Affective Well-Being in the Last Years of Life: The Role of Health Decline
Affective Well-Being in the Last Years of Life: The Role of Health Decline
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DOI：
10.1037/pag0000279
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发表时间：
2018-08-01
影响因子：
3.7
通讯作者：
Huisman, Martijn
中科院分区：
文献类型：
--
作者：
Schilling, Oliver K.;Deeg, Dorly J. H.;Huisman, Martijn
除了最近情感幸福感最终下降的证据外，这项研究还检查了身体健康在解释与死亡时间相关的积极情绪(PA)和负面情绪(NA)变化中的作用。我们区分了终末期健康水平预测水平(保持分化)和终末期变化(终末期变化)的影响，以及终末期健康下降预测生命末期情感幸福感的终末期变化(终末期反应性)的影响。数据来自阿姆斯特丹纵向老龄化研究的第一个队列，包括从1992-1993到2011-2012的三年测量(N=2310，基线年龄=55-85)。PA和NA的测量来自流行病学研究中心抑郁量表。健康测量包括自我评估的健康状况、自我报告的功能限制和步态速度。用混合回归模型分析PA和NA的指数死亡时间相关轨迹。结果证实PA与死亡时间相关加速下降，NA升高。关于健康影响，研究结果支持终末期反应性，因为生命末期情感幸福感的变化量与同时发生的终末期健康变化密切相关。临终前的健康水平不能预测情感幸福感的终末期变化量；然而，到了生命的最后几年，功能健康水平更好的人似乎会更长时间地保持更好的情感幸福感水平，而临终时的下降更“压缩”到死亡前的较短时间。研究结果指出，需要加强个人资源，以弥补其生命末期的健康损失。
Adding to recent evidence of terminal decline in affective well-being, this study examined the role of physical health in accounting for time-to-death-related changes in positive affect (PA) and negative affect (NA). We distinguished effects of preterminal health levels predicting levels ("preserved differentiation") and terminal changes ("differential preservation") and of terminal health declines predicting terminal changes ("terminal reactivity") of affective well-being in the terminal period of life. Data were used from the first cohort of the Longitudinal Aging Study Amsterdam, including 3-yearly measurements from 1992-1993 to 2011-2012 (N = 2310, age = 55-85 at baseline). Measures of PA and NA were derived from the Center for Epidemiologic Studies Depression Scale. Health measures included self-rated health, self-reported functional limitations, and gait speed. Exponential time-to-death-related trajectories in PA and NA were analyzed with mixed regression models. Results confirmed accelerated time-to-death-related decline of PA and increase of NA. Regarding health effects, the findings support terminal reactivity, in that the amount of end-of-life changes in affective well-being was closely linked to the concurrent terminal changes in health. Preterminal health levels did not predict the amount of terminal changes in affective, well-being; however, reaching the final years of life with better levels of functional health appeared to promote longer maintenance of better levels of affective well-being and terminal declines more "compressed" to a shorter period prior to death. The findings point to needs to strengthen individuals resources to compensate for health losses at the end of their life span.