International Psychogeriatrics

Research Article

Successful aging in health adversity: results from the National Psychiatric Morbidity Survey

Claudia Coopera1 c1, Paul Bebbingtona1, Cornelius Katonaa1 and Gill Livingstona1

a1 Department of Mental Health Sciences, University College London, U.K.


Background: We aimed to investigate factors enabling older people with cognitive impairment to age successfully.

Methods: We used the 12-item Short Form Health Survey to measure health-related quality of life (HR-QoL) in 2,007 people aged ≥60 in the 2000 British National Psychiatric Morbidity Survey. We tested the hypothesis that affective symptoms and social support mediated the relationship between cognitive functioning and poorer HR-QoL.

Results: The mean age of the participants was 66.2 (66.0–66.4). The majority of people with suspected dementia reported high mental health-related quality of life, suggesting they may not be distressed by, or aware of, cognitive and mental impairment, and the majority are aging “successfully.” The relationship between cognitive impairment and mental HR-QoL was mediated by affective symptoms, but not by social support. After considering mediators and confounders, HR-QoL was no longer associated with cognitive impairment.

Conclusions: The lower quality of life previously reported by people with cognitive impairment is due to the greater physical and mental health problems in this population, rather than to cognitive impairment per se. Active management of mental and physical health may improve the HR-QoL of those with cognitive impairment who are not ageing successfully.

(Received July 03 2008)

(Revised October 03 2008)

(Revised October 27 2008)

(Accepted October 29 2008)

(Online publication June 04 2009)


c1 Correspondence should be addressed to: Claudia Cooper, Dept of Mental Health Sciences, University College London, Holborn Union Building, Archway Campus, Highgate Hill, London N19 5LW, U.K. Phone: +44 (0) 207 2885931 Email: