Abstract
BackgroundSense of Coherence (SOC) is defined as a tendency to perceive life experiences as comprehensible, manageable and meaningful. The construct is split in three major domains: Comprehensibility, Manageability, and Meaningfulness. SOC has been associated with successful coping strategies in the face of illness and traumatic events and is a predictor of self-reported and objective health in a variety of contexts. In the present study we aim to evaluate the association of SOC with disability and dependence in Spanish elders.MethodsA total of 377 participants aged 75 years or over from nine locations across Spain participated in the study (Mean age: 80.9 years; 65.3% women). SOC levels were considered independent variables in two ordinal logistic models on disability and dependence, respectively. Disability was established with the World health Organization-Disability Assessment Schedule 2.0 (36-item version), while dependence was measured with the Extended Katz Index on personal and instrumental activities of daily living. The models included personal (sex, age, social contacts, availability of an intimate confidant), environmental (municipality size, access to social resources) and health-related covariates (morbidity).ResultsHigh Meaningfulness was a strong protective factor against both disability (Odds Ratio [OR] = 0.50; 95% Confidence Interval [CI] = 0.29–0.87) and dependence (OR = 0.33; 95% CI = 0.19–0.58) while moderate and high Comprehensibility was protective for disability (OR = 0.40; 95% CI = 0.22–0.70 and OR = 0.39; 95%CI = 0.21–0.74), but not for dependence. Easy access to social and health resources was also highly protective against both disability and dependence.ConclusionsOur results are consistent with the view that high levels of SOC are protective against disability and dependence in the elderly. Elderly individuals with limited access to social and health resources and with low SOC may be a group at risk for dependence and disability in Spain.
Highlights
Sense of Coherence (SOC) is defined as a tendency to perceive life experiences as comprehensible, manageable and meaningful
In order to provide a multi-faceted approach to disability in line with the conceptual basis provided by the International classification of disability (ICF) system, we introduced selected social, and environmental variables, whose influence on disability is well documented [1, 13, 15]
Sex and morbidity were non-significant for all analyses with the exception of sex for disability
Summary
Sense of Coherence (SOC) is defined as a tendency to perceive life experiences as comprehensible, manageable and meaningful. Greater attention has been devoted to behavioral risk factors (e.g., anger, type A behavior pattern), as opposed to protective behavioral factors. Among the latter, resilience, hardiness and sense of coherence (SOC) have been associated with selfreported health, sickness recovery, and protection against sickness [2]. Sense of coherence is defined as “a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that (a) the stimuli deriving from one’s internal and external environments in the course of living are structured, predictable, and explicable (comprehensibility); (b) the resources are available to one to meet the demands posed by these stimuli (manageability); and (c) these demands are challenges, worthy of investment and engagement (meaningfulness)” [4]
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