The prediction of subjective wellness among the old-old: Implications for the "fourth-age" conception

Dov Shmotkin*, Amit Shrira, Nitza Eyal, Tzvia Blumstein, Aviva Shorek

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objectives. As the "fourth-age" conception suggests that the adaptability of psychosocial capabilities is disrupted at old-old age due to failures in maintaining balanced functions, this study examines the predictability of subjective wellness outcomes by factual dysfunction markers of health among old-old people across 12 years. Method. Participants were self-respondents in a 3-wave survey that sampled the older (age 75-94) Jewish population in Israel. Wave 1 (N = 1,369, mean age = 83.5) preceded Wave 2 (N = 687, mean age = 85.4) by 4 years and Wave 3 (N = 164, mean age = 91.6) by 12 years. Results. The dysfunction markers (comorbidity, medication consumption, doctor's visits, and difficulties in activities of daily living [ADL]) predicted subjective wellness by relating to an increase in depressive symptoms, as well as to a decrease in life evaluation and self-rated health, beyond adjustment for sociodemographics. However, in most cases, an interaction finding indicated that dysfunction markers were weaker predictors of age-related change in subjective wellness among older participants. Discussion. At old-old age, the results point to reduced predictability of subjective wellness by factual dysfunction. This finding supports the fourth-age model. Still, researchers should consider an alternative interpretation, by which increasing independence between factual and subjective indicators is protective, rather than debilitating, among old-old people.

Original languageEnglish
Pages (from-to)719-729
Number of pages11
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Volume69
Issue number5
DOIs
StatePublished - Sep 2014

Funding

FundersFunder number
Department of Clinical Epidemiology at the Chaim Sheba Medical Center
Ellern Foundation
Herczeg Institute on Aging
Israel Academy of Science1041–541
National Institute on AgingR01-5885-06, R01-5885-03
Israel National Institute for Health Policy ResearchR/17/2001
Tel Aviv University

    Keywords

    • Aging
    • Dysfunction markers
    • Fourth age
    • Old-old
    • Subjective wellness

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