Abstract
Psychological reactions and health-related quality of life were studied in relation to stressful life events, such as bereavement and ill health, among younger elderly persons (70–76 years) living in their own homes. The present studies are part of the gerontological and geriatric population studies in Göteborg, Sweden. I. Grief reactions studied in 50 newly bereaved subjects were characterised by loneliness, low mood, fatigue, anxiety and perceived cognitive dysfunctioning, generally diminishing during the one-year follow-up. Post-bereavement hallucinations and illusions one month after death of the spouse were feeling presence (illusions) (52%), seeing, hearing and talking to the deceased (26%, 30%, 30%), and being touched (6%). There was no spontaneous disclosure of hallucinations/illusions, although almost all subjects found it comforting and helpful. The quality of life was significantly lower among the bereaved than among married people. II. Stressful life events were experienced by 2/3 of the sample (n = 565) between 70 and 76 years of age, mostly related to health and bereavement. However, there was no relationship between life stresses and cognitive decline, except for the bereavement situation, especially in men. III. Quality-of-life (QL) domains and health-related problems in daily areas were measured at 76 years of age with the Nottingham Health Profile (NHP). In the sample (n = 565) 97% were ambulant and lived independently. Although the majority (80%) had one or more diseases or disorders, they felt healthy and had good health-related QL. Impaired QL was related to observed and perceived illness, institutionalization, widowhood, lacking someone close and being financially discontent. Women had more pain, emotional, sleep and mobility problems than men. Generally, mobility problems had the most negative influence on daily activities. IV. About half of the sample had more than one diagnosis and health-related QL was found to deteriorate in proportion to the number of diagnoses, especially in lack of energy, pain, sleep and mobility problems. Surprisingly, emotional reactions and social isolation withstood the influence of multiple morbidity. Anginal pain, urinary incontinence, locomotor and mental disorders were most closely associated with impaired QL. V. Dizziness (34% in women and 23% in men), mostly reported as unsteadiness, was significantly associated with locomotor disorders, anginal pain, incontinence, stroke/paresis and mental disorders. Dizziness had a detrimental influence on health-related QL and was associated with anxiety, nervousness, depression and memory problems. It should be recognized as a serious complaint, especially when it is reported to interfere with daily life. VI. Health-related QL was studied in a female group (n = 120) with urinary incontinence and compared with the age-matched IVEG sample (n = 313). QL was reduced in the incontinent group as regards emotional reactions and social isolation.

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