Philadelphia Geriatric Center Morale Scale Research Articles

The Potential of Informal Care for Self-Perceptions of Aging Among Older Community-Dwelling Adults: Longitudinal Findings From the Health and Retirement Study.

This is the first study to analyze, whether receipt of (informal) care with (instrumental) activities of daily living (IADL/ADL) is associated with (positive and negative) self-perceptions of aging among community-dwelling older adults; and whether chronological age moderates these associations, using a longitudinal design. Longitudinal data of the Health and Retirement Study in the United States was used. The sample was composed of up to 9,198 observations of community-dwelling adults aged ≥50 years pooled over 6 waves (2008-2018). Receiving care at all and the amount of care received with (I)ADL were analyzed in association with positive and negative attitudes towards own aging (ATOA; 8-item modified Philadelphia Geriatric Center Morale Scale, positive and negative subscore). Adjusted fixed effects regression analyses with robust standard errors were calculated. Transitioning into receipt of care with any (I)ADL was associated with lower positive ATOA but not with any change in negative ATOA. Chronological age moderated the association between receipt of informal care, primarily with IADL, and negative ATOA. More negative ATOA was found among care recipients between 50 and 64 years but less among care recipients aged ≥80 years. Receiving any form of informal care was associated with an increase in internalized ageism, in particular among adults aged 50 to 64 years, but a decrease among those aged ≥80 years. Psycho-educative measures are recommended for adults with care needs to prevent a loss of positive self-perceptions of aging, and reduce the danger to their healthy aging, with the receipt of care.

The Relationship between Subjective Aging and Cognition in Elderly People: A Systematic Review.

There is a growing body of evidence on the effects of subjective aging on health, well-being and quality of life. This review aims to synthesize findings about the link between subjective aging and cognition and cognitive decline. Furthermore, it provides an examination of variation sources such as subjective aging construct, cognitive domains, measures employed, age and moderator variables. A systematic search was performed in PubMed, PsychInfo and Web of Science, as well as grey literature searches in Google Scholar, OpenGrey, WorldCat and NDLTD, which resulted in 59 reports being included. Subjective aging is a relevant construct in the explanation and prediction of cognitive aging and cognitive decline in elderly adults. More positive views about own aging and self-perceptions of aging, as well as a younger subjective age, were consistently related to better cognition and lower risk of cognitive decline. However, there were differences due to subjective aging subdimensions and cognitive domains, as well as an effect of age. Additionally, there were concerns about the content validity of some measures employed, such as the Philadelphia Geriatric Center Morale Scale for subjective aging and the Mini Mental State Examination for global cognition. Further studies should employ longitudinal designs with a process-based approach to cognition and precise subjective aging measures.

Association between serum oxytocin levels and depressive state in community‐dwelling older adults: A cross‐sectional study

AbstractAimIdentifying peripheral biomarkers related to the prevention or modification of unhealthy mental conditions in older adults would be extremely beneficial. This study aimed to evaluate serum oxytocin levels in older adults living in a rural community and their association with cognitive function, anxiety, depressive state, and well‐being.MethodsThis survey was conducted between November 2016 and September 2017 in Kurokawa‐cho, Imari, Saga Prefecture, Japan, among people aged ≥65 years. Blood samples were collected from the participants for serum oxytocin level analysis, which was performed using peptide enzyme immunoassay. Participants underwent neuropsychological assessments, including the Mini‐Mental State Examination, Clinical Dementia Rating, Frontal Assessment Battery, State‐Trait Anxiety Inventory, 15‐item Geriatric Depression Scale, and 17‐item Philadelphia Geriatric Center Morale Scale. We examined the association between serum oxytocin levels and neuropsychological assessment results.ResultsOut of 94 participants, 25 were men and 69 were women, with mean ages of 78.24 ± 3.85 years and 78.10 ± 5.43 years, respectively. Serum oxytocin levels were negatively associated with 15‐item Geriatric Depression Scale scores. Additionally, nondepressive state/depressive state was classified by the 15‐item Geriatric Depression Scale (cut‐off 5/6). Logistic regression analysis showed that higher serum oxytocin levels tended to be associated with a less depressive state at that time.ConclusionsSerum oxytocin levels may be associated with depressive state in adults aged ≥65 years.

Association Between Higher-Level Functional Capacity and Subjective Well-Being in Older Adults with Chronic Conditions: A Cross-Sectional Study

Aims The aim of the present study was to examine the associations between higher-level functional capacity and subjective well-being (SWB) in older adults with chronic conditions. Materials We used data from a self-administered questionnaire survey conducted in two day-service facilities and one home-visit nursing station. We performed multiple linear regression analyses with SWB measured by the revised Philadelphia Geriatric Center Morale Scale and higher-level functional capacity including instrumental self-maintenance, intellectual activity, and social role. Results 140 persons were included in the analyses. We did not find an association between instrumental self-maintenance and SWB (B = 0.30, 95% confidence interval [CI]: −0.15, 0.75). On the other hand, intellectual activity (B = 0.77, 95%CI: 0.19, 1.34) and social role (B = 0.88, 95% CI: 0.34, 1.43) were associated with SWB. Conclusions Being intellectually active and performing social role may be important to increase SWB in older adults with chronic conditions.

Impact of skin care on body image of aging people: A quasi-randomized pilot trial

AimSupport for various activities of daily living is essential for maintaining the health of residents in nursing homes. Although aging people who move to nursing homes often change their skin care habits, how these changes impact aging adults’ social and mental well-being remains unclear. This study aimed to evaluate the effects of facial skin care on aging residents’ self-body image, self-esteem, well-being, depressive symptoms and social cognitive function by a quasi-randomized controlled pilot trial in Japanese nursing homes. MethodThirty-seven older adult women living in nursing homes took part in this quasi-randomized controlled pilot trial. Eighteen participants applied a skincare gel-cream to the face twice a day for three months, while 19 participants used no skincare products. Self-body image and psychological measures such as the Cutaneous Body Image Scale (CBIS), the Rosenberg Self-esteem Scale (RSES), Philadelphia Geriatric Center Morale Scale (PGCMS) and Geriatric Depression Scale (GDS) were used in each nursing home to evaluate the pre- and post-treatment scores. In addition, cognitive items of the Functional Independence Measure (FIM) were evaluated as social cognitive function at pre- and post-treatment. ResultsThere was a significant different change of the Cutaneous Body Image Scale scores (p = 0.045, r = 0.34) after three months between skin care group and control group. Although there were no clear significant differences in other psychological assessments, there was a higher number of them with positive changes in the skin care group compared to the control group. ConclusionSkin care may help improve cutaneous self-body image and positive emotion in aging female residents of Japanese nursing homes.

Associations between everyday physical activity and morale in older adults

Studies that objectively investigate patterns of everyday physical activity in relation to well-being and that use measures specific to older adults are scarce. This study aimed to explore objectively measured everyday physical activity and sedentary behavior in relation to a morale measure specifically constructed for older adults. A total of 77 persons (42 women, 35 men) aged 80 years or older (84.3 ± 3.8) wore an accelerometer device for at least 5 days. Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). PGCMS scores were significantly positively associated with number of steps, time spent stepping, and time spent stepping at >75 steps per minute. Sedentary behavior did not associate with PGCMS. Promoting PA in the form of walking at any intensity–or even spending time in an upright position—and in any quantity may be important for morale, or vice versa, or the influence may be bidirectional.

Reliability and Validation of the Japanese Version of the Patient Empowerment Scale.

Empowerment scales for inpatients have been developed worldwide, but their validity and reliability have not been adequately tested and applied to the health promotion and care among older adults during hospitalization. In this study, the Patient Empowerment Scale developed by Faulkner was translated into Japanese, and Japanese patients were surveyed to test its clinical applicability. To test its applicability, 151 patients in rehabilitation wards were surveyed in four municipalities. After considering ceiling/floor effects and validating the structure, the Patient Empowerment Scale—Japanese comprised 37 items and six factors: subject–staff interaction, environmental adjustment through collaboration, necessary information gathering and problem awareness, proactive behavioral practices, self-disclosure, and self-management of activities. Criteria-related validity assessment confirmed the scale’s correlation with the Health Locus of Control Scale, General Self-Efficacy Scale, 13-item Sense of Coherence Scale, Rosenberg Self-Esteem Scale, and Philadelphia Geriatric Center Morale Scale. Regarding internal consistency, the Cronbach’s alpha was 0.93 for all 37 items. The Cronbach’s alphas for the six factors were 0.93, 0.91, 0.92, 0.92, 0.91, and 0.75, respectively. In our test/re-test of reliability, Spearman’s rank correlation coefficient between the first and second total scores was ρ = 0.96, p < 0.01. These results confirm the scale’s validity and reliability, and its applicability to older hospitalized patients.

Relationship between morality, happiness, and social support among elderly people

BackgroundVarious factors influence the lives of elders, such as social support, which is critical in preventing physical, psychological, and social difficulties. This study aimed to investigate the relationship between morality, happiness, and social support among elderly people. A descriptive correlational design was used in carrying out this study. This study was conducted at the Geriatric Social Club in El-Qawmia; Zagzig City, Alsharkia Governorate. A purposeful sample of 235 elders was recruited for this study. Four tools were used to collect data: A structured interview questionnaire, Philadelphia Geriatric Center Morale Scale (interview version), Multidimensional Scale of Perceived Social Support, and Oxford Happiness Questionnaire.ResultsResults denoted that less than half of studied elders had moderate score as regards morale scale and perceived social support. As well, less than three-fifths of them had moderate score regards total happiness. There were statistically significant relations between morality and both of age, income, chronic diseases, and taking medication. Perceived social support was positively statistically significantly related with elders’ gender, marital status, chronic diseases, medication, and income. There were statistical significant relations between elderly happiness level and working condition, income, and with whom they live. Elders’ perceived social support was highly positively statistically correlated with happiness and morality.ConclusionsIt was concluded that these variables were positively correlated with each one, where increasing perceived social support and feeling of happiness associated with enhancing feeling of morality among elders. The perceived social support and happiness were the key co-existences of elders’ morality. Therefore, it is recommended to implement caring and training programs focusing on enhancing social support in order to develop morale among elders. The country should provide various kinds of assistance to the elderly, such as counseling services.

Subjective Wellbeing and Related Factors of Older Adults Nine and a Half Years after the Great East Japan Earthquake: A Cross-Sectional Study in the Coastal Area of Soma City.

This study examined older adults’ subjective wellbeing and related factors in the coastal area of Soma City nine and a half years after the Great East Japan Earthquake (GEJE). Data were collected from 65- to 84-year-old residents and 1297 participants via a questionnaire from October to November 2020. The participants were divided into two groups: housing complexes and non-housing complexes. The dependent variable was subjective wellbeing assessed via Lawton’s Philadelphia Geriatric Center Morale Scale (PGCMS). Using multivariate regression analysis, the factors most strongly related to a low PGCMS score for both groups were poor health conditions, difficulties resting while asleep, poor financial wellbeing, inability to chew certain foods, and fear of solitary death. The GEJE experience was further distinguished in the housing complex group by the loss of an important non-family individual; for the other group, important factors were female gender, junior high school education level or lower, limited social networks, and deterioration of a family member’s health. Older adults’ subjective wellbeing in Soma City was low after nine and a half years following the GEJE. For disaster victims and their families in both groups, it is crucial to implement measures such as long-term, continuous physical and mental health support.

Effect of life-space mobility on subjective well-being in aged home-based rehabilitation users with different levels of independence in activities of daily living.

[Purpose] The relationship between quality of life and life-space mobility in community-dwelling older adults has recently been reported. The present study aimed to elucidate this relationship in home-based rehabilitation users with limited life-space mobility and loss of independence in activities of daily living. [Participants and Methods] The study population comprised 33 home-based rehabilitation users. The participants were expected to have a wide range of the level of independence in activities of daily living; therefore, they were categorized into three groups according to the Barthel Index score: independent (95–100 points), moderately disabled (90–65 points), and severely disabled (60–0 points) groups. We examined the relationships among the Philadelphia Geriatric Center Morale Scale, Life-Space Assessment, and Barthel Index scores and age. [Results] We detected a strong positive correlation between the Philadelphia Geriatric Center Morale Scale and Life-Space Assessment scores in the independent group; however, no significant correlations were observed in the moderately and severely disabled groups. [Conclusion] Our findings suggest a relationship between subjective well-being and life-space mobility in home-based rehabilitation users who are mostly independent in activities of daily living. However, owing to the small sample size and characteristics of the scales used in this study, further studies are warranted to verify these results.

MORAL AND SOCIAL SUPPORT STATUSES AND DEPRESSIVE SYMPTOMS OF PATIENTS AGED 65 AND OVER WHO HAVE CHRONIC OBSTRUCTIVE LUNG DISEASE

The current study was undertaken to determine status of morale, social support and depressive symptoms among patients aged ≥ 65 years old with chronic obstructive pulmonary disease. This study conducted in a descriptive and correlational design. The data were collected using patient descriptive forms developed by the researchers, a personal information form about the disease, Philadelphia Geriatric Center Morale Scale, the Multidimensional Scale of Perceived Social Support and Geriatric Depression Scale through face to face interview method. For the analyses of the data; percentages, means, Mann Whitney U, Kruskall Wallis and Correlation Analyses tests were employed.The rate of patients currently smoking was 6.2% whereas the rate of patients previously smoking was 60.6%. It was found that 50.9% of the elderly COPD patients had severe depression and their average depression score was 13.76±5.02, their average morale score was 5.78±2.11 and their average social support score was 54.71±16.80. It was found that there was a negative and significant correlation between morale and social support status of the elders whereas there was no correlation between morale and depression symptoms. It was identified that elderly COPD patients had lower morale status, moderate social support status and more than half of them demonstrated depressive symptoms. While morale levels of the patients decreased, their social support status increased. It is recommended that sufficient support systems should be provided to the elders in order to reduce their depression symptoms and to elevate their morale levels.

Positive Self-Perceptions of Aging Play a Significant Role in Predicting Physical Performance among Community-Dwelling Older Adults.

Self-perceptions of aging (SPA) is associated with various health-related outcomes, including physical performance. No previous study has investigated the potential predictive influence of SPA on physical performance among Swedish community-dwelling older adults. This was a cross-sectional study using a random sample of 153 Swedish community-dwelling individuals aged 70 and older. Multiple logistic regression analysis was performed, using the subscale “Attitude Towards Own Aging” of the Philadelphia Geriatric Center Morale Scale, as a measure of SPA. The Short Physical Performance Battery (SPPB) was dichotomized and used as the outcome variable. SPA was a significant predictor (OR = 1.546, CI = 1.066–2.243) of physical performance, adjusted for age, cognitive function, and life-space mobility. Further analyses revealed significant sex differences, with SPA not being included in the model for the men whilst it was still a significant predictor (OR = 1.689, CI = 1.031–2.765) of physical performance in the group of women. SPA plays a significant role in predicting physical performance among Swedish community-dwelling older adults. To further clarify this relationship and its consequences, future longitudinal research should focus on the relationship between SPA, physical performance, and fall risk.

Purposes of Going out and Subjective Well-Being in Older Adults with Impairments

Aims To examine the association between diverse purposes of going out and the participant’s subjective well-being and their orientation toward going out. Methods We conducted a self-administered questionnaire survey to assess the association between orientation toward going out, purposes of going out, and the Philadelphia Geriatric Center Morale Scale (PGCMS) score in adults > 65 years. Results A regression analysis of 138 responses using a multistage adjustment approach showed no significant association, only with diverse purposes of going out (b: −1.74; 95%CI: −4.17, 0.69). In contrast, the interaction term was significantly associated with the PGCMS score (b: 3.28; 95%CI: 0.38 6.17). Conclusions Having diverse purposes of going out was associated with a higher level of subjective well-being in individuals with an orientation toward going out, suggesting the importance of increasing the variety of purposes of going out.

Psychometric Properties of the Persian Version of the 11-Item de Jong Gierveld Loneliness Scale in Iranian Older Adults.

Loneliness is usually a chronic condition which may lead to physical and psychological undesirable consequences, and requires measurement and intervention. This study was conducted with the aim of preparing a Persian version of the 11-item de Jong Gierveld Loneliness Scale and evaluating its psychometric properties among the Iranian older adults. After applying the translation-back translation method, the prepared script was subjected to the face and content validity evaluations and a Persian version of the scale was prepared. Factor analysis, concurrent validity, internal consistency, and test-retest methods were used to validate the scale. The Persian version of the 11-item de Jong Gierveld Loneliness Scale showed acceptable content validity. The negative and significant correlations between the loneliness scores and the Philadelphia Geriatric Center Morale Scale indicated that the questionnaire had acceptable concurrent validity. The results of confirmatory factor analysis confirmed two factors for the scale. Also, the results of the intra-class correlation coefficient and Cronbach's alpha coefficient demonstrated that the scale had acceptable reliability. The Persian version of the 11-item de Jong Gierveld Loneliness Scale is an appropriate tool for measuring loneliness in the Iranian older adults.

Health-Related Quality of Life With Trastuzumab Monotherapy Versus Trastuzumab Plus Standard Chemotherapy as Adjuvant Therapy in Older Patients With HER2-Positive Breast Cancer.

We report findings on quality of life (QoL) in the RESPECT trial, which compared adjuvant trastuzumab monotherapy with trastuzumab plus chemotherapy in older patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC). Patients age 70-80 years with human epidermal growth factor receptor 2-positive surgically treated breast cancer were randomly assigned to receive trastuzumab (T) or trastuzumab plus chemotherapy (T + C). QoL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G), Philadelphia Geriatric Center Morale Scale, Hospital Anxiety and Depression Scale, Patient Neurotoxicity Questionnaire, and Tokyo Metropolitan Institute of Gerontology Index of Competence at baseline and after 2, 12, and 36 months. Comparisons were based on individual changes from baseline and were performed by Fisher's test or mixed-model repeated-measures. Among 275 patients in the parent study, 231 (84%) (average age: 74 years) were included in the analysis. At 2, 12, and 36 months, 198, 177, and 178 patients completed surveys, and the mean FACT-G scores at each survey point were 78.9, 80.4, 82.7, and 79.1 in group T and 79.5, 74.5, 78.4, and 78.5 in group T + C. Compared with group T + C, the proportion of patients showing QoL deterioration (≥ 5 points decrease from baseline in FACT-G) was significantly lower at 2 months (31% v 48%; P = .016) and 12 months (19% v 38%; P = .009). In group T, the Hospital Anxiety and Depression Scale score (P = .003) and the proportion of severe sensory peripheral neuropathy (P = .001) were significantly lower at 2 months, and Philadelphia Geriatric Center Morale Scale and Tokyo Metropolitan Institute of Gerontology Index of Competence scores were significantly higher (P = .024, .042) at 12 months. At 36 months, there were no significant differences in any QoL items. Detrimental effects of adjuvant chemotherapy on global QoL, morale, and activity capacity lasted for at least 12 months but were not observed at 36 months.

Development of a resilience scale for oldest-old age (RSO)

BackgroundGlobally, the population of oldest-old (those aged ≥80 years) is rapidly growing. This change is likely to have a deep impact on societies. Resilience is a key concept related to facilitating adaptation, and can be applied, to aging-related change and losses, as well as promoting health and well-being in this population. However, no existing scales have been developed to measure resilience among oldest-old people. To address this, we developed a resilience scale for oldest-old age (RSO), and examined its reliability and validity.MethodsThe RSO is a self-administered questionnaire developed via a literature review, interviews with oldest-old individuals, and interviews with experts. The survey included 3000 community-dwelling oldest-old people who were recruited via random sampling in Yokohama city, Japan. Construct validity was determined using confirmatory factor analysis. Internal consistency was calculated using Cronbach’s alpha. The revised Philadelphia Geriatric Center Morale Scale (PGC) and the self-anchoring scale to measure the feeling that life is worth living (SAS-WL) were used to assess the criterion-related validity of the RSO.ResultsWe received 1283 valid participant responses. Confirmatory factor analysis identified nine items from one factor of the RSO with a goodness of fit index of 0.979, adjusted goodness of fit index of 0.963, comparative fit index of 0.973, and root mean square error of approximation of 0.049. Cronbach’s alpha was 0.800. The total RSO score was positively correlated with the PGC (r = .492, p < 0.001) and the SAS-WL (r = .559, p < 0.001).ConclusionsThe RSO demonstrated adequate reliability and validity for assessing individual resilience among oldest-old people. Thus, the scale is potentially useful for promoting health and well-being in oldest-old age.

Self-Efficacy as a Mediator Between Lifestyle and Self-Perceptions of Aging

A growing body of literature demonstrates the public health impacts of negative self-perceptions of aging (SPA). However, minimal research has explored mediating mechanisms as well as which lifestyle activities may influence SPA. Based on theory and prior research in successful aging, this study explored the impact of lifestyle activities on SPA and tested self-efficacy as a mediator between lifestyle activities and SPA. This study analyzed cross-sectional data from the psychosocial module in the 2018 wave of the Health and Retirement study (N = 2,675; mean age = 65.67/ SD = 9.95). Eight SPA items (e.g., “Things keep getting worse as I get older”) were derived from the Attitudes Toward Own Aging subscale of the Philadelphia Geriatric Center Morale Scale. 10 items measure self-efficacy on a 6-point Likert-type scale from strongly disagree to strongly agree. 21 lifestyle activities covering physical, intellectual, social, and spiritual domains were dichotomized into whether respondents participate at least monthly. Multiple regression analyses were utilized. Results indicate that self-efficacy explained 23% of the variance in SPA while holding constant age, gender, and functional ability. Sobel’s test showed that self-efficacy mediated the relationship between lifestyle activities and SPA. Exercise explained the most variance in SPA, followed by computer use and volunteering. Building upon successful aging literature, this study demonstrates the impact of self-efficacy and helps distinguish which lifestyle activities may be most effective in improving SPA. In addition to individual-level lifestyle activities, the impact of structural interventions on SPA should be tested in future research.

The Association Between Recent Family Death and Self-Perceptions of Aging Among Middle-Aged and Older Adults

The loss of a family member may have a significant influence on one’s aging experience in life. Self-perceptions of aging, which are an individual’s beliefs or evaluation of their experiences of aging, have been described as an important factor for one’s health and daily life. However, there is little research on the association between family death and self-perceptions of aging. This study examines the relationships between recent family death, self-perceptions of aging, and gender of the bereaved among middle-aged and older adults. Using nationally representative data from the Health and Retirement Study (HRS), we conducted cross-sectional analysis on adults age 50 years and older (n=1,839). Self-perceptions of aging were accessed by 8 items derived from the Attitudes Toward Own Aging subscale of the Philadelphia Geriatric Center Morale Scale and the Berlin Aging Study, and we considered recent family death (i.e., parental death, spousal death, sibling death and child death), as well as gender of the bereaved. Multiple linear regression analyses revealed that respondents who experienced recent family death report less positive self-perceptions of aging compared to those who did not experience recent family death (t = 12.40, p < .01). Recent parental death was more negatively related with self-perceptions of aging for bereaved women than for bereaved men (χ2 = 4.28, p < .05). Findings suggest that middle-aged and older adults experiencing recent family loss have less positive self-perceptions of aging, and gender of the bereaved plays an important role in the relationship between parental death and self-perceptions of aging.

Scaling Down the PGCM Scale to Assess Views on Ageing More Efficiently: Finding a New Alternative.

The aim of the study is to present a new and efficient way of measuring the quality of life among older populations, with special attention to morale, positive outlook on life and ageing. The measure is based on the Philadelphia Geriatric Center Morale Scale (PGCM), originally consisting of 22 items. The growing numbers and proportions of older people among European populations has increased the need to obtain more reliable data on their needs, values, life experiences and overall quality of life. Using data from six surveys conducted in the Czech Republic, we have formulated a three-item positive outlook on life and ageing (POLA) scale. Our analyses are divided into three steps: (1) constructing the scale and testing its internal consistency; (2) testing the scale’s external validity using mean comparisons and correlation coefficients; and (3) determining the factors affecting a positive outlook on later life, such as gender and education. We have confirmed that the three-item approach to measuring positive outlook on ageing as a part of morale is highly applicable to surveys, producing compelling results in assessing important quality-of-life sub-concepts, such as subjective health, subjective age, and loneliness.

Morale in Old Age and Its Association with Sociodemographic, Social, and Health-Related Factors in Different Age Groups.

Morale can be viewed as a future-oriented optimism or pessimism regarding challenges associated with aging and is closely related to subjective well-being. Promoting morale in old age could be considered to have important implications for aging well, and increased knowledge about morale in different stages of old age is needed. Hence, the aim of this study was to investigate factors associated with morale in different age groups among old people. Data were derived from a survey conducted in 2016, as a part of the Gerontological Regional Database (GERDA). The sample consisted of 9,047 individuals aged between 65 and 86 years from Ostrobothnia and Southern Ostrobothnia in Finland, and Västerbotten in Sweden. Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS) and regressed upon a number of sociodemographic, social, and health-related factors using linear regression analyses. The results showed that older age was an independent factor explaining lower level of morale. Additionally, the sociodemographic, social, and health-related variables could explain a large proportion of the variance in morale. Perceived loneliness, having gone through a crisis in life, poor self-rated health, and depression were associated with lower morale, and sleeping well with higher morale, in all age groups. Furthermore, the oldest age groups seem to be more exposed to several risk factors of lower morale identified in this study. Multidimensional interventions targeting especially social and mental health and the oldest-old could therefore be recommended.