Charting everyday activities in later life: Study protocol of the mobility, activity, and social interactions study (MOASIS)

Prominent theories of aging emphasize the importance of resource allocation processes as a means to maintain functional ability, well-being and quality of life. Little is known about which activities and what activity patterns actually characterize the daily lives of healthy older adults in key domains of functioning, including the spatial, physical, social, and cognitive domains. This study aims to gain a comprehensive understanding of daily activities of community-dwelling older adults over an extended period of time and across a diverse range of activity domains, and to examine associations between daily activities, health and well-being at the within- and between-person levels. It also aims to examine contextual correlates of the relations between daily activities, health, and well-being. At its core, this ambulatory assessment (AA) study with a sample of 150 community-dwelling older adults aged 65 to 91 years measured spatial, physical, social, and cognitive activities across 30 days using a custom-built mobile sensor ("uTrail"), including GPS, accelerometer, and audio recording. In addition, during the first 15 days, self-reports of daily activities, psychological correlates, contexts, and cognitive performance in an ambulatory working memory task were assessed 7 times per day using smartphones. Surrounding the ambulatory assessment period, participants completed an initial baseline assessment including a telephone survey, web-based questionnaires, and a laboratory-based cognitive and physical testing session. They also participated in an intermediate laboratory session in the laboratory at half-time of the 30-day ambulatory assessment period, and finally returned to the laboratory for a posttest assessment. In sum, this is the first study which combines multi-domain activity sensing and self-report ambulatory assessment methods to observe daily life activities as indicators of functional ability in healthy older adults unfolding over an extended period (i.e., 1 month). It offers a unique opportunity to describe and understand the diverse individual real-life functional ability profiles characterizing later life.

Investigating the Relationship between Resident Physician Implicit Bias and Language Use during a Clinical Encounter with Hispanic Patients

Prior research suggests that the implicit biases of physicians are negatively associated with quality of medical care and patient satisfaction among minority patients. However, relatively little is known about how physicians express these subtle forms of bias in patient interactions. This study examined the implicit and explicit anti-Hispanic biases of 53 resident physicians and the relationship between anti-Hispanic bias and language use during outpatient medical appointments with 291 Hispanic patients. Physician implicit bias was positively associated with use of interrogatives and work-related words and negatively associated with the use of prepositions and relativity-related words (e.g., words related to time and the future). These findings contribute to the growing body of evidence suggesting that, in addition to nonverbal and paraverbal behaviors, providers may communicate implicit bias to patients through the words they use during a clinical visit.

Psychological Factors That Suppress Help-Seeking among Middle-Aged and Older Adults Living Alone

Help-seeking among destitute adults has not been adequately investigated. Therefore, this study clarifies the mechanisms that suppress help-seeking in middle-aged and older adults living alone. Data were collected from 1274 individuals (aged 50-79 years) who were living alone, using a survey that measured future time perspective, barriers to help-seeking, help-seeking intentions, and current and childhood economic statuses. Men living alone experienced lower help-seeking intention than women, were more likely to try to solve problems by themselves, and experienced greater distrust in others. No sex differences were observed in "future anxiety" and "resignation to the future." Poor economic status was associated with high "resignation to the future," "future anxiety," and "distrust of others" for both sexes. "Resignation to the future" was particularly higher among men with a poorer current economic status, which suppressed help-seeking. Abandoning hope for the future, which is characteristic of middle-aged and older men living alone, may inhibit help-seeking behavior.

Eavesdropping on Autobiographical Memory: A Naturalistic Observation Study of Older Adults' Memory Sharing in Daily Conversations

The retrieval of autobiographical memories is an integral part of everyday social interactions. Prior laboratory research has revealed that older age is associated with a reduction in the retrieval of autobiographical episodic memories, and the ability to elaborate these memories with episodic details. However, how age-related reductions in episodic specificity unfold in everyday social contexts remains largely unknown. Also, constraints of the laboratory-based approach have limited our understanding of how autobiographical semantic memory is linked to older age. To address these gaps in knowledge, we used a smartphone application known as the Electronically Activated Recorder, or “EAR,” to unobtrusively capture real-world conversations over 4 days. In a sample of 102 cognitively normal older adults, we extracted instances where memories and future thoughts were shared by the participants, and we scored the shared episodic memories and future thoughts for their make-up of episodic and semantic detail. We found that older age was associated with a reduction in real-world sharing of autobiographical episodic and semantic memories. We also found that older age was linked to less episodically and semantically detailed descriptions of autobiographical episodic memories. Frequency and level of detail of shared future thoughts yielded weaker relationships with age, which may be related to the low frequency of future thoughts in general. Similar to laboratory research, there was no correlation between autobiographical episodic detail sharing and a standard episodic memory test. However, in contrast to laboratory studies, episodic detail production while sharing autobiographical episodic memories was weakly related to episodic detail production while describing future events, unrelated to working memory, and not different between men and women. Overall, our findings provide novel evidence of how older age relates to episodic specificity when autobiographical memories are assessed unobtrusively and objectively “in the wild.”