Higher Purpose In Life Research Articles

Trajectories of Pain in Very Old Age: The Role of Eudaimonic Wellbeing and Personality.

Pain is common in very old age and in the last years prior to death. However, little is known regarding longitudinal trajectories of pain in very old age and at the end of life. Moreover, whereas medical and morbidity-related factors contributing to pain are established, the role of psychosocial factors, such as eudaimonic wellbeing or personality as potential determinants of late-life pain trajectories has so far not been sufficiently investigated. We used data from the LateLine project. The sample consisted of n = 118 very old adults (M = 90.5 years, SD = 2.8 years) who were living alone at baseline and who had died between 2009 and 2021. They took part in up to 16 measurement occasions (M = 5.2, SD = 4.7, range 1–16) within an observational interval of 7 years. Assessment of pain was based on the SF-36 bodily pain subscale. Key indicators of eudaimonic wellbeing (autonomy, environmental mastery, and purpose in life) as well two of the Big Five personality traits (neuroticism and extraversion) were included as predictors. We controlled in all analyses for gender, education, subjective health, and depressive symptoms. Contrasting pain trajectories over chronological age (time since birth) vs. time to death, a time-to-death-related model resulted in a better model fit and accounted for a larger amount of pain variability than the age-related model. Mean-level change in pain, both over age and time to death, was not significant, but there was substantial interindividual variability in intraindividual trajectories. Age-related change in pain was significantly predicted by autonomy and neuroticism, with increasing pain among those who had lower initial autonomy scores and higher initial neuroticism scores. With regard to time-to-death-related trajectories of pain, higher purpose in life as well as lower extraversion at baseline predicted less increase or even steeper decrease in pain with approaching death. Our findings suggest that, despite overall mean-level stability in pain both over age and time to death, there is a substantial proportion of individuals who reveal deterioration in pain over time. Regarding the role of psychosocial predictors, personality traits and eudaimonic wellbeing are related with late-life pain trajectories both over age and time-to-death.

Sense of Purpose in Life and Markers of Hearing Function: Replicated Associations across Two Longitudinal Cohorts

Introduction: A sense of purpose in life is a psychological resource that is associated with healthier outcomes. The present research examines whether a greater sense of purpose in life is associated with subjective and objective markers of hearing health and whether hearing acuity contributes to the association between purpose and episodic memory. We sought to evaluate whether these associations were replicable across 2 independent samples. Methods: Participants in the Health and Retirement Study (N = 14,291) and the English Longitudinal Study of Ageing (N = 8,844) reported on their purpose in life and perceived hearing quality at baseline. Hearing acuity was measured using an audiometer 2–4 years later, and episodic memory was measured at baseline and 6–8 years later. Results: In both samples, higher purpose in life was associated with better hearing quality measured concurrently, lower risk of either subjective or objective hearing impairment, and hearing acuity accounted for some of the longitudinal relation between sense of purpose and better episodic memory. Discussion: Across samples, measures, and analytical approaches, the present research indicates replicable associations between sense of purpose in life and hearing health. It further indicates that hearing may be one factor that associates purpose with better episodic memory.

Propósito de vida e desempenho de atividades avançadas de vida diária em idosos mais velhos

Abstract Objective To verify the association between purpose in life (PL) and the performance in advanced (AADL) and instrumental (IADL) activities of daily living. Methods Cross-sectional community-based study which analyzed data from the follow-up assessment of the FIBRA Study (Frailty in Elderly Brazilians) in the cities of Campinas and Ermelino Matarazzo (SP), Brazil, in 2016 and 2017. Participants were 187 community dwelling persons aged 80 years and older. The protocol included the application of a cognitive deficit screening test suggestive of dementia, an inventory assessing AADL, the Lawton and Brody scale (IADL), the Geriatric Depression Scale and the Ryff and Keyes’ (1995) Purpose in Life Scale. Results Participants had an average of 83.81 (±3.60) years, 4.38 (± 3.76) years of schooling, 3.49 minimum wages (±2.61) of income, 125 (66.8%) being women. Hierarchical linear regression analyzes showed that PV and depressive symptoms were significantly associated with a higher number of AADL (p=0.003) and no significant association with IADL scores (0.580), in a model adjusted for sociodemographic variables, self-rated health, cognitive performance and depression. Conclusions The results suggest that older adults with higher PL and lower number of depression symptoms are more likely to perform a higher number of AADL. This association was not observed for IADL, which were associated with age, sex, depression and cognitive performance. PL may have an impact on complex levels of functional status in the elderly, thus contributing to healthy aging.

Resilience, Purpose in Life, Loneliness, and Associated Medical Costs in Older Adults

Resilience, purpose in life (PIL), and loneliness have been linked, and used to characterize the health and well-being of older adults. Studies demonstrate that higher resilience, PIL, and minimal loneliness are associated with better late-life outcomes. However, research on how these constructs negatively impact medical costs is limited. Using survey and claims data from a large sample of older adults age 65+ (N=4,496), resilience, PIL, and loneliness were examined to determine associations with medical costs. Among study participants, 11% exhibited low resilience, 19% severe loneliness, and 35% low PIL. Low resilience was associated with 24% higher medical costs compared to participants with high resilience, severe loneliness with 20% higher costs compared to participants with no loneliness, and low PIL marginally associated with 12% higher costs compared to participants with high PIL. Interventions targeting resilience, PIL, and loneliness could be beneficial to promoting successful aging and lowering medical costs.

Pathways to Reduced Overnight Hospitalizations: Evaluating 62 Physical, Behavioral, and Psychosocial Factors

As healthcare costs rise steadily and rapidly, researchers and policymakers are increasingly interested in reducing healthcare utilization costs. Growing evidence documents many factors that may influence healthcare utilization; however, less is known about how changes in candidate predictors influence subsequent healthcare utilization. Using data from 11,374 participants in the Health and Retirement Study (HRS)—a diverse, longitudinal, and nationally representative sample of older adults in the United States, we evaluated a large range of candidate predictors of overnight hospitalizations. Using generalized linear regression models with a lagged exposure-wide approach, we evaluated if changes in 62 predictors over four-years (between t0;2006/2008 and t1;2010/2012) were associated with subsequent hospitalizations during the two years prior to t2 (2012-2014 (Cohort A) or 2014-2016 (Cohort B)). After adjustment for a rich set of baseline covariates, changes in some health behaviors (e.g., frequent physical activity), physical health conditions (e.g., no physical functioning limitations), and psychosocial factors (e.g., higher purpose in life, lower anxiety, more volunteering) were associated with decreased hospitalizations four years later. However, there was little evidence that other factors (e.g. smoking, obesity) were associated with subsequent hospitalizations. Notably, some psychosocial factors had effect sizes as large as some physical health conditions. Several indicators of physical health, health behaviors, and psychosocial well-being may predict subsequent hospitalizations, and these factors may be novel targets for interventions and policies aiming to reduce healthcare costs in older adults.

Associations Between Changes in Loneliness and Social Connections, and Mental Health During the COVID-19 Pandemic: The Women's Health Initiative.

BackgroundOlder women have faced significant disruptions in social connections during the coronavirus disease 2019 pandemic. Whether loneliness increased, or whether a change in loneliness from pre- to intra-pandemic period was associated with mental health during the pandemic is unknown.MethodsOlder women (n=27,479; mean age 83.2 [SD: 5.4] years) completed surveys in mid-2020, including questions about loneliness, living arrangements, changes in social connections, and mental health. Loneliness was also previously assessed in 2014-2016. We examined whether loneliness changed from the pre- to intra-pandemic period and explored factors associated with this change. In multivariable models, we investigated the association of changes in loneliness and social connections with mental health.ResultsLoneliness increased from pre- to intra-pandemic levels. Factors associated with worsening loneliness included older age, experiencing stressful life events, bereavement, histories of vascular disease and depression, and social connection disruptions. Factors associated with a decrease in loneliness included identifying as Black, engaging in more frequent physical activity, being optimistic, and having a higher purpose in life. A 3-point increase in loneliness scores was associated with higher perceived stress, higher depressive, and higher anxiety symptoms. Social connection disruptions showed modest or no associations with mental health.ConclusionsLoneliness increased during the pandemic in older women and was associated with higher stress, depressive and anxiety symptoms. Our findings point to opportunities for interventions targeting lifestyle behaviors, well-being, disrupted social connections, and paying closer attention to those with specific medical and mental health histories that may reduce loneliness and improve mental health.

Psychosocial factors associated with changes in cognition among middle‐aged and older Hispanics/Latinos: Findings from the HCHS/SOL and the sociocultural and SOL‐Investigation of Neurocognitive Aging (SOL‐INCA) ancillary studies

AbstractBackgroundPsychosocial factors including intrapersonal and interpersonal resources and social stressors are associated with changes in cognition in older non‐Hispanic whites and Blacks. Few studies have examined these associations in Hispanics/Latinos, the largest ethnic/racial group in the US, or evaluated ethnically‐based psychosocial factors that may be more relevant to this population. We examined whether psychosocial factors predict seven‐year cognitive changes among US Hispanics/Latinos.MethodData from the parent HCHS/SOL, and Sociocultural and SOL‐Investigation of Neurocognitive Aging ancillary studies were used (n= 2,158; ages 45+). Baseline psychosocial factors included: intrapersonal factors (optimism; purpose in life), interpersonal factors (family cohesion; social network embeddedness; social support), social stressors (loneliness; subjective social status), and ethnically‐based factors (ethnic identity; familism; perceived ethnic discrimination). Outcomes were changes in individual test scores for episodic learning and memory (B‐SEVLT‐Sum and SEVLT‐Recall), word fluency (WF), and processing speed (Digit Symbol Substitution, DSS) derived using regressions adjusting for time between assessments. Survey linear regression models were used to examine the associations between each psychosocial factor (z‐scores) and 7‐year changes in cognitive outcomes adjusting for age, sex, education, income, Hispanic/Latino background, language preference, and depressive symptoms.ResultMean age was 55.9±7.9 years; females 54% of target population. Higher (baseline) levels of familism [(βSEVLT‐Sum (SE))= ‐0.08 (0.03), P<0.05)] predicted seven‐year decline in verbal learning. Higher optimism [βSEVLT‐Recall= 0.09 (0.03), P<0.01], social support [βSEVLT‐Recall= 0.07 (0.03), P<0.05], and ethnic identity [βSEVLT‐Recall= 0.06 (0.03), P<0.05] each predicted increase in memory. Higher familism [βSEVLT‐Recall= ‐0.08 (0.03), P<0.05] and loneliness [βSEVLT‐Recall= ‐0.06 (0.03), P<0.05] each predicted decline in memory. Higher purpose in life [βWF= 0.07 (0.03), P<0.05] predicted increase in word fluency. Higher family cohesion [βDSS= ‐0.08 (0.03, P<0.01) predicted decline in processing speed. Social network embeddedness, subjective social status, and perceived ethnic discrimination were not associated with any outcome.ConclusionPsychosocial factors differentially related to changes in cognition. Results confirm previous studies in non‐Hispanic whites on associations of optimism, purpose in life, social support, and loneliness with select cognitive tests. They also highlight that ethnic identity and familism are ethnically‐based psychosocial factors that should be considered when examining healthy cognitive aging in US Hispanics/Latinos.

Relationship of Purpose in Life to Dementia in Older Black and White Brazilians.

To test the hypothesis that higher level of purpose in life is associated with lower likelihood of dementia and mild cognitive impairment (MCI) in older Brazilians. As part of the Pathology, Alzheimer's and Related Dementias Study (PARDoS), informants of 1,514 older deceased Brazilians underwent a uniform structured interview. The informant interview included demographic data, the Clinical Dementia Rating scale to diagnose dementia and MCI, the National Institute of Mental Health Diagnostic Interview Schedule for depression, and a 6-item measure of purpose in life, a component of well-being. Purpose scores ranged from 1.5 to 5.0 with higher values indicating higher levels of purpose. On the Clinical Dementia Rating Scale, 940 persons (62.1%) had no cognitive impairment, 121 (8.0%) had MCI, and 453 (29.9%) had dementia. In logistic regression models adjusted for age at death, sex, education, and race, higher purpose was associated with lower likelihood of MCI (odds ratio = .58; 95% confidence interval [CI]: .43, .79) and dementia (odds ratio = .49, 95% CI: .41, .59). Results were comparable after adjusting for depression (identified in 161 [10.6%]). Neither race nor education modified the association of purpose with cognitive diagnoses. Higher purpose in life is associated with lower likelihood of MCI and dementia in older black and white Brazilians.

Purpose In Life in Relation to Stress Coping Strategies: An Exploratory Study of Youth

The aim of the research was to study the relationship between purpose in life and stress coping strategies among youth. Purpose in life is an accomplishing intention which is generalized and stable that is meaningful to oneself and beyond oneself to the world. It can be understood as a central and self- organizing life aim. Stress coping strategies are the ways through which an organism abates the intensity of stressor, by devoting the sensible efforts or developing tolerance towards stress and conflicts. The research design is descriptive and quantitative in nature. The sample of the study comprised of 128 unmarried individuals (64 males and 64 females) in the age range of 18 to 25. The sampling method used in the research study was convenient sampling and the data collection for the study was done using Google Forms through the questionnaires namely, Brief cope Inventory and Purpose in life scale. The study findings revealed that males use more maladaptive ways to cope with stressors. Dysfunctional/Maladaptive coping negatively effects the purpose in life; and Adaptive coping positively predicts purpose in life for both males and females. If an individual employs more adaptive coping strategies including problem and emotion focused coping, higher purpose in life is predicted. Hence, adoption of adaptive coping styles, especially for males is recommended through the research findings.

The Role of Purpose in Life in the Relationship Between Widowhood and Cognitive Decline Among Older Adults in the U.S.

The objective of this study was to examine the role of purpose in life in the relationship between widowhood and cognitive decline. This study used a sample of 12,856 respondents (20,408 observations) collected from a national panel survey, the 2006-2014 waves of the Health and Retirement Study (HRS), that sampled older adults aged 50 or older. The study estimated growth-curve models with years since spousal death, purpose in life, and interaction between the two to predict cognition using three measures-total cognition, fluid, and crystallized intelligence scores. We also estimated growth-curve models by sex, race/ethnicity, and education. While years since spousal death negatively correlated with cognition, purpose in life positively correlated with cognition. Furthermore, purpose in life had a moderating effect on the relationship between years since spousal death and cognition. This effect was found by using total cognition (coef.=0.0515; z=2.64; p < 0.01) and fluid intelligence scores (coef.=0.0576; z=3.23; p < 0.05). The same effects were salient among females (coef.=0.0556; z=2.19; p < 0.05), Whites (coef.=0.0526; z=2.52; p < 0.05), and older adults with more education (coef.=0.0635; z=2.10; p < 0.05). Higher purpose in life relates to the negative correlations between widowhood and cognition of older adults. Educational programs improving purpose in life are a possible avenue for reducing the adverse effect of widowhood on cognition and warrant future exploration.

Associations Between Purpose in Life and Mortality by SES

Having a higher purpose in life has been linked to favorable health outcomes. However, little research has examined whether the purpose-health association persists across different levels of SES. This study assesses whether the association between higher purpose in life and lower mortality is similar across the levels of SES. A national sample of 13,159 U.S. adults aged >50 years from the Health and Retirement Study was analyzed. The baseline year was 2006‒2008. Purpose in life was assessed at baseline using Purpose in Life Subscale of the Ryff Psychological Well-being Scales. The risk of death during an 8-year follow-up was assessed. SES was measured using education, income, and wealth. Using multivariable Poisson regression, effect modification by SES was tested on both the additive and multiplicative scales. Analyses were done in 2020. In analyses stratified by SES, people with the highest level of purpose consistently tended to have lower mortality risk across the levels of SES than those with the lowest level of purpose. However, people with middle-range purpose levels had lower mortality risk only if they also had mid-to-high education, income, and wealth. When formally testing the effect modification by SES, there was modest evidence that the associations between higher purpose and lower mortality were stronger among individuals with high education, income, and wealth. The highest level of purpose appeared protective against all-cause mortality regardless of the levels of SES. By contrast, when levels of purpose were more modest, people with lower SES may benefit less health-wise from having a purpose.

Monitorization of Autonomic Stress Response of Nurse Students in Hospital Clinical Simulation.

The aims of this study were to analyze the autonomic stress response of nurse degree students during a hospital clinical simulation and to analyze differences in the autonomic stress response of nurse degree students during a hospital clinical simulation depending on their psychological profile. We analyzed in 45 nurse students their psychological profile (purpose in life, coping flexibility, perceived stress, Framingham Type A Behavior, and personality) and the autonomic modulation by the heart rate variability in a hospital clinical simulation. Students presented decreased heart rate variability and different autonomic stress responses depending on the different psychological parameters evaluated. We concluded that a hospital clinical simulation produced a large sympathetic modulation of nurse students that was maintained during the entire clinical simulation. The autonomic response was modulated by the psychological profile of students, showing higher purpose in life, perceived stress, and neuroticism, presenting higher parasympathetic modulation.

СТРУКТУРА ТА КОМПОНЕНТНИЙ АНАЛІЗ ЕТИЧНОЇ КОМПЕТЕНТНОСТІ МАЙБУТНЬОГО ПЕРЕКЛАДАЧА

In this article, the authors reveal the structural and component composition of the ethical competence of the future translator. It is formed on the concept of moral consciousness, the principles of professional ethics and a certain set of professionally important qualities. On this basis, the psychological mechanism of the ethical competence of the translator is made, because in our study the spiritual development of the translator means awareness of its high purpose in life, responsibility to present and future generations, understanding the complexity of nature and constant pursuit of moral improvement. The measure of a translator's spiritual development can be the degree of his responsibility for his physical, mental and social development, and professionally important qualities.

Psychological Resilience in Frontline Health Care Workers During the Acute Phase of the COVID-19 Pandemic in New York City.

Data were collected between April 14 and May 11, 2020, during the peak and initial decline of the acute patient surge. An anonymous, incentivized ($25 gift card) survey was emailed to a purposively selected sample of 6,026 FHCWs at Mount Sinai Hospital, an urban tertiary care hospital in NYC. Importance analyses revealed that positive emotions (interested [relative variance explained [RVE] = 14.7%], enthusiastic [RVE = 11.2%]), self-efficacy (RVE = 13.8%), nonengagement in substance use coping (RVE = 9.9%), higher purpose in life (RVE = 7.8%), and emotional support (RVE = 6.9%) and leadership support (RVE = 6.8%) were most strongly associated with psychological resilience, collectively explaining > 70% of the variance in these scores. To our knowledge, this is the first study to examine factors associated with psychological resilience in FHCWs during the acute phase of the COVID-19 pandemic.

Psychosocial Factors Associated with Cognitive Function Among Middle-Aged and Older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos and its Sociocultural Ancillary Study.

Evidence suggests that psychosocial factors are associated with cognitive health in older adults; however, associations of psychosocial factors with cognition remain largely unexamined in middle-aged and older Hispanics/Latinos. To examine the cross-sectional associations of psychosocial factors with cognitive function among middle-aged and older Hispanics/Latinos living in the US. Baseline (2008-2011) data from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (n = 2,818; ages 45-74) were used to examine the associations of each psychosocial factor with global cognition (GC), verbal learning, verbal memory, verbal fluency, and processing speed independent of age, sex, education, Hispanic/Latino background, income, language, and depressive symptoms. Psychosocial variables included: intrapersonal factors (ethnic identity, optimism, and purpose in life), interpersonal factors (family cohesion, familism, social network embeddedness, and social support), and social stressors (perceived ethnic discrimination, loneliness, and subjective social status). In fully-adjusted models, purpose in life and social support were each positively associated with all five cognitive variables. Loneliness was negatively associated with GC, verbal learning, memory, and processing speed. Ethnic identity was positively and familism negatively associated with GC, verbal fluency, and processing speed. Family cohesion was positively associated with verbal learning. These findings extend previous evidence from older, largely non-Hispanic White cohorts to show that higher purpose in life and social support are also strongly associated with cognitive health among middle-aged and older Hispanics/Latinos. We also highlight that intrapersonal factors, interpersonal factors, and social stressors have differential relationships with individual cognitive tests.

Purpose in Life and Motoric Cognitive Risk Syndrome: Replicable Evidence from Two National Samples.

Motoric cognitive risk (MCR) syndrome is characterized by cognitive complaints and slow gait speed in the absence of dementia. Consistent evidence indicates that it predicts dementia and premature mortality. Less is known about its antecedents, particularly the role of psychological function. Purpose in life is an aspect of well-being that reflects a goal-oriented and -driven life that has been implicated in cognitive aging. We aimed to examine the cross-sectional association between purpose in life and MCR and to test the hypothesis that purpose is associated with a lower risk of new cases of MCR over an up to 12-year follow-up. Cross-sectional and longitudinal multi-cohort design. Health and Retirement Study (HRS) and the National Health and Aging Trends Study (NHATS). A total of 6,785 individuals from the HRS and 5,665 from the NHATS. Participants reported on their purpose in life and cognitive complaints and completed a walking speed assessment. Cognitive complaints and walking speed were assessed again up to 12 years later in HRS and up to 7 years later in NHATS. Higher purpose in life was associated with a 33% lower risk of MCR concurrently (meta-analytic odds ratio = .75; 95% confidence interval [CI] = .62-.90; P = .002) and an about 26% lower risk of incident MCR longitudinally (meta-analytic hazard ratio = .77; 95% CI = .70-.84; P < .001). These associations were significant in each sample, were independent of sociodemographic covariates, and persisted after controlling for personality and health-related factors (depressive symptoms, physical activity, disease burden). Purpose in life is associated with a lower risk of incident MCR, an association that was replicated in two independent samples. Purpose is a malleable aspect of psychological function that is a promising target of intervention for healthier cognitive aging.

Surviving and Thriving: Fundamental Social Motives Provide Purpose in Life.

Purpose in life (PIL) is often associated with grand achievements and existential beliefs, but recent theory suggests that it might ultimately track gainful pursuit of basic evolved goals. Five studies (N = 1,993) investigated the relationships between fundamental social motives and PIL. In Study 1, attribution of a life goal pursuit to disease avoidance, affiliation, or kin care motives correlated with higher PIL. Studies 2 and 3 found correlations of self-protection, disease avoidance, affiliation, mate retention, and kin care motives with PIL after controlling for potential confounds. Study 4 showed that writing about success in the status, mating, and kin care domains increased PIL. Study 5 replicated the effect for mating and kin care, but not for status. Results imply that fundamental motives link to PIL through a sense of progress, rather than raw desire. Overall, this set of studies suggests that pursuit of evolved fundamental goals contributes to a purposeful life.

Reducing burnout, vicarious trauma, and secondary traumatic stress through investigating purpose in life in social workers

Summary Social workers fulfill vital roles, servicing clients from vulnerable populations and maintaining their welfare. As a result of frequent interaction with clients who have often experienced trauma, these workers are susceptible to experiencing burnout, secondary traumatic stress, and vicarious trauma. This study aimed to identify if purpose in life is a protective factor for adult/elder protective services (AEPS) and child protective services (CPS) workers. A comprehensive search of AEPS and CPS agencies resulted in more than 500 agencies throughout the United States. Three multiple regressions were run, with purpose in life as the independent variable, controlling for social workers’ years of experience, ethnicity, average of number of hours worked per week. Findings A sample of 292 participants ranging in age from 18 to 58 years of age, with a mean age of 42.03(12.34), participated in this study. Of the 292 social workers, 126 reported being CPS workers and 166 reported being AEPS workers. In all three linear regressions, higher purpose in life resulted in lower rates of vicarious trauma ( F(3, 263)=10.364, p&lt;.001), secondary traumatic stress ( F(3, 263)=16.548, p&lt;.001), and burnout ( F(3, 263)= 23.912, p&lt;.001) when controlling for number of hours worked per week and years of experience. The amount of variance explained by these models ranged from 11 to 21%. Post hoc correlations between study variables were conducted, including the association between purpose in life and CS. Applications This study provides evidence necessary to warrant an intervention for protective services workers, specifically targeted toward increasing purpose in life.

HEALTH AND PHYSICAL FUNCTIONING AS DETERMINANTS OF PURPOSE IN LIFE IN OLD AGE

AbstractPurpose in life reflects the feeling of having goals and meaning in life. Higher purpose in life has been shown to predict better health outcomes in old age and even buffer against mortality. However, it is not known how current health and functional status reflect on the possibilities of older people to live a meaningful life. Therefore, this study aimed to explore associations of health and physical functioning with purpose in life. The participants were 273 community-dwelling 75-year-old men and women from the AGNES study. Purpose in life was assessed with the subscale of the Scales of Psychological well-being (range 7–42). Current health situation and walking ability were self-reported (range 1–5). Physical performance was measured with the Short Physical Performance Battery (range 0–12). Linear regression models adjusted for sex, years of education and marital status were used in the analyses. Better self-rated health (β=1.49, p<.001) and self-reported walking ability (β=0.69, p=.016) were associated with higher purpose in life. Physical performance was not associated with purpose in life (β=0.19, p=.187). Based on the results, it seems that self-reports of health and functioning may be more relevant when considering older people’s possibilities to live a meaningful life than objective measures of functioning.

Profiles of recovery from alcohol use disorder at three years following treatment: can the definition of recovery be extended to include high functioning heavy drinkers?

Recovery from alcohol use disorder (AUD) is often narrowly defined by abstinence from alcohol and improvements in functioning (e.g. mental health, social functioning, employment). This study used latent profile analysis to examine variability in recovery outcomes, defined by alcohol use, alcohol-related problems and psychosocial functioning at 3years following treatment. Secondary analysis investigated pre-treatment, post-treatment and 1- and 3-year post-treatment covariate predictors of the latent profiles. Secondary analysis of data from a randomized clinical trial. United States. We used data from the out-patient arm of Project MATCH (n=806; 29.7% female, 22.2% non-white). Recovery was defined by latent profile analyses including measures of psychosocial functioning and life satisfaction (Psychosocial Functioning Inventory), unemployment and mental health (Addiction Severity Index), alcohol and other drug use (Form 90) and alcohol-related consequences (Drinker Inventory of Consequences) 3 years following treatment. Mixture modeling was used to examine correlates of profiles. We identified four profiles at 3years following treatment: (1) poor functioning frequent heavy drinkers, (2) poor functioning infrequent heavy drinkers, (3) high functioning occasional heavy drinkers and (4) high-functioning infrequent non-heavy drinkers. There were relatively few differences on indicators of functioning and treatment-related variables between the high functioning infrequent non-heavy drinkers and the high-functioning occasional heavy drinkers, other than high-functioning occasional heavy drinkers having lower alcohol dependence severity [odds ratio (OR)=0.94, 95% confidence interval (CI)=0.90, 0.98], fewer post-treatment coping skills (OR=0.54, 95% CI=0.32, 0.90) and lower 3-year post-treatment abstinence self-efficacy (OR=0.37, 95% CI=0.28, 0.49) and Alcoholics Anonymous (AA) involvement (OR=0.87, 95% CI=0.85, 0.99). The two high-functioning profiles showed the greatest improvements in functioning from baseline through the 3-year follow-up, whereas the low-functioning profiles showed the least amount of improvement. High-functioning occasional heavy drinkers had higher purpose in life than the poor-functioning profiles. Some individuals who engage in heavy drinking following treatment for alcohol use disorder may function as well as those who are mostly abstinent with respect to psychosocial functioning, employment, life satisfaction and mental health.