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Mixed-methods quantitative–qualitative study of 29 nonagenarians and centenarians in rural Southern Italy: focus on positive psychological traits

Published online by Cambridge University Press:  12 December 2017

Anna Scelzo ,
Salvatore Di Somma ,
Paola Antonini ,
Lori P. Montross ,
Nicholas Schork ,
David Brenner  and
Dilip V. Jeste
Anna Scelzo
Affiliation:
Department of Mental Health and Substance Abuse, ASL4, Chiavarese, Italy
Salvatore Di Somma
Affiliation:
Department of Medical-Surgery Sciences and Translational Medicine, University of Rome La Sapienza, Rome, Italy
Paola Antonini
Affiliation:
3B Biotech Research, Lugano, Switzerland
Lori P. Montross
Affiliation:
Department of Psychiatry, University of CaliforniaSan Diego, USA Department of Family Medicine and Public Health, University of CaliforniaSan Diego, USA
Nicholas Schork
Affiliation:
Department of Psychiatry, University of CaliforniaSan Diego, USA Department of Family Medicine and Public Health, University of CaliforniaSan Diego, USA Translational Genomics Research Institute, Phoenix, Arizona, USA J.Craig Venter Institute, La Jolla, California, USA
David Brenner
Affiliation:
School of Medicine, University of CaliforniaSan Diego, USA
Dilip V. Jeste*
Affiliation:
Department of Psychiatry, University of CaliforniaSan Diego, USA Department of Neurosciences, University of CaliforniaSan Diego, USA Sam and Rose Stein Institute for Research on Aging, University of CaliforniaSan Diego, USA
*
Correspondence should be addressed to: Dilip V. Jeste, MD, Senior Associate Dean for Healthy Aging and Senior Care, Distinguished Professor of Psychiatry and Neurosciences, Estelle and Edgar Levi Chair in Aging, Director, Sam and Rose Stein Institute for Research on Aging, University of CaliforniaSan Diego, 9500 Gilman Drive #0664 La Jolla, CA 92023-0664, USA. Phone: +(858) 534-4020; Fax: (858) 534–5475. Email: [email protected].
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Abstract

Objective:

This was a study of positive psychological traits in a group of rural Italians aged 90 to 101 years, and their children or other family members.

Design:

Mixed-methods quantitative (standardized rating scales) and qualitative (semi-structured interviews) study.

Setting:

Study participants’ homes in nine villages in the Cilento region of southern Italy.

Participants:

Twenty-nine nonagenarians and centenarians and 51 family members aged 51–75 years, selected by their general practitioners as a part of a larger study called CIAO (Cilento Initiative on Aging Outcomes).

Methods:

We used published rating scales of mental and physical well-being, resilience, optimism, anxiety, depression, and perceived stress. Qualitative interviews gathered personal narratives of the oldest-old individuals, including migrations, traumatic events, and beliefs. Family members described their impressions about the personality traits of their older relative.

Results:

Participants age ≥90 years had worse physical health but better mental well-being than their younger family members. Mental well-being correlated negatively with levels of depression and anxiety in both the groups. The main themes that emerged from qualitative interviews included positivity (resilience and optimism), working hard, and bond with family and religion, as described in previously published studies of the oldest old, but also a need for control and love of the land, which appeared to be unique features of this rural population.

Conclusions:

Exceptional longevity was characterized by a balance between acceptance of and grit to overcome adversities along with a positive attitude and close ties to family, religion, and land, providing purpose in life.

Keywords

resiliencedepressionanxietycognitive impairmentqualitative research
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 1 , January 2018 , pp. 31 - 38
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Andersen-Ranberg, K., Christensen, K., Jeune, B., Skytthe, A., Vasegaard, L. and Vaupel, J. W. (1999). Declining physical abilities with age: a cross-sectional study of older twins and centenarians in Denmark. Age and Ageing, 28, 373–377.Google Scholar
Andersen-Ranberg, K., Schroll, M. and Jeune, B. (2001). Healthy centenarians do not exist, but autonomous centenarians do: a population-based study of morbidity among Danish centenarians. Journal of the American Geriatrics Society, 49, 900–908.CrossRefGoogle Scholar
Archer, S., Brathwaite, F. and Fraser, H. (2005). Centenarians in Barbados: the importance of religiosity in adaptation and coping and life satisfaction in the case of extreme longevity. Journal of Religion, Spirituality & Aging, 18, 3–19.CrossRefGoogle Scholar
Boulet, J. and Boss, M. W. (1991). Reliability and validity of the Brief Symptom Inventory. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3, 433–437.Google Scholar
Campbell-Sills, L. and Stein, M. B. (2007). Psychometric analysis and refinement of the Connor-Davidson resilience scale (CD-RISC): validation of a 10-item measure of resilience. Journal of Traumatic Stress, 20, 1019–1028.Google Scholar
Cohen, S., Kamarck, T. and Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.CrossRefGoogle ScholarPubMed
Connor, K. M. and Davidson, J. R. (2003). Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC). Depression and Anxiety, 18, 76–82.Google Scholar
Darviri, C. et al. (2009). Psychosocial dimensions of exceptional longevity: a qualitative exploration of centenarians' experiences, personality, and life strategies. The International Journal of Aging and Human Development, 69, 101–118.Google Scholar
Derogatis, L. R. (1993). BSI, Brief Symptom Inventory: Administration, Scoring, and Procedures Manual. Minneapolis: National Computer Systems.Google Scholar
Engberg, H., Christensen, K., Andersen-Ranberg, K., Vaupel, J. W. and Jeune, B. (2008). Improving activities of daily living in Danish centenarians–but only in women: a comparative study of two birth cohorts born in 1895 and 1905. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 63, 1186–1192.Google Scholar
Herzberg, P. Y., Glaesmer, H. and Hoyer, J. (2006). Separating optimism and pessimism: a robust psychometric analysis of the revised Life Orientation Test (LOT-R). Psychological Assessment, 18, 433–438.CrossRefGoogle ScholarPubMed
Hill, P. L. and Turiano, N. A. (2014). Purpose in life as a predictor of mortality across adulthood. Psychological Science, 25, 1482–1486. doi:10.1177/0956797614531799.CrossRefGoogle ScholarPubMed
Hinck, S. (2004). The lived experience of oldest-old rural adults. Qualitative Health Research, 14, 779–791. doi:10.1177/1049732304265774.Google Scholar
Hutnik, N., Smith, P. and Koch, T. (2016). Using cognitive behaviour therapy to explore resilience in the life-stories of 16 UK centenarians. Nursing Open, 3, 110–118.Google Scholar
Hwang, K. (2012). Face and morality in Confucian society. In Marsella, A. J. (ed.), Foundations of Chinese Psychology. International Cultural Psychology (pp. 265–295), vol. 1. New York: Springer.Google Scholar
Jeste, D. V. et al. (2013). Association between older age and more successful aging: critical role of resilience and depression. American Journal of Psychiatry, 170, 188–196.Google Scholar
Jeste, D. V. and Oswald, A. J. (2014). Individual and societal wisdom: explaining the paradox of human aging and high well-being. Psychiatry, 77, 317–330. doi:10.1521/psyc.2014.77.4.317.Google Scholar
Keys, A. and Keys, M. (1959). Eat Well and Stay Well. New York: Doubleday.Google Scholar
Kim, E. S., Kawachi, I., Chen, Y. and Kubzansky, L. D. (2017). Association between purpose in life and objective measures of physical function in older adults. JAMA Psychiatry, 74, 1039–1045. doi:10.1001/jamapsychiatry.2017.2145.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L. and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.Google Scholar
Lavretsky, H. (2014). Resilience and Aging: Research and Practice. Baltimore: Johns Hopkins University Press.CrossRefGoogle Scholar
Lin, Y. N. (2002). The application of cognitive-behavioral therapy to counseling Chinese. American Journal of Psychotherapy, 56, 46–58.Google Scholar
Martin, A. S., Distelberg, B., Palmer, B. W. and Jeste, D. V. (2015). Development of a new multidimensional individual and interpersonal resilience measure for older adults. Aging and Mental Health, 19, 32–45. doi:10.1080/13607863.2014.909383.Google Scholar
Pascucci, M. A. and Loving, G. L. (1997). Ingredients of an old and healthy life. A centenarian perspective. Journal of Holistic Nursing, 15, 199–213. doi:10.1177/089801019701500209.Google Scholar
Perls, T. T., Bochen, K., Freeman, M., Alpert, L. and Silver, M. H. (1999). Validity of reported age and centenarian prevalence in New England. Age and Ageing, 28, 193–197.CrossRefGoogle ScholarPubMed
Perls, T. and Terry, D. (2003). Understanding the determinants of exceptional longevity. Annals of Internal Medicine, 139, 445–449.Google Scholar
Poon, L. W. et al. (1992). The Georgia centenarian study. International Journal of Aging & Human Development, 34, 1–17. doi:10.2190/8m7h-cjl7-6k5t-umfv.CrossRefGoogle ScholarPubMed
Poon, L. W. et al. (2007). Methodological considerations in studying centenarians: lessons learned from the Georgia centenarian studies. Annual Review of Gerontology and Geriatrics, 27, 231–264.Google ScholarPubMed
Poon, L. W. et al. (2010). Understanding centenarians' psychosocial dynamics and their contributions to health and quality of life. Current Gerontology and Geriatrics Research, 2010, 1–13.CrossRefGoogle ScholarPubMed
Powell, J. (ed.) (1988). Cicero: Cato Maior de Senectute. Cambridge: Cambridge University Press.Google Scholar
Read, A. E. and Carstensen, L. L. (2012). The theory behind the age-related positivity effect. Frontiers in Psychology, 3, 1–9.Google Scholar
Rius-Ottenheim, N. et al. (2012). Parental longevity correlates with offspring's optimism in two cohorts of community-dwelling older subjects. Age, 34, 461–468.Google Scholar
Thomas, M. L. et al. (2016). Paradoxical trend for improvement in mental health with aging: a community-based study of 1,546 adults aged 21–100 years. Journal of Clinical Psychiatry, 77, e1019–e1025. doi:10.4088/JCP.16m10671.Google Scholar
United Nations (2002). World Population Ageing: 1950–2050. New York, NY: United Nations Publications.Google Scholar
United States Census Bureau World population by age and sex. Available at: https://www.census.gov/population/international/data/idb/worldpop.php; last accessed 6 March 2017.Google Scholar
Von Faber, M. et al. (2001). Successful aging in the oldest old: who can be characterized as successfully aged? Archives of Internal Medicine, 161, 2694–2700.Google Scholar
Ware, J. E., Kosinski, M. and Keller, S. D. (1996). A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.Google Scholar
Willcox, D. C., Willcox, B. J., Hsueh, W. C. and Suzuki, M. (2006). Genetic determinants of exceptional human longevity: insights from the Okinawa centenarian study. Age (Dordr), 28, 313–332. doi:10.1007/s11357-006-9020-x.Google Scholar
Wong, W.-C. P. et al. (2014). The well-being of community-dwelling near-centenarians and centenarians in Hong Kong a qualitative study. BMC Geriatrics, 14, 63.CrossRefGoogle Scholar
Zeng, Y., Poston, D. L. Jr, Vlosky, D. A. and Gu, D. (2008). Healthy Longevity in China: Demographic, Socioeconomic, and Psychological Dimensions. Dordrecht, Netherlands: Springer Science & Business Media.Google Scholar