 65+ during an 8-year period. METHODS: The subjects (N = 663) who participated both at the baseline (1988) and the follow-up (1996) interviews were selected for the analyses. The dependent variable depressive symptoms was assessed by the Finnish modified version of Beck's 13-item depression scale. The independent variable was the intensity of physical exercise. RESULTS: The intensity of physical exercise decreased among the older men and women. Those who had reduced their intensity of physical exercise during the 8 years reported more depressive symptoms at the follow-up than those who had remained active or increased their physical activity. Depressive symptoms were predicted by the intensity of baseline physical exercise, earlier depressive symptoms, older age, gender, having three or more chronic somatic conditions, and difficulties in performing ADL activities. CONCLUSIONS: Age-related decrease in the intensity of physical exercise increases the risk of depressive symptoms among older adults. This calls for effective measures in maintaining and supporting an adequate level of physical exercise among the aging population.

Depressed mood among the elderly in Jyväskylä. A five-year follow-up.

The aim of this article is to describe the changes that occurred in depressive symptomatology over a five-year period among 75- and 80-year old residents of Jyväskylä. It also addresses the question of whether the mood disturbance detected is a permanent phenomenon or whether it has a more episodic nature. In both follow-up cohorts, depressed people were interviewed to find out how the elderly themselves experienced depression and to assess the validity of the CES-D self-rating scale in measuring depressive symptomatology. The purpose of the study was also to find out if depression was predictive for survival. During the five-year follow-up the mean score describing depressed mood (CES-D total scale) did not significantly change in any age group or gender, nor did the mean score of those who died during the follow up differ significantly from the core of the survivors. The mean score of the CES-D subscale Lack of well-being increased among 80-year old women over a five-year follow-up period and those who died had a significantly lower well-being score than those who survived. More than half of the interviewees were classified depressed in both age-cohorts in both examination times. Almost all those elderly people whose score indicated depressiveness in the second examination confirmed that the diagnoses of depressed mood based on the CES-D scale was correct. The higher the CES-D score, the more frequent and/or the more difficult were the problems mentioned in their narratives of depression. Compared with the situation at baseline, the proportion of men and women aged 80 who reported loneliness increased significantly during the follow-up.

Depressive symptoms in late life : Results from a study in three Nordic urban localities.

The prevalence and correlates of depressive symptoms among 75-year-olds were examined in three Nordic urban localities: Gothenburg, Sweden (n=446), Jyväskylä, Finland (n=382) and Glostrup, Denmark (n=541). Depressive symptomatology was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). Prevalence figures for depressiveness seemed to be somewhat higher in Jyväskylä than in the two other localities. Women had more depressive symptoms than men in all three areas. The lowest mean score was recorded for Danish men and the highest level of symptoms in Finnish women. The associations discovered in this Nordic comparative study between demographic characteristics and depressive symptoms are very similar to the findings of earlier studies: male sex, being married, a high level of education, and a good financial situation seemed to afford 'protection' against depressiveness. Morbidity and poor self-rated health showed a clear correlation with frequent depressive symptoms, as did loneliness variables describing the quality or the lack of human relations.

Factors related to carrying out everyday activities among elderly people aged 80.

The study was based on an epidemiological model in which performing activities of daily living (ADL) was the dependent variable. Variation in performing was explained by physical and mental health, and by physical performance. The population consisted of all 80-year-old residents (N = 291) of the city of Jyväskylä in central Finland; 90% of them agreed to take part in the interviews at home, while 72% took part in the laboratory examinations to determine health status and functional capacity. Difficulties in at least some PADL (Physical Activities of Daily Living) tasks were reported by 86.5% of the men, and 87.2% of the women; none said they could perform all IADL (Instrumental Activities of Daily Living) tasks without difficulty. Physical performance (grip strength and stair mounting test in men, and stair mounting test, balance, and upper extremity function test in women) and visual acuity showed a significant association with ADL performance both in men and in women. In addition, depressive symptoms in women, and cognitive capacity in men were associated with both PADL and IADL, and ADL performance, respectively. In the search for pathways to reduced ADL performance, it is important to look not only at chronic diseases but also at the aging processes as well as the disabilities caused by inactivity. Tests of cognitive capacity, psychological well-being and physical performance provide valuable information on the factors that underlie the aged individual's reduced functional capacity.

Two approaches to the study of experiences of health and old age: the thematic interview and the narrative method.

This paper discusses two methods of data collection for the study of experienced health and old age: the thematic interview and the narrative method, both of which represent the interpretive research paradigm. Two applications of the method are described: the thematic interview was used in a study of patient experiences of health and nursing, and the narrative method in a study of experiences of ageing. The role and utility of the methods are discussed from the point of view of nursing research.

Patterns of experienced aging with a Finnish cohort.

A cohort study of eighty-year old residents in Jyväskylä (pop. 66,000), central Finland, was carried out in 1990 as part of the EVERGREEN-project. A total of 262 persons born in 1910 were interviewed in the cohort study. The survey data produced a fairly accurate picture of the respondents' objective situation. In order to shed further light on how the respondents felt about growing old, tape recorded narrative stories were collected from a subsample of twenty persons (10 women and 10 men). The stories revealed the subjective meanings and evaluations attached by the individuals concerned to their own aging. Being members of the same culture and the same age cohort, they also shared the same way of perceiving themselves and the surrounding world. It became obvious that there existed some kind of boundary conditions for the experience of aging. The model of boundary conditions for the experience of aging was developed on the basis of the narratives.