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The sense of coherence scale of Atonovsky is seen as valid, reliable and cross culturally applicable instrument [1]. Boeckxstaens et al. offer here a first glimpse at the longitudinal predictive value of sense of coherence (SOC) in a 80 years and older population. The protective effect of SOC is a very interesting finding, and indicate that it's an important concept to take in consideration in patient-oriented care. It's also noteworthy to observe that the mean disease count is comparable between low and high tertile, multimorbidity was not associated with lower SOC in this population.
Studies on the stability of sense of coherence have showed inconsistent results. Antonovsky has described SOC as a stable developmental construct once the individual is passed the age of thirty [2]. However, longitudinal studies have showed that the construct isn't stable in time in middle aged [3] and ederly populations [4]. As it was raised in the paper, protective nature of SOC tends to fade in longer follow-up, it could then also be relevant to assure that SOC is stable in the population.
The dimensional nature of the SOC instrument could also be instructive in the understanding of SOC for the population 80 and older. Factorial analysis has suggested that SOC seem to have a multidimensional (3 dimensions) factorial structure [5]. It would be interesting to see how each of these dimensions impact the outcomes measured. In a study by Drageset et al. (2014) it is proposed that social support has a significant influence on SOC, which could be true also for meaningfulness (the extent to which one feels that life makes sense and that challenges are worthy of commitment) in an elderly population.
1. Eriksson, M. and B. Lindstrom, Validity of Antonovsky's sense of coherence scale: a systematic review. Journal of epidemiology and community health, 2005. 59(6):460-6.
2. Antonovsky, A., Unraveling the mystery of health: How people manage stress and stay well. 1987: Jossey-Bass.
3. Feldt, T., et al., The stability of sense of coherence: comparing two age groups in a 5-year follow-up study. Personality and Individual Differences, 2003. 35(5):1151-1165.
4. Drageset, J., et al., Sense of coherence among cognitively intact nursing home residents--a five-year longitudinal study. Aging Ment Health, 2014. 18(7):889-96.
5. Naaldenberg, J., et al., Psychometric properties of the OLQ-13 scale to measure Sense of Coherence in a community-dwelling older population. Health and Quality of Life Outcomes, 2011. 9:37
Competing interests: None declared