Purpose in life and reduced incidence of stroke in older adults: 'The Health and Retirement Study'

Social integration and long-term physical and psychosocial quality of life among prostate cancer survivors in the Health Professionals Follow-up Study

PURPOSE

Prostate cancer survivors may benefit from a supportive social environment. We investigated associations of social integration and long-term physical and psychosocial quality of life among prostate cancer survivors who were participants in the Health Professionals Follow-up Study.

METHODS

We included 1,428 individuals diagnosed with non-metastatic prostate cancer between 2008 and 2016. Social integration was measured by the Berkman-Syme Social Network Index (SNI) and marital status. We fit generalized linear mixed effect models for associations of SNI and marital status with patient reported outcome measures on physical and psychosocial quality of life captured between 2008 and 2020, adjusting for age, race, employment status, body mass index, comorbidities, smoking history, and clinical factors.

RESULTS

Among those with baseline SNI (N = 1,362), 46.4% were socially integrated, 20.3% were moderately integrated, 27.4% were moderately isolated, and 5.9% were socially isolated. Among those reporting baseline marital status (N = 1,428), 89.5% were married. Socially integrated survivors (vs. socially isolated) reported fewer depressive signs and better psychosocial wellbeing. Physical quality of life did not differ by social integration. Married survivors (vs. not married) reported fewer urinary symptoms, but there were no differences in bowel, sexual, or vitality/hormonal symptoms.

CONCLUSIONS

Among prostate cancer survivors, being socially integrated was associated with fewer depressive signs and better psychosocial wellbeing, and married prostate cancer survivors had fewer urinary symptoms.

IMPLICATIONS FOR CANCER SURVIVORS

This study highlighted aspects of long-term physical and psychosocial quality of life that are more favorable among prostate cancer survivors with a supportive social environment.

Bidirectional associations between meaning in life and the health, emotional ill-being and daily life functioning outcomes among older adults

OBJECTIVE

Meaning and purpose in life are recognised health determinants. Evidence on the factors contributing to the experience of meaning and purpose in life is limited. The bidirectional associations between the experience of meaning in life and physical health, emotional ill-being and daily life functioning from a 6-year perspective are examined.

METHODS AND MEASURES

Longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed using generalised estimating equations. The sample included 16,361 middle-aged and older adults from 13 countries.

RESULTS

Living a meaningful life was found to be associated with subsequent reduced risks of depression, loneliness, limitations in activities of daily living, and heart attack (at the 6-year follow-up). It was also found that prior experience of depression, loneliness and limited activities of daily living were associated with subsequent reduced sense of meaningful life. These associations were independent of demographics, socioeconomic status, personality, prior history of diseases and lifestyle. The sensitivity analyses provided evidence for the robustness of these associations.

CONCLUSIONS

Evidence for health practitioners and policymakers on factors that may hamper the development and maintenance of meaningful life as well as on the role of sense of meaning in life for healthy aging was presented.

Purpose in life and slow walking speed: cross-sectional and longitudinal associations

The present research examines the association between purpose in life - a component of well-being defined as the feeling that one's life is goal-oriented and has direction - and slow walking speed and the risk of developing slow walking speed over time. Participants (N = 18,825) were from three established longitudinal studies of older adults. At baseline, participants reported on their purpose in life, and interviewers measured their usual walking speed. Walking speed was measured at annual or biannual follow-up waves up to 16 years later. Random-effects meta-analysis was used to summarize the estimates from the individual studies. Every standard deviation higher in purpose in life (as a continuous measure) was associated with a lower likelihood of cross-sectional slow walking speed at baseline (meta-analytic OR = .80, 95% CI = .77-.83). Among participants who did not have slow walking speed at baseline (n = 8,448), every standard deviation higher purpose in life was associated with a lower likelihood of developing slow walking speed over the up to 16 years of follow-up (meta-analytic HR = .93, 95% CI = .89-.96). Physical activity and disease burden accounted for 25% and 14% of the cross-sectional and longitudinal associations, respectively. The associations were independent of age, sex, race, ethnicity, and education and not moderated by these factors. Higher purpose in life is associated with a lower risk of slow walking speed and a lower risk of developing slow walking speed over time. Purpose in life is a psychological resource that may help to support aspects of physical function, such as walking speed, and may help support better function with age.

What predicts personal growth following a deployment? An examination of National Guard soldiers through the lens of posttraumatic growth

National Guard soldiers experience unique reintegration challenges. In addition to managing the consequences of combat-related trauma, they also navigate multiple transitions between military and civilian life. Despite these obstacles, many soldiers report positive outcomes and personal growth due to deployment, a phenomenon most commonly referred to in the literature as posttraumatic growth (PTG). The current study explored PTG in National Guard soldiers using a multidimensional longitudinal approach, with the goal of validating reports of PTG in soldiers. Data were collected from National Guard soldiers at pre-deployment, reintegration, one year post-deployment and two years post-deployment. Informed by PTG theory, three PTG constructs were measured (perceived ability to handle stress, social support seeking, and purpose in life) at each of the four time points, with increases in these constructs indicating growth. Potential predictors of growth in these PTG constructs were also explored. Results from a repeated measure latent profile analysis indicated that PTG did occur in certain soldiers, and that higher optimism and less severe PTSD symptoms predict this growth. These findings emphasize the importance of making efforts to facilitate PTG in soldiers.

Measuring the purpose in life in the adult population: A scoping review

Background

The purpose in life can motivate individuals to realize that life is essential for existence and well-being. Adults might experience crises that can lead to a lack of purpose in life. Consequently, promoting purpose in life is necessary, but it requires a suitable measurement scale.

Objective

This scoping review aimed to identify and map the content, psychometric properties, and answer option scales of instruments intended to measure purpose in life in adult populations.

Design

A scoping review was employed.

Data Sources

The database used was PubMed. The libraries were APA PsycNet, Wiley Online Library, and Cochrane Library. The search strategy was performed between 1 November 2023 and 14 February 2024.

Review Methods

This review used the scoping review framework described by Arksey and O'Malley. The identified instruments were assessed for quality based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. This study also used the PRISMA Extension for Scoping Reviews (PRISMA-ScR) reporting guideline.

Results

A total of 348 studies were identified, and seven articles were involved in the final synthesis. These seven articles included five instruments measuring the concept of purpose in life, of which two instruments had two versions: 1) Purpose in Life Test (20 items, 4 items); 2) Life Engagement Test (6 items); 3) Psychological Well-Being (120 items, 18 items); 4) Self-Assessment Goal Achievement (9 items); and 5) National Institutes of Health Tuberculosis Meaning and Purpose Scale Age 18+ (18 items). The validity of all instruments was tested using factor analysis, known groups, face, concurrent, convergent, discriminant, and construct validity. The reliability of four instruments was tested by Cronbach's alpha and Spearman-Brown formula.

Conclusion

Five instruments measuring purpose in life in the adult population with adequate psychometric properties were identified. The clinical implication of this study suggests that nurses may consider employing an appropriate instrument to assess the purpose of life in the adult population, thus enabling them to offer holistic, individualized care to adults, particularly addressing the spiritual dimension.

What can we learn about stress and sleep from COVID-19 pandemic-perspective from the theory of preventive stress management

Background

The COVID-19 pandemic has presented unique challenges to individuals worldwide, with a significant focus on the impact on sleep. However, the precise mechanisms through which emotional and cognitive variables mediate this relationship remain unclear. To expand our comprehensive understanding of variables, the present study utilizes the Preventive Stress Management theory, to test the relationship between perceived social support and sleep quality, as well as the effect of perceived COVID-19 stress, hope, negative emotions and coping styles.

Methods

Data were collected in March 2022 from 1,034 college students in two universities located in Liaoning Province, China, using an online survey platform regarding perceived social support, perceived COVID-19 stress, sleep quality, hope, negative emotions and coping styles. The moderated mediation model were conducted using Process macro program (Model 6) and the syntax in SPSS.

Results

The results revealed perceived COVID-19 stress and negative emotions sequentially mediated the negative relationship between perceived social support and sleep quality. Furthermore, hope and coping styles were found to moderate the sequential mediating effect.

Conclusion

The present study sheds light on the pathways that affect sleep quality among college students during the COVID-19 pandemic. Findings highlight the protective roles played by positive social and personal resources, such as perceived social support, hope, and effective coping styles, against sleep problems. These insights have important implications for the development of targeted interventions to improve sleep outcomes during this challenging time.

Purpose in Daily Life: Considering Within-Person Sense of Purpose Variability

Sense of purpose refers to the extent to which one feels that they have personally meaningful goals and directions guiding them through life. Though this construct predicts a host of benefits, little is known regarding the extent to which sense of purpose fluctuates within an individual and the affective changes tied to those fluctuations. The current study uses daily diary data to addresses this gap by exploring (1) how much sense of purpose and different components of purpose fluctuate from one day to the next, (2) the extent to which these fluctuations correlate with positive and negative affect, and (3) whether dispositional sense of purpose and age correlate with greater variability. Participants (N = 354) reported on their sense of purpose and positive and negative affect every day for 10 days. Results suggest that approximately 45-61% of the variability in sense of purpose scores occurs between-person depending on how it is assessed. Furthermore, the within-person variability in sense of purpose is more strongly correlated with changes in positive affect relative to negative affect. Finally, higher levels of dispositional sense of purpose and age do not appear to be associated with how much variability an individual experiences in their purposefulness from one day to next. The discussion focuses on what these findings mean for the trait-like nature of sense of purpose, short-term sense of purpose measurement, lifespan development, and intervention efforts.

Changes in Purpose in Life and Low-Grade Chronic Inflammation Across Older Adulthood

Background: Older adults often experience an increase in low-grade chronic inflammation. Purpose in life could act as a protective factor as it is associated with beneficial health outcomes. Purpose in life may exert part of its adaptive function by promoting persistence in goal pursuit. During older adulthood, however, when many individuals experience an increase in intractable stressors and declining resources, the adaptive function of purpose could become reduced. Purpose: We examined whether the association between inter- and intra-individual differences in purpose in life and chronic inflammation differed across older adulthood. Method: We assessed four waves of data among 129 older adults (63-91 years old) across 6 years. Results: Hierarchical linear modeling demonstrated that within-person increases in purpose in life predicted reduced levels of chronic inflammation in early old age (25th percentile or 73 years, coefficient = -.016, p < .01), but not in advanced old age (75th percentile or 81 years, coefficient = .002, p = .67). Between-person differences in purpose were not related to chronic inflammation. Conclusions: These results suggest that greater within-person increases in purpose may protect health processes particularly in early old age but become less effective in advanced old age.

Social network type contributes to purpose in life among older people, mediated by social support

A sense of Purpose in Life is an important aspect of ageing well which is related to older adult's social relationships. Social network types and the different sources of support they provide are theorized here as a pathway to maintaining a sense of purpose as we age. The study utilized a population sample from the 2016 and 2020 NZ Health, Work, and Retirement (NZHWR) longitudinal survey waves; N = 2869 (mean age of 65.82 years (SD = 6.40). A structural equation model investigated the relationship between Social Network Type and Purpose in Life and the mediating role of Social Support. The final model had a good fit to the data and explained 33.7% of the variance in Purpose in Life. Private, Self-Contained and Family Dependent network types (2016) were negatively related to Purpose in Life 4 years later (2020). Support from sense of Attachment, Reassurance of Worth, Reliable Alliance and Social Integration played a mediating role between Social Network type and Purpose in Life. These findings highlight the importance of social networks in maintaining a sense of purpose among older adults and highlight pathways for the types of networks, and kinds of social support they offer, which contribute to a sense of purpose in life. They underscore the importance of social support for the well-being of older adults and highlight the need to consider the quality and type of social networks and support they provide, when designing interventions to enhance well-being.

Purpose in Life and Risk of Falls: A Meta-Analysis of Cross-Sectional and Prospective Associations

Background and Aim: Purpose in life is an aspect of well-being that is associated with better health outcomes in older adulthood. We examine the association between purpose in life and likelihood of a recent fall and risk of an incident fall over time. Methods: Purpose in life and falls were reported concurrently and falls were reported again up to 16 years later in four established longitudinal studies of older adults (total N = 25,418). Results: A random-effects meta-analysis of the four samples indicated that purpose was associated with a 14% lower likelihood of having fallen recently at baseline (meta-analytic OR = 0.88, 95% CI [0.84-0.92]). Among participants who reported no falls at baseline (N = 15,632), purpose was associated with a nearly 10% lower risk of an incident fall over the up to 16-year follow-up (meta-analytic HR = 0.92, 95% CI [0.90-0.94]). These associations were independent of age, sex, race, ethnicity, and education, were not moderated by these factors, and persisted controlling for physical activity and disease burden. Conclusion and Recommendations: Purpose in life is a meaningful aspect of well-being that may be useful to identify individuals at risk for falling, particularly among individuals without traditional risk factors, and be a target of intervention to reduce fall risk.

Measures of Aging Biology in Saliva and Blood as Novel Biomarkers for Stroke and Heart Disease in Older Adults

BACKGROUND AND OBJECTIVES

The role of aging biology as a novel risk factor and biomarker for vascular outcomes in different accessible body tissues such as saliva and blood remain unclear. We aimed to (1) assess the role of aging biology as a risk factor of stroke and heart disease among individuals of same chronologic age and sex and (2) compare aging biology biomarkers measured in different accessible body tissues as novel biomarkers for stroke and heart disease in older adults.

METHODS

This study included individuals who consented for blood and saliva draw in the Venous Blood Substudy and Telomere Length Study of the Health and Retirement Study (HRS). The HRS is a population-based, nationally representative longitudinal survey of individuals aged 50 years and older in the United States. Saliva-based measures included telomere length. Blood-based measures included DNA methylation and physiology biomarkers. Propensity scores-matched analyses and Cox regression models were conducted.

RESULTS

This study included individuals aged 50 years and older, who consented for blood (N = 9,934) and saliva (N = 5,808) draw in the HRS. Blood-based biomarkers of aging biology showed strong associations with incident stroke as follows: compared with the lowest tertile of blood-based biomarkers of aging, biologically older individuals had significantly higher risk of stroke based on DNA methylation Grim Age clock (adjusted hazard ratio [aHR] = 2.64, 95% CI 1.90-3.66, p < 0.001) and Physiology-based Phenotypic Age clock (aHR = 1.75, 95% CI 1.27-2.42, p < 0.001). In secondary analysis, biologically older individuals had increased risk of heart disease as follows: DNA methylation Grim Age clock (aHR = 1.77, 95% CI 1.49-2.11, p < 0.001) and Physiology-based Phenotypic Age clock (aHR = 1.61, 95% CI 1.36-1.90, p < 0.001).

DISCUSSION

Compared with saliva-based telomere length, blood-based aging physiology and some DNA methylation biomarkers are strongly associated with vascular disorders including stroke and are more precise and sensitive biomarkers of aging. Saliva-based telomere length and blood-based DNA methylation and physiology biomarkers likely represent different aspects of biological aging and accordingly vary in their precision as novel biomarkers for optimal vascular health.

Contributions of Eudaimonic Well-Being to Mental Health Practice

Purpose

Synergies between a eudaimonic model of psychological well-being (Ryff, 1989) and mental health practice are examined. The model grew out of clinical, developmental, existential, and humanistic perspectives that emphasized psychological strengths and capacities, in contrast to the focus on emotional distress and dysfunction in clinical psychology.

Design/Approach

Conceptual foundations of the eudaimonic approach are described, along with the six components positive functioning that are used to measure well-being. These qualities may be important in facilitating the recovery experiences, which are of interest in Mental Health and Social Inclusion.

Findings

Four categories of empirical evidence about eudaimonia are reviewed: (1) how it changes with aging, (2) how it matters for health, (3) what are its biological and neurological underpinnings, and (4) whether it can be promoted. Major contemporary forces against eudaimonia are also considered, including ever-widening inequality, the enduring pandemic, and world-wide strife. In contrast, encounters with the arts and nature are put forth as forces for eudaimonia. The relevance of these ideas for mental health research and practice is considered.

Originality

Mental health is often defined as the absence of mental illness. The novelty of the eudaimonic approach is to define mental health as the presence of well-being, assessed with different components of positive functioning.

Practical Implications

Enormous suffering defines our contemporary world. Such realities call for greater attention to factors that undermine as well as nurture the realization of human potential, the core of eudaimonic well-being.

Testing the Reciprocal Relationship Between Social Networks and Purpose in Life Among Older Adults: Application of a Random Intercept Cross-Lagged Panel Model

Objectives: The purpose of this study is to examine if there are longitudinal reciprocal effects between social network size and purpose in life among older adults. Methods: Using data from the National Health and Aging Trends Study, the sample included 1485 male and 2058 female adults 65 years and older. We first computed t-tests to assess gender differences in social network size and purpose in life. In order to examine the reciprocal effects between social network size and purpose in life over four time points (2017, 2018, 2019, and 2020), a RI-CLPM (Model 1) was computed. In addition to the main model, two multiple group RI-CLPM analyses (Model 2 and 3) were computed to test the moderated gender effect on the relationship with models estimating unconstrained and constrained cross-lagged parameters. Results: The results of the t-tests denoted significant gender differences in social network size and purpose in life. The results indicated that Model 1 fit the data well. The carry-over effects of social networks and purpose in life and spill-over effect from wave 3 purpose in life on wave 4 social networks were significant. There were no significant differences between the constrained and unconstrained models testing for moderated gender effects. Discussion: The findings of the study highlight the significant carry-over effect of purpose in life and social network size over four years and the positive spill-over effect from purpose in life on social network size at the subsequent wave, which only appeared at the last time point.

Older Adults Documenting Purpose and Meaning Through Photovoice and Narratives

BACKGROUND AND OBJECTIVES

The purpose of this study was to explore how older adults perceived meaning and purpose in their lives.

RESEARCH DESIGN AND METHODS

Participants (N = 15) ranged in age from 66 to 89 years, and were asked to document purpose and meaning in their lives for 15 consecutive days by using photovoice and narrative methodologies. Latent thematic analysis was used to interpret the data.

RESULTS

Findings indicated 3 themes including: (1) mindful practices, (2) active participation in society with a subtheme on technology, and (3) goal-oriented mindset. Mindful practices involved spending time in nature and working to improve it and reflecting and engaging in creative endeavors to help understand the changing world. Active participation in society created feelings of usefulness and belonging among participants and ranged from taking care of and helping others to leaving a legacy. The subtheme on technology demonstrated it used to maintain social relationships, particularly during the pandemic. Examples of the goal-oriented mindset incorporated informal lifelong learning opportunities that encouraged physical and cognitive stimulation. In addition, possessions appeared to bring increased meaning and purpose to individuals who were more homebound.

DISCUSSION AND IMPLICATIONS

Older adults identified purpose and meaning in their lives and demonstrated adaptability. For example, due to the pandemic or other personal dynamics such as declining mobility, some participants modified their activities to compensate. These findings have implications for policy and practice. Although older adults in this study demonstrated adaptability, others will need guidance and resources to successfully adapt and maintain levels of well-being.

Analysis of action planning, achievement and life purpose statements in an intervention to support caregivers of persons with heart failure

BACKGROUND

Caregivers of persons living with heart failure (HF) experience uncertainty related to heart failure trajectory and caregiving demands. Caregiver Support is a nurse-led intervention consisting of a well-being assessment, development of a life purpose statement, and action planning related to self-care and support for caregivers.

OBJECTIVES

The goal of this study was to describe the caregivers' action plans, action plan achievement and life purpose statements.

METHODS

We used inductive content analysis to code life purpose statements and action plans by 2 coders. Descriptive statistics were used to describe the average number of action plans set per caregiver, the average number of themes coded per action plan and life purpose statement, and the status of goal achievement (i.e., by thematic domain, subdomains). Goal achievement was defined categorically: Achieved, not achieved, and not assessed. The achievement rate was calculated as the proportion of achieved action plans out of the total number of assessed action plans.

RESULTS

The sample (n = 22) was predominantly women, spousal caregivers, and an average age of 62±14.2 years. Thirty-six percent of caregivers were Black and 41% reported financial strain. Action plans comprised five categories: personal health and well-being, social support, home environment, instrumental support and other. The most common topics of life purpose statements were faith and self-care/actualization. Of 85 action plans, 69 were assessed and 66.7% were achieved.

CONCLUSIONS

These findings highlight the diversity of values and needs of caregivers and provides insights for additional person-centered support.

Unpacking Psychological Vulnerabilities in Deaths of Despair

Recent demographic findings show increased rates of death due to suicide, drug addictions, and alcoholism among midlife white adults of lower socioeconomic status (SES). These have been described as "deaths of despair" though little research has directly assessed psychological vulnerabilities. This study used longitudinal data from the Midlife in the U.S. (MIDUS) study to investigate whether low levels of eudaimonic and hedonic well-being predict increased risk of deaths of despair compared to other leading causes of death (cancer, heart disease). The investigation focused on 695 reported deaths with cause of death information obtained from 2004 to 2022 via NDI Plus. Key questions were whether risk for deaths due to despair (suicide, drug addiction, alcoholism) compared to deaths due to cancer or heart disease were differentially predicted by deficiencies in well-being, after adjusting for sociodemographic variables. Low levels of purpose in life, positive relations with others, personal growth and positive affect predicted significantly greater likelihood of deaths of despair compared to deaths due to heart disease, with such patterns prominent among better-educated adults. The findings bring attention to ongoing intervention efforts to improve psychological well-being.

A Pilot Randomized Trial of a Purposeful and Stimulating Volunteer Opportunity: Program Satisfaction and Potential Impacts on Perceived Cognitive Change in a Neurologically Mixed Sample of Older Adults

BACKGROUND

Purposeful social interactions are important for healthy aging. We conducted a pilot trial of SPEAK! (Seniors Promoting English Acquisition and Knowledge), an intervention providing older volunteers with a safe, accessible opportunity to converse via webcam with English-language learners.

METHODS

A neurologically mixed sample of older adults was randomized to 8 weekly, webcam conversations with English-language learners or a waitlist control. Outcomes included the Cognitive Change Index (CCI) and surveys of program satisfaction. Here, we report on session completion, intervention satisfaction, and follow-up CCI scores. Exploratory analyses of CCI intervention effects controlled for baseline CCI scores and the interaction between group and baseline CCI.

RESULTS

Participants (N=38) were on average 70.8 years of age, 28/38 were White, and 16/38 demonstrated possible cognitive impairment on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Pairs completed 115/136 sessions (85%) and all volunteers said they would recommend the program. Controlling for the interaction between baseline CCI and randomization group, SPEAK! volunteers had better follow-up CCI scores than controls (P=0.018). Improvements in CCI were greater among participants with fewer baseline memory problems.

CONCLUSIONS

SPEAK! was feasible and appreciated by older adults with and without cognitive impairment. Larger studies should confirm benefits for memory and other determinants of quality of life.

Sense of purpose in life and allostatic load in two longitudinal cohorts

OBJECTIVE

Sense of purpose in life has been linked with better physical health, longevity, and reduced risk for disability and dementia, but the mechanisms linking sense of purpose with diverse health outcomes are unclear. Sense of purpose may promote better physiological regulation in response to stressors and health challenges, leading to lower allostatic load and disease risk over time. The current study examined the association between sense of purpose in life and allostatic load over time in adults over age 50.

METHODS

Data from the nationally representative US Health and Retirement Study (HRS) and English Longitudinal Study of Ageing (ELSA) were used to examine associations between sense of purpose and allostatic load across 8 and 12 years of follow-up, respectively. Blood-based and anthropometric biomarkers were collected at four-year intervals and used to compute allostatic load scores based on clinical cut-off values representing low, moderate, and high risk.

RESULTS

Population-weighted multilevel models revealed that sense of purpose in life was associated with lower overall levels of allostatic load in HRS, but not in ELSA after adjusting for relevant covariates. Sense of purpose in life did not predict rate of change in allostatic load in either sample.

CONCLUSIONS

The present investigation supports sense of purpose predicting preserved differentiation of allostatic regulation, with more purposeful individuals demonstrating consistently lower allostatic load over time. Persistent differences in allostatic burden may account for divergent health trajectories between individuals low and high in sense of purpose.

Did Resilience and Socioeconomic Status Predict Older Adults' Finding a Silver Lining in COVID?

Background and Objectives

The coronavirus disease 2019 (COVID-19) pandemic stretched our limits-physically, mentally, and economically. However, some older adults report that it led to positive changes. This study aims to understand whether prepandemic resilience, education, or income predicted older adults' subsequent likelihood of reporting positive changes in their lives during the pandemic.

Research Design and Methods

We use data from the National Social Life, Heath, and Aging Project, an ongoing panel study with a COVID-19 ancillary supplement (N = 2,650).

Results

The study results aligned with the fundamental cause theory. In demographically adjusted models including resilience, education, and income, as well as the effect of the pandemic on employment and a COVID-disruption score, the odds of reporting any positive change were 2.6 times higher for those with an associate degree (p < .01) and 4.7 times higher for those with a bachelor's or higher (p < .001), compared to those without a high school degree. In contrast, neither resilience nor income was significantly associated with endorsing a positive change. We also categorize specific changes thematically coded from open-ended responses and examine their demographic distributions. Categories include spirituality, home organization, hygiene practices, and increased quality time with others.

Discussion and Implications

These findings show that older adults with more education could navigate COVID-19 challenges in a way that improved their perspectives on at least one aspect of their lives.

Subjective Happiness, Frequency of Laughter, and Hypertension: A Cross-Sectional Study Based on the Japan Gerontological Evaluation Study (JAGES)

In recent years, positive psychological factors, such as subjective happiness and laughter, have been reported to be associated with cardiovascular disease. In this study, we examined the relationship of hypertension with subjective happiness and frequency of laughter using the data from the Japan Gerontological Evaluation Study (JAGES). Of the 138,294 respondents, 26,368 responded to a version of the self-administered questionnaire that included a question about the frequency of laughter in the JAGES 2013. In total, 22,503 (10,571 men and 11,932 women) were included in the analysis after excluding those with missing responses regarding a history of hypertension, frequency of laughter, and subjective happiness. The prevalence of hypertension in this study was 10,364 (46.1%). Multivariate logistic regression analysis showed that age, female sex, obesity, infrequent chewing, former and current drinker, seeing three to five friends, and the absence of hobbies were positively associated with hypertension. However, infrequent laughter/high level of subjective happiness, frequent laughter/high level of subjective happiness, being underweight, and current smoker were negatively associated with hypertension. As per the findings of this study, it was determined that subjective happiness was negatively associated with hypertension. Therefore, this study suggests that having more opportunities to feel happiness may be important in preventing hypertension.

Applying an Allportian Trait Perspective to Sense of Purpose

Sense of purpose captures the extent to which one feels that they have personally meaningful goals and directions guiding them through life. While this construct has illustrated its ability to robustly predict desirable outcomes-ranging from happiness to mortality-the nature of this construct remains unclear. I begin by describing different definitions and measures from the purpose literature. From there, I review the debates suggesting that it should be classified as a component of identity development, a facet of well-being, or even a virtue. In the current paper, I argue that sense of purpose could be best served when qualified as a trait, building from the eight components of defining a trait from Allport's (1931) paper: "What is a trait of personality?". Using this classic piece as a framework, I integrate empirical and theoretical work on purpose and personality to dive into whether sense of purpose is a trait. I conclude by discussing the challenges and implications of bolstering sense of purpose if it is best classified as a trait.

Psychological Well-being Relates to Healthcare and Financial Decision Making in a Study of Predominantly White Older Adults

The purpose of this study was to test the hypotheses that psychological well-being is associated with healthcare and financial decision making in older adults and that this association varies by the level of cognitive function. Participants were 1082 older adults (97% non-Latino White; 76% women; mean age = 81.04 years; SD = 7.53) without dementia (median MMSE score = 29.00, IQR = 27.86-30.00). In a regression model adjusted for age, gender, and years of education, higher levels of psychological well-being were associated with better decision making (estimate = 0.39, standard error [SE] = 0.11, p < .001), as was better cognitive function (estimate = 2.37, SE = 0.14, p < .0001). In an additional model, an interaction of psychological well-being and cognitive function was significant (estimate = -0.68, SE = 0.20, p < .001), such that higher levels of psychological well-being were most beneficial for decision making among participants with lower levels of cognitive function. Higher levels of psychological well-being may help sustain decision making among older persons, particularly those with lower levels of cognitive function.

Mediation effects of cognitive, physical, and motivational reserves on cognitive performance in older people

Introduction

We study from a multidimensional perspective the different factors that help prevent the development of cognitive impairment in old aging.

Methods

This study analyzed in 300 elderly subjects the relationship between cognitive reserve (CR), physical reserve (PR) and motivational reserve (MR) with cognitive impairment. This study also takes into consideration different variables (sex, age, educational level, and institutionalization) that might affect the results in the different types of reserves (CR, physical and MR) and cognitive impairment.

Results

The results show that people with a higher cognitive reserve, physical reserve and motivational reserve have less cognitive impairment.

Discussion

Therefore, it is important to consider measuring the CR as a variable to diagnose neurodegenerative illnesses but it is also essential to consider the physical state and physical activity, as well as the motivational dimension. With the cognitive reserve and sex variables no significant differences were observed. Age had a negative effect on strategic flexibility, but those with higher CR had better cognitive flexibility and the educational.

Positive attributes in elderly people with different degrees of depression: a study based on network analysis

INTRODUCTION

Depression in aging may lead to loss of autonomy and worsening of comorbidities. Understanding how positive attributes contribute to healthier and happier aging has been one of the purposes of Positive Psychology. However, the literature still lacks studies that evaluate how depression in the elderly is related to constructs considered positive.

OBJECTIVE

The present study aimed comparing scores of constructs of spiritual well-being, social support, self-esteem, life satisfaction, affection, optimism, and hope in the elderly with minimal, mild, moderate, and severe depression and healthy controls in order to investigate possible indirect and mediated relationships between positive constructs and depression.

METHODS

A cross-sectional study was conducted with elderly, 62 of whom were diagnosed with different severity of Major Depression (DSM-V) (minimum, mild, moderate, and severe according to the Beck Depression Inventory - BDI) and 66 healthy controls matched by age, sex and schooling. The instruments used were adapted and validated versions of the Spirituality Self-Rating Scale, the Rosenberg Self-Esteem Scale, the Medical Outcomes Social Scale of Support, the Life Satisfaction Scale, the Positive and Negative Affect Schedule, the Revised Life Orientation Test, and the Adult Dispositional Hope Scale. After comparing the means of scores between groups, an analysis of normalized partial association networks was performed to investigate the direct and mediated relationships between depression and other evaluated constructs.

RESULTS

Scores of spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism, negative affects, and hope differed significantly between the control group and the degrees of depression (p < 0.001). The analysis of normalized partial association networks has shown that the relations of depression with the constructs of life satisfaction, self-esteem, and social support are mediated, while the constructs of dispositional hope, positive affect, spiritual well-being, and optimism are indirectly related to depression. The social class was also positively related to depression.

CONCLUSION

Depression in different degrees is associated with a reduction in the scores of instruments that evaluate positive attributes. The constructs directly associated with depression are spiritual well-being, optimism, positive affect, and dispositional hope. The others had mediated relationship. These results may contribute to the planning of future interventions for the prevention of depression among the elderly.

Stability of Psychological Well-being Following a Neurological Event and in the Face of a Global Pandemic

This study examined the stability of psychological well-being in people who have experienced a neurological event resulting in focal brain damage. Evidence suggests that psychological well-being is largely stable in healthy adult populations. However, whether such stability exists in neurological patients with acquired brain lesions is an open question. Given the trait-like characteristics of psychological well-being, we hypothesized that psychological well-being would be stable in neurological patients who are in the chronic epoch of recovery (≥3 months after the neurological event). Eighty participants (women = 40; age: M = 56, standard deviation ( SD) = 13) completed the Ryff Scales of Psychological Well-Being (PWBS) twice between 2016 and 2020 (Time 1 [T1] and Time 2 [T2]). The Ryff Scales measure various facets of well-being, including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Approximately half of participants completed their T2 assessment during the COVID-19 pandemic, creating an opportunity to investigate the effects of the pandemic on the stability of psychological well-being in a neurological population that may be particularly vulnerable to reduced well-being in this context. Pearson correlations and within-sample t-tests were conducted to examine the stability of self-reported well-being over time. Test–retest correlations ranged from .71 to .87, and no significant differences in well-being emerged across the two time points. Significant correlations between T1 and T2 were also evident in the subsample of participants who completed their second assessment during the COVID-19 pandemic. These findings provide evidence that long-term psychological well-being is remarkably reliable and consistent over time in patients who have experienced a major neurological event, even when an unprecedented global event occurred between measurement epochs. Treatment implications of these findings are discussed.

Correlated Change in Sense of Purpose and Romantic Relationship Quality

Sense of purpose, or feeling that that one has personally meaningful goals and directions guiding them through life, consistently predicts a variety of desirable well-being, health, and social outcomes. However, work has been limited with respect to evaluating it as a predictor and promoter of romantic relationships, or how purpose may develop in these contexts. For instance, healthy romantic relationships could also help individuals develop and maintain a higher sense of purpose. With cross-sectional evidence finding positive associations between sense of purpose and romantic relationship commitment and satisfaction, the current study expanded on past work by using longitudinal data with three months between two measurement occasions (Time 1: N = 2243; Time 2: N = 1284) to evaluate whether sense of purpose predicted relationship status over time and how changes in relationship quality and sense of purpose were associated. Results showed that greater sense of purpose predicted maintaining a romantic relationship, but did not predict later romantic relationship quality, while higher romantic relationship quality predicted an increase in sense of purpose. Findings are discussed regarding why people with a higher sense of purpose may be more likely to stay in relationships as well as the role that positive romantic relationships may play in helping maintain a higher sense of purpose.

Purpose in life (Ikigai) and employment status in relation to cardiovascular mortality: the Japan Collaborative Cohort Study

OBJECTIVES

To investigate whether having a purpose in life (Ikigai) is associated with risk of cardiovascular disease (CVD) mortality and whether the association varies by employment status.

DESIGN

Prospective cohort study.

SETTING

Residents in 45 municipalities, Japan.

PARTICIPANTS

29 517 men and 41 984 women aged 40-79 years, free of CVD and cancer at baseline from 1988 to 1990.

PRIMARY OUTCOME MEASURES

CVD mortality.

RESULTS

During the median follow-up of 19.1 years, 4680 deaths (2393 men and 2287 women) from total CVD were observed. Greater Ikigai was associated with a lower risk of CVD mortality, and the result was stronger for men than for women. Stratified by employment status, the inverse association was confined to unemployed persons. Among unemployed persons, the multivariable HRs of total CVD were higher for moderate and high versus low levels of Ikigai. Multivariable HRs (95% CIs) were 0.74 (0.57 to 0.97) and 0.69 (0.52 to 0.93), P for trend <0.044, respectively in men, and 0.78 (0.64 to 0.95) and 0.77 (0.61 to 0.97), P for trend=0.039 in women. No association was observed among the employed, including part-time workers, self-employed and homemakers for both men and women. Such an inverse association remained even after excluding early deaths within 5 years from the baseline survey.

CONCLUSION

Higher levels of Ikigai were associated with a lower risk of CVD mortality, especially for unemployed men and women.

Being active for a purpose: Evaluating the bi-directional associations between monthly purpose and physical activity

BACKGROUND

Sense of purpose is a salient predictor of health outcomes, at least partially because individuals with a higher sense of purpose appear to engage in healthier lifestyle behaviors. Yet, little work has considered the role that greater physical activity may play in allowing individuals to maintain or develop a higher sense of purpose.

METHODS

Using five waves of monthly data (total n = 2337), the current study investigates the bi-directional association between sense of purpose and monthly reports of average time spent per day in moderate and vigorous physical activity utilizing Random Intercept Cross-Lagged Panel models.

RESULTS

Findings suggested differences based on physical activity intensity. For moderate physical activity, concurrent within-person associations revealed that during months when sense of purpose was higher relative to a person's usual level, they also spent more time than usual engaging in moderate physical activity. Bi-directional cross-lagged effects indicated that higher sense of purpose predicted more next-month moderate physical activity, and vice versa. Only between-person associations were evident for vigorous physical activity, such that people with a higher sense of purpose on average spent more time in vigorous physical activity on average. The discussion focuses on the methodological advances of the current study, as well as implications for future research.

Can adherence to moral standards and ethical behaviors help maintain a sense of purpose in life? Evidence from a longitudinal study of middle-aged and older adults

Personal factors, such as character strengths, have been shown to be favorably associated with concurrent and future well-being. Positive associations have also been reported between purpose in life and concurrent and subsequent health and well-being. Evidence on antecedents of purpose in life is, however, limited. This study examines whether the adherence to moral standards and ethical behaviors (AMSEB) is associated with subsequent purpose in life. Data from the Health and Retirement Study obtained from a sample of 8,788 middle-aged and older adults in the US (mean age = 64.9 years, age range 50–96 years) were used. The prospective associations between AMSEB and purpose in life were examined using generalized linear models. A rich set of covariates and prior outcomes were used as controls to reduce the risk of reverse causation. The robustness analyses included computation of sensitivity measures, E-values, and running a set of secondary analyses conducted on subsamples of respondents and using a limited set of covariates. It was found that middle-aged and older adults who demonstrated higher AMSEB reported a higher sense of purpose in life after the 4-year follow-up period. This association was found to be monotonic, moderately robust to potential unmeasured confounding and independent of demographics, prior socioeconomic status, prior health conditions, and health behaviors as well as prior psychological predispositions such as dispositional optimism and life satisfaction. It was also robust to missing data patterns. Policymakers and health practitioners may consider a predisposition to adherence to moral standards and ethical behaviors as a potential intervention target, as its improvement and/or maintenance has the potential to improve longevity and to help promote healthy and purposeful aging.

Psychological well‐being and salivary markers of inflammation: The moderating effect of age

Increasing evidence suggests a significant impact of higher psychological well-being (PWB) on health outcomes; however, such associations have been studied exclusively in middle-aged to older adults. This study examined the aging effect on PWB measures as well as the moderating effect of age on the link between PWB and inflammation, using salivary markers by comparing the younger adults (n = 127; M_age  = 22.98 years) versus older adults (n = 75; M_age  = 75.60 years). Older adults showed significantly lower levels of PWB, particularly regarding purpose in life and personal growth. Moreover, higher purpose in life was associated with lower salivary IL-1ß and IL-6 (b = 0.83, p < .001; b = 0.81, p < .01) only in the older adult group but not in younger adults. These findings highlight the potential buffering effect of the sense of living well on physiological pathways in later life.

Being Social May Be Purposeful in Older Adulthood: A Measurement Burst Design

OBJECTIVE

Sense of purpose predicts a wide array of positive health, cognitive, and well-being outcomes during older adulthood. However, work is limited regarding how social relations correspond to purposefulness in daily life. The current study explored daily social interactions as a route to daily purposefulness in older adults, using a measurement burst design.

METHODS

Older adults completed surveys for three 5-day bursts each spread 6 months apart (M_age = 70.75, SD = 7.23; N = 104).

RESULTS

Multilevel models demonstrated that on days when individuals reported more positive social interactions, they reported feeling more purposeful (est. = 0.39, 95% CI [0.28, 0.51]) when accounting for health, employment, and relationship status. Employment status moderated this association, as daily social interactions were more strongly associated with daily purpose for unemployed/retired individuals (est. = -0.23, 95% CI [-0.38, -0.08]).

CONCLUSION

Positive social interactions thus may help older adults maintain purposefulness, particularly after retirement.

Hope, Purpose, and Religiosity: The Impact of Psychosocial Resources on Trajectories of Depressive Symptoms Among Middle-Aged and Older Blacks

Objective: We assessed the effects of hope, purpose in life, and religiosity on trajectories of depressive symptoms among middle-aged and older Blacks, with a focus on age differences in these associations. Methods: Data come from 1906 respondents from the 2006-2016 Health and Retirement Study. Linear mixed models were estimated and included interactions between age and time and between age and each psychosocial resource. Results: Depressive symptoms decreased for Blacks ages 51-64, did not change for those 65-74, and increased among Blacks age 75+. Hope and purpose in life were inversely associated with symptom levels but were not associated with change over time in symptomology. Associations were stronger among the youngest age group and weakest among the oldest. Religiosity was unrelated to depressive symptoms. Discussion: Psychosocial resources protect against depressive symptoms in age-dependent ways among middle-aged and older Blacks. Differences in these effects may be related to aging, cohort, and selection effects.

When the end feels near: sense of purpose predicts well-being as a function of future time perspective

OBJECTIVES

While sense of purpose is a robust predictor of well-being, little work has considered whether the associations vary based on future time perspective. Exploring this possibility is important given that the extent to which one may pursue their life aims could be dependent upon how much time they feel that they have remaining.

METHODS

Using three samples (total n = 2333), the current study considered the association between sense of purpose and future time perspective. Moderation tests also examined whether the associations between sense of purpose and three well-being components (positive affect, negative affect, life satisfaction) differed as a function of future time perspective.

RESULTS

Across all three studies, people with a broader time perspective reported a higher sense of purpose. Both constructs predicted greater well-being, even after accounting for chronological age. Future time perspective moderated the associations between sense of purpose and well-being, such that the negative association between sense of purpose and negative affect was stronger for those with a broader time perspective and the positive association between sense of purpose and life satisfaction was stronger for those with a limited time perspective.

CONCLUSION

The well-being benefits associated with sense of purpose in adulthood may depend on future time perspective. Findings are discussed in the context of how purpose can be harnessed to enhance well-being even when older adults feel that their time left is limited.

Relationships Between IKIGAI Well-Being and Motivation for Autonomous Regulation of Eating and Exercise for Health - Included the Relevance Between Sense of Coherence and Social Support

BACKGROUND

Self-regulated motivation is associated with better behavior change, health, and hedonic well-being in the health domain. Meanwhile, there are evidences that eudaemonic well-being contributes to health. As well as reducing lifestyle diseases, the promotion of IKIGAI well-being (encompassing hedonic and eudaemonic well-being) has been targeted in Japan. However, little is known about the impact of IKIGAI well-being on the motivation for health. This study explored the relationships between autonomous motivation for eating and exercise for health, IKIGAI well-being, sense of coherence, and social support.

METHODS

The participants were 622 Japanese (269 males and 353 females, aged 20 to 59 years). They completed a questionnaire on motivation for healthy eating (MHE), exercise motivation for health (EMH), sense of coherence, social support, and IKIGAI well-being.

RESULTS

IKIGAI well-being was positively associated to the relative autonomy index (RAI)-MHE and RAI-EMH. Social support exerted a positive effect on sense of coherence and IKIGAI well-being; sense of coherence positively affected IKIGAI well-being. The invariances of the model across groups, such as gender, age, and subjective economic status, were verified using multiple-group structural equation models.

CONCLUSION

With IKIGAI well-being as a mediating factor, social support and sense of coherence play important roles in promoting autonomous motivation for healthy eating and exercise.

Purpose in Life and Cognition Interact to Impact Healthcare and Financial Decision Making in Old Age

Objectives: Little is known about the contribution of positive psychological factors, such as purpose in life, to healthcare and financial decision making in aging. Here, we examined the relationship between purpose and decision making and tested the hypothesis that purpose benefits decision making, particularly when cognition is limited. Methods: Participants were 1081 community-based older adults without dementia. Healthcare and financial decision making was measured via a 12-item performance-based instrument. Purpose was measured via a 10-item scale. Results: In a linear regression model adjusted for age, sex, and education, higher global cognition was associated with better performance on the decision making measure, as expected. Purpose was not directly related to decision making. However, the interaction of purpose with cognition was significant, such that greater purpose was associated with better decision making among persons with lower cognition. Discussion: Purpose in life may promote better decision making among older adults with lower cognition.

Strengths-building through life purpose, self-care goal setting and social support: Study protocol for Caregiver Support

Background

For caregivers of people with heart failure, addressing a range of care recipient needs at home can potentially be burdensome, but caregivers may also gain meaning from caregiving. The Caregiver Support Program, a multicomponent strengths-based intervention, is designed to improve outcomes of heart failure caregivers.

Objectives

1) Test the feasibility and gauge an initial effect size of the Caregiver Support Program to improve caregiver quality of life (primary outcome), and fatigue and burden (secondary outcomes) from baseline to 16 weeks, 2) test whether fatigue and caregiver burden are associated with objective measures of resilience (sweat inflammatory cytokines (Il-6 and IL-10) and self-reported resilience, 3) evaluate changes in heart rate variability, IL-6 and IL-10, pre- and post-intervention.

Methods

This is a single-blind, two group, waitlist control trial. Eligible caregivers are 1) ≥ 18 years, 2) English speaking, 3) live with the person with heart failure or visit them at least 3 days per week to provide care, 4) provide support for at least 1 instrumental activity of daily living (IADL), 5) live within a 1 h driving radius of the Johns Hopkins Hospital, and 6) the care-recipient has been hospitalized within the last 6 months. Trial participants are randomized into the immediate intervention (n = 24) or waitlist control group (n = 24). Data collection is at baseline, 16 weeks, and 32 weeks.

Conclusion

The Caregiver Support program has the potential to increase quality of life and decrease fatigue and caregiver burden for caregivers of people with heart failure and multiple co-morbidities.

Associations of recognition at work with subsequent health and quality of life among older working adults

PURPOSE

Recognition for work-an act of conveying non-financial appreciation for an outstanding accomplishment or performance-is the top motivator of employee performance and important contributor to psychologically healthy work. Employee recognition programs are offered by many companies and have been shown to retain top talent, increase job satisfaction, and performance. Yet, evidence on the role of received employee recognition for health and quality of life remains limited. This study examined whether receiving recognition for work was prospectively associated with six indicators of health, quality of life, and loneliness.

METHODS

Data were retrieved from the Survey of Health, Ageing and Retirement in Europe (SHARE), a biennial cross-national panel database of people aged > 50 years. Our sample included 5,048 middle-aged and older working adults.

RESULTS

The results indicated that employees receiving recognition for work reported higher quality of life ([Formula: see text]=0.065, 95% CI = 0.047, 0.082), had lower risks of hypertension (RR = 0.932; 95% CI = 0.899, 0.966) and high blood cholesterol (RR = 0.922; 95% CI = 0.879, 0.967). These associations were independent of demographics, socioeconomic status, personality, prior history of diseases, depression, lifestyle, and work conditions. The set of sensitivity analyses provided substantial evidence for the robustness of the associations between recognition for work and quality of life as well as hypertension but not necessarily with high blood cholesterol.

CONCLUSIONS

Promotion of employee recognition might emerge as a valuable business resource and health policy tool helping middle-aged and older adults maintain health and good quality of life. It may also help willing older adults to remain on the labour market until older age.

Sense of Coherence Mediates the Relationship Between Cognitive Reserve and Cognition in Middle-Aged Adults

In recent years, supported by new scientific evidence, the conceptualization of cognitive reserve (CR) has been progressively enriched and now encompasses not only cognitive stimulating activities or educational level, but also lifestyle activities, such as leisure physical activity and socialization. In this context, there is increasing interest in understanding the role of psychological factors in brain health and cognitive functioning. In a previous study, we have found that these factors mediated the relationship between CR and self-reported cognitive functioning. In this study, we have confirmed an association between two important constructs included in the psychological wellbeing and salutogenic models, "purpose in life" and "sense of coherence," CR, as assessed using a questionnaire, and cognitive functioning, as evaluated using a comprehensive neuropsychological battery. Results from 888 middle-aged healthy participants from the Barcelona Brain Health Initiative indicate that both sense of coherence (SoC) and CR were positively associated with verbal memory, reasoning and attention, working memory, and global cognition. Moreover, the relation between CR and cognitive functioning in the different domains is partially mediated by SoC. When we controlled for brain integrity, introducing into the model neurofilament light chain measures, the mediator role of SoC was confirmed for reasoning and attention and global cognition. However, purpose in life was not associated with cognitive functioning. These results reveal the central role of the SoC construct, which mediates the association between classic CR estimates and cognitive functions, potentially representing a modifiable target for interventions that aim to promote brain health.

Negative and Positive Psychosocial Factors in Relation to Cognitive Health in Older African Americans

Background and Objectives

Identifying potential intervention strategies to reduce cognitive decline, particularly among older African Americans at high risk for Alzheimer’s dementia, is critical. This study aimed to investigate whether depressive symptoms, purpose in life, and their interrelations are associated with cognitive decline in older African Americans.

Research Design and Methods

We included older African Americans from the Minority Aging Research Study (n = 748) and Rush Memory and Aging Project (n = 109), without dementia at baseline. We assessed associations of depressive symptoms, purpose in life, and their interrelations, with baseline levels and change in global cognition using linear mixed-effects models.

Results

At baseline, each unit increment in depressive symptoms was related to worse initial global cognition (mean difference = −0.03 standard unit; p = .003), while higher purpose in life was related to better cognition (mean difference = 0.12; p = .002). Further, participants with ≥1 depressive symptom who had a purpose in life score above the median appeared to have better global cognition (mean difference = 0.10; p = .01), compared to those with depressive symptoms but lower levels of purpose in life. However, we did not find relations of depressive symptoms or purpose in life with rates of cognitive decline over time, likely due to the modest follow-up.

Discussion and Implications

In older African Americans, we found that lower depressive symptoms and greater purpose in life were independently related to higher initial levels of global cognition, but not cognitive decline. Preliminary findings of higher global cognition in individuals with depressive symptoms but greater purpose in life merit further investigation if purpose may eventually be considered as an intervention.

Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity

While much attention has been paid to healthcare provider and trainee burnout, less is known about provider well-being (i.e., flourishing) or about the effects of well-being on immune function. This study examined the demographic and psycho-social correlates of well-being among healthcare trainees (resident physicians and physician assistant (PA) trainees) and evaluated the association of well-being with the “conserved transcriptional response to adversity” (CTRA) characterized by up-regulated expression of pro-inflammatory genes and down-regulated expression of innate antiviral genes. Participants (n = 58) completed self-reported assessments of sleep disturbance, loneliness, depressive symptoms, anxiety, stress, and well-being (flourishing). Blood sample RNA profiles were analyzed by RNA sequencing to assess the CTRA. Slightly over half (n = 32; 55.2%) of healthcare trainees were categorized as flourishing. Flourishing was less prevalent among primary caregivers, and more prevalent among trainees who exercised more frequently and those with fewest days sick. Loneliness (AOR = 0.75; 95% CI = 0.61, 0.91; p = 0.003) and stress (AOR = 0.65; 95% CI = 0.45, 0.94; p = 0.02) were associated with decreased odds of flourishing when controlling for other variables. Flourishing was associated with down-regulated CTRA gene expression, whereas loneliness was associated with up-regulated CTRA gene expression (both p < 0.05). Assessing these relationships in a larger, multi-site study is of critical importance to inform policy, curricula, and interventions to bolster sustainable trainee well-being.

The Impact of COVID-19 on Older Adults: Results from an Annual Survey

Objectives

Assess well-being among older adults through secondary analysis measured during an annual survey in 2018, 2019, and 2020, to determine trends from before and during the COVID-19 pandemic.

Methods

Mailed surveys sent annually included measures related to various psychosocial factors.

Main findings

Response rates were 29% in 2018, 25% in 2019, and 24% in 2020. Most respondents reported average or high resilience (89% 2018-2020), high purpose (64% in 2018 and 2019, 63% in 2020), moderate optimism (46% in 2019, 44% in 2020) and low stress (88% in 2019 and 2020). Reported loneliness increased 13% from 2018 to 2020. In 2020, only 45% reported high comfort with technology, decreasing with age (>75).

Principal conclusion

Psychosocial well-being of respondents were doing well despite changes related to COVID-19. However, increased loneliness may negatively impact long-term health outcomes; thus, a focus on technology options to stay socially connected and access healthcare are needed.

Productive Aging by Environmental Volunteerism: A Systematic Review

BACKGROUND

The aging society and climate changes pose significant challenges globally. Environmental volunteering solves these two problems by engaging older people in nature conservation as a possible model of productive aging. This review examines the current state of environmental volunteerism for older adults.

METHODS

We systematically searched for articles in Medline, Embase, CENTRAL, CINAHL, and PsycINFO. Environmental volunteerism was defined as nature conservation activity without payment. There were 9 studies with a total of 328 participants. We conducted a narrative synthesis and meta-ethnography, which focused on types, benefits, motivations, and drawbacks of environmental volunteerism.

RESULTS

Three types of volunteering were identified: greening, recycling, and project-oriented. Their shared factors included physical activity, social connection, and meaningful purpose. Environmental volunteerism associated with benefits in physical health, mental wellbeing, social capital, and personal empowerment with no apparent drawbacks. Retired people find a purpose to live, opportunities for socialization and physical activity, and increased self-esteem in the process. The motivations for initiation and continued engagement were found to be socialization, generativity, usefulness to others, and pro-environmental attitude. Among them, socialization was the most mentioned motivation, and generativity was the unique factor for older adults compared with the general population.

CONCLUSION

Environmental volunteerism may be a positive model for older adults, society, and environment. Policymakers can encourage more older adults to engage in environmental volunteering with concerns of motivations, found by this study. Future studies can further strengthen the evidence and explore more types of environmental volunteerism.

The Association of Psychological Well-Being With Sensory and Cognitive Function and Neuronal Health in Aging Adults

OBJECTIVES

Psychological well-being (PWB) may be a potential modifiable risk factor of age-related diseases. We aimed to determine associations of PWB with sensorineural and cognitive function and neuronal health in middle-aged adults.

METHODS

This study included 2039 Beaver Dam Offspring Study participants. We assessed PWB, hearing, visual acuity, contrast sensitivity impairment, olfactory impairment, cognition, and retinal (macular ganglion cell inner-plexiform layer, mGCIPL) thickness. Age-sex-education-adjusted multivariable linear, logistic regression, and generalized estimating equation models were used and then further adjusted for health-related confounders.

RESULTS

Individuals with higher PWB had better hearing functions, visual acuity, and thicker mGCIPL and reduced odds for hearing, contrast sensitivity and olfactory impairment in age-sex-education-adjusted models. Effects on mGCIPL and visual and olfactory measures decreased with adjustment. Higher PWB was associated with better cognition, better combined sensorineural-cognitive function, and decreased cognitive impairment.

DISCUSSION

Psychological well-being was associated with sensorineural-cognitive health indicating a potential of PWB interventions for healthy aging.

Psychological Science in the Wake of COVID-19: Social, Methodological, and Metascientific Considerations

The COVID-19 pandemic has extensively changed the state of psychological science from what research questions psychologists can ask to which methodologies psychologists can use to investigate them. In this article, we offer a perspective on how to optimize new research in the pandemic's wake. Because this pandemic is inherently a social phenomenon-an event that hinges on human-to-human contact-we focus on socially relevant subfields of psychology. We highlight specific psychological phenomena that have likely shifted as a result of the pandemic and discuss theoretical, methodological, and practical considerations of conducting research on these phenomena. After this discussion, we evaluate metascientific issues that have been amplified by the pandemic. We aim to demonstrate how theoretically grounded views on the COVID-19 pandemic can help make psychological science stronger-not weaker-in its wake.

Sense of Purpose in Life and Subsequent Physical, Behavioral, and Psychosocial Health: An Outcome-Wide Approach

PURPOSE

Growing evidence indicates that a higher sense of purpose in life (purpose) is associated with reduced risk of chronic diseases and mortality. However, epidemiological studies have not evaluated if change in purpose is associated with subsequent health and well-being outcomes.

DESIGN

We evaluated if positive change in purpose (between t₀; 2006/2008 and t₁;2010/2012) was associated with better outcomes on 35 indicators of physical health, health behaviors, and psychosocial well-being (at t₂;2014/2016).

SAMPLE

We used data from 12,998 participants in the Health and Retirement study-a prospective and nationally representative cohort of U.S. adults aged >50.

ANALYSIS

We conducted multiple linear-, logistic-, and generalized linear regressions.

RESULTS

Over the 4-year follow-up period, people with the highest (versus lowest) purpose had better subsequent physical health outcomes (e.g., 46% reduced risk of mortality (95% CI [0.44, 0.66])), health behaviors (e.g., 13% reduced risk of sleep problems (95% CI [0.77, 0.99])), and psychosocial outcomes (e.g., higher optimism (β = 0.41, 95% CI [0.35, 0.47]), 43% reduced risk of depression (95% CI [0.46, 0.69]), lower loneliness (β = -0.35, 95% CI [-0.41, -0.29])). Importantly, however, purpose was not associated with other physical health outcomes, health behaviors, and social factors.

CONCLUSION

With further research, these results suggest that sense of purpose might be a valuable target for innovative policy and intervention work aimed at improving health and well-being.

Psychological Resources and Biomarkers of Health in the Context of Chronic Parenting Stress

Background

Epidemiological studies link psychological resources to better physical health. One reason may be that psychological resources are protective in stressful contexts. This study tested whether indeed psychological resources are protective against biological degradation for healthy mid-life women under the chronic stress of caring for a child with an autism spectrum disorder diagnosis (“caregivers”).

Methods

We tested whether five types of psychosocial resources (i.e., eudaimonic well-being, autonomy, purpose in life, self-acceptance, and mastery) were associated with biological indices of aging in a sample of mid-life women stratified by chronic stress; half were caregivers (n = 92) and half were mothers of neurotypical children (n = 91; controls). Selected stress and age related biological outcomes were insulin resistance (HOMA-IR), systemic inflammation (IL-6, CRP), and cellular aging (leukocyte telomere length). We tested whether each resource was associated with these biomarkers, and whether caregiving status and high parenting stress moderated that relationship.

Results

All the psychological resources except mastery were significantly negatively associated with insulin resistance, while none were related to systemic inflammation or telomere length. The relationships between eudaimonic well-being and HOMA-IR, and self-acceptance and HOMA-IR, were moderated by parental stress; lower resources were associated with higher insulin resistance, but only for women reporting high parental stress. The well-known predictors of age and BMI accounted for 46% of variance in insulin resistance, and psychological resources accounted for an additional 13% of variance. 

Conclusion

These findings suggest that higher eudaimonic well-being and greater self-acceptance may be protective for the metabolic health of mid-life women, and particularly in the context of high parenting stress. This has important implications given the rising rates of both parental stress and metabolic disease, and because psychological interventions can increase eudaimonic well-being and self-acceptance.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12529-021-10007-z.

Maintaining sense of purpose in midlife predicts better physical health

OBJECTIVE

Having a sense of purpose in life is fundamental to psychological and physical well-being. Despite the benefits of purpose, it may be difficult to hold onto purpose as people age. The present research addressed four aims: (1) to estimate average change in sense of purpose during midlife; (2) to test associations between purpose levels and later physical health; (3) to test associations between purpose change and later physical health; (4) to examine the cross-cultural generalizability of findings.

METHODS

We used reliable change indices to estimate change in sense of purpose during midlife in three prospective cohorts: one comprised predominately of White participants in the U.S. (N = 2692), a second predominately of African American participants in the U.S. (N = 248), and a third of Japanese participants in Tokyo (N = 644). Next, we used linear regression to examine associations between purpose levels and purpose change and later self-reported general health and chronic health conditions.

RESULTS

At the group level, purpose declined slightly across time (Cohen's ds = -0.08 to -0.17). At the individual level, 10-14% of participants reliably decreased in purpose, whereas only 6-8% of participants reliably increased in purpose. Consistent with our preregistered hypotheses, higher purpose levels predicted better health in the two larger samples (βs = 0.10-0.18, small effects) and more positive purpose change predicted better health in all three samples (βs = 0.08--0.22., small to medium effects).

CONCLUSION

Together, these findings suggest that both having a sense of purpose and holding onto it may be important for physical health in middle to older adulthood.

Longitudinal Associations Between Physical Activity and Purpose in Life Among Older Adults: A Cross-Lagged Panel Analysis

Objective: The purpose of the current study was to examine the bidirectional relationship between physical activity (PA) and purpose in life in an older adult sample using longitudinal data. Method: Data were collected from three waves (2006, 2010, and 2014) of the Health and Retirement Study. A total of 4591 participants who had complete information of PA and purpose in life at baseline were included in the current study. A series of cross-lagged models were tested separately for vigorous-intensity PA, moderate-intensity PA, and light-intensity PA. Results: While higher levels of purpose in life were associated with more frequent engagement in future vigorous-intensity PA, moderate-intensity PA, and light-intensity PA, none of the PA variables predicted subsequent purpose in life. Discussion: The results did not support a reciprocal relationship between PA and purpose in life in older adults. It is more likely that purpose in life predicts PA, rather than vice versa.