Influences on the biopsychosocial health of older adults

Abstract

On average the last 12 to 16 years of life are spent in ill health, which represents a gradual decline in health and quality of life for individuals aged 65 and over. This demographic group is also the fastest growing in the UK and hence present significant financial implications for the health service.
Despite these age-related health declines, spanning physical, cognitive and psychosocial dimensions of health, known as biopsychosocial health, understanding of how these health dimensions interact is sparse. Recent research has suggested potential bi-directional relationship between physical and cognitive function with declining executive brain functions expressed through changes in walking gait (Ijmker & Lamoth, 2012; Verghese et al., 2012; Smith-Ray et al., 2013). Similarly, social isolation has been demonstrated to be severely detrimental to physical health; whereas strong social relationships reportedly elevate psychosocial and physical health (Holt-Lunstad et al., 2010). This evidence therefore suggests a potential tri-directional relationship between different manifestations of biopsychosocial health, with each dimension directly influencing one another. Traditionally, research in this field has used controlled environments and expensive equipment to establish functional abilities in older adults.
Therefore, identifying whether simple field-based assessments can accurately assess aspects of biopsychosocial health may provide a basis for novel practical interventions and inform professional practice.
Hence, the aims of this thesis were to enhance current understanding of biopsychosocial health in older adults and explore the relationship and integration between health dimensions. A further aim was to investigate whether simple, field-based measures can be utilised effectively to identify biopsychosocial health, in order to translate these findings into impactful interventions to aid promotion of longevity and functional independence in old age.
Literature reviews and a series of empirical studies were conducted to achieve these aims. Results illustrated that biopsychosocial health dimensions shared a complex relationship. Furthermore, it is possible to measure biopsychosocial functions with simple field-based and self-administered assessments. These findings are combined with advances in technology to provide a potential novel and impactful practical application to enable identification of declining health in older age. The thesis then concludes with final thoughts and reflections on professional practice and future directions.