The Disability Paradox? Trajectories of Well-Being in Older Adults With Functional Decline

Author:

van Loon Anouk M.1ORCID,Depla Marja F. I. A.12,Hertogh Cees M. P. M.12,Huisman Martijn234,Kok Almar A. L.234ORCID

Affiliation:

1. Department of Medicine for Older People, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

2. Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands

3. Department of Epidemiology & Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

4. Department of Sociology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

Abstract

Objectives: The ‘disability paradox’ (DP) suggests that most older adults maintain subjective well-being (SWB) despite functional decline. However, this may depend the SWB component: positive affect (PA), negative/depressed affect (NA/DA) or life satisfaction (LS). We assessed trajectories of these components in older adults with substantial functional decline. Methods: Data originated from the Longitudinal Aging Study Amsterdam ( N = 2545) observed during 1992–2008. Using latent class growth analysis, we distinguished a group with substantial functional decline and examined their SWB trajectories and individual characteristics. Results: The DP occurred more frequently for DA (Men:73%, Women:77%) and LS (Men:14%, Women:83%) than for PA (Men:26%, Women:17%). Higher perceived control (mastery) emerged as the most consistent factor associated with higher odds of the DP. Discussion: We provide a nuanced view of the DP, shifting the question from whether it exists to for which dimension of SWB and for whom it is more or less apparent.

Funder

Dutch Ministry of Health, Welfare and Sports

the Netherlands Ministry of Health, Welfare and Sport, Directorate of Long-Term Care

the Netherlands Organization for Scientific Research

Publisher

SAGE Publications

Subject

Geriatrics and Gerontology,Community and Home Care,Gerontology

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