Evidence on the Bidirectional Relationship Between Health and Life Satisfaction in Older Adults

Abstract

Previous research on health and life satisfaction in older adults has suggested a bidirectional relationship. However, most evidence either is based on cross-sectional data, being unsuitable for inferring any directionality on the results, or disregards the within-person stability of both variables over time, thus providing potentially biased results. We analysed data from 11,667 older adults interviewed between 2008 and 2016 within the English Longitudinal Study of Ageing. A health measure including self-reported and measured tests on cognitive and physical performance was computed using a Bayesian multilevel item-response theory approach. Life satisfaction was assessed with the Satisfaction with Life Scale. Cross-lagged models using a Structural Equation Modelling approach were used to analyse the longitudinal interrelation between health and life satisfaction. Models accounting and not accounting for the within-person stability in the measures were computed. Additional sensitivity models were ran using an exclusively self-reported measure of health. Health and life satisfaction were significant longitudinal predictors of one another only when the within-person stability was not considered. The effect of life satisfaction on health became negligible once that stability was modelled. The impact of not accounting for within-person stability was larger when health was measured exclusively with self-reported information. Our study suggests that health and life satisfaction are not bidirectionally related in older adults, but only health predicts a better life satisfaction over time. Thus, policies aimed at fostering older adults’ life satisfaction by focusing on health enhancement and maintenance may be fruitful, whereas the opposite may not.