A Salutogenic Analysis of the Well-Being Paradox in Older Age

Following Antonovsky's salutogenic perspective, we investigate to what extent the sense of coherence and psychological resources mediate the physical health-mental health relationship, assuming that these resilience factors mutually influence each other. In our questionnaire study, 387 older persons at the mean age of 73.8 years volunteered. We assessed physical health appraisals, sense of coherence components (comprehensibility, manageability, and meaningfulness), psychological resources (self-efficacy and self-esteem) and mental health (subjective well-being, depressive mood, and psychological health). We used structural equation modeling with latent variables and a bootstrapping method to test hypothesized mediation chains. We found (a) a significant direct effect of physical health on mental health, (b) two significant specific indirect effects of physical health on mental health, substantiating that the sense of coherence was a stronger mediator than psychological resources, and (c) two significant 3-path mediated effects. Physical health is profoundly associated with mental health. However, resilience factors such as the sense of coherence and psychological resources enable older people to maintain mental health when confronted with chronic physical health problems.