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The utility of estimating population-level trajectories of terminal wellbeing decline within a growth mixture modelling framework

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Abstract

Purpose

Mortality-related decline has been identified across multiple domains of human functioning, including mental health and wellbeing. The current study utilised a growth mixture modelling framework to establish whether a single population-level trajectory best describes mortality-related changes in both wellbeing and mental health, or whether subpopulations report quite different mortality-related changes.

Methods

Participants were older-aged (M = 69.59 years; SD = 8.08 years) deceased females (N = 1,862) from the dynamic analyses to optimise ageing (DYNOPTA) project. Growth mixture models analysed participants’ responses on measures of mental health and wellbeing for up to 16 years from death.

Results

Multi-level models confirmed overall terminal decline and terminal drop in both mental health and wellbeing. However, modelling data from the same participants within a latent class growth mixture framework indicated that most participants reported stability in mental health (90.3 %) and wellbeing (89.0 %) in the years preceding death.

Conclusions

Whilst confirming other population-level analyses which support terminal decline and drop hypotheses in both mental health and wellbeing, we subsequently identified that most of this effect is driven by a small, but significant minority of the population. Instead, most individuals report stable levels of mental health and wellbeing in the years preceding death.

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Acknowledgments

This work was supported by a National Health and Mental Medical Research Council grant (# 410215). The data on which this research is based were drawn from several Australian longitudinal studies including: the Australian longitudinal study of ageing (ALSA), the Australian longitudinal study of women’s health (ALSWH), the Australian diabetes, obesity and lifestyle study (AusDiab), the blue mountain eye study (BMES),the Canberra longitudinal study of ageing (CLS), the household, income and labour dynamics in Australia study (HILDA), the Melbourne longitudinal studies on healthy ageing (MELSHA), the personality and total health through life study (PATH) and the Sydney older persons study (SOPS). These studies were pooled and harmonized for the dynamic analyses to optimize ageing (DYNOPTA) project. All studies would like to thank the participants for volunteering their time to be involved in the respective studies. Details of all studies contributing data to DYNOPTA, including individual study leaders and funding sources are available on the DYNOPTA website (http://DYNOPTA.anu.edu.au). The findings and views reported in this paper are those of the author(s) and not those of the original studies or their respective funding agencies. Burns is supported by the Australian Research Council Centre of Excellence in Population Ageing Research (project #: CE110001029). Anstey is funded by an NHMRC Fellowship #1002560.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Building 62A, Eggleston Road, Canberra, 0200, ACT, Australia

    R. A. Burns & K. J. Anstey

  2. Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, NSW, Australia

    J. Byles

  3. BakerIDI Heart and Diabetes Institute, Melbourne, VIC, Australia

    D. J. Magliano

  4. Centre for Vision Research, Westmead Millennium Institute and Department of Ophthalmology, the University of Sydney, Sydney, NSW, Australia

    P. Mitchell

Authors
  1. R. A. Burns
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  2. J. Byles
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  3. D. J. Magliano
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  4. P. Mitchell
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  5. K. J. Anstey
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Correspondence to R. A. Burns.

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Burns, R.A., Byles, J., Magliano, D.J. et al. The utility of estimating population-level trajectories of terminal wellbeing decline within a growth mixture modelling framework. Soc Psychiatry Psychiatr Epidemiol 50, 479–487 (2015). https://doi.org/10.1007/s00127-014-0948-3

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