Impacts of illness and disability on the well-being of older people.

This study examined ways in which aspects of activity may mediate relationships between physical illness and well-being among older people. Data were from the Health Status of Older People survey of 1000 people aged 65 and over who lived in the community in Melbourne, Australia. After controlling for gender, marital status, and perceived social support, multivariate analyses showed that the major impacts of illness and pain were through their effects on activity limitations, which in turn were related to lowered well-being. Limitations with instrumental activities were associated most with lower positive affect, while perceived activity limitations due to major illness had more impact on increased negative affect and depressive symptoms. However, most older people with major illness still scored highly on well-being, and there was individual variability in well-being. Research on the impacts of illness needs to take more account of impacts on daily living and differences in individual interpretation of illness and disability. Health promotion and treatment can enhance the well-being of older people by maintaining and regaining independence and activity when individuals experience major illness.