Psychiatric morbidity among people aged 85+ in 1987. A follow‐up study at two and a half years: Associations with changes in psychiatric morbidity

Abstract

SUMMARYThis article reports findings from a longitudinal survey of very elderly people living at home in London. The research aimed to identify social, psychological and physical characteristics associated with positive ageing and successful survival in the community in later life and its converse-negative ageing-as well as the associated policy implications. Associations with psychiatric morbidity, measured using the General Health Questionnaire, among sample members without cognitive impairment between the baseline interviews in 1987 and at follow-up, two and a half years later in 1990, are reported. Twenty-five per cent of survivors scored over the threshold of the GHQ in 1987 and 30% scored over the threshold in 1990. Half of those with a score over the threshold in 1990 also scored over the threshold in 1987. Hierarchical regression (using residualized change analysis) was used to estimate the effects of the independent variables on changes in psychiatric morbidity. The most significant predictor of psychiatric morbidity (GHQ score) in 1990 was baseline GHQ score, followed by health and functional status scores. Health and functional status were also the strongest predictors of baseline (1987) GHQ scores. The uniqueness of the study lies in the collection of follow-up data on a sample of very elderly people, given that most surveys are cross-sectional and contain too few people aged 85+ to merit separate analysis. It contributes to the small body of literature on outcome of depression. The lack of consistent associations with recovery from psychiatric morbidity in the literature enhances the importance of studies aiming to identify factors associated with different outcomes.

Associations With Changes in Life Satisfaction Among Three Samples of Elderly People Living at Home

“…The importance of maintaining and improving good levels of functioning in old age cannot be overemphasized. Previously reported analyses of depression among the baseline and follow-up respondents to this study show that decline in health and functional ability was the strongest predictor of baseline depression, and, after baseline depression, declining health in particular was predictive of worsening of depression over time (Bowling and Browne, 1991;Bowling and Farquhar, 1991;Bowling et al, 1992Bowling et al, , 1996. The consistency of these separate analyses with these datasets emphasizes the importance of early detection and timely rehabilitation.…”

Outcome of anxiety and depression at two and a half years after baseline interview: associations with changes in psychiatric morbidity among three samples of elderly people living at home

“…There were no significant associations with GHQ score and marital status, household size and other network indicators, except that network size and structure (number of relatives and confidantes, and density) were significantly associated using chisquare test with change in GHQ score in the expected direction with the 85 plus sample; however, these variables were reduced to nonsignificance in a previous multiple regression analysis and are not re-presented here (Bowling et al, 1992).…”

“…The full baseline results, and some of the follow-up results for the 85 plus sample only, have been reported elsewhere (Bowling, 1990;Bowling and Farquhar, 1991;Bowling et a/., 1992). In previous baseline crosssectional analyses of the three samples of elderly people we found that 26% of the 85 plus inner city sample scored as a case using the General Health Questionnaire (GHQ), as did 10% of the inner city sample of people aged 65-75 and 21% of those aged 75-85; and 11% of the semi-rural sample of people aged 65-75 and 18% of those aged 65-75 scored as a case (Bowling and Farquhar, 1991).…”

“…All contactable survivors were followed up and the response rates for the two younger samples respectively were 83% (330includes two proxy interviews) and 78% (195includes three proxy interviews). Full details of the samples and the response rates are given elsewhere (Bowling, 1990;Bowling and Browne, 199 1 ;Bowling and Farquhar, 199 1;Bowling et al, 1992Bowling et al, , 1995.…”

Predicting psychological distress in college students: The role of rumination and stress

“…Higher scores reflect elevated psychological distress. The scale has been shown to be valid and reliable: it correlates well with psychiatric diagnoses of morbidity and depression (Finlay-Jones & Murphy, 1979), and it has good construct validity (Berwick et al, 1987;Huppert & Garcia, 1991) and predictive validity (Bowling, Farquhar, Grundy, & Formby, 1992). Split-half reliability is acceptable, with a correlation of 0.95 reported in the literature (Bowling, 1997).…”