Harkness, Frances Helen; (2021) Mastery in early old age: life course influences and its association with physical capability in the MRC National Survey of Health and Development. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Mastery is one of many related constructs indicating the sense of control a person believes they hold over their own life; associated with multiple aspects of health and wellbeing. Despite this, factors contributing to differences in mastery, and its adaptive mechanism, remain poorly understood. This thesis used a life course approach to investigate how factors across life contribute to mastery and to examine associations between mastery and physical capability in early old age. Data from the MRC National Survey of Health and Development (NSHD) were used. NSHD is a nationally representative sample of 5362 males and females, born in England, Scotland and Wales in March 1946 and followed up to 24 times across life. Mastery was assessed at age 68-9 (n=2038). Groups of socioeconomic and psychosocial resources across life were tested through linear regression. Associations between mastery and physical capability (physical performance scores, and functional limitations) at age 69-70 were tested using linear and ordinal logistic regressions. The early life factors (pre- age 16) of stressful life events (SLEs), perceived parental psychological control, weaker parental support, and poorer cognitive ability were associated with lower mastery in early old age (Chapter 3). Factors across adulthood were also associated with mastery (Chapter 4); higher occupational position (age 53), a higher accumulation of SLEs between 26 and 69, and contemporaneous factors such as lower social support, less comfortable income perception, and poor health. The positive association between mastery and physical capability was partially explained by fewer fears about falling, rather than more proactive health behaviours (Chapter 5). Finally, mastery was an effect modifier, buffering the association between physical performance and functional limitations; although not for more advanced disability (Chapter 6). Better understanding of the socioeconomic and psychosocial pathways across life, which relate to mastery, along with deeper understanding of the mechanism between mastery and physical capability, provides opportunities to intervene to support individuals to have greater mastery and maintain, or minimise losses to, their physical capability and independence in early old age.

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