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

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.

Mental well-being among the oldest old: revisiting the model of healthy ageing in a Finnish context

“…Supporting and increasing mental well-being into oldest old ageincluding the psychosocial (Bowling, 2007) aspects of health alongside physical aspects (Beard et al, 2016)-is an important and timely line of enquiry. Including a stronger focus on mental well-being could further bolster the healthy ageing approach and offer unique opportunities for interventions and policy development (Cresswell-Smith et al, 2019).…”

Is Mental Well-Being in the Oldest Old Different from That in Younger Age Groups? Exploring the Mental Well-Being of the Oldest-Old Population in Europe

“…The resource-based approach employed in the EMMY project highlighted the need to focus on positive aspects of MWB in oldest old age (Lara et al 2019;Cresswell-Smith et al 2019). This approach is also consistent with theoretical models emphasizing positive MWB such as those underlying the Seligman's PERMA model (Seligman 2011), WEM-WBS (Tennant et al 2007) and WHO-5 Well-Being Index (Topp et al 2015).…”

“…The final selection of items was settled by using the majority principle and included items which were supported by at least five experts. These items reflected a focus on positive aspects of MWB, in accordance with the EMMY project framework, which conceptualized MWB not just as the absence of ill-being or disability, but as the presence of positive emotions and functioning (Lara et al 2019;Cresswell-Smith et al 2019). In line with this, all negatively worded items (about affect, functioning or vitality) and items related to social trust, social growth and safety were excluded.…”

“…This demographic transition also includes an increased life expectancy at the age of 80 years, which has increased from 8.4 years in 2004 to 9.5 years in 2014 (Eurostat 2016). Although undoubtedly a positive outcome and a reflection of improvements in medical treatment, preventive measures and education levels, this demographic transition also brings new challenges for health-care services, public health and policy development (Cresswell-Smith et al 2019;Jaul and Barron 2017;Beard et al 2015;Cohen-Mansfield et al 2013).…”

‘If we would change things outside we wouldn’t even need to go in…’ supporting recovery via community‐based actions: A focus group study on psychiatric rehospitalization

“…Meaning is a very personal experience that can be promoted in different ways, participants in the current study mention the importance of spiritual meaning, nature and engaging in activities that feel personally significant. The importance of the everyday environment upon mental well‐being has been reported elsewhere, 69 as has the influence of eudaimonic well‐being reflecting judgements of meaning and purpose in life 70 . Meaning can also be supported by incorporating the environmental landscape into day‐to‐day life including agriculture, farms, animals, plants, gardening and the forest that have been found useful for promoting mental and physical health, 71 something which is also worth attending to in a hospital environment 72 .…”