Piloting an Intervention to Promote
Well-Being in Older Adults
A one-year translational research grant from
ICTR, UW Madison
Community/Academic Partners
University of Wisconsin-Madison
Elliot Friedman, PhD
Carol Ryff, PhD
Kenosha County ADRC
LaVerne Jaros
Renee Foy
Helen Sampson
Debbie Rueber
WELL BEING
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Different than absence of depression
Well Being is:
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Hedonic--More positive emotions than negative ones, general
satisfaction with life
Eudaimonic—Engagement in pursuits that are personally
meaningful and valued
MEASURES OF WELL-BEING
Haedonic Measures
•Happiness, joy
•Depression, sadness
•General satisfaction with life
Ryff Scales
•Autonomy
My decisions are not usually influenced by what everyone else is doing
•Environmental Mastery
I general, I feel I am in charge of the situation in which I live
•Personal Growth
For me, life has been a continuous process of learning, changing, and
growth
•Purpose in Life
I enjoy making plans for the future and working to make them a reality
•Positive social relationships
Most people see me as loving and affectionate
•Self-acceptance
When I look at the story of my life, I am pleased with how things have
turned out
WHY ARE WE CONCERNED ABOUT
WELL-BEING?
Studies have shown:
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Sense of well-being is lower among older adults than younger persons
Correlations between well-being, positive health measures and longevity
Nun Study
Written expression of positive emotions at age 22 predicted longer life decades
later Danner et al. J Personality Social Psych, 2001
Chicago Study
1,238 healthy adults in their 70s living in the community in Chicago
Purpose in life is protective against Alzheimer’s
Disease and cognitive impairment
Same study- 7 year follow-up
90th 2.4 times as likely to remain free
of Alzheimer’s Disease than 10th
Boyle et al, Archives of General Psychiatry, 2010
WELL-BEING AND BIOLOGY
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135 older women living independently in Wisconsin
Aging women with higher well-being (purpose in life, positive relations)
had:
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Lower cardiovascular risk
Better neuroendocrine regulation
Lower inflammatory markers
Better sleep
Philosophical Transactions of Royal Society of London, 2004
“…centenarians are often extroverts who embrace the world from an optimistic and
carefree perspective…neuroticism was notably the exception.”
”…’the main message of the study is that [although] these centenarians have a 'nice'
personality now, that was not always the case,’ opening the door to the notion that
it's never too late to adopt a ‘can-do’ spirit”
PROMOTING WELL-BEING
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Well-Being Therapy (WBT)
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Based on cognitive behavioral therapy
Focus on improving awareness of positive experiences and
extending their enjoyment
Fava et al, Archives of General Psychiatry, 1998
Well-being therapy and depression
Fava et al, Archives of General Psychiatry, 1998
Promoting Well Being Among
Older Adults: Lighten UP!
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8-week program
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Centered on eudaimonic well-being
90 min class sessions-various community settings
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Group discussion; brainstorming
Cognitive behavioral therapeutic perspectives on emotion
Theories of well-being
Daily homework (well-being diaries)
Evaluation
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Open-ended questions about program
Questionnaires before and after program
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Psychological well-being
Overall health and vitality
Depression
Lighten UP!
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Progress
6 classes, January-June, 2012
56 participants completing 7-8 sessions
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Preliminary data
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Descriptive information on 49 participants
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7 men and 42 women
Average age = 73.4 (range: 60-97)
33% married
42% have High School degree or less
63% live alone
Before and after data on 27 participants
In their own words…
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“…becoming more aware of what might ‘interrupt the positive’”
“I learned that most of my bad feelings about getting old are fixable by me.
My approach and outlook are paramount to getting through and enjoying
the last part of me.”
“More aware of doing some things that were mundane but very important
to my life.”
“I learned how to handle life’s ups and downs better through hearing
others’ experiences...”
“Each day brings something of value.”
“I truly see how my diminished health has changed the way I handle my life
now. I am happy that I accept the adjustments I’ve made.”
“I do things with friends more. I’m exercising more.”
“Took positive steps to control leg pain.”
“Have begun to take a broader look at my emotional reactions to things.”
Lighten UP!
Psychological Well-Being
Autonomy
Mastery
Growth
Relations
Purpose
6.5
6
5.5
5
4.5
4
Before
After
Self-Acceptance
Lighten UP!
Vitality
How much of the time during the last 4 weeks did you have a lot of energy?
1
2
3
4
5
6
None of
the time
A little of
the time
Some of
the time
A good bit of
the time
Most of
the time
All of
the time
4.8
4.6
4.4
4.2
4
3.8
3.6
3.4
Before
After
Lighten UP!
Geriatric Depression Scale
3
2.5
2
50% decrease
1.5
1
0.5
0
Before
After
SUCCESSES
•Recruitment close to target (56/60)
•High completion rates
•Positive outcomes for participants
•Leader manual and materials developed
•Wonderful individual stories
CHALLENGES
•Staffing for part time, short term project
•Delay in start due to IRB approval requirements
•Continued funding
FUTURE DIRECTIONS
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Control group
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Expand the program
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More counties
Telephone- or computer-based version for home-bound seniors
Extend the measures
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To determine whether improvements are related to the program or
to something more generic (e.g. social interaction)
Biological variables
Funding to sustain program