Life review in advanced age: qualitative research on the 'start in life' of 90-year-olds in the Lothian Birth Cohort 1921

Background: This research report presents findings on 'start in life' from a qualitative study of 90-year-olds from the Lothian Birth Cohort 1921. The study aimed to contextualise the LBC1921 cohort in time and place, describe cohort members' experiences of family and schooling and stimulate further inquiry into the relationships between 'start in life' and risk and resilience factors relating to longevity and healthy ageing. Scottish education and family life in the early 1930s are briefly described.

Methods: Life review questionnaire: A qualitative Life Review Questionnaire was developed, requiring free-text handwritten responses. Its 'Start in Life' section focused on schooling and family support.

Sample: Wave 4 of the Lothian Birth Cohort 1921 involved testing 129 members near to their 90(th) birthday. They reside largely in Edinburgh and its environs. The Life Review Questionnaire was administered to 126 participants, 54 % women. Qualitative analysis: Thematic analysis was the qualitative technique used to categorise, code and extract meaning from questionnaire text. Narratives were extracted from the data to present illustrative stories.

Results: Narratives of start in life gave contextual description. Thematic analysis showed LBC1921 members enjoying their schooling, highlighting teachers, academic achievement, school activities and school friendships. Personal qualities, family circumstances and aspects of schooling sometimes hindered educational performance. Family life was recalled mostly with warmth and parents were often portrayed as valuing education and supporting learning and development. Family adversity from poverty, parental illness and parental death was often mitigated by support from parents (or the remaining parent). Overall, most cohort members believed that they had got off to a good 'start in life'.

Conclusions: This qualitative investigation of 'start in life' adds context and richness to quantitative investigations of the sizeable LBC1921 cohort, stimulating fresh insights and hypotheses into the relationship between child risk and resilience factors that may influence ageing. It demonstrates the utility and wider application of the Life Review Questionnaire. Although the surviving cohort is not representative of their childhood peers, their words provide insight into the processes of weaving experience and memory into a rich texture of meanings that may help create wellbeing across a lifetime.