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Mental well-being in old age : distribution, determinants and consequences
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Wang, Jingjing (2019) Mental well-being in old age : distribution, determinants and consequences. PhD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b3717677~S15
Abstract
BACKGROUND:
We know a lot about illness, but we do not know as much about wellness. The positive psychology movements over recent decades have improved our understanding of wellness a lot. However, the current research on mental well-being (MWB) is still lacking in integrated evidence on the multifactorial association between MWB and its determinants and the incorporated effects of these determinants on MWB. Moreover, there is a dearth of research on the consequences of MWB in later life beyond associations with mortality. Furthermore, what is new to the current knowledge of MWB is whether MWB could mediate and moderate the association between later-life risk factors and ageing well.
AIM:
This thesis draws on the central question of the epidemiology of MWB in older age, from its distribution, determinants and consequences. The overall aim of this PhD research is to discover whether MWB influences outcomes associated with ageing and how it is associated with ageing well.
METHODS:
This thesis provided integrated quantitative evidence drawing on the Health Survey for England and the UK Household Longitudinal Study. It consisted of three phases: Phase 1. Preliminary research which included two parallel systematic reviews of the literature on the relationship between later life risk factors and MWB, and epidemiological findings on MWB consequences. Phase 2. Secondary data analysis to describe the distribution, investigate the determinants and explore the possible consequences of MWB in later life, and unveil the impact of MWB on ageing well. Multiple regression analysis and mixed-effects modelling were used to examine the determinants of older people's MWB. The association between MWB and its consequences was analysed using a random-effects model. The mediation effect of MWB 20 on the association between general health and physically ageing well (PCS) was analysed using structural equation modelling and path analysis, while the moderation effect of MWB was analysed using multiple regression and logistic regression. The Cox proportional hazards regression and a Kaplan-Meier survival curve were used to investigate the lost to follow-ups. Phase 3. Discussion and integrated findings with policy implementation ideas.
RESULTS:
The distribution of MWB generally displayed a slightly inverted ‘U-shape' (convex relationship) in old age after controlling for physical health and demographic & socio-economic variables. The results from the cross-sectional analysis and longitudinal analysis provided statistical evidence of the determinants of older people's MWB. In summary, ill-health (both physically and mentally), poor sleep quality and financial situation were all significantly associated with low MWB. On the other hand, being retired or remain employed, being married, being female, having a higher qualification level and being religious were all significantly associated with high MWB. Mental illness and physical health were demonstrated to be the most influential factors over all other determinants of older people's MWB. This PhD also confirmed that retaining MWB was a vital criterion of ageing well. MWB could enhance physically ageing well longitudinally. Moreover, what is new to the current knowledge of MWB is that MWB could mediate and moderate the association between general health and physically ageing well (PCS) even after controlling for demographic & socio-economic variables and psychological variables.
CONCLUSION:
This PhD underlined a critical message that MWB plays both roles as a critical outcome and a determinant of physical wellness. Furthermore, MWB was a protector against later-life risks. This PhD thesis is the first research that links the 21 distribution, determinants and consequences of MWB in old age. It could add value to the knowledge of MWB and promote MWB through policy initiatives.
Item Type: | Thesis (PhD) | ||||
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Subjects: | R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry | ||||
Library of Congress Subject Headings (LCSH): | Older people -- Mental health, Well-being -- Age factors | ||||
Official Date: | September 2019 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Weich, Scott ; Birchwood, M. J. ; Tadros, George, 1962- | ||||
Format of File: | |||||
Extent: | 332 leaves : illustrations (some colour) | ||||
Language: | eng |
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