Cognitive impairment and life satisfaction in older adults.

Background: Quality of life in dementia has been studied in clinical settings. There is less population-based research on life satisfaction and cognition.

Objectives: (1) To compare the overall life satisfaction (LS), LS with material circumstances (LS (material)), and LS with social circumstances (LS (social)) of older adults with no cognitive impairment, with cognitive impairment no dementia (CIND), and with dementia; (2) To examine the effect of cognition on LS across a broad spectrum of cognition; and (3) To explore the effect of factors such as depressive symptoms, functional impairment, education, and social support.

Population: 1620 community-dwelling older adults with a mini-mental state examination (MMSE) score > 10, sampled from a representative list were interviewed.

Measures: Age, gender, education, social networks, and social supports were all self-reported. The MMSE, the Centre for Epidemiologic Studies-Depression (CES-D), and the Older Americans Resource Survey (OARS) were used. Dementia was diagnosed by clinical examination using DSM-IIIR criteria. LS was measured using the Terrible-Delightful Scale. Factor analysis identified two factors: LS (material), and LS (social). A global item measuring overall LS was also used.

Results: Those with dementia and CIND had lower LS than those with normal cognition, but the effect was relatively small. There was a gradient in LS which extended into the normal range of cognition. Depressive symptoms and functional status were strongly associated with LS.

Conclusions: Cognition is associated with LS, but the effect is fairly small. Most older adults are satisfied with life.