This chapter describes the psychological and psychosocial status of the participants of the Berlin Aging Study (BASE). In the first section, we outline age trends in three domains: intelligence, self and personality, and social relationships. In the domain of intelligence, negative age differences between 70 and 103 years were substantial (representing a 1.8 SD difference in performance level and 35% of the interindividual variance) and were closely associated with indicators of biological deterioration. In contrast, age-related differences in personality, self-related beliefs, and social relationships were fewer and considerably smaller (approximately 0.5 SD). At a general level, these domains seemed to be less affected by age-related decline than is true for intellectual functioning. Closer examination, however, revealed that age differences on aspects of self, personality, and social relationships were all in a less-than-desirable direction. In advanced old age, individuals may be pushed to the limits of their adaptive psychological capacity.

A further question considered in the chapter concerns the overall systemic nature of psychological functioning in old age. Cluster analysis was used to identify nine subgroups of older individuals with different patterns of functioning across the three psychological domains. Four of these groups reflected various patterns of desirable functioning (47% of the sample), and five, less desirable functioning (53%). The relative risk of membership in the less desirable profile subgroups was 2.5 times larger for the very old (85–103 years) than for people between the ages of 70 and 84 years, and 1.3 times larger for women than for men. […]

In epidemiological investigations, one common but rarely analyzed threat to generalizability is sample selectivity or nonrandom sample attrition. In this chapter, we describe our approach to the study of selectivity and provide indepth analyses of the magnitude of sample selectivity in the Berlin Aging Study. Of all individuals eligible for participation (the verified parent sample, N = 1,908), 27% reached the highest level of participation (the Intensive Protocol, N = 516). With respect to levels of performance, projection of selectivity observed on lower levels of participation onto Intensive Protocol constructs indicates that the Intensive Protocol sample was, indeed, positively selected on medical, social, and psychological dimensions. However, the magnitude of observed selectivity effects did not exceed 0.5 standard deviations for any construct. In addition, variances and covariance relations observed in the Intensive Protocol sample were not markedly different from those found at lower levels of participation. We conclude that the degree of selectivity in BASE fell within the usual range and did not result in a decrease of sample heterogeneity. Given the magnitude of sample attrition and the high mean age of the sample, this is a satisfactory result.

In this chapter, we examine ideas about the sources and processes of well-being in the context of a model derived from the work of Campbell, Converse, and Rodgers (1976). The model allows an integration of medical, sociological, and psychological perspectives. We describe the levels of well-being reported by the participants in the first cross-sectional measurement phase of the Berlin Aging Study (BASE), and examine the extent to which objective and subjective indicators of specific life domains predict overall individual well-being. Results from this investigation were multifaceted. The majority of participants reported satisfaction with their present life conditions. However, older women, individuals aged 85 and over, and persons living in institutions reported less frequent experience of positive emotions, an important component of well-being. Path analysis indicated that subjective domain evaluations (especially subjective health) were stronger predictors of subjective well-being than were the objective measures of domain status. This finding is consistent with the theoretical framework of Campbell et al. (1976). It suggests that the self-regulation processes that contribute to adaptation to changing life conditions (e.g., changes in aspiration levels and comparison targets) operate effectively in old age. We argue, however, that the cumulative challenges and losses of very old age could tap the limits of these adaptive processes. For this reason, it is essential to implement measures supportive of well-being in late adulthood. […]

In this chapter, we report empirical findings from the Berlin Aging Study (BASE) on the types and frequencies of psychiatric illnesses in old age, their somatic and social predictors, and their consequences.

Nearly half (44%) of the West Berliners aged 70 and above had no psychiatric disorders, whereas less than a quarter (24%) were clearly psychiatrically ill (specified DSM-III-R diagnoses). The remaining third consisted of carriers of psychopathological symptoms without illness value (16%) and of psychiatric syndromes with illness value (17%). Because this last group (mainly affective disorders) differs from the psychiatrically healthy in indicators of health impairment (in prognosis and use of psychotropic drugs), despite not fulfilling the criteria of operationalized DSM-III-R diagnoses, we speak of “subdiagnostic psychiatric morbidity.” In further analyses we tried to determine the thresholds defining gradations from mental health to subdiagnostic psychiatric morbidity. Thus, with the help of a consensus conference between internists and psychiatrists, which was specifically developed for the purpose of BASE, we have demonstrated that in the case of depression, scores on the Hamilton Depression Scale (HAMD) are half as great when cases that are probably of somatic origin are excluded.

The most frequent psychiatric illness in old age is dementia, affecting 14% of those aged 70 years and above. Recalculated for the population of over-65-year-olds, this corresponds to a prevalence of 6% (excluding mild forms). The number of dementia cases increases strongly with age. […]

The goal of this chapter is twofold. First, this chapter describes various aspects of self and personality in old age (personality characteristics, self-definitions, experience of time, personal life investment, coping styles, affect) and relates them to individuals' satisfaction with their own aging. Second, based on a model of psychological resilience in old age, we examine whether these aspects of self and personality are protective of aging satisfaction (on a correlational level) in the face of somatic or socioeconomic risks. Taken together, our results indicate that self and personality involve processes and characteristics that help to maintain or minimize the loss of aging satisfaction in the presence of somatic and socioeconomic risk factors. On a correlational level, we observe different adaptive profiles for socioeconomic and somatic risks.

This introductory chapter describes the general basis, goals, and methods of the Berlin Aging Study (BASE). Three features represent the special characteristics of BASE: (1) sample heterogeneity through local representativeness (for West Berlin), (2) a focus on very old people (70–105 years), and (3) broadly based interdisciplinarity (internal medicine, geriatrics, psychiatry, psychology, sociology, and social policy). Apart from discipline-specific topics, four common and intersecting theoretical orientations guide the study: (1) differential aging, (2) continuity versus discontinuity of aging, (3) range and limits of plasticity and reserve capacity, and (4) old age and aging as interdisciplinary and systemic phenomena.

In this chapter we examine the social and economic life circumstances of old and very old people in West Berlin, and the ways different socioeconomic resources influence social participation and aspects of physical and mental health. Information on education, occupational position, household income, housing conditions, forms of household, social activities, and media consumption is analyzed. Three hypotheses about socioeconomic differentiation and its consequences are examined: (a) the hypothesis of age-relatedness, where socioeconomic factors lose importance in comparison to age-related conditions such as health; (b) the hypothesis of socioeconomic continuity, which suggests that socioeconomic differences continue to influence life-styles and activities in old age; and (c) the cumulation hypothesis, where the impact of socioeconomic differentiation increases in old age.

In this study, we mainly find age-associated differences in social activities and social participation, both of which are highly related to health status. In these cases, socioeconomic resources can only partially compensate for health impairments. Until the move into a senior citizens' home, stability in income and housing conditions is found, reflecting the social position attained before retirement. Thus, in terms of the economic situation, age does not discriminate between individuals. Only with regard to utilization of care can we confirm the cumulation hypothesis, where socioeconomic inequality in old age becomes more pronounced: Members (mostly male) of higher social classes are rarely institutionalized and are more likely to be cared for at home. […]

The increasing number of older people in Western societies has made dealing with their needs for help and care a pressing matter. In the interdisciplinary context of the Berlin Aging Study (BASE), involving geriatricians, psychiatrists, psychologists, and sociologists, it was possible to examine how older adults utilize health care and which predicting factors are important.

Major areas of health care utilization are: (1) physician contacts, (2) medication use, (3) different levels of caregiving, including informal, formal, and institutional care, and (4) inpatient treatment for acute illness episodes in hospitals. Results from the BASE assessments show that 85% of persons aged 70 and above had regular physician contact and that 96% used at least one medication. Thirty-one percent received some kind of informal or formal caregiving assistance. Multiple regression analyses revealed differential predictive relationships for each of the three dependent health care utilization variables. Higher use of medications was most strongly predicted by increased numbers of somatic diagnoses, better intellectual functioning, and particular health attitudes. Physician contact was weakly predicted by somatic health variables, hypochondriasis, and living alone. In contrast, living alone was the strongest predictor of the utilization of caregiving services, whereas children living in Berlin served as a protective factor against the need for more formal care. Thus, utilization of health care is a multidimensional phenomenon that continues to depend on the interaction between physical and mental health, attitudinal, and social factors in old age.

Evidence from gerontological research suggests that physical morbidity and disability in old age are among the most important causes for decline in other functional domains such as social and psychological functioning. However, comprehensive cross-disciplinary analyses on the significance of morbidity and disability in old age and during transition into very old age are scarce.

This chapter examines the strength of associations between (a) somatic and mental health, (b) health and psychosocial status, and (c) objective and subjective health by utilizing multidimensional indicators of physical, mental, psychological, and social functioning from the Berlin Aging Study (BASE) sample (N = 516; age range: 70–103 years). The analyses focus on two central questions, namely: (1) To what extent is health an explanatory variable for age differences in other functional domains? (2) Do the associations between health and other domains themselves vary with age?

The results reveal clear age-independent correlations between somatic and psychiatric morbidity as well as between psychosocial factors and health. Moreover, health indicators fully explain the negative effects of age on psychosocial resources and on mental health. However, the significance of objective health for subjective evaluations decreases significantly with age. In this domain, the findings are consistent with recent hypotheses that emphasize manifold intraindividual mechanisms working to maintain positive self-appraisal despite objective decline.

In this chapter, three sensory systems (hearing, vision, and balance/gait) are examined. We begin with a descriptive overview of individual differences and age difference patterns in sensory functioning. The pattern of how individual differences in sensory acuity might be related to performance in other psychological and behavioral domains is examined. We reveal a strong, negative pattern of age differences in all three senses studied. These negative age trends have implications for the classification of sensory impairment rates: Although participants in their 70s have levels of sensory acuity that might be classified, on average, as slightly or mildly impaired, by their 90s most participants evince levels that might be classified as moderately to severely impaired, not only in one but in multiple modalities. We also report prevalence rates for the use of commonly occurring compensatory devices and procedures (e.g., hearing aids, glasses, cataract operations). We report the following findings with regard to the relationship of sensory functioning to other domains of psychological and behavioral performance (e.g., intellectual functioning, basic and expanded everyday competence, personality characteristics, well-being, social network size):