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CASP-19 special section: how does chronic disease status affect CASP quality of life at older ages? examining the WHO ICF disability domains as mediators of this relationship
- Authors:
- SEXTON E., et al
- Journal article citation:
- Aging and Mental Health, 19(7), 2015, pp.622-633.
- Publisher:
- Taylor and Francis
Objectives: The effect of chronic disease status on quality of life (QoL) has been well established. However, less is known about how chronic diseases affect QoL. This article examines impairment in three domains of the WHO International Classification of Functioning, Health and Disability (ICF) – body function, activity and participation, as well as affective well-being, – as potential mediators of the relationship between chronic disease and QoL. Method: A cross-sectional sample (n = 4961) of the general Irish community-dwelling population aged 50+ years was obtained from the Irish Longitudinal Study of Ageing (TILDA). The CASP measure of QoL was examined as two dimensions – control/autonomy and self-realisation/pleasure. Structural equation modelling was used to test the direct and indirect effects of chronic disease on QoL, via variables capturing body function, activity, participation and positive affect. Results: A factor analysis showed that indicators of body function and activity loaded onto a single overall physical impairment factor. This physical impairment factor fully mediated the effect of chronic disease on positive affect and QoL. The total effect of chronic disease on control/autonomy (−0.160) was primarily composed of an indirect effect via physical impairment (−0.86), and via physical impairment and positive affect (−0.45). The decomposition of effects on self-realisation/pleasure was similar, although the direct effect of physical impairment was weaker. The model fitted the data well (RMSEA = 0.02, TLI = 0.96, CFI = 0.96). Conclusion: Chronic disease affects QoL through increased deficits in physical body function and activity. This overall physical impairment affects QoL both directly and indirectly via reduced positive affect. (Publisher abstract)
The stability of coping strategies in older adults with osteoarthritis and the ability of these strategies to predict changes in depression, disability, and pain
- Authors:
- REGIER Natalie G., PARMELEE Patricia A.
- Journal article citation:
- Aging and Mental Health, 19(12), 2015, pp.1113-1122.
- Publisher:
- Taylor and Francis
Given the chronically painful, incurable nature of osteoarthritis, effective cognitive and behavioural coping strategies may be critical for older adults with the disease. Little is known about how and why coping changes over time, nor about stability of coping strategies in persons with osteoarthritis. The aims of this work were to examine the structure of coping in older adults with osteoarthritis, the association of coping strategies with well-being, the stability of coping over time, and its association with changes in well-being over the same period. (Edited publisher abstract)