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Introduction: Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population., Aim: To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival., Methods: All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests., Findings: Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05)., Conclusion: This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population., Competing Interests: Declaration of competing interest No potential conflict of interest was reported by the authors., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: As the group of very old persons will form an increasing part of society, the study of how well-being is described and affected by specific factors will be of importance to meet the future needs of these persons. The aim of the study was to increase knowledge of well-being in very old persons by combining assessments and perceptions using the Philadelphia Geriatric Morale Scale (PGCMS)., Method: In a mixed method, convergent parallel design, 52 persons 80 years or older were assessed and interviewed using the PGCMS to combine assessment of morale and descriptions of perceptions of well-being using a mixed method approach., Results: Quantitative and qualitative results converged in four areas: not feeling lonely and being included, rating and perceiving health as good, high physical function/ability and being physically active, living in own house and feeling at home. Areas perceived as important to well-being captured only in qualitative analysis were having freedom and engagement. An example of insights not achievable from the quantitative or qualitative analysis alone was that individuals with high morale expressed anxiety about losing their health due to potential ageing-related threats and that individuals with low morale struggled with acceptance. Acceptance was the key strategy for handling adverse consequences of ageing in all described areas., Conclusion: When using standardized assessment scales in clinical practice, it could be useful to combine quantitative and qualitative data. Acceptance was key for well-being; however, acceptance could be resigned or reorienting in nature., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: The aim of this study was to investigate whether higher morale, i.e. future-oriented optimism, at baseline was associated with lower risk of depressive disorders five years later among very old people.Methods The Umeå85+/GErontological Regional Database, a population-based study with a longitudinal design, recruited participants in Sweden and Finland aged 85, 90 and ≥95 years. The sample in the present study included 647 individuals (89.1±4.4 years (Mean±SD), range 85-103). After five years, 216 were alive and agreed to a follow-up (92.6±3.4 years, range 90-104). The Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. The depressive disorder diagnosis was determined according to DSM-IV based on medical records and interview data including assessment scales for depressive disorders. A number of sociodemographic, functional and health-related variables were analysed as possible confounders.Results For those with no depressive disorders at baseline, the only baseline variable significantly associated with depressive disorders five years later was the PGCMS score. A logistic regression model showed lower risk of depressive disorders five years later with higher baseline PGCMS scores (odds ratio 0.779 for one point increase in PGCMS, p<0.001). The association remained after adjusting for social isolation (p<0.1 association with depressive disorders five years later).Conclusion Our results indicate that the higher the morale, the lower the risk of depressive disorders five years later among very old people. The PGCMS seems to identify those very old individuals at increased risk of depressive disorders five years later. Preventive measures could befocused on this group., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Stroke incidence increases with age and may impact on morale. The aim of this study was to investigate the prevalence of stroke among individuals aged 85 years or older in Northern Sweden and Western Finland and to evaluate factors associated with morale among those who have had a stroke compared with those without a stroke history. This population-based, cross-sectional study included 708 individuals (504 women and 204 men) aged 85 years and older (range 85-107). The study was conducted through structured interviews during home visits and from reviews of medical records, where demographic data and health-related factors were collected. The 17-item Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. Stroke-prevalence was 22% (156 of 708) in the study population. Ninety-one of 465 participants who could answer PGCMS questions had had a stroke. Those with stroke had significantly lower PGCMS scores than those without (10.9±3.8 SD vs. 12.1±3.0 SD, p-value 0.008), but 38.5% had high morale. A multiple linear regression analysis showed that low morale was independently associated with depression, angina pectoris and impaired hearing among those with stroke and another multiple linear regression, among those without a stroke history, showed that low morale was independently associated with depression, pain and poor nutritional status. A large proportion of very old have had stroke which is associated with reduced morale. Low morale among those with stroke was independently associated with depression, angina pectoris and impaired hearing which could be the focus for future intervention studies., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)