International Journal of Clinical and Health Psychology (2018) 18, 218---226 International Journal of Clinical and Health Psychology www.elsevier.es/ijchp ORIGINAL ARTICLE Changes in psychological well-being among older Lithuanian city dwellers: Results from a cohort study Laura Sapranaviciute-Zabazlajeva a,∗, Dalia Luksiene b, Dalia Virviciute b, Daina Kranciukaite-Butylkiniene b, Martin Bobak c, Abdonas Tamosiunas b a Department of Health Psychology, Lithuanian University of Health Sciences, Lithuania b Institute of Cardiology, Lithuanian University of Health Sciences, Lithuania c Department of Epidemiology and Public Health, University College London, United Kigdom Received 15 February 2018; accepted 23 May 2018 Available online 23 June 2018 KEYWORDS Abstract Background/Objective: The purpose of this study is to evaluate changes of psycho- Psychological logical well-being (PWB) in older Lithuanian city dwellers during ten years of follow-up, and to well-being; establish factors associated with it. Method: 7,115 men and women of age 45-72 years partici- Psychosocial factors; pated in the initial survey in 2006-2008. In 2016 the follow-up survey was performed among all Socio-demographic 6,210 participants who survived. 4,266 individuals responded to postal questionnaires. PWB was factors; evaluated by using CASP-12 questionnaire. Depressive symptoms were evaluated by CES-D-10 Socio-economic scale. Quality of life, self-rated health, and social activity were evaluated.Socio-demographic, factors; socio-economic factors were included into standard questionnaire. Results: PWB deteriorated Cohort study in all age groups during 10-years follow-up. Poor quality of life, poor self-rated health, hav- ing depressive symptoms, and not being member of social organization are associated with lower PWB after 10 years in men and women. Employed-retired, retired, and not socially active women have higher possibility to have lower PWB over 10 years. Conclusions: PWB in older Lithuanian city dwellers deteriorates as many other socio-economic and psychosocial indica- tors during ten-year follow-up. Mostly psychosocial factors, but not the socio-demographic, and socio-economic ones predict PWB over 10 years. It is crucial to understand and promote predictors of PWB in older age. © 2018 Asociación Espanola˜ de Psicología Conductual. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). ∗ Corresponding author: Lithuanian University of Health Sciences, Department of Health Psychology, Institute of Cardiology, Mickeviciaus g. 9, LT-44307, Kaunas, Lithuania E-mail address: [email protected] (L. Sapranaviciute-Zabazlajeva). https://doi.org/10.1016/j.ijchp.2018.05.002 1697-2600/© 2018 Asociación Espanola˜ de Psicología Conductual. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Changes in psychological well-being among older Lithuanian city dwellers 219 PALABRAS CLAVE Cambios en el bienestar psicológico de los habitantes de las ciudades más antiguas de Bienestar psicológico; Lituania: resultados de un estudio de cohorte factores Resumen Antecedentes/Objetivo: Evaluar los cambios en el bienestar psicológico (BP) de los psicosociales; habitantes de las ciudades lituanas más antiguas en un seguimiento de diez anos˜ e identificar factores factores asociados. Método: Inicialmente participaron 7.115 hombres y mujeres de 45-72 anos˜ sociodemográficos; de edad durante los anos˜ 2006-2008. En 2016, la encuesta de seguimiento se realizó entre 6.210 factores participantes. De ellos, 4.266 personas respondieron a los cuestionarios. El BP fue evaluado socioeconómicos; mediante el cuestionario CASP-12. Los síntomas depresivos mediante la escala CES-D-10. Se estudio de cohorte evaluó la calidad de vida, la salud y la actividad social. Resultados: El BP se deterioró en todos los grupos de edad a los 10 anos˜ de seguimiento. Mala calidad de vida, mala autoevaluación de la salud, síntomas depresivos y la no pertenencia a una organización social se asocian con BP más bajo. Mujeres jubiladas y socialmente inactivas tienen mayor probabilidad de peor BP. Conclusiones: El BP de los habitantes de las ciudades lituanas más antiguas se deteriora, al igual que otros muchos indicadores socioeconómicos y psicosociales a los diez anos˜ de seguimiento. La mayoría de los factores psicosociales, aunque no los sociodemográficos y socioeconómicos, predicen el BP. Es crucial promover predictores de bienestar psicológico en la vejez. © 2018 Asociación Espanola˜ de Psicología Conductual. Publicado por Elsevier España, S.L.U. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/ licenses/by-nc-nd/4.0/). When life expectancy is getting longer, factors related demographic or health factors (Snowden et al., 2010). As with healthy aging become more important. One of the fac- the population is aging, along PWB being one of the factors tors leading to successful aging is psychological well-being leading to successful aging, it is important to understand (PWB; Bowling & Dieppe, 2005). PWB consists of autonomy, dynamics and predictors of PWB in the light of aging. The self-acceptance, purpose in life, environmental mastery, purpose of this study - is to evaluate changes of PWB in older positive relationships and personal growth (Ryff & Singer, Lithuanian urban adults during ten years of follow-up, and 2008). It reflects person’s attitudes towards his life, feel- to establish factors associated with it. ing well (Huppert, 2009). In the last decades’ maintenance of PWB in older age became one of the public health pri- orities (Adler & Seligman, 2016). Previous studies linked Method PWB with various health conditions, especially cardiovas- cular health (Boehm & Kubzansky, 2012; Boehm, Peterson, Participants Kivimaki, & Kubzanky, 2011), and healthy lifestyle habits (Sapranaviciute-Zabazlajeva, Luksiene, Virviciute, Bobak, & Data from the surveys performed in the framework of the Tamosiunas, 2017). Moreover, PWB is associated not only international HAPIEE (Health, Alcohol and Psychosocial Fac- with healthier, but also with longer life (Steptoe, Deaton, tors in Eastern Europe) study are presented (Peasey et al., & Sone, 2015; Tamosiunas, Sapranaviciute-Zabazlajeva, 2006). A random sample of 10,940 Kaunas city (Lithuania) Luksiene, Virviciute, & Peasey, 2017; Zaninotto, Wardle, & men and women aged 45---72years, stratified by gender and Steptoe, 2016). Therefore, PWB draws not only scientists’ age was selected from Lithuanian register of population as attention but is one of the priorities in health policy. sample for initial survey. The response rate was 65%, thus It is known that PWB changes with age; however, it is not 7,115 respondents participated in this health survey from clear whether it improves or worsens with age (Ryff, 2014). 2006 to 2008. In 2016 the follow-up survey was performed Dynamic model of the concept varies across the nations among all 6,210 participants (2,569 male; 3,551 female) (Karasawa et al., 2011; Schönfeld, Brailovskaia, & Margraf, from the initial survey who survived till April of 2016. 4,266 2017; Steptoe et al., 2015). In English-speaking developed individuals (1,793 male; 2,473 female) responded to postal countries, PWB shows a U-shaped pattern with the worst questionnaires mailed during the follow-up survey (response PWB being at the age of around 50 years, but in Lithuania, rate was 68.7%). The final number of individuals in the as in other post-Soviet countries, PWB exhibits a decline analysis included all participants both during the initial with an increasing age (Steptoe et al., 2015). Why? What and follow-up survey with all variables used in the logistic factors influence dramatic decrease of PWB in older ages? regression models or other analysed groups --- 3,405 (1,480 Some studies have analysed the determinants of well-being male; 1,925 female). Distribution of study participants dur- in older age (Carlin et al., 2011; Snowden, Dhingra, Keyes, & ing the initial (2006-2008) and follow-up surveys (2016) by Anderson, 2010), but little is known about well-being among socio-demographic, socio-economic, and psychosocial char- older adults in the post-Soviet region. acteristics is presented in Table 1. Even there are many factors leading to the successful The study was approved by the Ethics Committee at transition to older age and retirement (Heaven et al., 2013), University College London, UK and by Kaunas Regional not all changes of well-being are successfully explained by Biomedical Research Ethics Committee. 220 L. Sapranaviciute-Zabazlajeva et al. Table 1 Distribution of study participants at initial survey (2006-2008) and follow-up survey (2016) by socio-demographic, socioeconomic, and psychosocial characteristics. Determinants Men Women 2006-2008 2016 p 2006-2008 2016 p Age, years 60.1 69 <.001 59.9 68.8 <.001 Education, % Primary 4.8 - - 4.2 - - Vocational 7.9 - - 6.9 - - Secondary 29.3 - - 23.3 - - College 18.1 - - 29.4 - - University 40 - - 36.2 - - Marital status, % Married 86.1 76.6 <.001 59.1 44.9 <.001 Single 2 1.6 .369 5.9 5.4 .448 Cohabiting 1.2 7 <.001 .8 4.7 <.001 Divorced 6.3 7.4 .193 15.3 14.7 .556 Widowed 4.4 7.3 <.001 18.9 30.3 <.001 Employment status, % Employed 45.1 17.6 <.001 35.1 15.5 <.001 Employed-retired 22.6 17.2 <.001 16.1 12.8 .001 Employed-disabled 4.3 2.5 .003 3.3 2 .005 Unemployed 2.1 1.7 .383 3.4 1 <.001 Retired 18.7 51.5 .013 33.5 58.9 <.001 Disabled 7.2 9.5 <.05 8.6 9.6 .003 Material deprivation, % 21.3 47.7 <.001 35.3 63.7 <.001 Depressive symptoms, % 12.5 26.7 <.001 27 39.2 <.001 Quality of life,% Good + very good 53.3 43 <.001 48.7 34.1 < .001 Average+ poor 46.7 57 <.001 51.3 65.9 < .001 Self-rated health, % Good 35.4 29 <.001 23.2 22.8 .741 Average 55.6 61.7 <.001 62.4 64.9 .070 Poor 8.9 9.3 .679 14.4 12.3 .032 Being member of social organization, % 18.3 - - 14.1 - - Social activity, % Low 28.8 - - 25.4 - - Moderate 34.5 - - 40.2 - - High 36.7 - - 34.4 - - Instruments changes of PWB over 10 years: between initial, and follow- up survey.