51
|
Browne-Yung K, Walker RB, Luszcz MA. An Examination of Resilience and Coping in the Oldest Old Using Life Narrative Method. THE GERONTOLOGIST 2017; 57:282-291. [PMID: 26511273 DOI: 10.1093/geront/gnv137] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 08/04/2015] [Indexed: 11/13/2022] Open
Abstract
We aimed to identify aspects of late-life resilience and sense of self-identity and locate them within a life narrative to provide insights into methods of coping with the challenges of aging. To do this, in-depth interviews were conducted with 20 oldest-old adults (aged 88-98 years) recruited from the Australian Longitudinal Study of Ageing. Design, analysis, and interpretation of the study were informed by McAdams' life narrative theory, using concepts of redemption and contamination. Participants discussed their autobiographies and recounted significant life events. Interviews drew on McAdams' approach to elicit positive, negative, vivid, and turning point experiences. Analysis involved coding transcripts of the emergent personal narratives specifically to understand a "resilience story." This included data immersion and review of interview transcripts. Emergent codes were identified and discussed among the researchers. Although no contamination events were narrated, we identified the following themes: Adapting to aging-related physical challenges; Changing social networks; Continuity in sense of identity to maintain unity and life's purpose; and Redemptive capacity to cope positively with life challenges. This study fills a gap in knowledge on resilience from a personal perspective by the oldest old. Older people may benefit from interventions that harness positive coping strategies and foster social connections and meaningful activities, especially at times of loss or grief.
Collapse
Affiliation(s)
- Kathryn Browne-Yung
- Flinders Centre for Ageing Studies.,Southgate Institute for Health, Society and Equity, and
| | - Ruth B Walker
- Disability and Community Inclusion Unit, Flinders University, Adelaide,South Australia
| | | |
Collapse
|
52
|
Nurius PS, Fleming CM, Brindle E. Life Course Pathways From Adverse Childhood Experiences to Adult Physical Health: A Structural Equation Model. J Aging Health 2017; 31:211-230. [PMID: 28845729 DOI: 10.1177/0898264317726448] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study examines pathways from adverse childhood experiences (ACEs) to physical health, directly and indirectly through lower income, health risk behaviors, social support, and adult adversity within a theoretical framework postulating stress proliferative and biological trajectories of cumulative adversity. METHOD Data were obtained from 12,549 adult respondents of a state Behavioral Risk Factor Surveillance System survey. Multigroup structural equation modeling elucidated pathways differentiated by sex and age (older/younger than 45). RESULTS Good model fit was achieved in each test, indicating consistency with stress theorizing that ACEs significantly contribute to poorer physical health through direct and mediated paths. Younger adults evidenced direct ACE pathway to poor health suggesting early biological erosion, whereas paucity of social support among older adults was directly associated. DISCUSSION Findings indicate that stress process roles in eroding physical health and experience of wellness. Addressing early adversity is an important strategy toward reducing preventable health problems.
Collapse
|
53
|
Carpentieri JD, Elliott J, Brett CE, Deary IJ. Adapting to Aging: Older People Talk About Their Use of Selection, Optimization, and Compensation to Maximize Well-being in the Context of Physical Decline. J Gerontol B Psychol Sci Soc Sci 2017; 72:351-361. [PMID: 28364519 PMCID: PMC5927091 DOI: 10.1093/geronb/gbw132] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 09/26/2016] [Indexed: 12/01/2022] Open
Abstract
Objectives: Selection, Optimization, and Compensation (SOC) may contribute to successful aging by helping older people maximize well-being in the context of physical decline. To explore this hypothesis, and to investigate the potential for narrative analysis to improve understanding of SOC, we analyze interviews conducted with 15 members of the 6-Day Sample, a cohort of Scots born in 1936. Method: Interviewees were chosen based on their physical function and well-being scores. Interviews were analyzed to investigate “SOC talk,” that is, older people’s talk about SOC behaviors in everyday life. Types and amounts of SOC talk were quantified, and talk was narratively analyzed. We hypothesized that older people who engaged in more SOC talk would have higher well-being. Results: Older people who engaged in high levels of SOC talk had high well-being despite low physical function. Those who engaged in little SOC talk had low well-being despite higher physical function. Discussion: The concept of successful aging is valuable in part because of its narrative quality: One must strive to keep one’s life story developing despite physical decline and other losses. We provide evidence, from the perspectives of older people themselves, of the ways in which SOC may play a role in that process.
Collapse
Affiliation(s)
| | | | - Caroline E Brett
- Liverpool John Moores University, UK
- MRC-BBSRC Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK
| | - Ian J Deary
- MRC-BBSRC Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, UK
| |
Collapse
|
54
|
Abstract
Quality of life (QoL) in the face of declining health, mobility, and social losses is a central issue for older adults. Our study examined changes in QoL over time for older adults residing in independent senior housing within continuing care retirement communities (CCRCs) and estimated how residents' social engagement during their first year influenced QoL over the next 4 years. Data were drawn from a 5-year panel study of 267 older adults who moved into senior housing within four CCRCs. Although initial QoL varied between individuals, QoL declined for the group over time. One component of early social engagement-participating in a greater number of formal social activities organized by the CCRC-significantly slowed the rate of decline in QoL. Findings suggest that senior housing residents may benefit from early participation in organized social and leisure activities soon after move-in to forestall declines in QoL over the long term.
Collapse
Affiliation(s)
- Amy Restorick Roberts
- 1 Department of Family Science and Social Work, Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Kathryn Betts Adams
- 2 Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| |
Collapse
|
55
|
Abstract
BACKGROUND Definitions of successful aging that incorporate dimensions of physical capacity and medical conditions are limited owing to the normative nature of experiencing medical conditions with age. We examine the capacity for older adults living in the community to live well with or without chronic disease as they age. METHOD Participants (n = 1,001) were from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) study who were aged 65+ years at baseline, were living in the community and followed for 16 years. RESULTS Aging was associated with not living well (OR = 1.21; p < 0.001) and having a chronic disease (OR = 1.09; p < 0.001). There was increasing proportion of older adults not living well with chronic disease as they aged. Those not living well were at a substantial risk of death with (OR = 3.63; p < 0.001) or without (OR = 3.59; p < 0.001) chronic disease. DISCUSSION The defining normative experience for older adults is that they are more likely to have a chronic disease and importantly not be living well with chronic disease as they age. However, it was the state of not living well that reflected the most substantial vulnerability for mortality, not chronic disease.
Collapse
|
56
|
Scharlach AE. Aging in Context: Individual and Environmental Pathways to Aging-Friendly Communities—The 2015 Matthew A. Pollack Award Lecture. THE GERONTOLOGIST 2017; 57:606-618. [DOI: 10.1093/geront/gnx017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Indexed: 12/17/2022] Open
|
57
|
Sapranaviciute-Zabazlajeva L, Luksiene D, Virviciute D, Bobak M, Tamosiunas A. Link between healthy lifestyle and psychological well-being in Lithuanian adults aged 45-72: a cross-sectional study. BMJ Open 2017; 7:e014240. [PMID: 28373254 PMCID: PMC5387968 DOI: 10.1136/bmjopen-2016-014240] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study uses a cross-sectional study design to analyse the connection between psychological well-being (PWB) and components of a healthy lifestyle in the Lithuanian population aged 45-72. The purpose of our study is to establish the links between PWB and lifestyle factors such as physical activity, smoking, alcohol consumption and dietary patterns in people above the age of 44. PARTICIPANTS A stratified sample of 10 940 urban citizens aged 45-72 years were randomly selected from the National Population Register. The response rate was 65%. METHODS PWB was evaluated by using a Control Autonomy Self-realization and Pleasure (CASP-12) questionnaire. The standard questionnaire included questions regarding the respondent's sociodemographic, socioeconomic and social status. The lifestyle questionnaire evaluated behavioural factors as smoking status, alcohol consumption, nutrition habits and physical activity. Objective measurements of cardiovascular disease (CVD) risk factors were taken. RESULTS Adjusted for sociodemographic, socioeconomic, social and biological CVD risk factors, the probability of higher PWB increased for physically active men and women and male former smokers. Higher PWB was directly associated with consumption of fresh vegetables and fruits. Responders who consumed potatoes, meat, boiled vegetables and eggs less frequently than average were more likely to have higher PWB. A direct association was ascertained between PWB and consumption of chicken and fish, as well as an inverse association between PWB and consumption of sweets in women. CONCLUSIONS Healthy lifestyle education efforts should focus on increasing physical activity, controlling smoking and improving diversity in healthy food consumption including the consumption of fresh vegetables and fruits, particularly among older adults with lower PWB.
Collapse
Affiliation(s)
- Laura Sapranaviciute-Zabazlajeva
- Health Psychology Department, Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Luksiene
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Virviciute
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Abdonas Tamosiunas
- Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| |
Collapse
|
58
|
Abstract
ABSTRACTIn this study we used individual differences concepts and analyses to examine whether older people achieve different ageing-well states universally or whether there are identifiable key groups that achieve them to different extents. The data used in the modelling were from a prospective 16-year longitudinal study of 1,000 older Australians. We examined predictors of trajectories for ageing well using self-rated health, psychological wellbeing and independence in daily living as joint indicators of ageing well in people aged over 65 years at baseline. We used group-trajectory modelling and multivariate regression to identify characteristics predicting ‘ageing well’. The results showed three distinct and sizeable ageing trajectory groups: (a) ‘stable-good ageing well’ (classified as ageing well in all longitudinal study waves; which was achieved by 30.2% of women and 28.0% of men); (b) ‘initially ageing well then deteriorating’ (50.5% women and 47.6% men); and (c) ‘stable-poor’ (not ageing well in any wave; 19.3% women and 24.4% men). Significant gender differences were found in membership in different ageing-well states. In the stable-poor groups there were 103/533 females which was significantly lower than 114/467 men (z-statistic = −2.6, p = 0.005); women had a ‘zero’ probability of progressing to a better ageing-well classification in later years, whilst males had a one-in-five probability of actually improving. Robust final state outcome predictors at baseline were lower age and fewer medical conditions for both genders; restful sleep and Australian-born for women; and good nutrition, decreased strain, non-smoker and good social support for men. These results support that ageing-well trajectories are influenced by modifiable factors. Findings will assist better targeting of health-promoting activities for older people.
Collapse
|
59
|
Abstract
Purpose Within public services there is a widely recognised role for workers who operate across organisational and professional boundaries. Much of this literature focusses on the organisational implications rather than on how boundary spanners engage with citizens. An increased number of public service roles require boundary spanning to support citizens with cross-cutting issues. The purpose of this paper is to explicate the emotional labour within the interactions that boundary spanners have with citizens, requiring adherence to display rules and building trust. Design/methodology/approach This is a conceptual paper which draws on illustrative examples to draw out the emotional labour within two types of boundary spanning: explicit and emergent. Findings Emotional labour theory offers a way to classify these interactions as requiring high, medium or low degrees of emotional labour. Boundary spanning theory contributes an understanding of how emotional labour is likely to be differently experienced depending on whether the boundary spanning is an explicit part of the job, or an emergent property. Originality/value Drawing on examples from public service work in a range of advanced democracies, the authors make a theoretical argument, suggesting that a more complete view of boundary spanning must account for individual-level affect and demands upon workers. Such a focus captures the "how" of the boundary spanning public encounter, and not just the institutional, political and organisational dimensions examined in most boundary spanning literatures.
Collapse
Affiliation(s)
- Catherine Needham
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - Sharon Mastracci
- Political Science Department, David Eccles School of Business, University of Utah, Salt Lake City, Utah, USA
| | - Catherine Mangan
- Institute of Local Government Studies, University of Birmingham, Birmingham, UK
| |
Collapse
|
60
|
Abstract
OBJECTIVES Successful aging continues to be applied in a variety of contexts and is defined using a number of different constructs. Although previous reviews highlight the multidimensionality of successful aging, a few have focused exclusively on non-biomedical factors, as was done here. METHODS This scoping review searched Ovid Medline database for peer-reviewed English-language articles published between 2006 and 2015, offering a model of successful aging and involving research with older adults. RESULTS Seventy-two articles were reviewed. Thirty-five articles met the inclusion criteria. Common non-biomedical constructs associated with successful aging included engagement, optimism and/or positive attitude, resilience, spirituality and/or religiosity, self-efficacy and/or self-esteem, and gerotranscendence. DISCUSSION Successful aging is a complex process best described using a multidimensional model. Given that the majority of elders will experience illness and/or disease during the life course, public health initiatives that promote successful aging need to employ non-biomedical constructs, facilitating the inclusion of elders living with disease and/or disability.
Collapse
Affiliation(s)
- Lisa F Carver
- Department of Sociology, Queen's University Kingston, ON, Canada
| | - Diane Buchanan
- School of Nursing, Queen's University Kingston, ON, Canada
| |
Collapse
|
61
|
Zambianchi M, Carelli MG. Positive Attitudes towards Technologies and facets of Well-being in Older Adults. J Appl Gerontol 2016; 37:371-388. [DOI: 10.1177/0733464816647825] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The current study investigates the relevance of positive attitudes toward Internet technologies for psychological well-being and social well-being in old age. A sample of 245 elderly people ( Mean age = 70; SD =9.1) filled in the Psychological Well-Being Questionnaire, the Social Well-Being Questionnaire, and Attitudes Toward Technologies Questionnaire (ATTQ). Favorable attitudes toward Internet technologies showed positive correlations with overall social well-being and all its components with the exception of social acceptance. Positive correlations with overall psychological well-being and two of its components, namely, personal growth and purpose in life, were also found. Two hierarchical multiple regression models underscored that positive attitudes toward Internet technologies constitute the most important predictor of social well-being, and it appears to be a significant predictor for psychological well-being as well. Results are discussed and integrated into the Positive Technology theoretical framework that sustains the value of technological resources for improving the quality of personal experience and well-being.
Collapse
|
62
|
Ye M, Chen L, Kahana E. Mealtime Interactions and Life Satisfaction Among Older Adults in Shanghai. J Aging Health 2016; 29:620-639. [DOI: 10.1177/0898264316641080] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: We examined the association between older adults’ mealtime interactions at senior centers in Shanghai and their life satisfaction. Competing hypotheses, derived from socioemotional selectivity theory and activity theory, were tested. Method: Data were obtained from the 2011 Shanghai senior center service utilization survey ( N = 320). Relationships between respondents’ mealtime interactions and life satisfaction were tested using multilevel regression modeling. Results: After adjusting for demographics, interactions with tablemates (companionship, self-disclosure, and instrumental support) were positively associated with respondents’ life satisfaction. These associations varied by senior centers. However, the number of tablemates was not significantly associated with respondents’ life satisfaction. Discussion: Findings support the activity-theory-based hypothesis that mealtime interactions are related to older adults’ life satisfaction independent of the number of tablemates. This study illuminates the value of social interactions in the context of community dining programs for the rapidly increasing older population in urban China.
Collapse
Affiliation(s)
- Minzhi Ye
- Case Western Reserve University, Cleveland, OH, USA
| | - Lin Chen
- Fudan University, Shanghai, China
| | - Eva Kahana
- Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
63
|
Lee JE, Kahana B, Kahana E. Social support and cognitive functioning as resources for elderly persons with chronic arthritis pain. Aging Ment Health 2016; 20:370-9. [PMID: 25806938 PMCID: PMC4583319 DOI: 10.1080/13607863.2015.1013920] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Arthritis pain and depression are prevalent physical and psychological disorders in late life and co-occur frequently. We explored the stability and covariation of arthritis pain and depressive symptoms. We also addressed the influence of cognitive functioning and social support on the relationship between pain and depressive symptoms among community-dwelling older individuals. METHOD This longitudinal study utilized a sample of 299 residents of Florida retirement communities who participated in a long-term panel study using yearly assessments across 4 years. Using multilevel modeling, we modeled the individual differences as well as stability in arthritis pain and depressive symptoms simultaneously. Further, we tested the role of cognitive functioning and social support in the association between arthritis pain and depressive symptoms. RESULTS We found substantial within-person variation in both pain and depressive symptoms (between 58% and 65%) across 4 years even after controlling for a time effect. After controlling for arthritis pain, persons with higher social support and higher cognitive functioning reported lower levels of depressive symptoms. DISCUSSION Findings suggest that fluctuations in pain and depressive symptoms are common for older adults. Furthermore, social support and intact cognitive functioning may serve as useful resources, as they buffer the negative impact of arthritis pain on depressive symptoms.
Collapse
|
64
|
Abstract
OBJECTIVE This paper aims to explore the concept and determinants of successful ageing as they apply to psychiatrists as a group, and as they can be applied specifically to individuals. CONCLUSIONS Successful ageing is a heterogeneous, inclusive concept that is subjectively defined. No longer constrained by the notion of "super-ageing", successful ageing can still be achieved in the face of physical and/or mental illness. Accordingly, it remains within the reach of most of us. It can, and should be, person-specific and individually defined, specific to one's bio-psycho-social and occupational circumstances, and importantly, reserves. Successful professional ageing is predicated upon insight into signature strengths, with selection of realistic goal setting and substitution of new goals, given the dynamic nature of these constructs as we age. Other essential elements are generativity and self-care. Given that insight is key, taking a regular stock or inventory of our reserves across bio-psycho-social domains might be helpful. Importantly, for successful ageing, this needs to be suitably matched to the professional task and load. This lends itself to a renewable personal ageing plan, which should be systemically adopted with routine expectations of self-care and professional responsibility.
Collapse
Affiliation(s)
- Carmelle Peisah
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, NSW, and; Discipline of Psychiatry, Sydney University Medical School, Sydney, NSW, and; Capacity Australia, Crows Nest, NSW, Australia
| |
Collapse
|
65
|
Park CL, Aldwin CM, Choun S, George L, Suresh DP, Bliss D. Spiritual peace predicts 5-year mortality in congestive heart failure patients. Health Psychol 2016; 35:203-10. [PMID: 26414488 PMCID: PMC4760860 DOI: 10.1037/hea0000271] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Spirituality is favorably related to depression, quality of life, hospitalizations, and other important outcomes in congestive heart failure (CHF) patients but has not been examined as a predictor of mortality risk in this population. Given the well-known difficulties in managing CHF, we hypothesized that spirituality would be associated with lower mortality risk, controlling for baseline demographics, functional status, health behaviors, and religiousness. METHOD Participants were 191 CHF patients (64% male; M age = 68.6 years, SD = 10.1) who completed a baseline survey and were then followed for 5 years. RESULTS Nearly 1/3 of the sample (32%) died during the study period. Controlling for demographics and health status, smoking more than doubled the risk of mortality, whereas alcohol consumption was associated with slightly lower risk of mortality. Importantly, adherence to healthy lifestyle recommendations was associated with halved mortality risk. Although both religion and spirituality were associated with better health behaviors at baseline in bivariate analyses, a proportional hazard model showed that only spirituality was significantly associated with reduced mortality risk (by 20%), controlling for demographics, health status, and health behaviors. CONCLUSIONS Experiencing spiritual peace, along with adherence to a healthy lifestyle, were better predictors of mortality risk in this sample of CHF patients than were physical health indicators such as functional status and comorbidity. Future research might profitably examine the efficacy of attending to spiritual issues along with standard lifestyle interventions.
Collapse
Affiliation(s)
| | - Carolyn M Aldwin
- Program in Human Development & Family Sciences, School of Social & Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University
| | - Soyoung Choun
- Program in Human Development & Family Sciences, School of Social & Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University
| | - Login George
- Department of Psychology, University of Connecticut
| | | | | |
Collapse
|
66
|
Rozanova J, Noulas P, Southwick SM, Pietrzak RH. Perceptions of Determinants of Successful Aging Among Older U.S. Veterans: Results from the National Health and Resilience in Veterans Study. Am J Geriatr Psychiatry 2015; 23:744-53. [PMID: 25488494 DOI: 10.1016/j.jagp.2014.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 08/26/2014] [Accepted: 09/12/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To conduct a qualitative study of older American veterans' subjective perceptions of factors that contribute to successful physical, emotional, and cognitive aging. METHODS A nationally representative sample of 2,025 veterans aged 60 or older (range: 60-96; 96.9% male, 39.4% combat veterans) participated in the National Health and Resilience in Veterans Study. Using qualitative analysis software, the authors coded responses to three open-ended questions, inductively developed categories, aggregated similar categories into factors, and grouped factors into broader themes. RESULTS A total of 53, 56, and 61 categories of responses was identified in response to questions about successful physical, cognitive, and emotional aging, respectively, with 10 aggregate factors linking these categories. The most prominent theme overall was "What you do," which received 2,295, 2,210, and 1,247 mentions for each of these domains of successful aging, with health behaviors the most common factor for both successful physical and cognitive aging and social engagement the most common for successful emotional aging. The theme "Who you are" was the second-most common factor (discerned from 376, 247, and 943 total mentions, respectively), with the factors that comprise this theme-personality and explanatory style, moral compass, and emotional dispositions-more commonly endorsed for successful emotional aging. External factors such as healthcare were least commonly endorsed across all domains. CONCLUSION Older U.S. Veterans emphasize health behaviors, social engagement, and dispositional characteristics as key determinants of successful aging. Prevention and treatment initiatives that target these potentially modifiable factors may help promote successful aging in this growing segment of the population.
Collapse
Affiliation(s)
- Julia Rozanova
- Department of Sociology, Yale University, New Haven, CT.
| | - Paraskevi Noulas
- VA Connecticut Healthcare System and Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Steven M Southwick
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder and Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder and Department of Psychiatry, Yale School of Medicine, New Haven, CT
| |
Collapse
|
67
|
Moore RC, Eyler LT, Mausbach BT, Zlatar ZZ, Thompson WK, Peavy G, Fazeli PL, Jeste DV. Complex interplay between health and successful aging: role of perceived stress, resilience, and social support. Am J Geriatr Psychiatry 2015; 23:622-32. [PMID: 25217186 PMCID: PMC4329284 DOI: 10.1016/j.jagp.2014.08.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 07/18/2014] [Accepted: 08/11/2014] [Indexed: 11/24/2022]
Abstract
Psychological and psychosocial resources, including resilience and social support, have traditionally been studied in the context of the stress paradigm and, more recently, in the context of successful aging. This study used moderated mediation analyses to examine the role of perceived stress in the relationships between physical and mental health functioning and self-rated successful aging (SRSA) and whether differences between people in level of resilience and social support changes the role of perceived stress in these relationships. A cross-sectional study of 1,006 older adults (mean age: 77 years) completed scales addressing SRSA, physical and mental health functioning, perceived stress, resilience, and social support. Results indicated that the strength of relationships between both physical and mental health functioning and SRSA were reduced after accounting for variation in level of perceived stress. The role of perceived stress in the association between mental health functioning and SRSA was found to be stronger among participants with the highest levels of resilience, and the influence of perceived stress on the degree of relationship between physical health functioning and SRSA was stronger among those with greatest social support. These findings suggest that interventions to reduce perceived stress may help break the link between disability and poor well-being in older adults. The findings further suggest that the impact of such interventions might differ depending on psychological resources (i.e., resilience) for mental health disabilities and external resources (i.e., social support) for those with physical health problems. The complex interplay of these factors should be taken into account in clinical settings.
Collapse
Affiliation(s)
- Raeanne C. Moore
- University of California San Diego Department of Psychiatry, La Jolla, CA
,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA
,Correspondence should be addressed to: Department of Psychiatry University of California, San Diego 9500 Gilman Drive (0993) La Jolla, CA 92093-0993
| | - Lisa T. Eyler
- University of California San Diego Department of Psychiatry, La Jolla, CA
,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA
| | - Brent T. Mausbach
- University of California San Diego Department of Psychiatry, La Jolla, CA
| | - Zvinka Z. Zlatar
- University of California San Diego Department of Psychiatry, La Jolla, CA
,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA
| | - Wesley K. Thompson
- University of California San Diego Department of Psychiatry, La Jolla, CA
,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA
| | - Guerry Peavy
- University of California, San Diego, Department of Neurosciences, La Jolla, CA
| | - Pariya L. Fazeli
- University of California San Diego Department of Psychiatry, La Jolla, CA
| | - Dilip V. Jeste
- University of California San Diego Department of Psychiatry, La Jolla, CA
,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA
| |
Collapse
|
68
|
Abstract
BACKGROUND In light of the demographic aging trend in Europe, investigation into successful aging is a public health priority. This paper describes the sense of coherence (SOC) of a sample of community-dwelling older adults in Spain and analyzes the relationship between SOC and both health and sociodemographic variables. SOC measures the extent to which an individual conceptualizes the world as comprehensible, manageable, and meaningful. Strong SOC may promote good health. METHODS The study followed a cross-sectional design involving a nationally representative sample of 1,106 community-dwelling adults aged 60 years and older in Spain. The sample was collected by geographically based proportional stratified sampling. RESULTS are based on responses to a questionnaire requesting sociodemographic information and including the following validated scales: SOC, Barthel index (BI), functional independence scale (FIS), personal wellbeing index (PWI), EQ-5D dimensions (mobility, personal care, daily activities, pain/discomfort, anxiety/depression), and the depression subscale of the hospital anxiety and depression scale (HADS-D). A multivariate linear regression model analyzed determinants of SOC. RESULTS Personal wellbeing (b = -0.32), depression (b = 0.26), and educational level (b = -0.06) were significant determinants of SOC. Lower SOC was associated with problems in all EQ-5D dimensions and moderate/severe disability as measured by the BI. CONCLUSIONS SOC in older adults is related to functional status, mental health status, personal wellbeing, and educational level. Public health initiatives should work to reduce the psychological and physiological impact of aging by focusing on the conditions that facilitate the coping of older adults.
Collapse
|
69
|
Abstract
OBJECTIVES The current study examined whether the link between stress and health-related quality of life was buffered by protective factors, namely mindfulness, in a sample of middle-aged and older adults. METHODS In this cross-sectional study, 134 healthy, community-dwelling adults (ages 50-85 years) were recruited from Dallas, TX. The participants were screened for depressive symptoms and severity (using the Patient Health Questionnaire [PHQ-9]). All participants completed measures of self-reported health status (i.e. SF36v2: mental and physical health composites), life stress (using the Elders Life Stress Inventory [ELSI]), and trait mindfulness (i.e. Mindful Attention Awareness Scale). RESULTS Hierarchical regressions (covarying for age, gender, and education) showed that life stress was inversely related to physical and mental health. Mindfulness was positively related to mental health. The negative effect of life stress on mental health was weakened for those individuals with higher levels of trait mindfulness. CONCLUSIONS The results suggest that mindfulness is a powerful, adaptive strategy that may protect middle-aged and older adults from the well-known harmful effects of stress on mental health.
Collapse
Affiliation(s)
- Cindy M. de Frias
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA,Corresponding author.
| | - Erum Whyne
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
| |
Collapse
|
70
|
Lee JE, Kahana E, Kahana B, Barnes K. Positive affect, depressive symptoms, and arthritis pain of elderly people over time. HEALTHY AGING RESEARCH 2015; 4:16. [PMID: 29399574 PMCID: PMC5792073 DOI: 10.12715/har.2015.4.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Older adults frequently experience physical symptoms of arthritis pain. We examined the dynamic change of arthritis pain and depressive symptoms over time. We also addressed the influence of time varying arthritis pain on depressive symptoms and positive affect among community dwelling older individuals. METHODS Analyses were based on data from 4 annual follow-ups in a sample of 299 elderly residents (M=83.78) of Florida retirement communities. We estimated a hierarchical growth curve model that related the effects of time varying pain and characteristics of participants such as age, gender, cognitive functioning, emotional support and health. Growth curve modeling was used to assess changes in emotional well-being as a function of arthritis pain over time. RESULTS We found that depressive symptoms increased over 4 years whereas positive affect declined over 4 years with significant between-person differences in levels and slopes. As predicted, changes in arthritis pain co-varied with both depressive symptoms and positive affect over time. Gender, cognitive functioning, health conditions and emotional support from others were associated with between person differences in level of emotional well-being. CONCLUSIONS Our findings suggest that conceptualization of emotional well-being of older adults as a dynamic, changing construct applies both depressive symptoms and positive affect. Findings also suggest that arthritis pain as well as emotional support contribute to depressive symptoms and to positive affect among older adults with arthritis.
Collapse
Affiliation(s)
- Jeong E. Lee
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Eva Kahana
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Boaz Kahana
- Cleveland State University, Cleveland, Ohio, USA
| | | |
Collapse
|
71
|
Martin P, Kelly N, Kahana B, Kahana E, Willcox BJ, Willcox DC, Poon LW. Defining successful aging: a tangible or elusive concept? THE GERONTOLOGIST 2015; 55:14-25. [PMID: 24840916 PMCID: PMC4542894 DOI: 10.1093/geront/gnu044] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 04/02/2014] [Indexed: 11/13/2022] Open
Abstract
PURPOSE OF THE STUDY Everyone wants to age successfully; however, the definition and criteria of successful aging remain vague for laypersons, researchers, and policymakers in spite of decades of research on the topic. This paper highlights work of scholars who made significant theoretical contributions to the topic. DESIGN AND METHODS A thorough review and evaluation of the literature on successful aging was undertaken. RESULTS Our review includes early gerontological definitions of successful aging and related concepts. Historical perspectives reach back to philosophical and religious texts, and more recent approaches have focused on both process- and outcome-oriented models of successful aging. We elaborate on Baltes and Baltes' theory of selective optimization with compensation [Baltes, P. B., & Baltes, M. M. (1990a). Psychological perspectives on successful aging: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 1-34). United Kingdom: Cambridge University Press], Kahana and Kahana's preventive and corrective proactivity model [Kahana, E., & Kahana, B. (1996). Conceptual and empirical advances in understanding aging well through proactive adaptation. In V. Bengtson (Ed.), Adulthood and aging: Research on continuities and discontinuities (pp. 18-40). New York: Springer], and Rowe and Kahn's model of successful aging [Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon Books], outlining their commonalities and differences. Additional views on successful aging emphasize subjective versus objective perceptions of successful aging and relate successful aging to studies on healthy and exceptional longevity. IMPLICATIONS Additional theoretical work is needed to better understand successful aging, including the way it can encompass disability and death and dying. The extent of rapid social and technological change influencing views on successful aging also deserves more consideration.
Collapse
Affiliation(s)
- Peter Martin
- Department of Human Development and Family Studies, Iowa State University, Ames.
| | - Norene Kelly
- Department of Human Development and Family Studies, Iowa State University, Ames
| | - Boaz Kahana
- Department of Psychology, Cleveland State University, Ohio
| | - Eva Kahana
- Department of Sociology, Case Western University, Cleveland, Ohio
| | - Bradley J Willcox
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu. Kuakini Medical Center, Honolulu, Hawaii
| | - D Craig Willcox
- Department of Human Welfare, Okinawa International University, Ginowan
| | | |
Collapse
|
72
|
Kahana E, Kahana B, Lee JE. Proactive approaches to successful aging: one clear path through the forest. Gerontology 2014; 60:466-74. [PMID: 24924437 DOI: 10.1159/000360222] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 02/03/2014] [Indexed: 11/19/2022] Open
Abstract
The importance of successful aging is increasingly acknowledged in the field of gerontology. In this paper we contribute to ongoing efforts to clarify and operationalize this concept by presenting our revised Comprehensive Preventive Corrective Proactive (PCP) model that builds on relevant research traditions, our prior formulations and accumulating research evidence based on testing this model. Recognizing biopsychosocial challenges and contextual stressors that are normative for older individuals, we emphasize the critical role of proactive behavioral adaptations in ameliorating the adverse effects of stressors. We argue that competent actions to address age-related changes and stressors are necessary to achieve positive quality-of-life outcomes. We propose that future research may benefit from employing more complex methodological approaches and data analytic tools.
Collapse
Affiliation(s)
- Eva Kahana
- Elderly Care Research Center, Case Western Reserve University, Cleveland, Ohio, USA
| | | | | |
Collapse
|
73
|
Compare A, Zarbo C, Marín E, Meloni A, Rubio-Arias JA, Berengüí R, Grossi E, Shonin E, Martini G, Alcaraz PE. PAHA study: psychological active and healthy aging: psychological wellbeing, proactive attitude and happiness effects of whole-body vibration versus Multicomponent Training in aged women: study protocol for a randomized controlled trial. Trials 2014; 15:177. [PMID: 24886107 PMCID: PMC4039325 DOI: 10.1186/1745-6215-15-177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 05/07/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Evidence demonstrates that physical exercise and psychological wellbeing are closely interlinked, particularly in older-aged women. However, research investigating how different forms of exercise influence mental health in older-aged women is underdeveloped. METHODS/DESIGN A randomized controlled trial (N = 300) will assess the relative effectiveness of two different exercise programs (whole-body vibration and Multicomponent Training) for improving psychological wellbeing in older-aged women. The following outcomes will be assessed at three time points (that is, pre, post, and follow-up): psychological wellbeing, proactive attitude, quality of life, and happiness. DISCUSSION Results will have important implications for preventing psychological and physiological disease in older-aged women and for managing health-related costs for this population group. TRIAL REGISTRATION Number NCT01966562 on Clinical Gov database the 8 October 2013.
Collapse
Affiliation(s)
- Angelo Compare
- University of Bergamo, Human Factors and Technologies in Healthcare Research Center, Bergamo, Italy
- University of Bergamo, P.le S.Agostino, 2/24129 Bergamo, Italy
| | - Cristina Zarbo
- University of Bergamo, Human Factors and Technologies in Healthcare Research Center, Bergamo, Italy
| | - Elena Marín
- Universidad Católica San Antonio de Murcia, Campus de los Jerónimos s/n., 30107, Guadalupe, Murcia, Spain
| | - Alessia Meloni
- University of Bergamo, Human Factors and Technologies in Healthcare Research Center, Bergamo, Italy
| | - Jacobo A Rubio-Arias
- Universidad Católica San Antonio de Murcia, Campus de los Jerónimos s/n., 30107, Guadalupe, Murcia, Spain
| | - Rosendo Berengüí
- Universidad Católica San Antonio de Murcia, Campus de los Jerónimos s/n., 30107, Guadalupe, Murcia, Spain
| | - Enzo Grossi
- Villa Santa Maria, Tavernerio, Como. Fondazione Bracco, Milano, Italy
| | - Edo Shonin
- Nottingham Trent University (UK), Nottingham, UK
| | - Gianmaria Martini
- Department of Engineering and Applied Sciences, University of Bergamo, Bergamo, Italy
| | - Pedro E Alcaraz
- Universidad Católica San Antonio de Murcia, Campus de los Jerónimos s/n., 30107, Guadalupe, Murcia, Spain
| |
Collapse
|
74
|
Choi M, Adams KB, Kahana E. Self-regulatory driving behaviors: gender and transportation support effects. J Women Aging 2014; 25:104-18. [PMID: 23488647 DOI: 10.1080/08952841.2012.720212] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examined the relationship between transportation support and self-regulatory driving behaviors of 566 community-dwelling older adults living in retirement communities, with a focus on gender differences. The results of logistic regression analysis showed that older women were more likely to avoid driving at night or on the highway than their male counterparts. Transportation support from peer friends was found to increase the likelihood of self-regulatory driving behaviors. The findings of this study imply that transportation policy and driving safety programs for older adults need to be developed, considering available transportation alternatives and gender differences in driving behaviors.
Collapse
Affiliation(s)
- Moon Choi
- College of Social Work, University of Kentucky, Lexington, KY 40506-0027, USA.
| | | | | |
Collapse
|
75
|
Cornwell B, Laumann EO. The health benefits of network growth: new evidence from a national survey of older adults. Soc Sci Med 2013; 125:94-106. [PMID: 24128674 DOI: 10.1016/j.socscimed.2013.09.011] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 09/09/2013] [Accepted: 09/11/2013] [Indexed: 11/26/2022]
Abstract
Scholars who study how social networks affect older adults' health are often concerned with the prospect of declining social connectedness in late life. This paper shifts the focus to older adults' tendencies to cultivate new social ties. This process of network growth can improve access to social resources, boost self-esteem, reduce loneliness, and increase physical activity. We therefore examine the link between tie cultivation and health using new longitudinal data from the National Social Life, Health, and Aging Project (NSHAP), which recorded changes in older adults' confidant network rosters over a period of about five years. Most respondents (81.8%) added at least one new network member during the study period, and most (59.4%) cultivated multiple new confidant relationships. Longitudinal analyses suggest that the addition of new confidants is associated with improvements in functional, self-rated, and psychological health, net of baseline connectedness as well as any network losses that occurred during the same period. Network losses were associated with physical but not psychological well-being. These findings underscore the importance of distinguishing between concurrent processes that underlie social network change in later life, and highlight the need for additional research on the mechanisms by which network change may improve health.
Collapse
Affiliation(s)
- Benjamin Cornwell
- Department of Sociology, Cornell University, 354 Uris Hall, Ithaca, NY 14853, USA.
| | - Edward O Laumann
- Department of Sociology, University of Chicago, 1126 E. 59th Street, Room 410, Chicago, IL 60637, USA.
| |
Collapse
|
76
|
Kahana E, Bhatta T, Lovegreen LD, Kahana B, Midlarsky E. Altruism, helping, and volunteering: pathways to well-being in late life. J Aging Health 2013; 25:159-87. [PMID: 23324536 DOI: 10.1177/0898264312469665] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE We examined the influence of prosocial orientations including altruism, volunteering, and informal helping on positive and negative well-being outcomes among retirement community dwelling elders. METHOD We utilize data from 2 waves, 3 years apart, of a panel study of successful aging (N = 585). Psychosocial well-being outcomes measured include life satisfaction, positive affect, negative affect, and depressive symptomatology. RESULTS Ordinal logistic regression results indicate that altruistic attitudes, volunteering, and informal helping behaviors make unique contributions to the maintenance of life satisfaction, positive affect and other well being outcomes considered in this research. Predictors explain variance primarily in the positive indicators of psychological well-being, but are not significantly associated with the negative outcomes. Female gender and functional limitations are also associated with diminished psychological well-being. DISCUSSION Our findings underscore the value of altruistic attitudes as important additional predictors, along with prosocial behaviors in fostering life satisfaction and positive affect in old age.
Collapse
Affiliation(s)
- Eva Kahana
- Department of Sociology, Case Western Reserve University, Cleveland, OH 44106, USA.
| | | | | | | | | |
Collapse
|
77
|
Q&A Eva Kahana: Ageing proactively. Interview by Rebecca Kessler. Nature 2012; 492:S9. [PMID: 23222674 DOI: 10.1038/492s9a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|