The Disability Paradox? Trajectories of Well-Being in Older Adults With Functional Decline

J Aging Health. 2023 Jan;35(1-2):125-137. doi: 10.1177/08982643221108660. Epub 2022 Jun 17.

Abstract

Objectives: The 'disability paradox' (DP) suggests that most older adults maintain subjective well-being (SWB) despite functional decline. However, this may depend the SWB component: positive affect (PA), negative/depressed affect (NA/DA) or life satisfaction (LS). We assessed trajectories of these components in older adults with substantial functional decline. Methods: Data originated from the Longitudinal Aging Study Amsterdam (N = 2545) observed during 1992-2008. Using latent class growth analysis, we distinguished a group with substantial functional decline and examined their SWB trajectories and individual characteristics. Results: The DP occurred more frequently for DA (Men:73%, Women:77%) and LS (Men:14%, Women:83%) than for PA (Men:26%, Women:17%). Higher perceived control (mastery) emerged as the most consistent factor associated with higher odds of the DP. Discussion: We provide a nuanced view of the DP, shifting the question from whether it exists to for which dimension of SWB and for whom it is more or less apparent.

Keywords: aging; longitudinal; negative affect; physical functioning; positive affect.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aging*
  • Female
  • Humans
  • Latent Class Analysis
  • Longitudinal Studies
  • Male
  • Personal Satisfaction*