Department of Geriatrics, Ghent University Hospital, Ghent, Belgium.
Department of Geriatrics, AZ Sint-Jan, Bruges, Belgium.
Aging Ment Health. 2024 Jan-Feb;28(2):302-306. doi: 10.1080/13607863.2023.2242302. Epub 2023 Aug 3.
Will-to-live is defined as the psychological expression of one's commitment to life and the desire to continue living. It is an important indicator of subjective wellbeing. This study aimed to assess the will-to-live in frail older hospitalized patients and nursing home residents as well as to evaluate its association with physical frailty, tiredness of life, depression and wish-to-die.
Between March and September 2021, we interviewed 186 older adults in six nursing homes and two acute geriatric wards across Belgium. Will-to-live was assessed using a single-item numeric rating scale from 0 to 5. A linear regression analysis was performed to assess the association between will-to-live and frailty (Clinical Frailty Scale) with adjustment for age, gender and setting. Mann-Whitney U test was used to evaluate the association between will-to-live and depression, tiredness of life and wish-to-die.
Mean age was 85 (± 6.2) years. Mean score on the Clinical Frailty Scale was five (± 1.5) and four on the will-to-live (± 1.3). No statistical significant association was found between will-to-live and age ( = 0.991), gender ( = 0.272), setting ( = 0.627) and frailty ( = 0.629). Multiple linear regression showed no significant association with Clinical Frailty Scale ( = 0.660), after adjustment for age, gender and setting. Will-to-live was negatively associated with tiredness of life ( = 0.020) and wish-to-die ( < 0.001), but not with depression ( = 0.186).
Both nursing home residents and older hospitalized patients expressed a strong or very strong will-to-live. Will-to-live was not associated with physical frailty as measured by the Clinical Frailty Scale. Nursing home residents with a weak will-to-live were more likely to have depressive symptoms. Most nursing home residents with a wish-to-die had also a low will-to-live, although some residents had both a high will-to-live and wish-to-die.
生存意愿是指一个人对生命的承诺和继续生存的渴望的心理表现。它是主观幸福感的一个重要指标。本研究旨在评估虚弱的老年住院患者和养老院居民的生存意愿，并评估其与身体虚弱、生活疲惫、抑郁和想死的愿望的关系。
2021 年 3 月至 9 月，我们在比利时的六家养老院和两家急性老年病房对 186 名老年人进行了访谈。使用从 0 到 5 的单点数字评分量表评估生存意愿。进行线性回归分析，以评估生存意愿与虚弱（临床虚弱量表）之间的关系，调整年龄、性别和环境因素。使用曼-惠特尼 U 检验评估生存意愿与抑郁、生活疲惫和想死的愿望之间的关系。
平均年龄为 85（±6.2）岁。临床虚弱量表的平均得分为 5（±1.5），生存意愿的平均得分为 4（±1.3）。生存意愿与年龄（ = 0.991）、性别（ = 0.272）、环境（ = 0.627）和虚弱（ = 0.629）之间无统计学显著关联。在调整年龄、性别和环境因素后，多变量线性回归显示与临床虚弱量表无显著关联（ = 0.660）。生存意愿与生活疲惫（ = 0.020）和想死的愿望（ < 0.001）呈负相关，但与抑郁（ = 0.186）无关。
养老院居民和老年住院患者都表达了强烈或非常强烈的生存意愿。生存意愿与临床虚弱量表测量的身体虚弱无关。生存意愿较弱的养老院居民更有可能出现抑郁症状。大多数有想死愿望的养老院居民也有较低的生存意愿，尽管一些居民既有较高的生存意愿又有想死的愿望。
