Changes in sense of coherence in old age - a 5-year follow-up of the Umeå 85+ study

Objective: This study aims to describe the changes in sense of coherence (SOC) over time and relate these changes to negative life events among very old people.

Design: Prospective and longitudinal study.

Subjects: 190 old women and men participated, of whom 56 could be included in the 5-year follow-up.

Methods: The mean SOC score from the first and second data collection were compared using a paired sample t-test. The relationship between the index of negative life events and the changes on SOC score between the two data collections was investigate using linear regression.

Main outcome measures: Antonovsky's SOC scale and an index of negative life events including severe physical and mental diseases, various losses as losses of spouses, cognitive and functional ability.

Result: For the whole group of subjects (n = 56), the SOC scores was higher (70.1 vs. 73.7, p = 0.029) at the second point measure. The most common negative life events at follow-up were loss of independence in activities in daily living and decrease in cognitive function. A significant correlation between the index of negative life events and changes in SOC over 5 years was found (p = 0.025). The more negative life events, the more decrease in SOC.

Conclusion: We concluded that there is a risk of decreased SOC and thereby quality of life when negative life events accumulate among very old people. Nursing interventions might play an important role for maintaining and perhaps strengthening SOC among old people exposed to negative life events.