Change in Life Satisfaction Under Chronic Physical Multi-morbidity in Advanced Old Age: Potential and Limits of Adaptation

Abstract

We examined the impact of chronic multi-morbidity on intra-individual change of life satisfaction (LS) in advanced old age, considering (1) adaptation in terms of stabilization or restoration of LS across accumulation of chronic conditions and (2) loss in functional competence to conduct activities of daily living (ADL) as potentially mediating the effect of chronic multi-morbidity on LS. Longitudinal data from a German sample (N = 451, aged 80–90 at baseline, 3 measurements covering 2.25 years) was analyzed by means of latent growth curve modeling. An adaptive curvilinear relationship between self-reported number of chronic conditions health constraints (NCC) at baseline and change in LS was confirmed, where the largest LS decline occurred under medium, but less worsening under highest levels of NCC. Change in ADL predicted LS change, but did not mediate the effects of NCC on LS. The findings confirmed the importance of both chronic multi-morbidity and loss of functional competence as independent predictors of decline in LS in very old age. Only limited evidence supported an adaptive stabilization of LS under accumulating levels of chronic multi-morbidity.