A High Sense of Coherence as Protection Against Adverse Health Outcomes in Patients Aged 80 Years and Older

Abstract

PURPOSEWe set out to assess whether a high sense of coherence (SOC) protects from adverse health outcomes in patients aged 80 years and older who have multiple chronic diseases.METHODS A population-based prospective cohort study in 29 primary care practices throughout Belgium included 567 individuals aged 80 years and older. We plotted the highest tertile of SOC scores in Kaplan-Meier curves representing 3-year mortality and time to first hospitalization. Using Cox proportional hazard regression analyses and multiple logistic regression analyses adjusted for sociodemographic characteristics, depression, cognition, disability, and multimorbidity we examined the relationship between SOC and mortality, hospitalization, and decline in performance of activities of daily living (ADL).RESULTS Subjects with high SOC scores showed a higher cumulative survival than others (Log rank = 0.004) independent of other prognostic characteristics (adjusted hazard ratio 0.62 (95% CI, 0.38-1.00), P = .049). For ADL decline, a high SOC was shown to be protective, and this effect tended to be independent from the covariates under study (adjusted odds ratio 0.56 (95% CI, 0.31-1.0), P = .05).CONCLUSION Even very elderly persons with high SOC scores were shown to have lower mortality rates and less functional decline. These effects were independent of multimorbidity, depression, cognition, disability, and sociodemographic characteristics.

The Barcelona Brain Health Initiative: Cohort description and first follow-up

“…Sense of coherence is a core component in the salutogenic model of Aaron Antonovsky [75] and is defined as "a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that (1) the stimuli deriving from one's internal and external environments in the course of living are structured, predictable, and explicable; (2) the resources are available to one to meet the demands posed by these stimuli; and (3) these demands are challenges, worthy of investment and engagement' [76]. Our findings are consistent with studies that argue that a high sense of coherence allows to better cope with stressors and represents a health promoting factor [71] associated with reduced mortality, increased well-being, and reduced incidence of depression [77,78,79].…”

Sense of Coherence mediates the association between temporomandibular disorders and quality of life

“…Our findings are in accordance with studies reporting that high SOC is associated with positive levels of health in adult life (Elyasi et al, ; Sipilä, Ylöstalo, Joukamaa, & Knuuttila, ). In addition, a systematic review that investigated the association between SOC and oral health behaviors showed that stronger SOC was associated with favorable oral health behaviors (Boeckxstaens et al, ; Elyasi et al, ).…”

“…The positive influence of SOC on OHRQoL and QoL, found in our study, is corroborated by previous investigations, which revealed that high SOC provides adaptive health behavior and ability for resilience (Miettinen et al, ). On a similar note, a holistic view of TMD is of importance, as high SOC contributes to the improvement of the capacity to cope with life stressors and health maintenance, and consequently QoL (Boeckxstaens et al, ).…”

Do the Positives Through Life Decrease Later-life Frailty?: Positive Psychosocial Resources and Health Status in Older Adult, a Prospective Cohort Study

“…7 The positive impact of a higher SOC extends into the ninth decade of life and beyond, with people who have scores in the highest tertile having a decreased risk of mortality and functional decline. 8 A way to operationalise the concept of salutogenesis is Health assets. Health assets are factors that predict health and recovery over and above conventional risk factors and are also desirable in their own right.…”