Meanings of “being happy in old age” and perceived quality of life according to Brazilian older adults

Valero, Catherine Nicol Aravena; Meira, Tulia Fernanda Garcia; Assumpção, Daniela de; Neri, Anita Liberalesso

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Revista Brasileira de Geriatria e Gerontologia

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Original Articles • Rev. bras. geriatr. gerontol. 24 (2) • 2021 • https://doi.org/10.1590/1981-22562021024.200298 copy

Meanings of “being happy in old age” and perceived quality of life according to Brazilian older adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

Identifyting associations between meanings of “being happy in old age” and perceived quality of life in a sample of community-dwelling older adults.

Methods

Data were drawn from the baseline (BL; 2008-2009) and follow up (FW; 2016-2017) records of the Fibra Campinas, a population-based study on frailty in old age. Two hundred and eleven individuals with an average age of 81.0±4.3 at follow-up, answered to an open question on happiness in old age at baseline and to the CASP-19 at follow-up. BL records were submitted to content analysis; those of FW to measures of frequency, position and dispersion, and both to logistic regression analyzes.

Results

The content analysis generated four themes: health and functionality (the most mentioned), psychological well-being, interpersonal relationships and material resources. The most cited categories were self-development and family relationships. High scores in CASP-19 prevailed and were more likely among participants who did not mention material resources (OR=2.44; 95%CI: 1.20-4.43), nor health and functionality (OR=2.03; 95%CI: 1.22-4.22), and among those who cited interpersonal relationships (OR=1.92; 95%CI: 1.08-3.41) at BL. High scores in the factor Self-Realization/Pleasure were more likely among those aged 80-84 (OR=1.93; 95%CI: 1.01-3.68) and among those who did not mention health and functionality (OR=1.98; 95%CI: 1,00-1.98) at BL.

Conclusion

Happiness in old age and quality of life related to psychological needs of control, autonomy, self-realization and pleasure are related constructs, whose evaluation captures experiences that exceed material and health conditions, predominant in classic measures of quality of life.

Keywords
Happiness; Healthy Aging; Longevity; Quality of Life

Theme 1. Health and functionality
Categories:
1.1. Physical health. Health status translated into medical diagnoses, signs, and symptoms; healthy lifestyles. E.g.: Take care of yourself.
1.2. Activity. Vital involvement, social participation, productivity, and energy. E.g.: having the will and strength to work.
1.3. Independence and autonomy. Physical and mental capacity that allows control over the environment; self-government, and self-determination. E.g.: Doing what you want, without any help.
1.4. Cognition. Preserved basic cognitive functions, allowing for problem solving, insight, reasoning, judgment, and autonomy. E.g.: I didn't want to lose my memory.
Theme 2. Psychological well-being
Categories:
2.1. Satisfaction and pleasure. Products of the sense that one has a good and happy life, in accordance with personal and social values, and expectations. E.g.: Have and joy, family.
2.2. Religiousness and spirituality. The sacred and the transcendent as sources of existential meaning and sense of belonging, and as coping resources. E.g.: First and foremost serve God.
2.3. Emotion-based coping. Management of stressful situations through cognitive-emotional strategies that protect self-esteem and save personal resources. E.g.: Being okay with yourself.
2.4. Self-development. Investments in self-knowledge and self-acceptance; seeking for personal excellence, purpose, and sense of self-fulfillment. E.g.: Learning to deal with difficulties.
Theme 3. Interpersonal relationships
Categories:
3.1. Family relationships. The family nucleus as a source of recognition, belonging, appreciation, respect, protection, affection, security, support, and satisfaction. E.g.: United family.
3.2. Social relationships. The group as a source of recognition, belonging, appreciation, protection, affection, security, and satisfaction. E.g.: It's about living well.. loving, living well with friends.
3.3. Social support. Relationships of giving and receiving affection, material goods, information, instrumental help, and help in solving problems. E.g.: It's about having a person who takes care of us, being able to take care of us.
Theme 4. Material resources
Possession of money, objects and opportunities that facilitate the achievement of well-being, in accordance with individual and social values. E.g.: Money to go to the doctor, to eat, to buy medicine.

	n (%)	Means (standard deviations)	Medians	Interquartile distances
Gender
Male	60 (33.2)
Female	151 (66.8)
Age (years)		81.0 ± 4.3	81.0	6.0
70-79	71 (33.7)
80-84	97 (46.4)
≥ 85	42 (19.9)
Occurrences of meaning categories of "being happy in old age"
T1. Health and functionality
C1.1. Physical health	122 (56.2)
C1.2 Activity	40 (18.4)
C1.3. Independence/autonomy	48 (22.2)
C1.4. Cognition	7 (3.2)
T2. Psychological well-being
C2.1. Satisfaction and pleasure	66 (32.0)
C2.2. Religiosity/spirituality	29 (14.1)
C2.3. Emotion-based coping	42 (10.4)
C2.4. Self development	69 (33.5)
T3. Interpersonal relationships
C3.1. Family relationships	80 (41.5)
C3.2. Social relationships	54 (28.0)
C3.3. Social support	59 (30.5)
T4. Material resources	56 (26.5)
Older people according to perceived quality of life score
Total CASP-19 scale		40.2 ± 8.7	40.0	10.0
Score below the median	101 (47.8)
Score above the median	110 (52.2)
Factor 1: Self-fulfillment / Pleasure		26.6 ± 7.3	26.0	10.0
Score below the median	98 (46.4)
Score above the median	113 (53.6)
Factor 2: Control / Autonomy		4.4 ± 3.4	4.0	4.0
Score below the median	101 (47.8)
Score above the median	110 (52.2)

Variables	n (%)	CASP-19 Scale		Factor 1. Self-fulfillment/ Pleasure		Factor 2. Control/ Autonomy
Variables	n (%)	≤ 39.0 (n=101)	≥ 40.0 (n=110)	≤ 25.0 (n=98)	≥ 26.0 (n=113)	≤ 3.0 (n=101)	≥ 4.0 (n=110)
Meanings of "being happy in old age"
T1. Health and functionality		p= 0.033		p= 0.038		p= 0.383
No	69 (32.7)	33.3	66.7	36.2	63.8	52.2	47.8
Yes	142 (67.3)	54.9	45.1	51.4	48.6	45.8	54.2
C1.1. Physical health		p= 0.065		p= 0.226		p= 0.132
No	89 (42.2)	40.0	59.6	41.6	58.4	53.9	46.1
Yes	122 (57.8)	53.3	46.7	50.0	50.0	43.4	56.6
C1.2. Activity		p= 0.515		p= 0.364		p= 0.450
No	171 (81.0)	46.8	53.2	47.9	52.1	49.1	50.9
Yes	40 (19.0)	52.5	47.5	40.0	60.0	42.5	57.5
C1.3. independence/autonomy		p= 0.099		p= 0.923		p= 0.748
No	163 (77.2)	44.8	55.2	46.6	53.4	48.5	51.5
Yes	48 (22.7)	58.3	41.7	45.8	54.2	45.8	54.2
C1.4. Cognition		p= 0.056		p= 0.051		p= 1.000
No	204 (96.7)	46.6	53.4	45.1	54.9	48.0	52.0
Yes	7 (3.3)	85.7	14.3	85.7	14.3	42.9	57.1
T2. Psychological well-being		p= 0.006		p= 0.127		p= 0.598
No	113 (53.5)	56.6	43.4	51.3	48.7	49.6	50.4
Yes	98 (46.5)	37.8	62.2	40.8	59.2	45.9	54.1
C2.1. Satisfaction and pleasure		p= 0.004		p= 0.048		p= 0.172
No	145 (68.7)	54.5	45.5	51.0	49.0	51.0	49.0
Yes	66 (31.3)	33.3	66.7	36.4	63.6	40.9	59.1
C2.2. Religiosity/spirituality		p= 0.724		p= 0.832		p= 0.724
No	182 (86.3)	48.3	51.7	46.1	53.8	48.3	51.7
Yes	29 (13.7)	44.8	55.2	48.3	51.7	44.8	55.2
C2.3. Emotion-based coping		p= 0.703		p= 0.861		p= 0.757
No	169 (80.0)	48.5	51.5	46.7	53.2	47.3	52.7
Yes	42 (20.0)	45.2	54.8	45.2	54.7	50.0	50.0
C2.4. Self-development		p= 0.077		p= 0.138		p= 0.993
No	142 (67.3)	52.1	47.9	50.0	50.0	47.9	52.1
Yes	69 (32.7)	39.1	60.9	39.1	60.9	47.8	52.2
T3. Interpersonal relationships		p= 0.011		p= 0.120		p= 0.820
No	102 (48.3)	56.9	43.1	52.0	48.0	47.1	52.9
Yes	109 (51.7)	39.4	60.6	41.3	58.7	48.6	51.4
C3.1. Family relationships		p= 0.038		p= 0.142		p= 0.628
No	131 (62.1)	53.4	46.6	50.4	49.6	46.6	53.4
Yes	80 (37.9)	38.7	61.3	40.0	60.0	50.0	50.0
C3.2. Social relationships		p= 0.031		p= 0.025		p= 0.190
No	157 (74.4)	52.2	47.8	51.	49.0	45.2	54.8
Yes	54 (25.6)	35.2	64.8	33.3	66.7	55.6	44.4
C3.3. Social support		p= 0.108		p= 0.023		p= 0.703
No	152 (72.0)	51.3	48.7	51.3	48.7	48.7	51.3
Yes	59 (28.0)	39.0	61.0	33.9	66.1	45.8	54.2
T4. Material resources		p= 0.025		p= 0.212		p= 0.709
No	155 (73.5)	43.2	56.8	43.9	56.1	47.1	52.9
Yes	56 (26.5)	60.7	39.3	53.6	46.4	50.0	50.0
Gender		p= 0.486		p= 0.206		p= 0.599
Male	60 (28.4)	51.7	48.3	53.3	46.7	45.0	55.0
Female	151 (71.5)	46.4	53.6	43.7	56.3	49.0	51.0
Age (years)		p= 0.228		p= 0.033		p= 0.377
70-79	71 (33.8)	53.5	46.5	50.7	49.3	43.7	56.3
80-84	97 (46.2)	41.2	58.8	37.1	62.9	47.4	52.6
≥ 85	42 (20.0)	52.4	47.6	59.5	40.5	57.1	42.9

Variables	Univariate logistic regression analysis			Multiple logistic regression analysis
Meanings of "being happy in old age"	*OR	**95% CI OR	p-value	*OR	**95% CI OR	p-value
T1. Health and Functionality
No	1.00	---	---	1.00	---	---
Yes	0.41	0.23-0.75	0.004	0.44	0.24-0.82	0.010
T2. Psychological Well-Being
No	1.00	---	---
Yes	2.15	1.24-3.74	0.007
T3. Interpersonal relationships
No	1.00	---	---	1.00	---	---
Yes	2.02	1.17-3.50	0.012	1.92	1.08-3.41	0.027
T4. Material resources
No	1.00	---	---	1.00	---	---
Yes	0.49	0.26-0.92	0.026	0.43	0.23-0.83	0.012
C1.1 Physical health
No	1.00	---	---
Yes	0.60	0.34-1.04	0.066
C1.2 Activity
No	1.00	---	---
Yes	0.80	0.40-1.59	0.515
C1.3 Independence/autonomy
No	1.00	---	---
Yes	0.58	0.30-1.11	0.101
C1.4 Cognition
No	1.00	---	---
Yes	0.15	0.02-1.23	0.077
C2.1 Satisfaction and pleasure
No	1.00	---	---
Yes	2.39	1.30-4.39	0.005
C2.2 Religiosity/spirituality
No	1.00	---	---
0.52-2.53	Yes	1.15	0.724
C.2.3 Coping/emotion
No	1.00	---	---
Yes	1.14	0.58-2.25	0.704
C.2.4 Self-development
No	1.00	---	---
Yes	1.69	0.94-3.04	0.078
C3.1 Family relationships
No	1.00	---	---
Yes	1.81	1.03-3.19	0.039
C3.2 Social relations
No	1.00	---	---
Yes	2.01	1.06-3.82	0.032
Gender
Male	1.00	---	---
Female	1.24	0.68-2.25	0.486
Age (years)
70-79	1.00	---	---
80-84	1.64	0.89-3.04	0.116
≥ 85	1.05	0.49-2.25	0.907

Variables	Univariate logistic regression analysis			Multiple logistic regression analysis
Variables	*OR	**95% CI OR	p-value	*OR	**95% CI OR	p-value
Meanings of "being happy in old age"
T1. Health and Functionality
No	1.00	---	---	1.00	---	---
0.54	0.30-0.97	0.039	0.51	0.27-0.95	0.035	Yes
T2. Psychological Well-Being
No	1.00	---	---
Yes	1.53	0.89-2.64	0.128
T3. Interpersonal relationships
No	1.00	---	---
Yes	1.54	0.89-2.65	0.121
T4. Material resources
No	1.00	---	---
Yes	0.68	0.37-1.25	0.213
C1.1 Physical health
No	1.00	---	---
Yes	0.71	0.41-1.24	0.226
C1.2 Activity
No	1.00	---	----
Yes	1.38	0.69-2.78	0.365
C1.3 Independence/autonomy
No	1.00	---	---
Yes	1.03	0.54-1.97	0.923
C1.4 Cognition
No	1.00	---	---
Yes	0.14	0.02-1.16	0.068
C2.1 Satisfaction and pleasure
No	1.00	---	---
Yes	1.82	1.01-3.32	0.049
C2.2 Religiosity/spirituality
No	1.00	---	---
Yes	0.92	0.42-2.01	0.831
C.2.3 Coping/emotion
No	1.00	---	---
Yes	1.06	0.54-2.09	0.861
C.2.4 Self-development
No	1.00	---	---
Yes	1.56	0.87-2.79	0.139
C3.1 Family relationships
No	1.00	---	---
Yes	1.52	0.87-2.68	0.143
C3.2 Social relations
No	1.00	---	---
Yes	2.08	1.09-3.97	0.020
C3.3. Social support
No	1.00	---	---	1.00	---	---
Yes	2.06	1.10-3.84	0.024	2.19	1.00-2.19	0.019
Gender
Male	1.00	---	---
Female	1.47	0.81-2.68	0.207
Age (years)
70-79	1.00	---	---	1.00	---	---
80-84	1.74	0.94-3.24	0.080	1.93	1.01-3.68	0.047
≥ 85	0.70	0.32-1.51	0.364	0.58	0.26-1.32	0.194

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[1] Correspondence Daniela de Assumpção danideassumpcao@gmail.com

Brasil

Brasil

Meanings of “being happy in old age” and perceived quality of life according to Brazilian older adults

Abstract

﻿Objective

Methods

Results

Conclusion

Objective