Anne Ingeborg Berg

What matters for life satisfaction in the oldest-old?

The purpose of this study was to examine factors associated with life satisfaction in the oldest-old within a spectrum of psychosocial and health related variables. Scores on the life satisfaction index (LSI-Z) were related to scales and questions regarding, demographics, depression, locus of control, cognitive function, functional capacity (instrumental and personal activities of daily living), self-rated overall health and medically based health, and social network. The sample consisted of 315 participants, aged 80–98 years; (M = 83 years, 66% women). Regression analyses indicated that social network quality, self-rated overall health, sense of being in control of ones life, and depressive symptoms were significantly associated with life satisfaction. There was no gender difference in overall life satisfaction. However, there were different patterns of variables associated with life satisfaction in men and women. Self-rated overall health and depressive symptoms were related to life satisfaction in women, whereas widowhood was significantly associated with lower life satisfaction among men. The results emphasize the need to analyse associates of life satisfaction within a broader context of psychosocial variables and separately for men and women.

What Matters, and What Matters Most, for Change in Life Satisfaction in the Oldest-Old? A Study Over 6 Years Among Individuals 80+

Objectives: The study investigates whether markers of life satisfaction identified in a cross-sectional study–quality of social network, self-rated health, depressive symptoms, locus of control and widowhood, in addition to financial satisfaction and the personality traits of extraversion and neuroticism–predict change in life satisfaction (LSI-Z) across four measurement occasions during a 6-year period in individuals aged 80+. Method: Data were drawn from the Swedish OCTO-Twin-study of individuals aged 80 and older. Results: Growth curve analysis showed a relatively consistent significant linear decline in life satisfaction, but certain markers predicted change in life satisfaction. The loss of spouse, in particular in men, and higher levels of depressive symptoms were related to lower levels of life satisfaction over time. Conclusion: The results from the study question the notion of a life-long stability of life satisfaction.

Amyloid-β42 is Associated with Cognitive Impairment in Healthy Elderly and Subjective Cognitive Impairment

The aim of this study was to predict cognitive performance on the basis of the cerebrospinal fluid (CSF) biomarkers total tau (T-tau) and amyloid-β₄₂ (Aβ₄₂) in controls and patients at various impairment levels. Previous studies have found an association of CSF T-tau levels with cognitive symptoms, but it has been difficult to relate Aβ to cognition, and it has thus been hypothesized that Aβ reaches a plateau level prior to cognitive symptoms. A comprehensive battery of neuropsychological tests was subjected to factor analysis to yield aggregated cognitive domains. Linear regression models were performed for the total sample of the Gothenburg MCI study (n = 435) and for each level of impairment. Aβ₄₂ and T-tau accounted for a significant proportion of performance in all cognitive domains in the total sample. In controls (n = 60) and patients with subjective cognitive impairment (n = 105), Aβ₄₂ predicted a significant proportion of semantic and working memory performance. For patients with mild cognitive impairment (n = 170), T-tau had the most pronounced impact across cognitive domains, and more specifically on episodic memory, visuospatial, and speed/executive performance. For patients with dementia (n = 100), the most pronounced impacts of Aβ₄₂ were found in episodic memory and visuospatial functioning, while T-tau was substantially associated with episodic memory. Our results suggest that cognition is related to CSF biomarkers regardless of impairment level. Aβ₄₂ is associated with cognitive functions from a potentially early to a later disease phase, and T-tau is more indicative of performance in a later disease phase.

Personality and personal control make a difference for life satisfaction in the oldest-old: findings in a longitudinal population-based study of individuals 80 and older

This study investigates life satisfaction in relation to impending death among the oldest-old using overall disease load, self-rated health, and personality as interacting covariates of level and change. We used data from a sample of 370 healthy individuals who completed the Life Satisfaction Index-Z at four measurement occasions during a 6-year period in the Swedish OCTO-Twin study of individuals aged 80 and older. Growth curve analyses showed a linear decrease in life satisfaction as individuals approached death. The decrease was not related to level or change in self-rated health and disease load. High disease load was, however, related to lower levels of life satisfaction, but, this association was moderated by locus of control, such that those with high disease load and high locus of control did not show lower life satisfaction. Poor self-rated health was also associated with lower life satisfaction, but, this association was moderated by neuroticism, such that those with poor-rated health and low neuroticism did not show lower live satisfaction. Personality factors such as locus of control and neuroticism can influence the association between health and life satisfaction. The findings suggest further investigations of the role of personality characteristics in late life satisfaction and whether interventions aimed to increase personal control can improve life satisfaction in old age.

Personality Change in the Oldest‐Old: Is It a Matter of Compromised Health and Functioning?

The present longitudinal study investigates continuity and change in the personality dimensions of extraversion and neuroticism among the oldest-old. Overall disease load, self-rated health, functional capacity, impaired vision and hearing, self-reported cognitive impairment, and measured cognitive status were tested for their role as potentially relevant late-life predictors of personality change. The sample consists of 408 individuals aged 80-98 in the Swedish OCTO-Twin Study who completed the Eysenck Personality Inventory at four measurement occasions during a 6-year period. Growth curve analyses revealed an age-related linear decrease in extraversion and stability in neuroticism. More extraverted individuals were more educated and perceived their health and cognition as better. Notably, only hearing impairment was found to be related to a steeper age-related decline in extraversion. A life span developmental model focusing on health-related changes can improve our understanding of personality change in late life.

Cerebrospinal Fluid Biomarkers Mirror Rate of Cognitive Decline

The ability to predict future decline in cognitive systems using the cerebrospinal fluid (CSF) biomarkers 42 amino acid form of amyloid-β (Aβ42) and total tau (T-tau) is not fully understood. In a clinical sample ranging from cognitively healthy to dementia (n = 326), linear regression models were performed in order to investigate the ability of CSF biomarkers to predict cognitive decline in all cognitive domains from baseline to 2-year follow-up. Gender, age, and years of education were included as covariates. In patients with subjective cognitive impairment, T-tau had a small impact on executive functions (r2 = 0.07). T-tau had a small to moderate influence (r2 = 0.06-0.11) on all cognitive functions with the exception of visuospatial functions in patients with mild cognitive impairment (MCI). In patients with dementia, the impact of T-tau was large (r2 = 0.29) on semantic memory. Aβ42 had a small effect (r2 = 0.07) on speed and executive functions in MCI. In patients with dementia, Aβ42 had a moderate influence (r2 = 0.13-0.24) on semantic and verbal working memory/fluency. Our results speak in favor of the notion that CSF biomarkers reflect the rate of cognitive decline across the continuum of cognitive impairment from healthy to dementia. CSF predicted subsequent decline in more cognitive domains among MCI cases, but the impact was most pronounced in patients with dementia.

“As long as I’m in good health”. The relationship between medical diagnoses and life satisfaction in the oldest-old

Background and aims: Life satisfaction in the elderly has usually been found to be closely related to self-rated health, and less to diagnoses and more objective measures of health status. However, few studies have examined the relative importance of various specific diagnoses in population-based samples. Methods: In this study, we investigate the relationship between life satisfaction and medical diagnoses in a non-demented sample of 392 participants aged 80 and older. Results: Among 25 common diagnoses, only sleeping problems, urinary incontinence and stroke were significantly related to life satisfaction. Men with angina pectoris and eczema were less satisfied with life compared with men without these diagnoses, whereas women with peptic ulcer were less satisfied with life compared with women without this diagnosis. Conclusions: Our results confirm previous findings of a weak relationship between medically based measures of health and life satisfaction. However, health care and future studies of health and quality of life need to focus on the fact that meaning and consequences of various diseases differ among individuals and that gender may partially account for variability.

Living with stable MCI: Experiences among 17 individuals evaluated at a memory clinic

Objectives: Mild cognitive impairment (MCI) is a state of mildly impaired cognitive functioning but with an intact capability of performing basic daily activities. Few studies have targeted personal narratives from persons living with MCI, the major focus in this study is directed to methods for better predictions of the likelihood for conversion to dementia. This study directly explores experiences among individuals who have lived with MCI over seven years without converting to dementia. Methods: Seventeen individuals, who had been diagnosed with MCI across four occasions over a seven-year period at a memory clinic, were interviewed at a single occasion about their experiences of living with MCI, life events, stress, coping, psychosocial resources, and lifestyle behaviors. Results: Thematic analysis of the transcripts of the interviews resulted in themes revolving around the life situation and events related to the first visit at the memory clinic, coping with lower cognitive capacity with the aim of enhancing quality of life, and worries about dementia and further cognitive deteriorations. Conclusion: The participants’ experiences of living with MCI indicate that issues and changes in life situations such as long-term stress, retirement, loss of relatives, perceived heritability of dementia, needs to be understood in the context of the individuals understanding and interpretation of their everyday cognitive functioning. Also, supportive long-term contacts with the specialist care unit were vital for creating a personal understanding of MCI. Addressing the intra-personal dynamics of cognitive functioning in the boundary between normal and pathological cognitive aging can also improve diagnostic accuracy.

Neuroticism and extroversion in suicide attempters aged 75 and above and a general population comparison group

Personality traits have been shown to influence suicidal behaviour but the literature on ‘older’ elderly is sparse. The aim was to compare neuroticism and extroversion in hospitalized suicide attempters aged 75 and above and a general population comparison group. Seventy-two hospitalized suicide attempters (mean age 81 years) were interviewed. Comparison subjects were drawn from participants in population studies on health and ageing. Participants completed the Eysenck Personality Inventory (EPI) and symptoms of depression were rated with the Montgomery–Asberg Depression Rating Scale (MADRS). Depression diagnoses were made in accordance with Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Attempters scored higher on the neuroticism scale than comparison subjects (mean = 9.9 vs. 7.6, t = 3.74, df = 358, p < 0.001) and lower on the extroversion scale (mean = 10.8 vs. 12.0; t = −2.76, df = 358, p = 0.006). While these differences did not remain after adjustment for major depression, attempters with minor depression were less neurotic than comparison subjects with this diagnosis (mean = 6.6 vs. 11.1, t = −3.35, df = 63, p = 0.001) and a negative association with neuroticism remained in a multivariate model. In conclusion cases scored higher on neuroticism and lower on extroversion compared to comparison subjects. The finding that attempters with minor depression were less neurotic than comparison subjects with this diagnosis was unexpected and needs to be examined in larger samples.

Factorial validity and invariance of the Life Satisfaction Index in older people across groups and time: Addressing the heterogeneity of age, functional ability, and depression

In the last decades, extensive research efforts have been directed at exploring life satisfaction in old age, and the Life Satisfaction Index A (LSIA) scale, developed by Neugarten et al. in the 1960s, is one of the most commonly used instruments. However, studies have focused on predicting and comparing changes in peoples life satisfaction without testing if the LSIA instrument is equally valid for different subgroups of people. The present study investigated the underlying dimensions of the LSIA in a Swedish population (n=1402) of people 60-96 years of age. The study also examined factorial invariance across age, gender, functional ability and depression during a six-year period. The results showed that while a five-factor solution of the LSIA did not exhibit an acceptable fit to the data, a three-factor solution did show a close fit. The two three-factor models that demonstrated the best fit showed invariance across gender and across time, but noninvariance across groups with different levels of reduced functional ability, depressive symptoms and age. These findings suggest that the psychometric properties of life satisfaction instruments like the LSIA need to be taken into consideration before drawing conclusions about life satisfaction when comparing older people of different ages and with different depression and function levels.