Environmental Factors that Regulate Terminal Decline: Late-Life as a Natural Experiment
Final Report Abstract
As more and more individuals live longer and longer lives, the perils of latelife frailty and accompanying declines in key functions portend enormous individual and societal burdens. Current estimates suggest that individuals in the last six months of their lives (representing about 1% of the adult population) account for approximately 20% of total health care expenditures. However, the mechanisms underlying late-life well-being declines and the factors that contribute to between-person differences therein are so far only very poorly understood. Our major objective here had been to examine how personal and contextual factors contribute to the differences in well-being that emerge at the end of life. Insights gained in the set of projects compiled here showcase that – at the individual level – factors that go beyond physical health are important resources to draw from in times of need. Such resources include but are not restricted to perceptions of control, prioritizing social goals, and living a socially active life. Independent of these individual-level factors and sometimes intertwined with these, a number of context factors have been found to play a major role in shaping late-life trajectories in indicators of quality of life. These context factors include economic, social, and care service characteristics of the geographic locations people are living and dying in and the socio-historical times people are living and dying in. These factors hold considerable potential to explore in more depth how specifically tailored individual and context changes contribute to alleviating the precipitous decrements that often accompany late life. (1) http://www.apa.org/news/press/releases/2016/03/active-social-life.aspx (2) http://www.fr.de/wissen/gesundheit/selbstbestimmung-das-kontrollerleben-im-alter-ist-gestiegen-a-1549379 (3) https://www.arte.tv/de/videos/069854-011-A/xenius-biologisches-alter/ (4) http://www.pressreader.com/germany/der-tagesspiegel/20160407/281844347786100 (5) https://www.medicalnewstoday.com/articles/307627.php (6) https://www1.wdr.de/radio/wdr3/programm/sendungen/wdr3-kultur-ammittag/denis-gerstorf100.html (7) https://www.welt.de/print/wams/wissen/article153229800/Ueberleben-fuer-Fortgeschrittene.html (8) https://www.tagesspiegel.de/politik/alt-werden-jenseits-der-ofenbank/11597346.html (9) http://www.spiegel.de/wissenschaft/mensch/psychologie-internet-macht-75-jaehrigegluecklich-a-1025018.html (10) http://www.fnp.de/ratgeber/familieundlebensart/Spaetes-Glueck-Im-Alter-sind-viele-zufrieden;art288,583923
Publications
- Terminal change across facets of affective experience and domain satisfaction: Commonalities, differences, and bittersweet emotions at the end of life. Developmental Psychology
Gerstorf, D., Hueluer, G., Wagner, G. G., Kunzmann, U., & Ram, N.
(See online at https://doi.org/10.1037/dev0000599) - (2013). Inquiry into terminal decline: Five objectives for future study. The Gerontologist, 53, 727-737
Gerstorf, D. & Ram, N.
(See online at https://doi.org/10.1093/geront/gnt046) - (2014). The promise and challenges of integrating multiple time-scales in adult developmental inquiry. Research in Human Development, 11, 75-90
Gerstorf, D., Hoppmann, C. A., & Ram, N.
(See online at https://doi.org/10.1080/15427609.2014.906725) - (2015). A framework for studying mechanisms underlying terminal decline in well-being. International Journal of Behavioral Development, 39, 210-220
Gerstorf, D., & Ram, N.
(See online at https://doi.org/10.1177/0165025414565408) - (2015). Social resource correlates of levels and time-to-death related changes in late-life affect. Psychology and Aging. 30, 136-148
Windsor, T. D., Gerstorf, D., & Luszcz, M. A.
(See online at https://doi.org/10.1037/a0038757) - (2016). Social interrelations in aging: The sample case of married couples. In K. W. Schaie & S. L. Willis (Eds.), Handbook of the Psychology of Aging (8th ed., pp. 263-277). San Diego, CA: Elsevier
Hoppmann, C. A., & Gerstorf, D.
(See online at https://doi.org/10.1016/B978-0-12-411469-2.00014-5) - (2016). Terminal decline in well-being: The role of social orientation. Psychology and Aging, 31, 149-165
Gerstorf, D., Hoppmann, C. A., Löckenhoff, C. E., Infurna, F. J., Schupp, J., Wagner, G. G., & Ram, N.
(See online at https://doi.org/10.1037/pag0000072) - (2016). Terminal decline of function. In V. L. Bengtson & R. A. Settersten, Jr. (Eds.), Handbook of theories of aging (3rd edition, pp. 277-300). New York, NY: Springer
Hueluer, G., Ram, N., & Gerstorf, D.
- (2017). How does availability of county-level health care services shape terminal decline in well-being? European Journal of Ageing
Vogel, N., Ram, N., Göbel, J., Wagner, G. G., & Gerstorf, D.
(See online at https://doi.org/10.1007/s10433-017-0425-4) - (2017). Levels of and changes in life satisfaction predict mortality hazards: Disentangling the role of physical health, perceived control, and social orientation. Psychology and Aging, 32, 507-520
Hueluer, G., Heckhausen, J., Hoppmann, C. A., Infurna, F. J., Wagner, G. G., Ram, N., & Gerstorf, D.
(See online at https://doi.org/10.1037/pag0000187) - (2017). Terminal decline in well-being differs between residents in East Germany and West Germany. International Journal of Behavioral Development, 41, 115-126
Vogel, N., Gerstorf, D., Ram, N., Goebel, J., & Wagner, G. G.
(See online at https://doi.org/10.1177/0165025415602561) - (2017). Terminal decline in well-being: The role of multi-indicator constellations of physical health and psychosocial correlates. Developmental Psychology, 52, 996-1012
Brandmaier, A. M., Ram, N., Wagner, G. G., & Gerstorf, D.
(See online at https://doi.org/10.1037/dev0000274) - (2017). The role of morbidity for proxy-reported well-being in the last year of life. Developmental Psychology, 53, 1795-1809
Gerlach, K., Ram, N., Infurna, F. J., Vogel, N., Wagner, G. G., & Gerstorf, D.
(See online at https://doi.org/10.1037/dev0000368) - (2018). Glücklich und zufrieden leben bis ans Ende? Forschungsergebnisse zum terminal decline. In M. Erlinghagen, K. Hank, & M. Kreyenfeld (Hrsg.), Innovation und Wissenstransfer in der empirischen Sozial- und Verhaltensforschung: Gert G. Wagner zum 65. Geburtstag. Frankfurt, Germany: Campus
Gerstorf, S., Ram, N., & Gerstorf, D.
- (2018). We are in this together: Dyadic patterns of self-esteem change in late-life couples. International Journal of Behavioral Development, 42, 34-42
Wagner, J., Voelkle, M. C., Hoppmann, C. A., Luszcz, M. A., & Gerstorf, D.
(See online at https://doi.org/10.1177/0165025416679742) - A conceptual framework for studying COntext Dynamics in Aging (CODA). Developmental Review
Wahl, H.-W. & Gerstorf, D.
(See online at https://doi.org/10.1016/j.dr.2018.09.003)
