The aim of the study is to present a new and efficient way of measuring the quality of life among older populations, with special attention to morale, positive outlook on life and ageing. The measure is based on the Philadelphia Geriatric Center Morale Scale (PGCM), originally consisting of 22 items. The growing numbers and proportions of older people among European populations has increased the need to obtain more reliable data on their needs, values, life experiences and overall quality of life. Using data from six surveys conducted in the Czech Republic, we have formulated a three-item positive outlook on life and ageing (POLA) scale. Our analyses are divided into three steps: (1) constructing the scale and testing its internal consistency; (2) testing the scale's external validity using mean comparisons and correlation coefficients; and (3) determining the factors affecting a positive outlook on later life, such as gender and education. We have confirmed that the three-item approach to measuring positive outlook on ageing as a part of morale is highly applicable to surveys, producing compelling results in assessing important quality-of-life sub-concepts, such as subjective health, subjective age, and loneliness.

Faculty of Social Studies Masaryk University Joštova 10 602 00 Brno Czech Republic

Zobrazit více v PubMed

Eurostat . Ageing Europe—Looking at the Lives of Older People in the EU. Publications Office of the European Union; Luxembourg: 2019.

Rowe J.W., Kahn R.L. Successful aging. Gerontologist. 1997;37:433–440. doi: 10.1093/geront/37.4.433. PubMed DOI

Foster L., Walker A. Active and successful aging: A European policy perspective. Gerontologist. 2015;55:83–90. doi: 10.1093/geront/gnu028. PubMed DOI PMC

Börsch-Supan A. Myths, scientific evidence and economic policy in an aging world. J. Econ. Ageing. 2013;1–2:3–15. doi: 10.1016/j.jeoa.2013.06.001. DOI

Harper S. Economic and social implications of aging societies. Science. 2014;346:587–591. doi: 10.1126/science.1254405. PubMed DOI

Carney G.M., Gray M. Unmasking the ‘elderly mystique’: Why it is time to make the personal political in ageing research. J. Aging Stud. 2015;35:123–134. doi: 10.1016/j.jaging.2015.08.007. PubMed DOI

Klusmann V., Notthoff N., Beyer A., Blawrt A., Gabrian M. The assessment of views on ageing: A review of self-report measures and innovative extensions. Eur. J. Ageing. 2020 doi: 10.1007/s10433-020-00556-9. PubMed DOI PMC

Bowling A., Hankins M., Windle G., Bilotta C., Grant R. A short measure of quality of life in older age: The performance of the brief Older People’s Quality of Life questionnaire (OPQOL-brief) Arch. Gerontol. Geriatr. 2013;56:181–187. doi: 10.1016/j.archger.2012.08.012. PubMed DOI

Bowling A., Stenner P. Which measure of quality of life performs best in older age? A comparison of the OPQOL, CASP-19 and WHOQOL-OLD. J. Epidemiol. Community Health. 2011;65:273–280. doi: 10.1136/jech.2009.087668. PubMed DOI PMC

Shiovitz-Ezra S., Leitsch S., Graber J., Karraker A. Quality of life and psychological health indicators in the national social life, health, and aging project. J. Gerontol. 2009:i30–i37. doi: 10.1093/geronb/gbn020. PubMed DOI PMC

Abbey A., Andrews F.M. Modelling the psychological determinants of life quality. In: Andrews F.M., editor. Research on the Quality of Life. Survey Research Centre; Ann Arbor, MI, USA: 1986. pp. 85–116.

McCulloch B.J. A longitudinal investigation of the factor structure of subjective well-being: The case of the Philadelphia Geriatric Center Morale Scale. J. Gerontol. 1991;46:251–258. doi: 10.1093/geronj/46.5.P251. PubMed DOI

Stock W.A., Okun M.A., Benin M. Structure of subjective well-being among the elderly. Psychol. Aging. 1986;1:91–102. doi: 10.1037/0882-7974.1.2.91. PubMed DOI

Ranzijn R., Luszcz M. Measurement of subjective quality of life of elders. Int. J. Aging Hum. Dev. 2000;50:263–278. doi: 10.2190/4B0W-AMGU-2NDX-CYUQ. PubMed DOI

Pinar R., Oz H. Validity and reliability of the Philadelphia Geriatric Center Morale Scale among Turkish elderly people. Qual. Life Res. 2010;20:9–18. doi: 10.1007/s11136-010-9723-4. PubMed DOI

Challis D.J. The measurement of outcome in social care of the elderly. J. Soc. Policy. 1981;10:179–208. doi: 10.1017/S004727940001062X. DOI

Wong E., Woo J., Hui E., Ho S.C. Examination of the Philadelphia Geriatric Morale Scale as a subjective quality-of-life measure in elderly Hong Kong Chinese. Gerontologist. 2004;44:408–417. doi: 10.1093/geront/44.3.408. PubMed DOI

Morris J.N., Sherwood S. A retesting and modification of the Philadelphia Geriatric Center Morale Scale. J. Gerontol. 1975;30:77–84. doi: 10.1093/geronj/30.1.77. PubMed DOI

Liang J., Bollen K.A. The structure of the Philadelphia Geriatric Center Morale Scale: A reinterpretation. J. Gerontol. 1983;38:181–189. doi: 10.1093/geronj/38.2.181. PubMed DOI

Liang J., Asano H., Bollen K.A., Kahana E.F., Maeda D. Cross-cultural comparability of the Philadelphia Geriatric Center Morale Scale: An American-japanese comparison. J. Gerontol. 1987;42:37–43. doi: 10.1093/geronj/42.1.37. PubMed DOI

Levy B.R., Slade M.D., Kasl S.V. Longitudinal benefit of positive self-perceptions of aging on functional health. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 2002;57:P409–P417. doi: 10.1093/geronb/57.5.P409. PubMed DOI

Levy B.R. Rigidity as a predictor of older persons’ aging stereotypes and aging self-perceptions. Soc. Behav. Personal. 2008;36:559–570. doi: 10.2224/sbp.2008.36.4.559. DOI

Kim G., Jang Y., Chiriboga D. Personal views about aging among Korean American older adults: The role of physical health, social network, and acculturation. J. Cross Cult. Gerontol. 2012;27:139–148. doi: 10.1007/s10823-012-9165-2. PubMed DOI

Miche M., Elsässer V.C., Schilling O.K., Wahl H.-W. Attitude toward own aging in midlife and early old age over a 12-year period: Examination of measurement equivalence and developmental trajectories. Psychol. Aging. 2014;29:588–600. doi: 10.1037/a0037259. PubMed DOI

Kornadt A.E., Siebert J.S., Wahl H.-W. The interplay of personality and attitudes toward own aging across two decades of later life. PLoS ONE. 2019;14:e0223622. doi: 10.1371/journal.pone.0223622. PubMed DOI PMC

Vidovićová L. Stárnutí, Věk a Diskriminace: Nové Souvislosti. Masarykova Univerzita; Brno, Czech Republic: 2008.

Kavirajan H., Vahia I.V., Thompson W.K., Depp C., Allison M., Jeste D.V. Attitude Toward Own Aging and Mental Health in Post-menopausal Women. Asian J. Psychiatry. 2011;4:26–30. doi: 10.1016/j.ajp.2011.01.006. PubMed DOI PMC

Dutt A.J., Wahl H.W., Diehl M. Oxford Research Encyclopedia of Psychology. Oxford University Press; Oxford, UK: 2018. Awareness of Aging Processes. DOI

Bodner E., Ayalon L., Avidor S., Palgi Y. Accelerated increase and relative decrease in subjective age and changes in attitudes toward own aging over a 4-year period: Results from the Health and Retirement Study. Eur. J. Ageing. 2017;14:17–27. doi: 10.1007/s10433-016-0383-2. PubMed DOI PMC

Tiit E.-M., Saks K. Subjective Quality of Life of Care-Dependent Older People in Five European Union Countries. In: Vaarama M., Pieper R., Sixsmith A., editors. Care-Related Quality of Life in Old Age: Concepts, Models and Empirical Findings. Springer; New York, NY, USA: 2008. pp. 153–167. DOI

Lawton M.P. The dimensions of morale. In: Kent D., Kastenbaum R., Sherwood S., editors. Research, Planning, and Action for the Elderly. Behavioral Publications; New York, NY, USA: 1972. pp. 144–165.

Lawton M.P. The Philadelphia Geriatric Center Morale Scale: A revision. J. Gerontol. 1975;30:85–89. doi: 10.1093/geronj/30.1.85. PubMed DOI

Challis D., Knapp M. An Examination for the PGC Morale Scale in an English Context. University of Kent, PSSRU; London, UK: 1980.

Royal College of Physicians and the British Geriatric Society . A Report of Joint Workshops of the Research Unit of the Royal College of Physicians and the British Geriatric Society: Standardised Assessment Scales for Elderly People. Royal College of Physicians and the British Geriatric Society; London, UK: 1992. pp. 16–17.

Kozma A., Stones M.J. Social desirability in measures of subjective well-being: A systematic evaluation. J. Gerontol. 1987;42:56–59. doi: 10.1093/geronj/42.1.56. PubMed DOI

Lohmann N. Correlations of life satisfaction, morale and adjustment measures. J. Gerontol. 1977;32:73–75. doi: 10.1093/geronj/32.1.73. PubMed DOI

Wenger G.C., Davies R., Shahtahmasebi S. Morale in old age: Refining the model. Int. J. Geriatr. Psychiatry. 1995;10:933–943. doi: 10.1002/gps.930101105. DOI

Niklasson J., Näsman M., Nyqvist F., Conradsson M., Olofsson B., Lövheim H., Gustafson Y. Higher morale is associated with lower risk of depressive disorders five years later among very old people. Arch. Gerontol. Geriatr. 2017;69:61–68. doi: 10.1016/j.archger.2016.11.008. PubMed DOI

Hedberg P., Gustafson Y., Brulin C. Purpose in life among men and women aged 85 years and older. Int. J. Aging Hum. Dev. 2010;70:213–229. doi: 10.2190/AG.70.3.c. PubMed DOI

Näsman M., Niklasson J., Nygård M., Olofsson B., Lövheim H., Gustafson Y., Nyqvist F. Risk factors for a decrease in high morale in very old people over a 5-year period: Data from two Nordic countries. Eur. J. Ageing. 2020;17:31–41. doi: 10.1007/s10433-019-00521-1. PubMed DOI PMC

Niklasson J., Conradsson M., Hörnsten C., Nyqvist F., Padyab M., Nygren B., Olofsson B., Lövheim H., Gustafson Y. Psychometric properties and feasibility of the Swedish version of the Philadelphia Geriatric Center Morale Scale. Qual. Life Res. 2015;24:2795–2805. doi: 10.1007/s11136-015-1009-4. PubMed DOI

Felton B.J., Hinrichsen G.A., Tsemberis S. Urban-suburban differences in the predictors of morale among the aged. J. Gerontol. 1981;36:214–222. doi: 10.1093/geronj/36.2.214. PubMed DOI

Yamashita K., Iijima K., Kobayashi S. Relationship among activities of daily living, apathy, and subjective well-being in elderly people living alone in a rural town. Gerontology. 1999;45:279–282. doi: 10.1159/000022102. PubMed DOI

Stock W.A., Okun M.A., Gomez-Benito J. Subjective well-being measures: Reliability and validity among Spanish elders. Int. J. Aging Hum. Dev. 1994;38:221–235. doi: 10.2190/MGGY-KFN3-M4YR-DFN4. PubMed DOI

Araki A., Ito H. Development of elderly diabetes burden scale for elderly patients with diabetes mellitus. Geriatr. Gerontol. Int. 2003;3:212–224. doi: 10.1111/j.1444-1586.2003.00084.x. DOI

Imanishi M., Tomohisa H., Higaki K. Impact of continuous in-home rehabilitation on quality of life and activities of daily living in elderly clients over 1 year. Geriatr. Gerontol. Int. 2017;17:1866–1872. doi: 10.1111/ggi.12978. PubMed DOI

Shmotkin D., Hadari G. An outlook on subjective well-being in older Israeli adults: A unified formulation. Int. J. Aging Hum. Dev. 1996;42:271–289. doi: 10.2190/JKMB-2TH6-YB74-L8PL. PubMed DOI

Loke S.C., Abdullah S.S., Chai S.T., Hamid T.A., Yahaya N. Assessment of factors influencing morale in the elderly. PLoS ONE. 2011;6:e16490. doi: 10.1371/journal.pone.0016490. PubMed DOI PMC

Jung S., Siedlecki K.L. Attitude toward own aging: Age invariance and construct validity across middle-aged, young-old, and old-old adults. J. Adult Dev. 2018;25:141–149. doi: 10.1007/s10804-018-9283-3. DOI

Burton A.E., Dean S.E., Demeyin W., Reeves J. Questionnaire measures of self-directed ageing stereotype in older adults: A systematic review of measurement properties. Eur. J. Ageing. 2020 doi: 10.1007/s10433-020-00574-7. PubMed DOI PMC

Vidovićová L. How Age-Friendly Are Cities? Measuring Age-Friendliness with a Composite Index. In: Jeremic V., Radojicic Z., Dobrota M., editors. Emerging Trends in the Development and Application of Composite Indicators. IGI Global; Hershey, PA, USA: 2017. pp. 277–297.

St John P.D., McClement S.S., Swift A.U., Tate R.B. Older men’s definitions of frailty—The Manitoba follow-up study. Can. J. Aging. 2019;38:13–20. doi: 10.1017/S0714980818000405. PubMed DOI

Paganini-Hill A., Kawas C.H., Corrada M.M. Positive mental attitude associated with lower 35-year mortality: The leisure world cohort study. J. Aging Res. 2018;2018:1–10. doi: 10.1155/2018/2126368. PubMed DOI PMC

Tilvis R.S., Laitala V., Routasalo P., Strandberg T.E., Pitkala K.H. Positive life orientation predicts good survival prognosis in old age. Arch. Gerontol. Geriatr. 2012;55:133–137. doi: 10.1016/j.archger.2011.06.030. PubMed DOI

Allen P.M., Mejía S.T., Hooker K. Personality, self-perceptions, and daily variability in perceived usefulness among older adults. Psychol. Aging. 2015;30:534–543. doi: 10.1037/pag0000039. PubMed DOI

Gruenewald T.L., Karlamangla A.S., Greendale G.A., Singer B.H., Seeman T.E. Increased Mortality Risk in Older Adults with Persistently Low or Declining Feelings of Usefulness to Others. J. Aging Health. 2009;21:398–425. doi: 10.1177/0898264308329023. PubMed DOI PMC

Sargent-Cox K.A., Anstey K.J., Luszcz M.A. Change in health and self-perceptions of aging over 16 years: The role of psychological resources. Health Psychol. 2012;31:423–432. doi: 10.1037/a0027464. PubMed DOI

Beridze G., Ayala A., Ribeiro O., Fernández-Mayoralas G., Rodríguez-Blázquez C., Rodríguez-Rodríguez V., Rojo-Pérez F., Forjaz M.J., Calderón-Larrañaga A. Are Loneliness and Social Isolation Associated with Quality of Life in Older Adults? Insights from Northern and Southern Europe. Int. J. Environ. Res. Public Health. 2020;17:8637. doi: 10.3390/ijerph17228637. PubMed DOI PMC

Mund M., Freuding M.M., Möbius K., Horn N., Neyer F.J. The Stability and Change of Loneliness Across the Life Span: A Meta-Analysis of Longitudinal Studies. Personal. Soc. Psychol. Rev. 2020;24:24–52. doi: 10.1177/1088868319850738. PubMed DOI PMC

Sunwoo L. Loneliness among older adults in the Czech Republic: A socio-demographic, health, and psychosocial profile. Arch. Gerontol. Geriatr. 2020;90:104068. doi: 10.1016/j.archger.2020.104068. PubMed DOI

Blanchard R.D., Bunker J.B., Wachs M. Distinguishing aging, period and cohort effects in longitudinal studies of elderly populations. Socio-Econ. Plan. Sci. 1977;11:137–146. doi: 10.1016/0038-0121(77)90032-5. DOI

Rodgers W., Herzog R. Collecting data about oldest old: Problems and procedures. In: Suzman R.M., Willis D.P., Manton K.G., editors. The Oldest Old. Oxford University Press; New York, NY, USA: 1995. pp. 135–156.

Doseděl L., Vidovićová L. Who Should Interview Older People? The Effect of Interviewer and Interviewee Characteristics in Surveys of Older People and Aging Topics. Sociológia. 2018;6:760–781. doi: 10.31577/sociologia.2018.50.6.28. DOI

Galiana L., Tomás J.M., Fernández I., Oliver A. Predicting Well-Being Among the Elderly: The Role of Coping Strategies. Front. Psychol. 2020;11:616. doi: 10.3389/fpsyg.2020.00616. PubMed DOI PMC