Psychological approach to successful ageing predicts future quality of life in older adults
Psychological approach to successful ageing predicts future quality of life in older adults
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DOI：
10.1186/1477-7525-9-13
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发表时间：
2011-03-09
影响因子：
3.6
通讯作者：
Iliffe, Steve
中科院分区：
文献类型：
--
作者：
Bowling, Ann;Iliffe, Steve
背景：公共政策旨在促进福祉，并最终提高以后的生活质量。对老龄化的积极看法得到了成功老龄化的一系列评价的支持。本研究旨在调查成功老龄化的生物、心理和社会基线因素是否可以预测未来的生活质量。方法：在2007/8年度对1999/2000年度全国随机抽样的999名65岁及以上老年人进行邮寄随访。在随访期的496个幸存者有效地址中，随访率为58%(287)。使用基线指标构建了成功老龄化的不同概念的衡量标准。他们被评估了他们独立预测生活质量的能力。结果：很少有受访者在每种成功老龄化的方法中都获得了所有的高分。当连续分析每种方法的得分时，每种方法都与随访的生活质量相关。当使用成功老龄化(完全健康)或不成功(不完全健康)的传统二分法分界点时，生物医学(健康)方法没有达到重要意义。在每种方法的相对预测能力的多元回归分析中，只有心理方法(自我效能感和乐观性)保持显著。结论：只有成功老龄化的心理方法独立预测随访时的生活质量。成功的衰老不仅关乎保持健康，还关乎最大限度地利用一个人的心理资源，即自我效能和韧性。更多地使用预防性护理，更好地对发病率进行医疗管理，以及改变老年人的生活方式，可能会对健康和长寿产生有益的影响，但可能不会改善他们的生活质量。增加生命的年数和增加寿命可能需要两种截然不同的方法，一种是身体上的，另一种是心理上的。随访的健康状况、支持者的数量和社交活动以及自我评估的积极老龄化也显著地预测了随访时的生活质量。对健康幸存者的纵向样本偏向可能低估了这些结果。
Background: Public policies aim to promote well-being, and ultimately the quality of later life. Positive perspectives of ageing are underpinned by a range of appraoches to successful ageing. This study aimed to investigate whether baseline biological, psychological and social aproaches to successful ageing predicted future QoL.Methods: Postal follow-up in 2007/8 of a national random sample of 999 people aged 65 and over in 1999/2000. Of 496 valid addresses of survivors at follow-up, the follow-up response rate was 58% (287). Measures of the different concepts of successful ageing were constructed using baseline indicators. They were assessed for their ability to independently predict quality of life at follow-up.Results: Few respondents achieved all good scores within each of the approaches to successful ageing. Each approach was associated with follow-up QoL when their scores were analysed continuously. The biomedical (health) approach failed to achieve significance when the traditional dichotomous cut-off point for successfully aged (full health), or not (less than full health), was used. In multiple regression analyses of the relative predictive ability of each approach, only the psychological approach (perceived self-efficacy and optimism) retained significance.Conclusion: Only the psychological approach to successful ageing independently predicted QoL at follow-up. Successful ageing is not only about the maintenance of health, but about maximising one's psychological resources, namely self-efficacy and resilience. Increasing use of preventive care, better medical management of morbidity, and changing lifestyles in older people may have beneficial effects on health and longevity, but may not improve their QoL. Adding years to life and life to years may require two distinct and different approaches, one physical and the other psychological. Follow-up health status, number of supporters and social activities, and self-rated active ageing also significantly predicted QoL at follow-up. The longitudinal sample bias towards healthy survivors is likely to underestimate these results.