title: Successful aging among older veterans in the United States.
abstract: OBJECTIVE
  To develop a unidimensional latent model of successful aging and to evaluate sociodemographic, medical, psychiatric, and psychosocial correlates of this construct in a nationally representative sample of older veterans in the United States.
  
  
  METHODS
  Data were analyzed from a cross-sectional web survey of 2,025 U.S. veterans aged 60 to 96 years who participated in the National Health and Resilience in Veterans Study. Self-report measures of sociodemographics; subjective physical, mental, and cognitive functioning; and psychosocial characteristics were used. Confirmatory factor analysis was used to construct a unidimensional latent factor of successful aging. Correlates of scores on this factor were then evaluated.
  
  
  RESULTS
  Most older veterans (82.1%) rated themselves as aging successfully. A unidimensional latent factor composed of seven measures of self-rated successful aging, quality of life, and physical, mental, cognitive, and social functioning provided a good fit to the data. Physical health difficulties (β = -0.39) and current psychological distress (β = -0.33) were most strongly negatively related to scores on this latent factor of successful aging, while protective psychosocial characteristics (β = 0.22), most notably resilience, gratitude, and purpose in life, were most strongly positively related to these scores. Additional positive predictors of successful aging included White, non-Hispanic race, being married or living with partner, perceiving a positive effect of the military on one's life, active lifestyle, positive expectations regarding aging, and conscientiousness; additional negative predictors included substance abuse history.
  
  
  CONCLUSIONS
  Results of this study provide a dimensional approach to characterizing components and correlates of successful aging in older veterans. Interventions and policy initiatives designed to mitigate physical health difficulties and psychological distress and to enhance protective psychosocial characteristics such as resilience, gratitude, and purpose in life may help promote successful aging in this population.
authors.affiliation: National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale University School of Medicine, New Haven, CT. Electronic address: robert.pietrzak@yale.edu.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
authors.affiliation: VA New England Mental Illness, Research, Education, and Clinical Center, Veterans Affairs Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
authors.forename: Jack
authors.initials: J
authors.lastname: Tsai
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Kirwin
authors.affiliation: National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale University School of Medicine, New Haven, CT.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Southwick
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D055500:Resilience, Psychological; D057566:Self Report; D013315:Stress, Psychological / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Successful aging; functioning; medical; psychiatric; resilience; veterans