RF13 The impact of life events on later life: a latent class analysis of the english longitudinal study of ageing

Journal of Epidemiology and Community Health(2018)

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摘要
Background Events over an individual’s life course can positively or negatively affect their health and wellbeing in older age. We aimed to identify associations between groups of older people with similar life events and their health, behaviours and social interactions in older age. Methods We undertook a latent class analysis of the English Longitudinal Study of Ageing wave 3. Groups of participants with similar life events were generated based on eight life events; maternal and paternal closeness, educational opportunities in childhood, financial hardship, bereavement due to war, involvement in conflict, violence, and experiencing a natural disaster. The number of groups was determined based on model fit and team discussion. Linear and logistic regression were used to explore associations between these groups and pre-specified health and wellbeing factors, adjusted for age, gender, ethnicity and socioeconomic class and weighted for group probability. Results 7555 participants were allocated to one of four groups: Group A ‘few life events’ (n=6,250), Group B ‘emotionally cold mother’ (n=724), Group C ‘violence in combat’ (n=274) and Group D ‘many life events’ (n=307). Participants in Group D were statistically significantly more likely than those in Group A to experience disability (coefficient 0.35, 95% CI 0.20 to 0.50), reduced quality of life (coefficient −5.33, 95% CI −6.61 to −4.05), psychological disorders (OR 3.01, 95% CI 2.18 to 4.17) and social detachment (OR 2.60, 95% CI 1.36 to 4.97). Group C membership compared to Group A was associated with reduced quality of life (coefficient –1.95, 95% CI −3.08 to −0.82) and a life-threatening illness or accident (OR 1.98, 95% CI 1.52 to 2.59). Group B membership, compared to Group A, was associated with reduced quality of life (coefficient −1.89, 95% CI −2.62 to −1.15), psychological disorders (OR 1.73, 95% CI 1.34 to 2.23), social detachment (OR 2.60, 95% CI 1.68 to 4.04) and the perceived long-term effect of ill health (OR 1.42, 95% CI 1.10 to 1.84). Conclusion We have identified four broad groups of older people; those with few life events, those with many life events, those with an emotionally cold mother and those who have experienced violence in combat. Compared to the group with few life events, all other groups had adverse health and wellbeing in later life, especially those with an emotionally cold mother or many life events. Policies to improve health and wellbeing in later life should have a life course perspective focusing on at risk groups.
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