A number of factors are thought to influence people's dietary choices, including health, cost, convenience and taste, but there are no measures that address health-related and non-health-related factors in a systematic fashion. This paper describes the development of a multidimensional measure of motives related to food choice. The Food Choice Questionnaire (FCQ) was developed through factor analysis of responses from a sample of 358 adults ranging in age from 18 to 87 years. Nine factors emerged, and were labelled health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity and ethical concern. The questionnaire structure was verified using confirmatory factor analysis in a second sample (n = 358), and test-retest reliability over a 2- to 3-week period was satisfactory. Convergent validity was investigated by testing associations between FCQ scales and measures of dietary restraint, eating style, the value of health, health locus of control and personality factors. Differences in motives for food choice associated with sex, age and income were found. The potential uses of this measure in health psychology and other areas are discussed.
Both social isolation and loneliness are associated with increased mortality, but it is uncertain whether their effects are independent or whether loneliness represents the emotional pathway through which social isolation impairs health. We therefore assessed the extent to which the association between social isolation and mortality is mediated by loneliness. We assessed social isolation in terms of contact with family and friends and participation in civic organizations in 6,500 men and women aged 52 and older who took part in the English Longitudinal Study of Ageing in [2004][2005]. A standard questionnaire measure of loneliness was administered also. We monitored all-cause mortality up to March 2012 (mean follow-up 7.25 y) and analyzed results using Cox proportional hazards regression. We found that mortality was higher among more socially isolated and more lonely participants. However, after adjusting statistically for demographic factors and baseline health, social isolation remained significantly associated with mortality (hazard ratio 1.26, 95% confidence interval, 1.08-1.48 for the top quintile of isolation), but loneliness did not (hazard ratio 0.92, 95% confidence interval, 0.78-1.09). The association of social isolation with mortality was unchanged when loneliness was included in the model. Both social isolation and loneliness were associated with increased mortality. However, the effect of loneliness was not independent of demographic characteristics or health problems and did not contribute to the risk associated with social isolation. Although both isolation and loneliness impair quality of life and well-being, efforts to reduce isolation are likely to be more relevant to mortality.
Summary Psychological wellbeing and health are closely linked at older ages. Three aspects of psychological wellbeing can be distinguished: evaluative wellbeing (or life satisfaction), hedonic wellbeing (feelings of happiness, sadness, etc), and eudemonic wellbeing (sense of purpose and meaning in life). We review recent advances in this field, and present new analyses concerning the pattern of wellbeing across ages and the association between wellbeing and survival at older ages. The Gallup World Poll, an ongoing survey in more than 160 countries, shows a U-shaped relationship between evaluative wellbeing and age in rich, English speaking countries, with the lowest levels of wellbeing around ages 45-54. But this pattern is not universal: for example, respondents from the former Soviet Union and Eastern Europe show a large progressive decline in wellbeing with age; Latin America also shows falling wellbeing with age, while wellbeing in sub-Saharan Africa shows little change with age. The relationship between physical health and subjective wellbeing is bidirectional. Older people suffering from illnesses such as coronary heart disease, arthritis and chronic lung disease show both raised levels of depressed mood and impaired hedonic and eudemonic wellbeing. Wellbeing may also have a protective role in health maintenance. In an illustrative analyses from the English Longitudinal Study of Ageing (ELSA), we find that eudemonic wellbeing is associated with longer survival; 29.3% of people in the lowest wellbeing quartile died over the average follow-up period of 8.5 years compared with 9.3% of those in the highest quartile. Associations were independent of age, gender, demographic factors, and baseline mental and physical health. We conclude that the wellbeing of the elderly is an important objective for both economic and health policy. Current psychological and economic theories do not adequately account for the variations in pattern of wellbeing with age across different parts of the world. The apparent association between wellbeing and survival is consistent with a protective role of high wellbeing, but alternative explanations cannot be ruled out at this stage.
The English Longitudinal Study of Ageing (ELSA) is a panel study of a representative cohort of men and women living in England aged ≥50 years. It was designed as a sister study to the Health and Retirement Study in the USA and is multidisciplinary in orientation, involving the collection of economic, social, psychological, cognitive, health, biological and genetic data. The study commenced in 2002, and the sample has been followed up every 2 years. Data are collected using computer-assisted personal interviews and self-completion questionnaires, with additional nurse visits for the assessment of biomarkers every 4 years. The original sample consisted of 11 391 members ranging in age from 50 to 100 years. ELSA is harmonized with ageing studies in other countries to facilitate international comparisons, and is linked to financial and health registry data. The data set is openly available to researchers and analysts soon after collection (http://www.esds.ac.uk/longitudinal/access/elsa/l5050.asp).
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