But they are particularly relevant to gerontology because of the greater vulnerability of older people to health shocks, and because reductions in physical capability and cognitive reserve coupled with chronic allostatic load will increase the risks associated with disturbances in biological regulation.
Sustained good health is of course highly desirable, but it is not the only important feature of ageing well. Another reason for taking happiness seriously in gerontology is that it is associated with numerous other features of a good life in later years. Studies of younger and middle-aged people have documented links between subjective well-being and more satisfactory personal and social relationships, work performance, and prosocial behaviours such as volunteering [ 27 , 28 ], and similar processes may apply among older people.
Some early studies failed to show stable longitudinal associations [ 29 , 30 ], but more recent work has established wide-rating associations between subjective well-being and various aspects of life outside the health domain. They rated the extent to which they felt that the things they did in life were worthwhile on a scale from 0 not at all worthwhile to 10 very worthwhile.
Ratings averaged 7. Higher ratings were associated with better health, less pain and disability, and more favourable biomarkers C-reactive protein, vitamin D concentration, white blood cell count, etc.
But in addition, worthwhile ratings predicted positive changes in the social, psychological, economic and behavioural domains over a 4-year period. As can be seen in Table 2 , people with higher ratings of doing worthwhile things in life had favourable outcomes in the personal, social, economic, and behavioural domains. Findings ranged from a reduced risk of divorce, to taking up a healthier diet, better sleep, and increased cultural participation. Similar longitudinal relationships have been reported in other studies [ 32 , 33 ].
It seems that the ramifications of subjective well-being spread far beyond health and disability. Subjective well-being and non-health outcomes 4 years after baseline [ 31 ]. The fourth reason for investing in happiness in gerontology is the notion that subjective well-being is not static, but can be enhanced. Although happiness has a genetic underpinning [ 34 ], it fluctuates through the life course, and there are multiple factors that have an impact on subjective well-being at older ages.
Analyses of changes in evaluative well-being in population cohorts indicate that social factors such as reductions in loneliness and more positive social support are as important as sustained health and lack of disability in predicting increases over an 8-year period [ 35 ]. An effective intervention programme that captures these elements might not only improve well-being but have an impact on social activity, health and cognitive function.
This is an active area of research, though much of the effort in this field is focused on the young in the hope that programmes might set them on life trajectories that reduce mental ill-health, and promote educational attainment and enduring social relationships. Other studies have involved working people in mid-life or groups at high risk of mental ill-health [ 36 , 37 ]. Potentially, interventions might also have an effect on disease onset and healthy life expectancy among older individuals.
But there are many challenges that need to be addressed. The first requirement is developing programmes that reliably increase well-being over sustained periods among older people.
Existing programmes are broadly of two types. First are interventions directed specifically at increasing subjective well-being, including mindfulness training, gratitude interventions, positive psychotherapy, and other methods [ 38 ]. A review of mindfulness interventions for older adults concluded that effects were mixed, due in part to weak methodologies [ 39 ]. The second group comprise procedures that may impact happiness but not necessarily as the primary outcome; examples include enhancing physical activity, increasing social activity or cultural engagement [ 40 , 41 ].
To date, most well-being interventions have measured outcomes over relatively short periods of 12—18 months. Such effects are worthwhile, but are unlikely to promote enhanced health unless sustained for longer periods. We also know little about how large improvements would have to be to have a convincing impact on health.
Thus, definitive studies establishing long-term effects of interventions on happiness and subsequently on the health of older men and women have yet to be conducted. Nonetheless, the field holds great promise. A strong case can be made for the assessment of subjective well-being not only at the individual level, but in large scale surveys of older people [ 42 ].
Although there are challenges in the interpretation of self-report measures of well-being [ 43 ], the monitoring of happiness provides valuable information about demographic trends, and might also be useful in gauging the impact of public policy. This is a fertile area of research and practice and opens up possibilities for gerontology from multiple perspectives ranging from economics and sociology, through psychology, to health and biology.
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George Eds. Social Demography Perspectives A core concept in gerontology is heterogeneity among the older adult population, which is substantiated by demographic research on gender, racial, ethnic, and socioeconomic variation among older Americans. Proudly serving the health care and helping professions. Douglas K. We refer to interdisciplinary as an inquiry involving a plurality of disciplines where disciplinary boundaries are often muted and the joint contributions of the synergy are highlighted.
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Institutional Login Shibboleth or OpenAthens For the academic login, please select your organization on the next page. Kenneth F. Ferraro has published over 90 articles and chapters in professional journals and books. Janet M.
Her research uses nationally representative data and longitudinal data analysis techniques to examine later-life living arrangements, financial security, and health status. She has published over 30 articles and chapters in professional journals and books. Description For all courses in gerontological nursing, and all nursing courses that address the unique challenges of caring for older adults. New to This Edition. Helps nursing students improve the safety and quality of their care.
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