Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-26T22:34:18.575Z Has data issue: false hasContentIssue false
  • English
  • Français

Meaning in life matters for older adults with Alzheimer’s disease in residential care: associations with life satisfaction and depressive symptoms

Published online by Cambridge University Press:  06 February 2019

Laura Dewitte Open the ORCID record for Laura Dewitte [Opens in a new window] ,
Mathieu Vandenbulcke  and
Jessie Dezutter
Laura Dewitte*
Affiliation:
Faculty of Psychology and Educational Sciences, KU Leuven—University of Leuven, Leuven, Belgium Research Foundation Flanders, Brussels, Belgium
Mathieu Vandenbulcke
Affiliation:
Faculty of Psychology and Educational Sciences, KU Leuven—University of Leuven, Leuven, Belgium University Psychiatric Centre, KU Leuven, Leuven, Belgium
Jessie Dezutter
Affiliation:
Faculty of Psychology and Educational Sciences, KU Leuven—University of Leuven, Leuven, Belgium
*
Correspondence should be addressed to: Laura Dewitte, Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102 − box 3717, Belgium. Phone: +32 16/37.42.54. Email: laura.dewitte@kuleuven.be.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To examine whether previously established associations between experiences of meaning in life on the one hand and life satisfaction and depressive symptoms on the other hand are transferable to a population of older residential care residents with Alzheimer’s disease (AD).

Design:

Cross-sectional study using questionnaires administered in a structured interview format.

Setting:

Nine residential care settings in Flanders, Belgium.

Participants:

Convenience sample of 138 older adults (+65) living in residential care with a diagnosis of AD.

Measurements:

Meaning in life was measured using the Presence of Meaning (PoM) subscale of the Meaning in Life Questionnaire-Short Form, life satisfaction was measured using the Satisfaction With Life Scale (SWLS), depressive symptoms were measured using a five-item short form of the Geriatric Depression Scale (GDS), and general cognitive status was measured using the Mini-Mental State Examination (MMSE).

Results:

Controlling for demographic variables (age, sex, and marital status) and cognitive status, meaning in life scores were positively predictive of life satisfaction scores and negatively predictive of depressive symptoms. Post-hoc analyses suggested a possible interaction between meaning in life and cognitive status in predicting both outcomes of psychological functioning (GDS and SWLS).

Conclusion:

The presence of meaning in life is related to important well-being outcomes for older adults with AD living in residential care. More awareness for the importance of existential themes and interventions fostering meaning might be warranted for this population.

Keywords

Alzheimer’sdementiameaning in lifedepressive symptomslife satisfactionwell-beingresidential care
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 5: Issue Theme: Well-Being in Dementia , May 2019 , pp. 607 - 615
Copyright
© International Psychogeriatric Association 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barca, M. L., Engedal, K., Laks, J. and Selbaek, G. (2010). A 12 months follow-up study of depression among nursing-home patients in Norway. Journal of Affective Disorders, 120, 141–148.CrossRefGoogle ScholarPubMed
Berg, A. I., Hoffman, L., Hassing, L. B., Mcclearn, G. E. and Johansson, B. (2009). What matters, and what matters most, for change in life satisfaction in the oldest-old? A study over 6 years among individuals 80+. Aging and Mental Health, 13, 191–201.CrossRefGoogle ScholarPubMed
Bergh, S., Engedal, K., Røen, I. and Selbæk, G. (2011). The course of neuropsychiatric symptoms in patients with dementia in Norwegian nursing homes. International Psychogeriatrics, 23, 1231–1239.CrossRefGoogle ScholarPubMed
Brownie, S. and Nancarrow, S. (2013). Effects of person-centered care on residents and staff in aged-care facilities: a systematic review. Clinical Interventions in Aging, 8, 1.CrossRefGoogle ScholarPubMed
Choi, N. G., Ransom, S. and Wyllie, R. J. (2008). Depression in older nursing home residents: the influence of nursing home environmental stressors, coping, and acceptance of group and individual therapy. Aging and Mental Health, 12, 536–547.CrossRefGoogle ScholarPubMed
Czekierda, K., Banik, A., Park, C. L. and Luszczynska, A. (2017). Meaning in life and physical health: systematic review and meta-analysis. Health Psychology Review, 11, 387–418.CrossRefGoogle ScholarPubMed
Davison, T. E., Mccabe, M. P., Knight, T. and Mellor, D. (2012). Biopsychosocial factors related to depression in aged care residents. Journal of Affective Disorders, 142, 290–296.CrossRefGoogle ScholarPubMed
Dawson, J. F. (2014). Moderation in management research: what, why, when, and how. Journal of Business and Psychology, 29, 1–19.CrossRefGoogle Scholar
Dezutter, J., Luyckx, K. and Wachholtz, A. (2015). Meaning in life in chronic pain patients over time: associations with pain experience and psychological well-being. Journal of Behavioral Medicine, 38, 384–396.CrossRefGoogle ScholarPubMed
Diener, E., Emmons, R. A., Larsen, R. J. and Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75.CrossRefGoogle ScholarPubMed
Enache, D., Winblad, B. and Aarsland, D. (2011). Depression in dementia: epidemiology, mechanisms, and treatment. Current Opinion in Psychiatry, 24, 461–472.CrossRefGoogle ScholarPubMed
Enkvist, Å., Ekström, H. and Elmståhl, S. (2012). What factors affect life satisfaction (LS) among the oldest-old? Archives of Gerontology and Geriatrics, 54, 140–145.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and Mchugh, P. R. (1975). Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Frisch, M. B., et al. (2005). Predictive and treatment validity of life satisfaction and the quality of life inventory. Assessment, 12, 66–78.CrossRefGoogle ScholarPubMed
Fry, P. S. (2000). Religious involvement, spirituality and personal meaning for life: existential predictors of psychological wellbeing in community-residing and institutional care elders. Aging & Mental Health, 4, 375–387.CrossRefGoogle Scholar
Gana, K., Bailly, N., Saada, Y., Joulain, M. and Alaphilippe, D. (2012). Does life satisfaction change in old age: results from an 8-year longitudinal study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 68, 540–552.CrossRefGoogle ScholarPubMed
George, L. S. and Park, C. L. (2016). Meaning in life as comprehension, purpose, and mattering: toward integration and new research questions. Review of General Psychology, 20, 205–220.CrossRefGoogle Scholar
Gottschall, A. C., West, S. G. and Enders, C. K. (2012). A comparison of item-level and scale-level multiple imputation for questionnaire batteries. Multivariate Behavioral Research, 47, 1–25.CrossRefGoogle Scholar
Graham, J. W. (2009). Missing data analysis: making it work in the real world. Annual Review of Psychology, 60, 549–576.CrossRefGoogle ScholarPubMed
Haugan, G. (2014). Meaning‐in‐life in nursing‐home patients: a valuable approach for enhancing psychological and physical well‐being? Journal of Clinical Nursing, 23, 1830–1844.CrossRefGoogle ScholarPubMed
Hoyl, M., et al. (1999). Development and testing of a five‐item version of the Geriatric Depression Scale. Journal of the American Geriatrics Society, 47, 873–878.CrossRefGoogle ScholarPubMed
Keyes, C. L. M., Shmotkin, D. and Ryff, C. D. (2002). Optimizing well-being: the empirical encounter of two traditions. Journal of Personality and Social Psychology, 82, 1007–1022.CrossRefGoogle ScholarPubMed
Kogan, A. C., Wilber, K. and Mosqueda, L. (2016). Person‐centered care for older adults with chronic conditions and functional impairment: a systematic literature review. Journal of the American Geriatrics Society, 64, e1–e7.CrossRefGoogle ScholarPubMed
Kok, R. and Verhey, F. (2002). Dutch Translation of the Mini Mental State Examination (Folstein et al., 1975) The Netherlands.Google Scholar
Kontos, P. C. (2004). Ethnographic reflections on selfhood, embodiment and Alzheimer’s disease. Ageing & Society, 24, 829–849.CrossRefGoogle Scholar
Kunik, M. E., et al. (2003). Health care utilization in dementia patients with psychiatric comorbidity. The Gerontologist, 43, 86–91.CrossRefGoogle ScholarPubMed
Lomas, T. and Ivtzan, I. (2016). Second wave positive psychology: exploring the positive-negative dialectics of wellbeing. Journal of Happiness Studies, 17, 1753–1768.CrossRefGoogle Scholar
Mackinlay, E. & Trevitt, C. (2010). Living in aged care: using spiritual reminiscence to enhance meaning in life for those with dementia. International Journal of Mental Health Nursing, 19, 394–401.CrossRefGoogle ScholarPubMed
Mak, W. (2010). Self-reported goal pursuit and purpose in life among people with dementia. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 66, 177–184.Google ScholarPubMed
Martela, F. & Steger, M. F. (2016). The three meanings of meaning in life: distinguishing coherence, purpose, and significance. The Journal of Positive Psychology, 11, 531–545.CrossRefGoogle Scholar
Menne, H. L., Kinney, J. M. & Morhardt, D. J. (2002). ‘Trying to Continue to Do as Much as They Can Do’ Theoretical insights regarding continuity and meaning making in the face of dementia. Dementia, 1, 367–382.CrossRefGoogle Scholar
O’connor, B. P. and Vallerand, R. J. (1998). Psychological adjustment variables as predictors of mortality among nursing home residents. Psychology and Aging, 13, 368.CrossRefGoogle ScholarPubMed
Olin, J. T., Katz, I. R., Meyers, B. S., Schneider, L. S. and Lebowitz, B. D. (2002). Provisional diagnostic criteria for depression of Alzheimer disease: rationale and background. The American Journal of Geriatric Psychiatry, 10, 129–141.CrossRefGoogle ScholarPubMed
Park, J. and Baumeister, R. F. (2017). Meaning in life and adjustment to daily stressors. The Journal of Positive Psychology, 12, 333–341.CrossRefGoogle Scholar
Peugh, J. L. (2010). A practical guide to multilevel modeling. Journal of School Psychology, 48, 85–112.CrossRefGoogle ScholarPubMed
Phinney, A. (2011). Horizons of meaning in dementia: retained and shifting narratives. Journal of Religion, Spirituality & Aging, 23, 254–268.CrossRefGoogle Scholar
Pinquart, M. (2002). Creating and maintaining purpose in life in old age: a meta-analysis. Ageing International, 27, 90–114.CrossRefGoogle Scholar
Podsakoff, P. M., Mackenzie, S. B. and Podsakoff, N. P. (2012). Sources of method bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63, 539–569.CrossRefGoogle ScholarPubMed
Rapp, M. A., et al. (2011). Cognitive decline in patients with dementia as a function of depression. The American Journal of Geriatric Psychiatry, 19, 357–363.CrossRefGoogle Scholar
Reker, G. T. and Wong, P. T. P. (2012). Personal meaning in life and psychosocial adaptation in the later years. In Wong, P. T. P. (ed.), The Human Quest for Meaning: Theories, Research, and Applications (2nd edn). New York: Routledge.Google Scholar
Robertson, J. M. (2014). Finding meaning in everyday life with dementia: a case study. Dementia, 13, 525–543.CrossRefGoogle ScholarPubMed
Ron, P. (2004). Depression, hopelessness, and suicidal ideation among the elderly: a comparison between men and women living in nursing homes and in the community. Journal of Gerontological Social Work, 43, 97–116.CrossRefGoogle Scholar
Starkstein, S. E., Jorge, R., Mizrahi, R. and Robinson, R. G. (2005). The construct of minor and major depression in Alzheimer’s disease. American Journal of Psychiatry, 162, 2086–2093.CrossRefGoogle ScholarPubMed
Starkstein, S. E., Mizrahi, R. and Power, B. D. (2008). Depression in Alzheimer’s disease: phenomenology, clinical correlates and treatment. International Review of Psychiatry, 20, 382–388.CrossRefGoogle ScholarPubMed
Steger, M. F. (2009). Meaning in life. In Lopez, S. J. and Snyder, C. R. (eds.), Oxford Handbook of Positive Psychology. New York, NY: Oxford University Press.Google Scholar
Steger, M. F. (2012). Experiencing meaning in life: optimal functioning at the nexus of well-being, psychopathology, and spirituality. In Wong, P. T. P. (ed.), The Human Quest for Meaning: Theories, Research, and Applications (2nd edn). New York: Routledge.Google Scholar
Steger, M. F. and Samman, E. (2012). Assessing meaning in life on an international scale: psychometric evidence for the Meaning in Life Questionnaire-Short Form among Chilean households. International Journal of Wellbeing, 2, 182–195.CrossRefGoogle Scholar
Sterne, J. A., et al. (2009). Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ, 338, b2393.CrossRefGoogle ScholarPubMed
Stoner, C. R., Orrell, M. and Spector, A. (2015). Review of positive psychology outcome measures for chronic illness, traumatic brain injury and older adults: adaptability in dementia? Dementia and Geriatric Cognitive Disorders, 40, 340–357.CrossRefGoogle ScholarPubMed
Sun, W., Chou, C.-P., Stacy, A. W., Ma, H., Unger, J. and Gallaher, P. (2007). SAS and SPSS macros to calculate standardized Cronbach’s alpha using the upper bound of the phi coefficient for dichotomous items. Behavior Research Methods, 39, 71–81.CrossRefGoogle ScholarPubMed
Tavakol, M. and Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 53.CrossRefGoogle ScholarPubMed
van der Wolf, E., van Hooren, S. A. H., Waterink, W. andLechner, L. (2017). Well-being in elderly long-term care residents with chronic mental disorder: a systematic review. Aging & Mental Health, 1–10.Google ScholarPubMed
Verkaik, R., Nuyen, J., Schellevis, F. and Francke, A. (2007). The relationship between severity of Alzheimer’s disease and prevalence of comorbid depressive symptoms and depression: a systematic review. International Journal of Geriatric Psychiatry, 22, 1063–1086.CrossRefGoogle ScholarPubMed
Westius, A., Kallenberg, K. and Norberg, A. (2010). Views of life and sense of identity in people with Alzheimer’s disease. Ageing & Society, 30, 1257–1278.CrossRefGoogle Scholar
Wong, P. T. P. (2017). Meaning-centered approach to research and therapy, second wave positive psychology, and the future of humanistic psychology. The Humanistic Psychologist, 45, 207.CrossRefGoogle Scholar
Wu, L. F. and Koo, M. (2016). Randomized controlled trial of a six‐week spiritual reminiscence intervention on hope, life satisfaction, and spiritual well‐being in elderly with mild and moderate dementia. International Journal of Geriatric Psychiatry, 31, 120–127.CrossRefGoogle ScholarPubMed