Late life changes in mental health: a longitudinal study of 9683 women

Objectives: To identify latent subgroups of women in late life who are alike in terms of their mental health trajectories.Method: Longitudinal data are for 9683 participants in the 1921–1926 cohort of the Australian Longitudinal Study on Women's Health, who completed at least two surveys between 1999 (aged 73–78 years) and 2008 (aged 82–87 years). Mental health was measured using the five-item mental health inventory (MHI-5). Latent profile analysis uncovered patterns of change in MHI-5 scores.Results: Three patterns of change were identified for women who were still alive in 2008 (n = 7061), and three similar patterns for deceased women (n = 2622): (1) ‘poor mental health’ representing women with low MHI-5 scores, (2) ‘good mental health’ and (3) ‘excellent’ mental health, where scores remained very high. Deceased women had lower mental health scores for each class. Remote areas of residence, higher education, single marital status, higher Body Mass Index (BMI) and falls were the covariates associated with mental health in the survivor group. For the deceased group, education, BMI and falls were significant. Arthritis, stroke, heart disease, bronchitis/emphysema, diabetes and osteoporosis were associated with worse mental health for both groups, while asthma increased these odds significantly for the survivor group only. Hypertension and cancer were not significant predictors of poor mental health.Conclusion: The results show associations between chronic disease and level of mental health in older age, but no evidence of a large decline in mental health in the period prior to death.