title: Regional resources buffer the impact of functional limitations on perceived autonomy in older adults with multiple illnesses.
abstract: Retaining perceptions of autonomy is a key component of successful aging. Perceived autonomy refers to the capacity to make and enact self-directed decisions. These perceptions are often threatened in older adults with multiple illnesses, when functional limitations resulting from these illnesses impede the enactment of self-directed decisions. Regional resources (in Germany specifically at the level of administrative districts) might counteract these impediments of autonomy. Economically stronger districts can provide more-concrete support resources for older adults, buffering the negative effect of functional limitations on self-perceived autonomy. This study assessed participants aged over 65 with 2 or more chronic conditions. In total, N = 287 provided data (Mage = 73.3, SD = 5.07), and n = 97 were women. Gross domestic product (GDP) per capita was used as a proxy measure of administrative district wealth in Germany. Hierarchical multilevel regression analyses with cross-level interactions were conducted. Results suggest that the detrimental effect of functional limitations on perceived autonomy is less pronounced for participants residing in higher GDP districts. Conversely, for participants in lower GDP districts, the effect is exacerbated. This finding suggests that districts with greater financial resources might be better able to invest in supports that promote and facilitate autonomy and, thus, provide a buffer against threats to individual perceived autonomy.
authors.affiliation: School of Medicine, Division of Psychology, University of Tasmania.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schüz
authors.affiliation: School of Medicine, Division of Psychology, University of Tasmania.
authors.forename: Josh N
authors.initials: JN
authors.lastname: Westland
authors.affiliation: Institute for Psychogerontology, Friedrich-Alexander-University.
authors.forename: Susanne
authors.initials: S
authors.lastname: Wurm
authors.affiliation: German Centre of Gerontology.
authors.forename: Clemens
authors.initials: C
authors.lastname: Tesch-Römer
authors.affiliation: German Centre of Gerontology.
authors.forename: Julia K
authors.initials: JK
authors.lastname: Wolff
authors.affiliation: Health Psychology, Freie Universität Berlin.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Warner
authors.affiliation: Institute for Positive Psychology and Education, Australian Catholic University.
authors.forename: Ralf
authors.initials: R
authors.lastname: Schwarzer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D002908:Chronic Disease / Q000191:economics / Q000523:psychology*; D005260:Female; D005858:Germany; D059066:Gross Domestic Product; D006801:Humans; D008297:Male; D055361:Multilevel Analysis; D026684:Personal Autonomy; D012649:Self Concept