The role of positive behaviors, attitudes and virtues in the mental health of community-dwelling older adults: A 1-year follow-up study

Objectives: Few studies have investigated the influence of positive behaviors, attitudes and virtues on mental health outcomes of older adults, particularly in developing countries. The aim of this longitudinal study was to investigate the influence of positive behaviors, attitudes and values on the mental health (depression, anxiety and stress) of Brazilian older adults treated in primary care. Methods: A longitudinal study, with a 1-year follow-up, of older adults seen by Family Medicine teams was conducted. Instruments were applied assessing traditional factors (cognition, physical activity, sleep, quality of life, social support), behavioral factors (religiousness, spirituality, satisfaction with life, resilience, altruism, volunteerism, loneliness, meaning in life) and mental health (depression, anxiety and stress). Analyses using linear and logistic regression models were performed. Results: A total of 490 older adults (91.8% of individuals assessed at baseline) were included. Traditional factors such as gender, sleep problems, ethnicity and alcohol use, as well as positive behavioral factors including loneliness, resilience and well-being at baseline, were found to be associated with mental health at 1-year followup. Similarly, changes in scores for quality of life, loneliness, religiousness, feeling at peace, sleep problems and altruism were associated with changes in mental health scores. Conclusions: The results revealed that positive behavioral factors influenced the mental health of older adults as much as traditional factors and should therefore be addressed by health professionals and medical managers.