[Predicting loss of mastery in older adults]

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.

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.

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.

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.