The elderly in a period of transition: health, personality, and social aspects of adaptation.

The dramatic changes in overall mode of life experienced since 1989 by the people in Central and Eastern Europe (CEE) provides a good opportunity to study the aging processes and the status of the elderly. In the 1980s, CEE countries were already at an advanced stage of demographic aging of their populations. The first years of the period of transition from totalitarianism to democracy and market economies were marked with an abrupt but varying degree of economic and social deterioration in CEE. This was followed by partial improvement. Earlier, in the late 1960s and 1970s, mortality rates had increased along with a stagnation and decrease of life expectancy in CEE. This contrasted with the steady improvement in the European Union (EU) during the 1970s and 1980s. By 1989, there already was a striking gap in life expectancy between eastern and western Europe, revealing the existence of an East-West health divide. The most important health problems contributing to greater mortality in CEE proved to be cardiovascular and alcohol-related diseases as well as violence and injury. Suicide rates also were found higher among the (elderly) population in the countries of CEE and Russia compared with the West. The gap was most expressed among the men. The reasons for deterioration in health are complex. There is evidence that negative economic and social changes can lead to psychosocial stress and to unhealthy behaviors. The morale of the elderly people in transition was affected and many-sided. The Sofia study described here has revealed positive as well as negative personal attitudes toward the changes in life. Feelings of liberation, hope, and new perspectives were reported along with sentiments of disappointment, pessimism, and fear. In sum, transition processes have run unevenly in different countries and have had differing impacts on individuals. Nevertheless, general trends toward improving the economic, psychosocial, and health aspects of the elderly are recently prevailing.