Changes in psychological well-being among older adults: a latent transition analysis from China

Psychological well-being is becoming an increasingly important part of the public health mission, and is multifaceted and has various interrelated dimensions. A thorough understanding of its presentation patterns (i.e., subtypes) and change process is essential for effective interventions. However, longitudinal research examining the subtypes of psychological well-being among Chinese older adults remains scarce, and little is known about the factors influencing the belonging and transition of these subtypes.

We used two waves of national longitudinal data (2011 and 2014) from the Chinese Longitudinal Healthy Longevity Survey, with 5778 respondents aged 65 and above. Psychological well-being was assessed by eight indicators from three dimensions: quality of life, positive feelings, and negative feelings. Latent profile transition analysis was used to identify subtypes of psychological well-being and explore the transition of older adults among different subtypes over time.

Four distinct subtypes of psychological well-being were identified, with the Mainly Unhappy Subtype being prevalent among Chinese older adults. Unhappiness and uselessness were indicative; eliminating unhappiness was vital to complete psychological recovery; feeling of uselessness was found as a crossroads in the process of psychological health. The psychological well-being of older adults was unstable; emotion blunting was found in the transition from the Mainly Unhappy Subtype to the Satisfied and Positive Subtype, and emotion augmentation was found in the transition from the Resilient yet Useless Subtype to the Discontented and Negative Subtype. A paradox in aging was observed in the membership of the Mainly Unhappy Subtype and the Discontented and Negative Subtype. Marital status, residence, education, household income, exercise, and leisure activity were significantly positively related to both initial membership and transition of the psychological well-being subtypes. Smoking status, drinking status, and social support were significantly associated with the transition between subtypes. Physical health was significantly correlated with the initial subtype membership.

Our findings suggest some indicators and critical steps in improving psychological well-being among older adults. These provide insight for healthcare professionals and policymakers to develop tailored interventions considering subtypes and individual characteristics.