Determinants of multidimensional mental wellbeing in the oldest old: a rapid review.

Johanna Cresswell-Smith, Francesco Amaddeo, Valeria Donisi, Anna K Forsman, Jorid Kalseth, Natalia Martin-Maria, Marta Miret, Kristian Walhbeck

Journal: Social psychiatry and psychiatric epidemiology 2019;54(2):135-144

PMID: 30498846

Abstract

PURPOSE

Improved life expectancy imposes new challenges for policy-makers. The growing oldest-old age group (defined as 80 and over) is often characterised by increased support needs. Greater attention to wellbeing in this population group is necessary, and may well require a shift in social policy focus. The current review seeks to explore current research on determinants of mental wellbeing for the oldest old.

METHODS

An iterative rapid review approach was used to review existing literature in line with four dimensions of mental wellbeing defined by the European Welfare Models and Mental Wellbeing in Final Years of Life (EMMY) study; functional, social, personal and environmental. A specific focus on articles employing multidimensional definitions of mental wellbeing was adopted.

RESULTS

Multidimensional indicators reflect the multifaceted and multidirectional dynamics of wellbeing in very old age. Considerable variety in both measures and terminology was found within the literature making precise comparison difficult. The current review takes steps towards comparability by focusing on studies implementing multiple measures of mental wellbeing including evaluative, hedonistic and eudaimonic factors. Clearly defined and multifaceted measures of mental wellbeing are needed to sharpen evidence used in policy development, appraisal and evaluation in light of the considerable diversity of health and functional states experienced in later life.

CONCLUSIONS

Previous studies appear to line up the four main dimensions of mental wellbeing identified in the EMMY study. Actively improving opportunities for older adults to produce benefits to society can be done via a stronger focus on resources such as mental wellbeing.

Address: Mental Health Unit, National Institute for Health and Welfare (THL), PL 30, 00271, Helsinki, Finland. [email protected].; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.; Faculty of Education and Welfare Studies, Åbo Akademi University, Health Sciences P.B. 311, 65101, Vaasa, Finland.; Department of Health Research, SINTEF Digital, Trondheim, Norway.; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.; Mental Health Unit, National Institute for Health and Welfare (THL), PL 30, 00271, Helsinki, Finland.

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