Advancing age is broadly associated with declining cognitive, physical and mental health. In a new study of older adults living independently in a senior continuing care facility, researchers at University of California San Diego School of Medicine analyzed how distinctive factors, such as wisdom, loneliness, income and sleep quality, impact -- for good and bad -- the physical and mental functioning of older persons.
Writing in the May 8, 2019 issue of American Journal of Geriatric Psychiatry, a research team headed by Dilip Jeste, MD, principal investigator of the study, Distinguished Professor of Psychiatry and Neurosciences at UC San Diego School of Medicine and director of the UC San Diego Center for Healthy Aging, found that physical health correlated with both cognitive function and mental health.
Specifically, cognitive function was significantly associated with physical mobility, wisdom and satisfaction with life. Physical health was associated with mental well-being, resilience and younger age. Mental health was linked to optimism, self-compassion, income and lower levels of loneliness and sleep disturbances.
"Continuing care senior housing communities are important sites for studying and promoting health in older adults," said Jeste. "Most people focus on diseases and risk factors, like old age, unhealthy diet and lack of activity. These are important, of course, but we also need to focus on areas that make up the whole person.
"Psychological traits like optimism, resilience, wisdom and self-compassion were found to be protective, while loneliness seemed to be a risk factor. An 85-year-old can be functioning better than a 65-year-old due to protective and risk factors."
In modern society, said co-author Danielle Glorioso, LCSW, executive director of the UC San Diego Center for Healthy Aging, aging persons do not necessarily receive the support of younger family members who can serve as caregivers.
"Younger family members have jobs and children to take care of," said Glorioso, "so older adults often have to choose between staying at home and feeling lonely versus moving to a more supportive and socially engaging senior housing system. This becomes an important but complex decision impacted by a large number of factors, including financial cost of the senior housing."
A popular model of supported senior housing provides a continuum of care, from independent living to assisted living to full-time care for significant physical and cognitive impairment. For the majority of continuing care senior housing facilities, costs increase as residents transition to greater levels of assisted-living. "Delaying these transitions through facilitating longer independent living should be an important health care goal," said Jeste. "Our findings shed light on areas that need to be a focus for seniors to live full, enriched lives."
One-hundred and twelve residents participated in the study, with a mean age of 84. Sixty-eight percent were female; 69 percent possessed a college education; 41 percent were married; and 72 percent reported total annual incomes exceeding $50,000.
Jeste said more longitudinal studies involving diverse samples of older adults are necessary to determine if psychosocial and other variables are potential risks or protective factors related to cognitive, physical and mental health and diseases.
"The eventual goal would be to develop new health-focused interventions based on such research. Senior centers in the community should incorporate activities that address physical, social and mental aspects. We can all do something to improve and strengthen the quality of life of our aging population."
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