Successful Life Conduct in Very Old Age: Theoretical Implications and Empirical Support from a Population-Based Study

Social survey data on those aged 80 years or older is sparse. Based on a representative sample, this paper validates a multidimensional model proposed for understanding of quality of life (QoL) in very old age. Towards this goal, this paper estimated levels and heterogeneity of personal and environmental resources, well-being, autonomy, and perceived appreciation by society in the population of the very old in Germany. Next, the contribution of personal and environmental resources to QoL outcomes and overlap between these outcomes was estimated using a multivariate approach. Results were based on a representative survey on QoL of the very old in North Rhine-Westphalia, Germany's most populous state. The survey included comprehensive information on socio-demographics, health, social and personal QoL resources including objective testing of cognitive function. The sample comprised 1,863 individuals (mean age 86.5 years, range 80-102 years), including 211 individuals residing in non-private dwellings. Interviews with proxy informants were conducted for 176 individuals that were willing to participate but could not conduct the interview themselves due to limited ability to communicate (PLC). Pronounced differences were found for PLC with respect to environmental and personal resources and QoL outcomes. Pronounced differences were also found both with respect to lower observed levels of QoL outcomes (e.g., autonomy) and predictors of QoL outcomes (e.g., effect of negative "external" appreciation on subjective well-being). Contrary to the deficit-oriented model of old age, a high degree of autonomy was observed. However, substantial and consequential negative "external" appreciation of very old age was also apparent.