Health and quality of life of older people, a replication after six years

摘要

Replicating a survey of 875 people 55 years old or more undertaken in September 1999 throughout the former Northern Interior Health Region (NIHR) of British Columbia, in September 2005 a sample of 656 people completed a 22-page questionnaire. The average age of the respondents was 68, with a range running from 55 to 96 years, and 64% were women. Responses to the SF-36 questionnaire indicated that for male respondents aged 55–64, the mean score for the 8 dimensions was 76.1. This mean was a bit higher than the 74.4 mean of 1999. For male respondents aged 65 and older the mean was 69.0, which was also higher than the 68.3 mean of 1999. For females aged 55–64, the mean score for 8 dimensions was 73.1, versus 73.0 in 1999. For female respondents aged 65 and older, the mean score was 67.0, versus 65.4 in 1999. Based on these mean scores for the 8 dimensions, then, it is fair to say that the overall health status of males and females aged 55 years and older in the region in 2005 was at least as good as (i.e., the same as or better than) that in 1999. Comparing 28 average figures for the 2005 respondents on satisfaction with specific domains of life (e.g., financial security, health, sense of meaning) and three global indicators (satisfaction with life as a whole and with the overall quality of life, and happiness) with those of the 1999 respondents, we found that the scores for the 2005 sample were at least as high as those of the other sample. Thus, it seems fair to say that the perceived quality of life of older people in the former NIHR so far as it is revealed in domain and global satisfaction and happiness scores, is at least as good as the perceived quality of life of a similar sample in 1999. Although a large majority perceived increases in crime in the 2 year periods prior to both surveys, smaller percentages of the 2005 sample than of the 1999 sample thought that crime had increased over the past two years, avoided going out at night, feared for their safety, had crime-related worries, engaged in crime-related defensive behaviours and were actually the victims of any crimes. Therefore, it seems fair to say that, so far as crime-related issues are concerned for the two samples of seniors responding to our surveys, there is more evidence of improvement than of deterioration. Applying stepwise multiple regression, each of the eight dependent variables was explained on the basis of four clusters of predictors separately and then a final regression was run using only the statistically significant predictors from the four clusters. Broadly speaking, 7 SF-36 health status scales explained from 28% to 45% of the variance in the 8 dependent variables, running from satisfaction with the overall quality of life (28%) to the single item measure of general health (45%). The seven predictors in the Social Relations cluster explained from 7% of the variance in the SF-36 General Health scale scores to 57% of the variance in the Life Satisfaction scores. The four predictors in the Problems cluster explained from 10% of the variance in the SF-36 General Health scale scores to 24% of the variance in the SWLS scores. The 11 predictors in the Domain Satisfaction cluster explained from 14% of the variance in the SF-36 General Health scale scores to 64% of the variance in the SWB scores. Putting all the significant predictors together for each dependent variable, in the weakest case, 4 of 11 potential predictors explained 33% of the variance in the SF-36 General Health scale scores and in the strongest case, 9 of 15 potential predictors explained 70% of the variance in Life Satisfaction scores. Among other things, these results clearly show that respondents’ ideas about a generally healthy life are different from, but not independent of, their ideas about a happy, satisfying or contented life, or about the perceived quality of their lives or their subjective wellbeing. Finally, the 7 core discrepancy predictors of MDT plus incomes were used to explain the eight dependent variables. From 13% of the variance in the SF-36 General Health scale scores to 57% of the variance in SWLS scores was explained using those predictors. Based on an examination of the Total Effects scores for the predictors of the 8 dependent variables, the most influential predictors were Self-Wants, followed by Self-Others and then Self-Best. In other words, the most influential discrepancy predictors of respondents’ overall life assessments were those between what respondents have versus what they want, followed by what they have versus what others of the same age and sex have, and then by what they have versus the best they ever had in the past.