Temporary Setback or Lasting Challenge? The Impact of Transient and Persistent Functional disability on later life well-being

Abstract

Objectives While most people spend the last years of their life with health limitations, these do not arise at the same timepoint for everyone or have the same consequences for our well-being. The aim of this study is to investigate how well-being trajectories evolve after the onset of functional disability, comparing affective, cognitive, and eudemonic dimensions, while also assessing how they are influenced by temporary functional disability, distinguishing between persistent and transient cases. Methods We reordered longitudinal panel data from waves 4 to 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE), from more than 3,500 Europeans to align on the transition from no limitation to at least one limitation in activities of daily living. We used linear spline growth models separately for each of the three well-being measures used (EURO-D, CASP, life satisfaction) to examine trajectories. Results We observed a substantial decline in all three well-being measures at functional disability onset, with life satisfaction less affected (standardised mean differences = -0.11) than quality of life (-0.23) and depression (-0.27). Short-term disability on average led to a return to the initial well-being level within, while long-term disability led to a pronounced decline during the transition, with much less adaptation. Discussion Our findings highlight the significant impact that functional disability can have on well-being, revealing distinct patterns across various dimensions. Persistent disability often marks a crucial stage in the well-being of older people, whereas transient cases are characterised by a subsequent return to previous levels of well-being.