S2.2 Psychological distress, mental illness, and mood fluctuations in old age – causes and consequences
Wednesday 16:45-18:00 S2.2 Hall B
Psychological distress, mental illness, and mood fluctuations in old age – causes and consequences
Chair: Ingmar Kåreholt
Psychological distress and mental problems is highest among young adults and lowest the years after retirement age (age 65) and increases again from the age 70. The proportion reporting mental problems in old age are almost as large as in young adulthood. The age-related pattern of mental problems is u-shaped. Mental health is dependent on experiences during the life course. The first presentation is about the association between financial hardship and psychological distress in a life-course perspective. Limited psychological well-being is associated to many other health problems, both preceding and following other health problems. The second presentation is about the association between intra-individual variations in mood and mortality. Severe mental illness has an overarching influence in the life of those affected. The knowledge about the situation for older persons with severe mental illness is limited. The third and fourth presentations respond to that. While the third provides an overview of the living situation among older people with severe mental illness as compared to the population of older people without such a condition, the fourth is based on a narrative analysis of life stories among older people who experienced periods of inpatient psychiatric care and are currently residing in nursing homes.
S2.1.1 Linking financial hardship and psychological distress from childhood to old age:
testing the sensitive period, chain of risks, and accumulation of risks hypotheses Alexander Darin-Mattsson, Ross Andel, Roger Keller-Celeste, Ingemar Kåreholt
Aging Research Centre, Karolinska Institutet, Stockholm, Sweden
Background: Financial hardship is associated with more psychological distress. We study financial hardship and psychological distress in old age by investigate three life-course hypotheses – sensitive period, chain of risks, and accumulation hypotheses. Methods: Swedish longitudinal surveys based on nationally representative samples were used. Financial hardship in childhood was assessed retrospectively at first participation, and currently at mean ages 54, 61, 70, and 81. Psychological distress (self-reported) was assessed at same ages. Path-analysis with repeated measures and WLSMV estimation was used. Results: There was a direct association from financial hardship in childhood to psychological distress at age 70 (0.26, p=0.002), but not at age 81. Childhood financial hardship increased the risk of psychological distress and financial hardship at baseline (age 54), and, in turn, later on. There was a bi-directional relationship between psychological distress and financial hardship over the life-course. Employment and higher education decreased the negative effects of financial hardship in childhood on later psychological distress and financial hardship. Conclusion: Hardship in childhood sets people on a negative path; in addition, there is a direct effect of adverse conditions in childhood on health in later-life. Education and employment might decrease negative outcomes of childhood financial hardship.
S2.2.2 Longitudinal changes in within-person fluctuation in mood as a marker of
Deborah Finkel, Nilam Ram, Nancy Pedersen
Indiana University Southeast, USA
Background: Recent findings indicate that widely spaced longitudinal assessments may be unable to detect declines that result when an individual’s capacity for regulation is overwhelmed. Research on intraindividual variability suggests that extent of fluctuations in cognitive performance or control across trials or days is an early marker of decline and/or death. Methods: In the Swedish Adoption Twin Study of Aging, bursts of daily measurements were collected from a subsample of participants aged 62 to 91 years (M = 72.15, SD = 6.58) at Wave 9 (N = 147, 58% women), and again two years later at Wave 10 (N = 106); 101 participated in both waves. On each of the 5 days following the in-person assessments, participants completed a booklet wherein they provided self-reports of their daily positive and negative affect. Results: Intraindividual mean level of daily positive and negative affect was relatively stable across waves (across-wave rs = .74 and .79, respectively). In contrast, extent of intraindividual fluctuation in daily mood (operationalized as the intraindividual standard deviation, iSD) was less stable across waves (across-wave rs = .43 and .46), with individuals who have since died exhibiting greater day-to-day fluctuation in mood than their still-living peers, and an increase in amount of fluctuation across the two years. Conclusions: The results suggest that day-to-day fluctuation in mood may be an early marker of terminal decline
S2.2.3 Older people with and without mental illness – register-based population study
Marie Ernsth-Bravell, Per Bülow, Joy Torgé, Monika Wilinska, Pia H. Bülow, Magnus Jegermalm
Jönköping University, Sweden
Background: After the 1995 Swedish psychiatric reform, institutions for people with severe mental illness (SMI) shut down and the responsibility for support in everyday life moved to municipal social services. As people with SMI age in the community, knowledge is needed about their living situation. Yet, older people with SMI is a forgotten group in polices and research. Methods: Our study investigates living conditions, social networks, health and care of this group. In this presentation, we use descriptive statistical analysis to compare groups of older persons from two samples: 1) inventories of people with SMI, conducted every fifth year in one Swedish municipality from 1996 to 2011 (SMI-O) and 2) a population-based study with a representative sample of older people, conducted in the same municipality with similar questions (OCTO-2). Results: The mean ages in the groups were similar (SMI-O: 76; OCTO-2: 78) but the distribution of men and women differed (35/65%; 48/52%) as did the proportion of persons living alone (83%; 48%). The samples had similar frequencies in social contacts (51%; 52%) but SMI-O reported significantly more problems in performing personal and instrumental daily activities. Conclusions: As SMI-O is a vulnerable group compared to older people in general, understanding their support needs is required.
S2.2.4 Severe mental illness from a life course perspective- the meaning of times and
Monika Wilinska, Pia Bülow, Per Bülow, Marie Ernsth-Bravell, Magnus Jegermalm, Joy Torgé
Jönköping University, Sweden
Background: The presentation is based on individual life stories of older persons with severe mental illness who have lived through changing political context of deinstitutionalization of mental health care in Sweden. Methods: In this narrative study, we apply a life course approach to delve into times and spaces of severe mental illness as lived through. We also discuss the intersections of life histories and illness histories and their temporal and spatial grounding to gain a better understanding of life-long experience of severe mental illness. Results: All research participants, currently residing in nursing homes, share experiences of shorter or longer periods of inpatient psychiatric care. Their experiences however reveal dissimilarities in relation to various times and spaces that became relevant for shaping their individual lives. Conclusions: Based on our results, we propose a contextual understanding of severe mental illness in later life that implies an attention to political, institutional and personal times and spaces that when interacting, produce diverse life pathways. Focus on times and spaces brings out the necessity of listening to individual voices who demonstrate their agency.