Objective: The objective of this study was to describe the health and psychological well-being of women in advanced old age and to examine predictors and correlates of older women's psychological well-being and mental health.
Design: The design was a longitudinal study over ten years with three waves of data collection (1989, 1995, 1999).
Population, Sample, Setting, Years: Participants were community-dwelling women (N=61, mean age=81) who had participated in a 10-year longitudinal survey study in the midwest and had data available from all three waves of data collection. Women's ages ranged from 74- to 91, 61% were widowed, 70% lived alone, and they had an average of 13 years of education. They reported an average of 4 chronic conditions (range=0 - 11).
Variables: Multiple reliable and valid measures of physical health and functioning, psychological well-being, and mental health were collected at all three data collection times. Demographic data were also collected.
Methods: For this study, participants from 1995 (wave 2, N=103, mean age=77) were contacted by mail and ask to complete at home and return a third set of mailed surveys. The response rate was 73%.
Findings: Repeated measures MANOVAs indicated significant increases in number of chronic conditions, symptoms (mean number=8), and difficulty with ADLs over time. There were significant decreases in having a sense of purpose in life, personal growth, and positive relations with others; stability in autonomy and depressive symptoms, and an increase in anxiety. The percentage of women who scored in the range for clinical depression, however, increased from 16 to 21% over time. Of these women, 69% had not had clinically significant symptoms in the past. Women who were depressed at wave 3 were more likely to have had worse functional status, lower ratings of subjective health, more bothersome symptoms, and higher anxiety at time 1. There were no demographic differences between depressed and nondepressed women.
Conclusions: For the majority of these women in their eighties, there was a high level of psychological well-being in spite of a decline in physical health and functioning. For a minority, however, levels of depressive symptoms suggested clinical depression, which was related to poorer health at baseline.
Implications: The results suggest a need for nursing interventions aimed at mental health promotion and detection of clinical depression in very old women. These may need to target both older women and their health care providers.
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