Abstract
Advanced old age has been characterized as a biologically highly vulnerable life phase. Biological, morbidity-, and cognitive impairment-related factors play an important role as mortality predictors among very old adults. However, it is largely unknown whether previous findings confirming the role of different wellbeing domains for mortality translate to survival among the oldest-old individuals. Moreover, the distinction established in the wellbeing literature between hedonic and eudaimonic wellbeing as well as the consideration of within-person variability of potentially relevant mortality predictors has not sufficiently been addressed in prior mortality research. In this study, we examined a broad set of hedonic and eudaimonic wellbeing indicators, including their levels, their changes, as well as their within-person variability, as predictors of all-cause mortality in a sample of very old individuals. We used data from the LateLine study, a 7-year longitudinal study based on a sample of n = 124 individuals who were living alone and who were aged 87–97 years (M = 90.6, SD = 2.9) at baseline. Study participants provided up to 16 measurement occasions (mean number of measurement occasions per individual = 5.50, SD = 4.79) between 2009 and 2016. Dates of death were available for 118 individuals (95.2%) who had deceased between 2009 and 2021. We ran longitudinal multilevel structural equation models and specified between-person level differences, within-person long-term linear change trends, as well as the “detrended” within-person variability in three indicators of hedonic (i.e., life satisfaction and positive and negative affect) and four indicators of eudaimonic wellbeing (i.e., purpose in life, autonomy, environmental mastery, and self-acceptance) as all-cause mortality predictors. Controlling for age, gender, education, and physical condition and testing our sets of hedonic and eudaimonic indictors separately in terms of their mortality impact, solely one eudaimonic wellbeing indicator, namely, autonomy, showed significant effects on survival. Surprisingly, autonomy appeared “paradoxically” related with mortality, with high individual levels and intraindividual highly stable perceptions of autonomy being associated with a shorter residual lifetime. Thus, it seems plausible that accepting dependency and changing perceptions of autonomy over time in accordance with objectively remaining capabilities might become adaptive for survival in very old age.
Highlights
The fourth age has been described, both from a theoretical perspective as well as from an empirical perspective, as a biologically highly vulnerable phase in life (Baltes, 1997; Baltes and Smith, 2003; Wahl and Ehni, 2020), characterized by changing life circumstances and loss experiences across various domains, such as decreasing physical health and functional ability, declining cognitive and sensory resources, as well as increasing constraints in self-regulation (Gerstorf and Ram, 2009)
“risk factor paradoxes,” such as identified for medical risk factors in geriatric research (Ahmadi et al, 2015), might be detectable in psychological adaptation to typical late-life conditions (Schilling, 2016). This might be true with regard to psychological aspects of wellbeing and their adaptive – or maladaptive – role in very old age, with wellbeing representing a domain of psychological functioning that can be considered as both outcome and driver of successful aging
As life circumstances and resources become qualitatively different in the final years of the life span (Baltes and Smith, 2003; Gerstorf and Ram, 2009; Wahl and Ehni, 2020), this may, for one, lead to reversed interrelations in which specific resource constellations being protective for health and survival in early old age may become dysfunctional under conditions of the fourth age (Schilling, 2016; Mueller et al, 2017)
Summary
The fourth age has been described, both from a theoretical perspective as well as from an empirical perspective, as a biologically highly vulnerable phase in life (Baltes, 1997; Baltes and Smith, 2003; Wahl and Ehni, 2020), characterized by changing life circumstances and loss experiences across various domains, such as decreasing physical health and functional ability, declining cognitive and sensory resources, as well as increasing constraints in self-regulation (Gerstorf and Ram, 2009). “risk factor paradoxes,” such as identified for medical risk factors in geriatric research (Ahmadi et al, 2015), might be detectable in psychological adaptation to typical late-life conditions (Schilling, 2016). This might be true with regard to psychological aspects of wellbeing and their adaptive – or maladaptive – role in very old age, with wellbeing representing a domain of psychological functioning that can be considered as both outcome and driver of successful aging
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