Successful ageing in adversity – The LASER-AD longitudinal study
Abstract
Background:Most models of successful ageing do not allow for the possibility of living“successfully,” despite some degree of cognitive or physical impairment. We reviewed the successful ageing and related quality of life literature to identify their potential predictors. We then tested our hypotheses that wellbeing in adversity would be predicted by mental health (anxiety and depression) and social factors rather than physical health and that it would be stable over time.
Method:We interviewed 224 people with Alzheimer’s disease (AD) and their family carers, recruited to be representative of those living with AD in the community. We reinterviewed 122 (73.1% of eligible) participants 18 months later. Our main outcome measure was the person with AD’s own perception of their life as a whole.
Results:Mean “wellbeing in adversity” scores did not change significantly over time (t = 0.23). Social relationships, subjective mental health, health perception, ADL and baseline wellbeing in adversity were the significant correlates of wellbeing in adversity on univariate analysis. Only baseline wellbeing in adversity and mental health score were significant predictors in our regression analysis. In a well-fitting structural equation model, less severe dementia and better health perception predicted fewer mental health problems and social relationships, but were not direct predictors of wellbeing in adversity at eighteen months.
Conclusion:Successful ageing was common amongst a cohort of people with dementia. The most important predictors of this were mental health and social relationships, which fully mediated the relationship we found between health perception and wellbeing 18 months later.
