Kaspar Roman, Wahl Hans-Werner, Diehl Manfred
Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany.
Network Aging Research, Heidelberg University, Heidelberg, Germany.
Innov Aging. 2023 May 15;7(4):igad044. doi: 10.1093/geroni/igad044. eCollection 2023.
Advanced old age is a life stage with a high likelihood of age-related loss experiences. However, little is known about remaining gain experiences and their relation with perceived losses and health correlates in community-dwelling very old adults. Moreover, virtually nothing is known in this regard about the experiences of individuals in long-term care settings. First, we strived to establish the normative course of age-related gains and losses in advanced old age. Second, we examined whether such gain/loss perceptions in advanced aging moderated health correlates.
Data came from the nationally representative survey "Old Age in Germany D80+" conducted in 2020/2021. The sample comprised 10 578 individuals aged 80-106 years, including 587 individuals in long-term care. We used the multidimensional Awareness of Age-Related Change (AARC) questionnaire and moderated regression to analyze associations with late-life health and functioning correlates.
Levels of AARC-Gains were higher than those of AARC-Losses across most of the age range. Long-term care residents showed more AARC-Losses and fewer AARC-Gains compared with community-dwelling adults and contributed significantly to an overall negative balance of more losses than gains in those aged 90 years or older. Regarding functional health and autonomy, negative age effects were amplified by AARC-Losses, but buffered by AARC-Gains. A more positive ratio of gains-to-losses predicted better health and functioning.
Findings suggest that the loss aspect of development in very late life might have been overstated in the existing literature. Perceived gains and losses are of critical importance for the understanding of health correlates in very old age.
高龄是一个极有可能经历与年龄相关的丧失体验的生命阶段。然而，对于社区居住的高龄成年人中尚存的获得体验及其与感知到的丧失和健康相关因素之间的关系，我们知之甚少。此外，对于长期护理机构中个体在这方面的经历，我们几乎一无所知。首先，我们努力确定高龄阶段与年龄相关的获得和丧失的规范进程。其次，我们研究了高龄阶段这种获得/丧失的认知是否会调节健康相关因素。
数据来自2020/2021年进行的具有全国代表性的“德国80岁及以上老年人”调查。样本包括10578名年龄在80 - 106岁之间的个体，其中587人在长期护理机构。我们使用多维的与年龄相关变化的认知（AARC）问卷和调节回归分析与晚年健康和功能相关因素的关联。
在大部分年龄范围内，AARC - 获得水平高于AARC - 丧失水平。与社区居住的成年人相比，长期护理机构居民表现出更多的AARC - 丧失和更少的AARC - 获得，并且在90岁及以上人群中，长期护理机构居民对整体丧失多于获得的负平衡有显著贡献。关于功能健康和自主性，AARC - 丧失会放大年龄的负面影响，但AARC - 获得会起到缓冲作用。更积极的获得与丧失比例预示着更好的健康和功能。
研究结果表明，现有文献可能夸大了生命极晚期发展中丧失的方面。感知到的获得和丧失对于理解高龄阶段的健康相关因素至关重要。
