title: Successful aging in health adversity: results from the National Psychiatric Morbidity Survey.
abstract: BACKGROUND
  We aimed to investigate factors enabling older people with cognitive impairment to age successfully.
  
  
  METHODS
  We used the 12-item Short Form Health Survey to measure health-related quality of life (HR-QoL) in 2,007 people aged > or =60 in the 2000 British National Psychiatric Morbidity Survey. We tested the hypothesis that affective symptoms and social support mediated the relationship between cognitive functioning and poorer HR-QoL.
  
  
  RESULTS
  The mean age of the participants was 66.2 (66.0-66.4). The majority of people with suspected dementia reported high mental health-related quality of life, suggesting they may not be distressed by, or aware of, cognitive and mental impairment, and the majority are aging "successfully." The relationship between cognitive impairment and mental HR-QoL was mediated by affective symptoms, but not by social support. After considering mediators and confounders, HR-QoL was no longer associated with cognitive impairment.
  
  
  CONCLUSIONS
  The lower quality of life previously reported by people with cognitive impairment is due to the greater physical and mental health problems in this population, rather than to cognitive impairment per se. Active management of mental and physical health may improve the HR-QoL of those with cognitive impairment who are not ageing successfully.
authors.affiliation: Department of Mental Health Sciences, University College London, UK. ccooper@doctors.org.uk
authors.forename: Claudia
authors.initials: C
authors.lastname: Cooper
authors.forename: Paul
authors.initials: P
authors.lastname: Bebbington
authors.forename: Cornelius
authors.initials: C
authors.lastname: Katona
authors.forename: Gill
authors.initials: G
authors.lastname: Livingston
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000342:Affective Symptoms / Q000453:epidemiology / Q000523:psychology; D000367:Age Factors; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology / Q000523:psychology*; D001364:Awareness; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D012959:Socioeconomic Factors; D006113:United Kingdom