Spirituality and Aging

Helen Lavretsky

Disclosures

Aging Health. 2010;6(6):749-769. 

In This Article

Research on Spirituality

The challenges that research on spirituality and religion face include logistical and funding limitations, but also the ambiguity of defining and measuring spirituality and religiosity.

There are very few well-designed large-scale studies. Many publications are purely anecdotes or editorials, which can stimulate discussion but cannot establish causality or scientifically justify the use of specific interventions.[157] The majority of existing studies are correlational, which may be plagued by spurious findings. For example, in a systematic review of studies from 1996 to 1999, Townsend and colleagues counted nine randomized controlled trials.[158] Hopefully, with increasing interest in spirituality and mind, the number and sophistication of scientific studies should continue to improve.[158]

Some of the inherent challenges of defining and measuring spirituality lie in separating religiosity and spirituality,[159,160] which is particularly important in studying participants who consider themselves spiritual but not religious. Subjects may be unwilling to alter their religious beliefs or practices for a study with a design that uses a particular spiritual practice. Monitoring of practice adherence or correct performance of a subject may become a problem. In these cases, a subject inadvertently may be noncompliant.

The use of accurate and valid measures of religiosity and spirituality is very important, with different rating scales identifying subjective and objective measures of either. The use of daily diaries can be helpful to track compliance with daily practices. When considering the direct effects of religious or spiritual activities on one's health, it is important to consider secondary effects, such as an increase in social support, social activities leading to improved chances of finding a life partner, or chances for better healthcare. Establishing the direction of causality can be challenging. For example, health status can influence whether a person can participate in a religious activity. Practices and doctrines can vary among different religions and denominations. Local environments can influence the status of religious movement and add stress if a particular religion is an object of persecution. It is not entirely clear what the proper duration of the spiritual intervention should be, such as prayer, yoga or meditation, all of which may have immediate or delayed effects on physiological measures, such as blood pressure or markers of inflammation. Multidisciplinary research, although necessary, can be challenging because of the differences in definitions and motivations. Some of the scientific approach limitations include failure to control for confounding variables and other covariates, as well as to control for multiple comparisons using multiple statistical procedures, which can lead to the biased estimation of an association.[161]

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