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Objective: to identify predictors of mortality among a national sample of elderly widowed people 28 years post-baseline interview. Design and setting: face to face home interview survey across England. Measures: physical, psychological, social, and socio-economic status and circumstances. Results: excess risk of mortality, which had been noted up to six months post bereavement among males aged 75+, had disappeared. In contrast to findings up to 13 years post-bereavement, neither psycho-social factors, social circumstances nor social class independently predicted differentials in mortality when analysed up to 28 years post-bereavement. The most significant, independent predictors, up to the 28-year term, were, as would be expected, male sex, older age, poorer physical functioning, and expressed 'relief at the death of the spouse'. When the sample was split by duration of widow(er)hood male sex and older age retained significance. Conclusion: the increasing frailty of the sample overall, and reduced statistical power in split-sample analyses, may explain the loss of significance of physical functioning and 'expressed relief at the death' in the split-sample results. The psycho-social risk factors for mortality after bereavement reduce over time, although further examination of expressed relief would be worthwhile. [ABSTRACT FROM AUTHOR]

Objective: to investigate the apparently incongruous coupling of poor physical functioning with high QoL. Study design and setting: face-to-face interview survey of random sample of 999 people aged 65+ across Britain. Results: twenty-one per cent of respondents reported fairly to very severe levels of functional difficulty, and 62% of these rated their QoL as 'good'. Better self-rated health, lower burden of chronic disease, not having fallen, higher social engagement and higher levels of perceived control over life, distinguished between people who had difficulties with physical functioning and who perceived their QoL to be 'good', rather than 'not good'. The open-ended survey responses broadly supported the quantitative findings. Conclusion: people with difficulties with physical functioning, who perceived their QoL to be 'not good', as opposed to 'good', were adversely affected by a higher burden of disease and having fewer socio-psychological resources to help them to cope effectively. [ABSTRACT FROM AUTHOR]

Background: there is increasing interest in how to age 'successfully' and in reaching consensus over its definition. Objective: to assess different models of successful ageing, using a British longitudinal survey of ageing in 2000-1. Setting: community, settings in Britain. Methods: five models of successful ageing were tested on a British cross-sectional population survey of 999 people aged 65+. The models were biomedical, broader biomedical, social, psychological and lay based. Results: the lay model emerged as the strongest. Respondents who were classified as successfully aged with this model, compared with those not successfully aged, had over five times the odds of rating their quality of life (QoL) as good rather than not good [odds ratio (OR) = 5.493, 95% confidence interval (95% CI) - 2.655-11.364]. Conclusion: the lay-based, more multidimensional, model of successful ageing predicted perceived QoL more powerfully than unidimensional models and should be used to evaluate the outcomes of health promotion in older populations. [ABSTRACT FROM AUTHOR]