Mental Well-being Of Older People Research Articles

Physical capability and subsequent positive mental wellbeing in older people: findings from five HALCyon cohorts

Objective measures of physical capability are being used in a growing number of studies as biomarkers of healthy ageing. However, very little research has been done to assess the impact of physical capability on subsequent positive mental wellbeing, the maintenance of which is widely considered to be an essential component of healthy ageing. We aimed to test the associations of grip strength and walking, timed get up and go and chair rise speeds (assessed at ages 53 to 82 years) with positive mental wellbeing assessed using the Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS) 5 to 10 years later. Data were drawn from five British cohorts participating in the Healthy Ageing across the Life Course research collaboration. Data from each study were analysed separately and then combined using random-effects meta-analyses. Higher levels of physical capability were consistently associated with higher subsequent levels of wellbeing; for example, a 1SD increase in grip strength was associated with an age and sex-adjusted mean difference in WEMWBS score of 0.81 (0.25, 1.37), equivalent to 10 % of a standard deviation (three studies, N = 3,096). When adjusted for body size, health status, living alone, socioeconomic position and neuroticism the associations remained albeit attenuated. The finding of these consistent modest associations across five studies, spanning early and later old age, highlights the importance of maintaining physical capability in later life and provides additional justification for using objective measures of physical capability as markers of healthy ageing.Electronic supplementary materialThe online version of this article (doi:10.1007/s11357-013-9553-8) contains supplementary material, which is available to authorized users.

Social capital as a resource for mental well-being in older people: A systematic review

Social capital has previously been reviewed in relation to mental health. However, none have focused specifically on positive aspects of mental health such as mental well-being. This review aimed to explore the relationship between social capital and mental well-being in older people. Ten relevant databases were systematically searched using an extensive search strategy for studies, analyzing the link between social capital and mental well-being. Criteria for inclusion in the systematic review were: the study sample included older people (≥50 years); the study reported a mental well-being outcome; social capital was an exposure variable; and empirical research using quantitative methods and published in English, between January 1990 and September 2011. Eleven studies met the inclusion criteria. Each study was assessed against seven possible exposure measures (structural, cognitive; bonding, bridging, linking; individual, collective). The results showed that all included studies found positive associations between parts of social capital and aspects of mental well-being. Typically, the relationship between social capital and mental well-being differed within as well as between studies. Our results highlight that there is no ‘gold standard’ of how to measure social capital or mental well-being. Social capital is generated in the interaction between individual and collective life. A possibility for future research is therefore to follow Bronfenbrenner's classical division into macro, meso, and micro levels. We consider family and friends at the micro level to be the key factors in generating social capital and well-being in older people.

Cognitive Function in Childhood and Lifetime Cognitive Change in Relation to Mental Wellbeing in Four Cohorts of Older People

BackgroundPoorer cognitive ability in youth is a risk factor for later mental health problems but it is largely unknown whether cognitive ability, in youth or in later life, is predictive of mental wellbeing. The purpose of this study was to investigate whether cognitive ability at age 11 years, cognitive ability in later life, or lifetime cognitive change are associated with mental wellbeing in older people.MethodsWe used data on 8191 men and women aged 50 to 87 years from four cohorts in the HALCyon collaborative research programme into healthy ageing: the Aberdeen Birth Cohort 1936, the Lothian Birth Cohort 1921, the National Child Development Survey, and the MRC National Survey for Health and Development. We used linear regression to examine associations between cognitive ability at age 11, cognitive ability in later life, and lifetime change in cognitive ability and mean score on the Warwick Edinburgh Mental Wellbeing Scale and meta-analysis to obtain an overall estimate of the effect of each.ResultsPeople whose cognitive ability at age 11 was a standard deviation above the mean scored 0.53 points higher on the mental wellbeing scale (95% confidence interval 0.36, 0.71). The equivalent value for cognitive ability in later life was 0.89 points (0.72, 1.07). A standard deviation improvement in cognitive ability in later life relative to childhood ability was associated with 0.66 points (0.39, 0.93) advantage in wellbeing score. These effect sizes equate to around 0.1 of a standard deviation in mental wellbeing score. Adjustment for potential confounding and mediating variables, primarily the personality trait neuroticism, substantially attenuated these associations.ConclusionAssociations between cognitive ability in childhood or lifetime cognitive change and mental wellbeing in older people are slight and may be confounded by personality trait differences.

Promoting the mental well-being of older people from black and minority ethnic communities in United Kingdom rural areas: Findings from an interview study

Drawing from 81 interviews with practitioners in social care and housing with care services in the United Kingdom, this paper explores practice issues in rural areas when supporting the mental health and well-being of older people from Black and minority ethnic groups. The paper begins with a review of the literature which provides evidence that BME older people are likely to be increasingly part of the populations of rural areas. Next it presents interview data revealing that while practitioners are aware of such demographic changes in general terms; some feel that they lack training and skills in adapting their professional practice to support all older people. Others express feelings of professional isolation in seeking to support older people from minority groups and are concerned that older people from minority groups may be at risk of isolation and loneliness. The paper concludes with a discussion of the study's implications for rural practice, policy and research.

What do we know about economic evaluations of psychosocial interventions to promote mental health and wellness in older people?

Background/Objectives: A systematic review was undertaken to map what is known about the cost effectiveness of investing in interventions to promote the mental wellbeing of older people and/or to prevent the onset of depression or depressive symptoms in people aged 65 or older. This was undertaken as part of the EU Research Framework Programme funded DATAPREV project, which sought to synthesise high quality research evidence on the effectiveness and cost effectiveness of mental health promoting interventions across the lifespan.

Is exercise effective in promoting mental well-being in older age? A systematic review

Background: Promoting the mental well-being of older people has been neglected. Aim: To examine the clinical and cost-effectiveness of exercise and physical activity interventions on mental well-being in people aged 65+. Design: Systematic review, meta-analysis, economic model. Methods: Reports published in English, identified by searching 25 databases, 11 websites and references lists of systematic reviews. Eligible studies were those with a comparison or control group or offering qualitative evidence; exercise and physical activity interventions for people aged 65 and above living at home, in the community, in supported housing or in residential care homes; including outcome measures of mental well-being, not simply measures of depression or anxiety. Low-quality studies were excluded from the data synthesis. Results: An overall effect of exercise on mental well-being was found (standardised effect size = 0.27; CI = 0.14–0.40). The included interventions were designed for older people, targeted those who are sedentary and delivered in a community setting, primarily through a group-based approach led by trained leaders. As a minimum, the evidence would suggest two exercise sessions per week, each of 45 min duration. There is some indication that exercise can also improve the mental well-being of frail elders. Economic evidence indicated incremental cost-effectiveness ratios (compared with minimal intervention) of £7300 and £12,100 per quality adjusted life year gained for community-based walking and exercise programmes, respectively. Conclusions: Mental well-being in later life is modifiable through exercise and physical activity. To generalise the findings, there is a need for more evidence of effectiveness from older people in the UK.

Physical activity and mental well-being in older people participating in the Better Ageing Project

Increasing evidence suggests that physical activity can prevent some aspects of mental illness in older people such as depression, dementia and Alzheimer's disease. Additionally, limited research has shown that engagement in structured exercise can improve aspects of psychological well-being such as mood and self-perceptions in older adults. However, the relationship between incidental daily activity such as walking or time spent sedentary, with psychological well-being has not been investigated. The Better Ageing Project provided an opportunity to assess well-being and quality of life using standardised questionnaires with 176 adults aged 70 and over. Accelerometry was used to objectively assess daily energy expended in physical activity at different levels of intensity. In addition, an assessment of the impact of the 12-month Better Ageing structured group exercise programme was assessed through questionnaires and interviews. Total daily physical activity energy expenditure (joules/day) and amount of time spent in activity of at least moderate intensity were weakly related (r = 0.20-0.28) to quality of life, subjective well-being and physical self-perceptions. Time spent sedentary (min/day) was weakly and negatively related to several mental health indicators. The quantitative data showed only minor psychological benefits of the exercise intervention. In contrast, interviews with 27 research participants and 4 exercise leaders suggested that important improvements in perceived function and social benefits had been experienced.

Interview Modality

Objectives:To contrast the costs and quality of data collected in person, by telephone, and by self-administered questionnaires in a sample of older persons. Methods: Data collected via interviews with 586 women are contrasted on four dimensions. Results:The cost of data collection was 25% to 30% lower for the self-administered mode than for other modes. Response rates were highest for the inperson interviewand lowest for the self-administered questionnaire. The rate of missing data was highest for the self-administered questionnaire. Significant differences in response effects were found across mode, with respondants to self-administered questionnaires profiling the poorest. Discussion:The costs and quality of data collected by various modes are discussed in terms of their implications for understanding the physical and mental well-being of older people.