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Abstract
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Abstract
Due to continued demographic change the group of the oldest-old (aged 85 years and
above) has become the fastest growing population segment. Persons in this Fourth Age are
prone to suffer from functional and cognitive impairments, multimorbidity as well as diminishing
social contacts. Despite the fact of an increased vulnerability, findings, notably
the well-being paradox or conceptual frameworks such as emotional control theory, suggest
a great adaptational potential for the oldest-old to cope with these deficits, e.g. by
means of cognitive reframing or the use of psychological resources like personality traits.
Does this also hold true for the confrontation with one`s own restricted lifetime and thus
mortality? To date, there have been only a few studies aimed at shedding light on the field
of attitudes towards dying and death in old age, although these might be of particular importance
in the proximity to death. Moreover, death-related attitudes might act as so far
unknown determinants of successful ageing.
In the study presented, these attitudes were examined with the Multidimensional
Orientation Toward Dying and Death Inventory (MODDI-F), comprising fear of one`s
own dying, fear of one`s own death and neutral acceptance of one`s own dying and death.
The sample consisted of 113 cognitively healthy people aged 87 to 89 years. Due to the
lack of integrative models for the use of anxiety-related and affirmative attitudes towards
finitude in latest life, a hypothetically constructed model to explain these attitudes in old
age was developed conceptually and consecutively tested empirically. The hierarchical
model postulated determinants on two hypothetical levels, one consisting of stable trait
variables established early in the course of the life span, the other including variables assumed
to mediate the influence of the earlier developed constructs. Altogether, determinants
at the first level enclosed a range of variables covering resourceful and risky personality
traits, intrinsic religiosity and spirituality as well as functional health; whereas the
second level implemented the hypothetical mediator variables loneliness, future time perspective
and subjective health.
Since the MODDI-F makes use of an a priori factorial structure yet not validated
explicitly for oldest-old, the attitudes towards dying and death were firstly psychometrically
tested. Confirmatory structural equation modeling yielded satisfactory replication of the
three factors. Moreover, reliability analyses showed good internal consistence of the
scales. Regarding general characteristics of the attitudes towards dying and death a ceiling
effect for neutral acceptance of one`s own finitude and a floor effect for anxiety of one`s
own death could be found for the presented sample. On average, values for anxiety of
one`s own dying were located in a medium range. Simultaneous empirical testing of the
two model levels predicting the attitudes towards dying and death in old age provided
basic support for the hypothetically developed model. Thus, with regard to the personality
component, internally controlled persons with little trait-anxiety, low perceived loneliness
and an optimistic view of their own personal future showed high acceptance and low anxiety
towards their own mortality. The role of resilience was ambiguous, though. Findings
for functional health were somewhat unexpected as persons without or only few functional
limitations, good visual acuity and sound muscular strength of the lower extremities ex-