Verlies van regie over het leven

Purpose: This study aimed to investigate the risk factors of decreasing mastery in old age. An adequate level of mastery is essential in order to preserve the ability to maintain self-sufficiency and to cope with changes due to deterioration of health.

Method: Data of the cycles 1998/1999 and 2001/2002 of the Longitudinal Aging Study Amsterdam (LASA) were used. Included are respondents having data on mastery in the first as well as the second cycle (n=1268). In order to identify older persons at risk the method of ‘classification tree’ was used, which enables to define groups at risk of loss of mastery.

Results: The mastery level decreased beneath risk level within three years in fourteen percent of older persons still having sufficient mastery in 1998/1999. The risk of loss of mastery doubles in case older persons are suffering from depression and increases to fifty-six percent in case of cognitive impairment in addition to depression. The risk of loss of mastery increases to 33% in case depressed older persons with sufficient cognition are suffering from functional limitations. Finally, non-depressive older persons with low self-esteem and low self-efficacy are at risk of loss of mastery (38%). The classification tree could identify increased risk of loss of mastery in 9.9% of the sample.

Conclusion: The combination of depression and cognitive impairment is the main predictor for decreased mastery in older adults. This affects however only a small number of respondents. A lower but substantial risk is observed in the combination of depression and functional limitations with intact cognition.