Table 1.
Study characteristics of the included studies and measures used.
| No. | Study ID | Country | Setting | Design | Population | Number of Participants | Outcome Measures |
|---|---|---|---|---|---|---|---|
| 1 | Gerwood (1996) [39] | USA | Community, senior citizen centers | Cross sectional | Older adults 65 and above | n = 130 | Demographic questionnaire, CEDS, and the 20-items Purpose in Life scale (by Crumbaugh and Maholick, PIL Test-C). |
| 2 | * Gerwood et al. (1998) [40] | USA | Community, senior citizen centers | Cross sectional | Older adults 65 and above | n = 130 | Demographic questionnaire (for Spirituality) and PIL Test-C (20-items). |
| 3 | Bondevik and Skogstad (2000) [41] | Norway | Community and nursing home | Cross sectional | Older adults: 80 years and above | n = 110 for older adults from community; N = 111 those from nursing homes | Short Form Scale of the Revised UCLA Loneliness Scale; PIL test-C (20-items); A single item to measure religiosity (Would you say that religion means anything to you?) |
| 4 | Greenfield and Marks (2004) [42] | USA | Community | Cross sectional | Older adults 65–74 years | n = 373 | Negative and positive affect scale; Ryff’s PWB Index (3-item); Major role-identity absences questionnaire. |
| 5 | Frazier et al. (2005) [43] | USA | Community: Senior centers, and public service organizations. | Cross sectional | Older adults 65 and above | n = 86 | Multidimensional Measure of Religious Involvement for African Americans; Ryff’s PWB scale (14-item). |
| 6 | Nygren (2005) [44] | Sweden | Community | Cross sectional | Older adults 85 years of age or older | n = 125 n = 26 participants were 95 years or older, n = 46 were 90 years of age, and n = 53 were 85 years of age |
The Swedish version of the PIL Scale-C (20-item); The Resilience Scale; SOC Scale: STS; SF-36 Health Survey. |
| 7 | Cicirelli (2006) [45] | USA | Community | Cross sectional | Older adults: young old group (60–74 years) and mid old group (75–84 years) | n = 192; young-old group n = 132 and mid-old group n = 60. | Self-rating of health, 2-items scale for Discrepancy between expected and desired time to live; PIL Scale-C (20-items); MFDS. |
| 8 | Dixon (2007) [46] | USA | Community (retirement community) | Cross sectional | Older adults above 70 years | n = 167 | Interpersonal Mattering Scale; 20-item PIL Test-C; Short version of the Geriatric Depression Rating Scale; Older Adult Wellness Evaluation. |
| 9 | Triado et al. (2007) [47] | Spain | Community, retired individuals | Cross sectional study | Retired persons ages 65 and older | n = 422; n (men) = 200 n (women) = 222 |
Spanish version of the Ryff’s PWB Scale (9-items); Spanish version of Life Satisfaction Index; Philadelphia Geriatric Scale. |
| 10 | Moon and Mikami (2007) [48] | Japan | Community | Cross sectional | Older adults 65 years of age or older | n = 425 (n = 204 ethnic Korean residents; n = 221 for Japanese residents) | CGA for Activities of Daily Living, TMIG Index of Competence, short version of GDS-15 in Japanese and Korean visual horizontal analogue scale items to capture “sense of purpose in life”, self-reported medical history, and receipt of public assistance. |
| 11 | Ottenbacher et al. (2007) [49] | USA | Hospitalized inpatient sample (acute cases) | Cross sectional study | Older adults 65 years of age or older | n = 40 | Ryff’s PWB scale (9-items) |
| 12 | Hedberg et al. (2009) [50] | Sweden | Community: town and rural areas | Qualitative | Women aged 85 and above | n = 30 women | PIL Test-C (20-items) for screening and the qualitative interview included various aspects of their lives, such as experiences of aging; difficult and positive life events; and experiences of loneliness, comfort, spirituality, and purpose in life. |
| 13 | Krause (2009) [51] | USA | Community | Cohort study | Older adults above 65 years | n = 1361 | Informant report for mortality status; MIL scale (2-items for PIL); Self-rated health; Acute and chronic health conditions check list; Questions on Functional disability and Frequency of attendance at religious services; Emotional support scale. |
| 14 | Ferguson and Goodwin (2010) [52] | Australia | Community retirement villages, volunteer organizations and community organizations | Cross sectional | Older adults 65 to 94 years | n = 225 | PIL subscale (14-items) of Ryff’s PWB scale; Affect Balance Scales (5-item subscale of Positive Affect scale); Revised Life Orientation Test (Dispositional optimism); The Social Support Questionnaire; Short Form. A scale (perceived control). |
| 15 | Hedberg et al. (2010a) [53] | Sweden | Community: town and rural areas | Longitudinal cohort | Elderly above 85 years | n = 149; women n = 88, men n = 61 | GDS-15; OBS; OBS Scale; MADRS; DSM-IV; PIL Test-C (20-items). |
| 16 | Hedberg et al. (2010b) [54] | Sweden | Community: town and rural areas | Cross sectional | Elderly between 85 to 103 years of age. | n = 189; women n = 120, men n = 69 | PIL Test-C (20-item); PGCM scale; GQL instrument; SF-36 Health survey; Katz Activity of Daily Living Index; sociodemographic questionnaire (social relations). |
| 17 | Hedberg et al. (2011) [55] | Sweden | Community: town and rural areas | Longitudinal study cohorts | Elderly above 85 years | n = 51 (42 women and 9 men) | PIL Test-C (20-item); GDS; The Minimal Nutritional Assessment; The Barthel Index for ADL (for PA), The Mini-Mental State Examination. |
| 18 | Lundman et al. (2012) [56] | Sweden | Community | Cross-sectional | Older adults 85 years and above | n = 185 | The Swedish version of the PIL Scale-C; The Resilience Scale; SOC scale; STS scale; GDS-15; ADL scale; Self-reported measures for Living Arrangements and Social Relationships. |
| 19 | Hedberg et al. (2013) [57] | Sweden | Community: town and rural areas | Qualitative | Men above 85 years | n = 30 | Interviews included questions about various aspects of their experiences of becoming and being very old. |
| 20 | Wilson et al. (2013) [58] | USA | Community (retirement communities, subsidized housing facilities, local churches, and social service agencies) | Cohort study | Older adults aged 65 years or older. | n (initial) = 1049 n (additional analysis) = 560 |
Ryff’s PWB scale (10-items; annually); Between 2008 and 2011, 18-item version of Ryff’s PWB Scales administered once to a subgroup; Cognitive tests for annual measures Episodic Semantic, working memory; Perceptual speed and Visuospatial ability; Guidelines of the joint working group of NINDS and SARDA; CESD; Katz disability scale. |
| 21 | Pearson et al. (2013) [59] | Australia | Community | Cohort study | Older adults aged 55 years of age or older | n = 545, 55–64 years n = 300, 65–74 years n = 167, 75 years and older n = 74 |
LET (6-items) |
| 22 | Zaslavsky et al. (2014) [26] | USA | Community | Cohort study | Women 85 years and older | n = 8880 | All chronic conditions and disability (except diabetes) were diagnosed by a clinician while diabetes was captured based on self-report; Ryff PWB scale (7-item); Keyes scale for PG. |
| 23 | Windsor et al. (2015) [60] | Australia | Community | Cohort study Longitudinal |
Older adults aged 65 and above. | n = 1475 | PIL subscale from Ryff’s PWB scale (3-item); Items on Functional disability (sum of two mobility items and five items assessing difficulties with physical movement and lifting/ handling objects); Single item on self-rated health; CESD scale; Digit Symbol Substitution subscale of the revised WAIS (speed of processing); Boston Naming Task for episodic memory. |
| 24 | Tomioka et al. (2016) [61] | Japan | Community | Cohort study | Older adults aged 65 and older | n (total, mortality study) = 1853 n (ADL study) = 1556 n (IADL study) = 1399 |
Barthel index for ADL; TMIG Index of Competence; Single item for PIL; CPS for cognitive functions; GDS; Information about mortality, death and migration were obtained from the Shimoichi Town Hall; vital statuses of the participants were determined through the residential registration cards and death certificates. |
| 25 | Woods et al. (2016) [62] | USA | Community | Cohort study | Women 80 years and older | n = 26,704 | ADL scale, major causes of morbidity, Perceived Health Scale. And questionnaire on Independent living and physical function for measuring successful aging; BRS; Self-Mastery; Confidence, Environmental Mastery and Self-control for effective aging; Optimal aging measured using emotional Well-being Scale and asking “Have you been happy” and “you enjoyed life most of the time”; Satisfaction with Life Scale, Positive Relations (Social Support Scale) and Satisfaction with Current QOL. Eudemonic well-being measured using PG subscale and PIL Subscale (8-items) from Ryff’s PWB Scales. |
| 26 | Sano (2016) [63] | Japan | Community, day-service centers | Cross-sectional | Older adults. No age limits specified. Mean age of participants was 77.1 + 8.7 years old |
n = 281 n (male) = 127, n (female) = 154 |
SAMR and SOPI for Achievement motive; K-1 scale for PIL (16-items); Role expectation checklist. |
| 27 | Cook Maher et al. (2017) [64] | USA | Community | Longitudinal study cohorts | Older adults above 80 years | n = 50; Super agers n = 31, cognitively average older adults n = 19 | Ryff’s PWB questionnaire (42-items). |
| 28 | Vanhove-Meriaux and Claude (2018) [65] | France | Community, non-nursing home | Cross-sectional study | Older adults, age 65 years and older | n = 182 n (women) = 102 n (men) = 80 |
Subscales of the French version of the Psychological Need Thwarting Scale—Older Adults; Psychological needs satisfaction was measured using three different questionnaires; French version of the Ryff’s PWB scales (14-items); French version of the subjective vitality scale; French version of the Rosenberg self-esteem Scale; French versions of the Positive and Negative Affect Schedule; French version of the GDS. |
| 29 | Musich et al. (2018) [66] | US | Community | Cross sectional | Older adults 65 years of age or older | n = 4563 | NIH Tuberculosis Meaning and Purpose Scale Age 18+ (7-items) for PIL; BRS; ISEL; Self-reported measures on HL and reliance on faith; Health care utilization, compliance and expenditures measured through claims submitted, adherence to treatment protocol or medication adherence; Veteran’s RAND 12-item QOL scale. |
| 30 | Orang et al. (2018) [67] | Iran | Community | Cross sectional | Young (aged 17–25 years), middle-aged (aged 26–46 years), and older adults (aged 65–80 years) | n = 215 n = 84 young (aged 17–25 years), n = 59 middle-aged (aged 26–46 years), and n = 72 older adults (aged 65–80 years) | Stareg’s MIL Scale; Ryff’s PWB scale. |
| 31 | Polenick et al. (2018) [68] | USA | Community | Cross sectional | Older adults 65 years of age or older | n = 315 | PIL subscale of Ryff’s PWB scale (1-item); Self-reports for Caregiving difficulties and gender. |
| 32 | Kim et al. (2019) [22] | South Korea | Community | Cross sectional | Older adults above 50; Age groups 50–59 years, 60–69 years, 70–79 years, 80 and above. | N = 11,525 | PIL was measured through a modified scale created by combining five items from the Ryff Measures of Psychological Wellbeing and two additional items from Personal Growth and Self-Acceptance. |
| 33 | Oliveira et al. (2019) [69] | Brazil | Community | Cross sectional | Older adults 60 years of age or older | n = 92; n = 61 were 60–69 years old n = 31 were 70 years old or over | Sociodemographic questionnaire (use of medicine, patterns of PA, et c); The Satisfaction with Life Scale; Ryff PWB scale (10-item). |
| 34 | Poulos et al. (2019) [70] | Australia | Community | Mixed methods | Older adults 65 years of age or older | n = 127 | Open-ended questions; WEMWBS; measures for Frailty; Focus group interviews |
| 35 | Sutin et al. (2020) [71] | USA | Community | Cross-sectional and longitudinal multi-cohort design | HRS: American and their spouses, 65 years and above NHATS: Participants aged 65 years and above from Medicare beneficiaries | Baseline sample: n = 6785 in HRS, n = 5665 in NHATS longitudinal sample: n = 4616 in HRS, n = 2877 in NHATS | HRS measured PIL using Ryff’s PWB scale (7-items) while NHATS used a single item; TICSm for cognitive function in HRS while sum of 3 tasks (memory, orientation and executive functions) in NHATS; HRS use 26 item version of MDI, NHATS use 10 item version of MDI; CESDS and PHQ-2; chronic conditions checklist of 7 conditions; Single items for PA. |
| 36 | Tkatch et al. (2020) [72] | USA | Community | Longitudinal cohort | Older adults above 65 years old | n (T1) = 216 n (T1 + 2) = 168 n (T1 + 2 + 3) = 125 |
HCC risk score for Clinical health status; Veteran’s RAND(VR-12); short version of the UCLE Loneliness Scale; BRS; NIH Tuberculosis Meaning and Purpose Scale Age 18+ (7-item); LOT-R for optimism. |
| 37 | Vanhove-Meriaux and Ferrand (2020) [73] | France | Community | Cross-sectional study | Older adults, above 65 years older | n = 154 | French version of the PNFS-OA (BPNF); French version Ryff’s PWB scale (14 items); French version of the subjective vitality scale; PANAS; French version of the Rosenberg Self-Esteem. |
| 38 | Lewis et al. (2020) [74] | Canada | Community, Retirement individuals | Qualitative study | Older adults between the ages of 71 and 94 years (mean = 85.22 years) | n = 18 | PIL sub-section of Ryff’s PWB scale (7-items); IADL Scale; Perceived Isolation Scale; GDS. |
| 39 | Lopez et al. (2020) [75] | Spain | Community | Cross sectional | Young-old (60–70 years) and Old-old (71–80 years). | n = 878 | The Family APGAR; BRCS; Gratitude subscale of the Values in Action Inventory of Strengths-Short Form; AAQ-II; PG and PIL subscale of Ryff’s PWB scale (6-items). |
| 40 | Matud et al. (2020) [76] | Spain | Community | Cross sectional | Older adults 65 years of age or older | n = 1201 | Spanish version of the Ryff’s PWB Scale (38-items (6 items for PIL)); scales of masculinity and femininity of the BSRI; Spanish version of the York Self-Esteem Inventory; Social Support Scale. |
| 41 | Bundick et al. (2021) [77] | USA | Community | Cross sectional | Older adults of 2 age groups 50–64 (midlife sample), and 65 and older (later life sample). | n = 1198; midlife sample: n = 799; later life sample n = 399. |
WHO-HPQ; A new survey measure (10 items on a 5-point scale) for PIL and Purpose in Life (PIL) subscale of Ryff’s PWB scales (9-items); Empathic Concern subscale of Davis’s Interpersonal Reactivity Index (IRI). LGS for Generativity; GQ-6 for gratitude; Satisfaction with Life Scale; PGIS; BWSS. |
| 42 | Alfonso-Benlliure et al. (2021) [78] | Spain | Community | Cross sectional | Aged 65 years or older. | n = 152 | MMSE for cognitive impairment; CESDS; TCI-A; Ryff’s PWB scale (items not reported). |
| 43 | Musich et al. (2021) [79] | USA | Community | Cross-sectional | At least 65 years of age with minimum of 12 month continuous medical plan enrolment (AARP Medicare Supplement Insured) | n = 3573 | LET (6-items); BRS; LOT-R; Wallston’s MHLC scale; Social Network Index; PHQ-2; Veterans Rand-12 (VR-12); Healthcare utilization and expenditure captured from administrative medical claims as IP admissions or ER visits and paid medical claims within the one-year pre-survey period. |
| 44 | Zhang and Chen (2021) [80] | USA | Community | Cohort study | Older adults 65 years and older | n (T1) = 4591 n (T2) = 3687 n (T3) = 2818 |
Three items assessing the frequency of PA (vigorous, moderate and light-intensity PA); PIL subscale from Ryff’s PWB scale (7 items). |
* Secondary analysis of Gerwood (1996). CEDS: The Centre for Epidemiologic studies Depression Scale; PIL Test-C: Purpose in Life scale (by Crumbaugh and Maholick); Ryff’s PWB scale: Ryff’s Psychological Well-Being scale; SOC scale: The Sense of Coherence Scale; STS: The Self-Transcendence Scale; MFDS: Multidimensional Fear of Death Scale; CGA: Comprehensive Geriatric Assessment; MIL: Meaning in Life; TMIG: Tokyo Metropolitan Institute of Gerontology Index; GDS-15: Geriatric Depression Scale; OBS scale: The Organic Brain Syndrome scale; MADRS: The Montgomery–Asberg Depression Rating Scale; DSM-IV: Diagnostic and Statistical Manual of Mental Disorders-IV; PGCM: The Philadelphia Geriatric Centre Morale; GQL: Gothenburg Quality of Life; PA: Physical Activities; ADL: Activities of Daily Living; PG: Personal Growth; WAIS: Wechsler Adult Intelligence Scale; NINDS: National Institute of Neurological Disorders and Stroke; SARDA: Stroke and the Alzheimer’s disease and Related Disorders Association; LET: Life Engagement Test; CPS: Cognitive Performance Scale; BRS: Brief Resilience Scale; SAMR: Scale for Achievement Motive in Rehabilitation; SOPI: Self-completed Occupational Index; NIH: National Institutes of Health; ISEL: Interpersonal Support Evaluation List, HL: Health Literacy; WEMWBS: Warwick–Edinburgh Mental Health and Well-Being Scale; HRS: Health and Retirement Survey; NHATS: National Health and Aging Trends Survey; TICSm: Telephone Interview for Cognitive Status, modified version; MDI: Midlife Development Inventory; PHQ: Patient Health Questionnaire; HCC: Hierarchal Condition Category; LOT-R: Life Orientation Test-Revised; BPNF: Basic Psychological Need Frustration; PNFS-OA: Psychological Need Frustration Scale for Older Adults; PANAS: Positive and Negative Affect Schedule; IADL: Instrumental Activities of Daily Living; BRCS: Brief Resilient Coping Scale; AAQ-II: The Acceptance and Action Questionnaire—II; BSRI: Bem Sex Role Inventory; WHO: World Health Organization; HPQ: Health and Performance Questionnaire; IRI: Interpersonal Reactivity Index; LGS: Loyola Generativity Scale; GQ-6: Gratitude Questionnaire-Six; PGIS: Personal Growth Initiative Scale; BWSS: Brief Wisdom Screening Scale; MMSE: Mini-Mental State Examination; TCI-A: Test of Creative Imagination for Adults; MHLC: Multidimensional Health Locus of Control.