Piloting an Intervention to Promote Well-Being in Older Adults

A one-year translational research grant from ICTR, UW Madison

Community/Academic Partners

University of Wisconsin-MadisonElliot Friedman, PhD Carol Ryff, PhD

Kenosha County ADRCLaVerne JarosRenee FoyHelen SampsonDebbie Rueber

WELL BEING

Different than absence of depression Well Being is:

Hedonic--More positive emotions than negative ones, general satisfaction with life

Eudaimonic—Engagement in pursuits that are personally meaningful and valued

MEASURES OF WELL-BEINGHaedonic Measures

•Happiness, joy•Depression, sadness•General satisfaction with life

Ryff Scales•Autonomy My decisions are not usually influenced by what everyone else is doing•Environmental Mastery I general, I feel I am in charge of the situation in which I live•Personal Growth For me, life has been a continuous process of learning, changing, and growth•Purpose in Life I enjoy making plans for the future and working to make them a reality•Positive social relationships Most people see me as loving and affectionate•Self-acceptance When I look at the story of my life, I am pleased with how things have turned out

WHY ARE WE CONCERNED ABOUT WELL-BEING?

Studies have shown:• Sense of well-being is lower among older adults than

younger persons• Correlations between well-being, positive health measures

and longevity

Nun StudyWritten expression of positive emotions at age 22 predicted

longer life decades later Danner et al. J Personality Social Psych, 2001

Chicago Study1,238 healthy adults in their 70s living in the community in Chicago

Purpose in life is protective against Alzheimer’s Disease and cognitive impairmentSame study- 7 year follow-up

90th 2.4 times as likely to remain free of Alzheimer’s

Disease than 10th

90th 2.4 times as likely to remain free of Alzheimer’s

Disease than 10th

Boyle et al, Archives of General Psychiatry, 2010

Philosophical Transactions of Royal Society of London, 2004

WELL-BEING AND BIOLOGY

135 older women living independently in Wisconsin Aging women with higher well-being (purpose in life,

positive relations) had: Lower cardiovascular risk Better neuroendocrine regulation Lower inflammatory markers Better sleep

“…centenarians are often extroverts who embrace the world from an optimistic and carefree perspective…neuroticism was notably the exception.”

”…’the main message of the study is that [although] these centenarians have a 'nice' personality now, that was not always the case,’ opening the door to the notion that it's never too late to adopt a ‘can-do’ spirit”

PROMOTING WELL-BEING

Well-Being Therapy (WBT) Based on cognitive behavioral therapy Focus on improving awareness of positive

experiences and extending their enjoyment

Fava et al, Archives of General Psychiatry, 1998

Well-being therapy and depression

Fava et al, Archives of General Psychiatry, 1998

Promoting Well Being Among Older Adults: Lighten UP! 8-week program

Centered on eudaimonic well-being 90 min class sessions-various community settings

Group discussion; brainstorming Cognitive behavioral therapeutic perspectives on emotion Theories of well-being

Daily homework (well-being diaries)

Evaluation Open-ended questions about program Questionnaires before and after program

Psychological well-being Overall health and vitality Depression

Lighten UP! Progress

6 classes, January-June, 201256 participants completing 7-8 sessions

Preliminary data Descriptive information on 49 participants 7 men and 42 women Average age = 73.4 (range: 60-97) 33% married 42% have High School degree or less 63% live alone Before and after data on 27 participants

In their own words…

“…becoming more aware of what might ‘interrupt the positive’” “I learned that most of my bad feelings about getting old are

fixable by me. My approach and outlook are paramount to getting through and enjoying the last part of me.”

“More aware of doing some things that were mundane but very important to my life.”

“I learned how to handle life’s ups and downs better through hearing others’ experiences...”

“Each day brings something of value.” “I truly see how my diminished health has changed the way I

handle my life now. I am happy that I accept the adjustments I’ve made.”

“I do things with friends more. I’m exercising more.” “Took positive steps to control leg pain.” “Have begun to take a broader look at my emotional reactions to

things.”

Lighten UP!Psychological Well-Being

Lighten UP!Vitality

How much of the time during the last 4 weeks did you have a lot of energy?

1 2 3 4 5 6

None of the time

A little of the time

Some of the time

A good bit of the time

Most of the time

All of the time

Lighten UP!Geriatric Depression Scale

50% decrease

SUCCESSES•Recruitment close to target (56/60)•High completion rates•Positive outcomes for participants•Leader manual and materials developed•Wonderful individual stories

CHALLENGES•Staffing for part time, short term project•Delay in start due to IRB approval requirements•Continued funding

FUTURE DIRECTIONS

Control group To determine whether improvements are related to the

program or to something more generic (e.g. social interaction)

Expand the program More counties Telephone- or computer-based version for home-bound

seniors Extend the measures

Biological variables Funding to sustain program