Subjective wellbeing, health, and ageing.
Subjective wellbeing, health, and ageing.
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DOI：
10.1016/s0140-6736(13)61489-0
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发表时间：
2015-02-14
期刊：
影响因子：
--
通讯作者：
Stone AA
中科院分区：
文献类型：
--
作者：
Steptoe A;Deaton A;Stone AA
老年人的心理健康和健康密切相关。心理幸福感可以分为三个方面：评价性幸福感（或生活满意度）、享乐性幸福感（快乐、悲伤等的感觉）和幸福感（生活的目的感和意义感）。我们回顾了这一领域的最新进展，并提出了有关跨年龄段福祉模式以及老年福祉与生存之间关系的新分析。盖洛普世界民意调查（Gallup World Poll）是一项针对 160 多个国家/地区的持续调查，显示在富裕的英语国家中，评价幸福感与年龄之间呈 U 形关系，其中幸福感水平最低的年龄层为 45-54 岁左右。但这种模式并不普遍：例如，前苏联和东欧的受访者的幸福感随着年龄的增长而大幅下降；拉丁美洲的幸福感也随着年龄的增长而下降，而撒哈拉以南非洲的幸福感随着年龄的增长几乎没有变化。身体健康和主观幸福感之间的关系是双向的。患有冠心病、关节炎和慢性肺病等疾病的老年人表现出抑郁情绪水平升高以及享乐和幸福感受损。幸福感也可能对健康维护起到保护作用。在英国老龄化纵向研究 (ELSA) 的一项说明性分析中，我们发现幸福感与更长的生存期相关。在平均 8.5 年的随访期内，幸福感最低四分位数的人有 29.3% 死亡，而幸福感最高四分位数的人则为 9.3%。关联与年龄、性别、人口因素以及基线心理和身体健康无关。我们的结论是，老年人的福祉是经济和卫生政策的重要目标。当前的心理学和经济理论未能充分解释世界不同地区幸福感模式随年龄的变化。幸福感与生存之间的明显关联与高幸福感的保护作用是一致的，但现阶段不能排除其他解释。
Psychological wellbeing and health are closely linked at older ages. Three aspects of psychological wellbeing can be distinguished: evaluative wellbeing (or life satisfaction), hedonic wellbeing (feelings of happiness, sadness, etc), and eudemonic wellbeing (sense of purpose and meaning in life). We review recent advances in this field, and present new analyses concerning the pattern of wellbeing across ages and the association between wellbeing and survival at older ages. The Gallup World Poll, an ongoing survey in more than 160 countries, shows a U-shaped relationship between evaluative wellbeing and age in rich, English speaking countries, with the lowest levels of wellbeing around ages 45-54. But this pattern is not universal: for example, respondents from the former Soviet Union and Eastern Europe show a large progressive decline in wellbeing with age; Latin America also shows falling wellbeing with age, while wellbeing in sub-Saharan Africa shows little change with age. The relationship between physical health and subjective wellbeing is bidirectional. Older people suffering from illnesses such as coronary heart disease, arthritis and chronic lung disease show both raised levels of depressed mood and impaired hedonic and eudemonic wellbeing. Wellbeing may also have a protective role in health maintenance. In an illustrative analyses from the English Longitudinal Study of Ageing (ELSA), we find that eudemonic wellbeing is associated with longer survival; 29.3% of people in the lowest wellbeing quartile died over the average follow-up period of 8.5 years compared with 9.3% of those in the highest quartile. Associations were independent of age, gender, demographic factors, and baseline mental and physical health. We conclude that the wellbeing of the elderly is an important objective for both economic and health policy. Current psychological and economic theories do not adequately account for the variations in pattern of wellbeing with age across different parts of the world. The apparent association between wellbeing and survival is consistent with a protective role of high wellbeing, but alternative explanations cannot be ruled out at this stage.