Accounting for changes in social support among married older adults: Insights from the MacArthur Studies of Successful Aging

Sex and gender differences in social participation among community-dwelling older adults: a systematic review

Background

Frequent social participation among older adults is associated with greater health. Although understanding how sex and gender influence social participation is important, particularly in developing sex-inclusive health promotion and preventive interventions, little is known about factors influencing engagement of older women and men in social activities.

Aim

This study thus aimed to examine factors influencing social activities of older women and men.

Methods

A mixed-method systematic review was conducted in nine electronic databases from inception to March 2023. The studies had to define social participation as activities with others and examine its influencing factors among community-dwelling older women and men. Data were analyzed using convergent synthesis design from a socio-ecological perspective.

Results

Forty-nine studies, comprising 42 quantitative, five qualitative and two mixed method design were included. Themes identified concerned: (a) sociodemographic factors, (b) personal assets, (c) interpersonal relationships and commitments, (d) physical environment, and (e) societal norms and gender expectations. The findings identified the heterogeneous needs, preferences and inequalities faced by older women and men, considerations on sociocultural expectations and norms of each gender when engaging in social activities, and the importance of having adequate and accessible social spaces. Overall, this review identified more evidence on factors influencing social participation among women than in men.

Conclusion

Special attention is needed among community care providers and healthcare professionals to co-design, implement or prescribe a combination of sex and gender-specific and neutral activities that interest both older women and men. Intersectoral collaborative actions, including public health advocates, gerontologists, policymakers, and land use planners, are needed to unify efforts to foster social inclusion by creating an age-friendly and sustainable healthy environment. More longitudinal studies are required to better understand social participation trajectories from a sex and gender perspective and identify factors influencing it.

Systematic reviews registration

http://www.crd.york.ac.uk/PROSPERO, identifier [CRD42023392764].

Predictors of attitudes towards aging in elderly living in community care

BACKGROUND

Due to the aging of the population, the promotion of healthy aging is an important part of public health. Healthy aging of the population can be influenced by the attitudes of the elderly themselves towards old age and aging. The aim of this cross-sectional study was to find out the attitudes of older people living in a community environment toward old age and the predictors that influence these attitudes.

METHODS

The evaluation of attitudes towards old age using the WHO AAQ (Attitudes to Aging Questionnaire) questionnaire involved 1,174 elderly people living in the community. Age, sex, marital status, education, subjective health assessment, social support, depression (GDS-15), anxiety (GAI), sense of coherence (SOC-13) and self-esteem (RSES) were used to evaluate related factors.

RESULTS

As part of the exploratory factor analysis, a three-factor model (Psychosocial Loss, Physical Change, and Psychological Growth) was confirmed. The Cronbach alpha was found to be acceptable (α = 0.835). The predictors of better AAQ in the Psychological Loss domain were: subjective health, age, quality of life, self-esteem, sense of coherence, life satisfaction, anxiety, and social support; in the Physical Change domain: subjective health, quality of life, self-esteem, life satisfaction, cohabitation, and depression; and in the Psychological Growth domain: age, self-esteem, sense of coherence, life satisfaction, and social support.

CONCLUSION

Preventive and policy measures should aim to increase the satisfaction and self-assessment of the elderly, which can help them evaluate the period of old age more positively. It is also important to create a positive perspective of ageing and elderly in society.

The use of assistive devices and social engagement among older adults: heterogeneity by type of social engagement and gender

Little is known about the relationship between the use of assistive devices for functional loss and social engagement. This study investigated whether wearing assistive devices (dentures and hearing aids) is associated with social engagement among older adults in South Korea. Potential heterogeneity by type of social engagement (informal social contact versus formal social activity) and gender was also examined. This study analyzed data from 3725 individuals aged 65 or older collected over the course of 6 waves of the Korean Longitudinal Study of Ageing (KLoSA) from 2008 to 2018 (2150 women and 1575 men). Individual fixed effects models were used to account for unobserved individual-level heterogeneity that could confound the relationship between wearing assistive devices and social engagement. The fixed effects estimates showed that wearing assistive devices is associated with a decrease in formal social activity (b =  - 0.034 for dentures and b =  - 0.077 for hearing aids), but not informal social contact. Gender-stratified fixed effects revealed that the association between wearing assistive devices and social engagement is statistically significant only for men. In men, wearing assistive devices is associated with a decrease in formal social activity (b =  - 0.049 for denture and b =  - 0.095 hearing aids). The findings of this study suggest that wearing assistive devices may reduce the formal social activity of older adults, particularly men. Policymakers should consider developing interventions to help older adults overcome the stigma associated with assistive devices, which can hinder their social integration.

Coping or Thriving? Reviewing Intrapersonal, Interpersonal, and Societal Factors Associated With Well-Being in Singlehood From a Within-Group Perspective

Singlehood, defined as not being in a romantic relationship, is becoming increasingly common worldwide. Despite this, research on singlehood has not received remotely equivalent research attention as romantic relationships. Well-being research that has explicitly included singles has focused on whether coupled versus single people are more satisfied with their lives. However, these between-group comparisons have not attended to within-group variability among singles that can point to when and for whom singlehood is associated with thriving. In this review, we document findings from the emerging field of singlehood studies to highlight what is and is not known about factors that are associated with the well-being of single individuals from a within-group perspective. Our review examines (a) intrapersonal factors (characteristics of the individual), (b) interpersonal experiences (qualities of one's social relationships and experiences), and (c) societal influences (features related to one's broader social or cultural context) related to well-being in singlehood. We conclude by offering future directions for the conceptualization of and research on singlehood with the goal of promoting a thorough and inclusive perspective.

Associations between social health factors, cognitive activity and neurostructural markers for brain health - A systematic literature review and meta-analysis

Social health factors (e.g., social activities or social support) and cognitive activity engagement have been associated with dementia risk, but their neural substrates have not been well established. This systematic review and meta-analysis summarizes the available evidence regarding the association between these factors and cerebral macro- and micro-structure. A comprehensive literature search was conducted in various databases, following predefined criteria. Heterogeneity, risk of publication bias and overall certainty of evidence were assessed using standardized scales and, whenever appropriate, random effects meta-analysis was conducted. Of 6715 identified articles, 43 were included. Overall, consistency of findings was low and methodological heterogeneity high for all outcomes. However, in some studies cognitive and social activities were positively associated with total brain, global and cortical grey matter and hippocampal volume as well as white matter microstructural integrity. Furthermore, structural social network characteristics (e.g., social network size) were associated with regional grey matter volumes, while functional social network characteristics (e.g., social support) were additionally associated with total brain volume. Meta-analyses revealed small but significant partial correlations between cognitive and social activities and hippocampal (three studies; n = 892; rz =0.07) and white matter hyperintensity volume (three studies; n = 2934; rz =-0.04). More prospective studies are needed to assess temporal associations.

Spouse caregivers' identification of the patient as their primary support person is associated with better patient psychological well-being

Examine the impact of the primary-support person (PSP) role on advanced cancer patient and spouse caregiver psychological well-being, above and beyond the effects of relationship satisfaction.

Secondary analysis of cross-sectional questionnaire data.

88 advanced cancer patient/spouse-caregiver dyads.

Patients and caregivers independently completed measures assessing depression, anxiety, perceived stress, and relationship satisfaction, and identified their PSP. Patient and caregiver psychological well-being outcomes were regressed on patient and caregiver PSP variables in an actor-partner interdependence model.

Half of patients identified their caregiver as PSP; 9% of caregivers identified their patient as PSP. When caregivers identified their patient as PSP, the patient reported better outcomes. No associations were seen for patient identification of caregiver as PSP or caregiver well-being.

Clinicians can encourage patients to find ways to continue to focus on their relationship with the caregiver and help caregivers connect with other sources of support.

Positive social factors prospectively predict younger epigenetic age: Findings from the Health and Retirement Study

OBJECTIVES

Positive social factors may slow biological aging, but this has yet to be rigorously tested. This study investigated whether baseline levels or changes over time in social support and contact frequency prospectively predicted epigenetic age.

METHOD

Health and Retirement Study participants (N = 1912, 46.3 % male, aged 42-87 at baseline) reported longitudinal social support and contact frequency data up to 3 times between 2006 and 2016 and provided blood in 2016. Baseline levels (intercepts) and changes over time (slopes) in social support from and contact frequency with spouses, children, friends, and other family were outputted from multilevel models and used to predict epigenetic age, estimated from Horvath, Hannum, GrimAge, PhenoAge, and Dunedin Pace of Aging.

RESULTS

In models adjusted for demographic and health characteristics, higher baseline levels of support from and contact frequency with friends were prospectively associated with a slower Pace of Aging (support: p = .002; contact: p = 0.009) and a lower GrimAge (contact: p = .001). In addition, higher contact frequency with children at baseline was prospectively associated with a lower GrimAge (p < .001), and higher contact frequency with family at baseline and an increase in family contact over time was associated with a lower Hannum age (baseline: p = .005; slope: p = .015).

CONCLUSIONS

Perceived support from and contact with close others, particularly friends, may have implications for healthy biological aging. Notably, the effect sizes for friends were comparable to the effect of body mass index on epigenetic age. Positive social factors were generally associated with second- and third-generation clocks, which may be more sensitive to psychosocial factors than first-generation clocks.

Living Arrangements and Intergenerational Support in Puerto Rico: Are Fathers Disadvantaged?

OBJECTIVES

To examine how intergenerational support varies by parents' living arrangements and whether there are gender differences in received support in Puerto Rico.

METHODS

Data come from the 2006-2007 Puerto Rican Elderly and Health Conditions Project, a representative longitudinal study of adults aged 60 and older in Puerto Rico (n = 2,288). We examined the association between parents' living arrangements (alone, with spouse/partner only, with children) and their receipt of functional (help with errands/housework/transport) and health (help when sick) support from children, and whether parents' gender moderates the association.

RESULTS

Intergenerational coresidence was associated with higher odds of receiving functional and health support than living alone. Women were more likely than men to receive both forms of support. Parents' gender significantly moderated the association between living arrangements and receiving health support-men living with their partners were less likely to receive health support from children than women in similar living arrangements. These associations persisted when analyses were restricted to those with disability.

DISCUSSION

Our findings suggest that parents' receipt of support from children is conditioned upon their living arrangement and gender, even when their functional health is jeopardized. We discuss these results in relation to the heterogeneous influence of living arrangements for older adults' support needs and provide suggestions for policy and directions for future research in rapidly aging Puerto Rico.

Staying connected: smartphone acceptance and use level differences of older adults in China

In recent years, an increasing number of studies have addressed the older adults' Information and Communication Technology acceptance, the majority of which concentrate on the use of computers and the internet. As smartphone use becomes further integrated into older adults' daily lives, it is important to investigate how perceptions about and use of smartphones intersect. This study (1) proposes an extended Technology Acceptance Model and tests the relationships between Perceived Usefulness, Perceived Ease of Use, Attitude, Behavioural Intention, Self-efficacy, Technology Anxiety, and Social Support in older adults' smartphone use by confirmatory factor analysis (CFA); and (2) analyses the specific differences between primary, medium, and advanced use level groups in each construct by Q-cluster and ANOVAs. We conduct a community-based survey with a sample of 1,006 older adults in East China. The data demonstrate that the extended model offered a good explanation of smartphone acceptance among the older adults, and the groups belong to different use levels show significant difference in all constructs. The findings indicate that digital divide is objectively inevitable in smartphone use, but the older adults are extremely diverse groups that do not uniformly conform to technology averse stereotypes.

Can the internet mitigate the negative effect of widowhood on Quality of Life? A gender analysis

Widowhood often reduces the Quality of Life of individuals of advanced ages by negatively affecting their social network ties. Yet conversely, the Internet has also created new opportunities for communication and interaction, thus contributing to improved Quality of Life. This research analyses the role of the Internet in the relationship between widowhood and Quality of Life from a gender perspective.

This study focuses on 31,814 individuals aged 65 or over residing in 17 European countries who participated in Wave 6 of SHARE – the Survey of Health, Ageing and Retirement in Europe.

The linear regression analyses highlighted that the role of the Internet in the relationship between widowhood and Quality of Life varies according to gender. More specifically, in Europe, the Quality of Life for widowed women aged 65+ using the Internet is .414 higher (CI=.006 to .0822) than widows who do not use the Internet and married women or women in a de facto relationship whether or not they use the Internet. The results have relevant implications for the development of social policies and suggest a need to develop digital inclusion projects targeting older people, particularly widows, to help promote their Quality of Life.

The association between relationship strain and emotional well-being among older adult couples: the moderating role of social connectedness

OBJECTIVES

The present study examines the moderating role of social connectedness (i.e. closeness, talk frequency, social network size, and neighborhood social ties) in the association between one's own and spouse's relationship strain and emotional well-being (i.e. depressive symptoms, happiness, and loneliness).

METHOD

Married couples (N = 865) were drawn from the second wave of the National Social, Health, and Aging Project. One Actor Partner Interdependence Model (APIM) and one Actor Partner Interdependence Model with Moderation (APIMoM) were conducted.

RESULTS

In terms of actor effects, relationship strain was associated with all emotional well-being outcomes. Wives' and husbands' greater relationship strain was associated with spouses' loneliness. Only wives' greater relationship strain was associated with her husbands' higher level of depressive symptoms and no partner effects were found for happiness. In six instances, social connectedness factors helped to ameliorate the association between self/spouse relationship strain, depressive symptoms, and happiness. However, wives' greater neighborhood social ties amplified the association between wives greater relationship strain and husbands' greater depressive symptoms. We did not find that social connectedness factors moderated the associations between self/spouse relationship strain and loneliness.

CONCLUSION

Even in late life marriages, marital strain is associated with less happiness and greater depressive symptoms and loneliness. Practitioners addressing emotional well-being may need to pay attention to spousal perceptions of relationship strain and social relationships external to the marital relationship when working with heterosexual couples. Efforts throughout the life course should be made to ensure connections with diverse types of social networks.Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2021.1910786.

Coping in the Emergency Medical Services: Associations with the personnel’s stress, self-efficacy, job satisfaction, and health

Background

Emergency Medical Services personnel (EMSP) are recurrently exposed to chronic and traumatic stressors in their occupation. Effective coping with occupational stressors plays a key role in enabling their health and overall well-being. In this study, we examined the habitual use of coping strategies in EMSP and analyzed associations of coping with the personnel’s health and well-being.

Method

A total of N = 106 German Red Cross EMSP participated in a cross-sectional survey involving standardized questionnaires to report habitual use of different coping strategies (using the Brief-COPE), their work-related stress, work-related self-efficacy, job satisfaction, as well as mental and physical stress symptoms.

Results

A confirmatory factor analysis corroborated seven coping factors which have been identified in a previous study among Italian emergency workers. Correlation analyses indicated the coping factor “self-criticism” is associated with more work-related stress, lower job satisfaction, and higher depressive, posttraumatic, and physical stress symptoms. Although commonly viewed as adaptive coping, the coping factors “support/venting”, “active coping/planning”, “humor”, “religion”, and “positive reappraisal” were not related to health and well-being in EMSP. Exploratory correlation analyses suggested that only “acceptance” was linked to better well-being and self-efficacy in EMSP.

Conclusion

Our results emphasize the need for in-depth investigation of adaptive coping in EMSP to advance occupation-specific prevention measures.

Rejection sensitivity and vulnerable attachment: associations with social support and PTSD symptoms in trauma survivors

Background

Although social support has been consistently associated with recovery from psychological trauma and prevention of posttraumatic stress disorder (PTSD), individual differences in seeking or benefitting from social support in trauma survivors are not well understood. Factors associated with negative internal working models of self and others, emotion dysregulation, and interrupted bonds with an individual's social support groups such as vulnerable attachment and rejection sensitivity could contribute to lower experienced social support and higher levels of PTSD.

Objective

The objective of this study was to test a theoretically informed model and investigate how psychosocial variables such as vulnerable attachment styles, rejection sensitivity, and social support are associated with PTSD.

Method

Using a cross-sectional survey and path analyses in 141 survivors of trauma (aged 18-69, M = 25.20), the relationship between vulnerable attachment style, rejection sensitivity, and PTSD were investigated.

Results

Higher vulnerable attachment, rejection sensitivity, and lower social support were found to be significant predictors of PTSD symptoms (f2 = 0.75). The relationships from vulnerable attachment to PTSD were mediated by rejection sensitivity and perceived social support. The results supported and extend theoretical models of PTSD that posit a role for predisposing factors in the development and maintenance of the disorder.

Conclusion

The findings suggest a potential benefit of identifying vulnerable groups that could benefit from a refinement of existing PTSD interventions by targeting the maladaptive effects of vulnerable attachment and rejection sensitivity, thus allowing the individual to draw effectively on social support networks.

Predictors of CRC Stage at Diagnosis among Male and Female Adults Participating in a Prospective Cohort Study: Findings from Alberta's Tomorrow Project

Colorectal cancer (CRC) is a leading cause of morbidity and mortality in Canada. CRC screening and other factors associated with early-stage disease can improve CRC treatment efficacy and survival. This study examined factors associated with CRC stage at diagnosis among male and female adults using data from a large prospective cohort study in Alberta, Canada. Baseline data were obtained from healthy adults aged 35–69 years participating in Alberta’s Tomorrow Project. Factors associated with CRC stage at diagnosis were evaluated using Partial Proportional Odds models. Analyses were stratified to examine sex-specific associations. A total of 267 participants (128 males and 139 females) developed CRC over the study period. Among participants, 43.0% of males and 43.2% of females were diagnosed with late-stage CRC. Social support, having children, and caffeine intake were predictors of CRC stage at diagnosis among males, while family history of CRC, pregnancy, hysterectomy, menopausal hormone therapy, lifetime number of Pap tests, and household physical activity were predictive of CRC stage at diagnosis among females. These findings highlight the importance of sex differences in susceptibility to advanced CRC diagnosis and can help inform targets for cancer prevention programs to effectively reduce advanced CRC and thus improve survival.

Gender differences in family support to older adults and implications for social work in south-east Nigeria

The increase in the number of older adults in Nigeria is a significant demographic trend, requiring adequate and sustainable attention. Usually, these older adults depend on family members for support due to increasing frailty and/or disengagement from the civil service or other income-earning pursuits. Studies that depict differences in gender vis a vis access to social support from family networks are limited. This study will attempt to contribute to filling this gap. Four focus group discussions and 16 in-depth interviews were conducted on a sample of (N = 56) older adults aged 70 years and above and their 23 to 46 year old family carers. The generated data were analysed in themes. Findings revealed no differences in access to health support by gender; however, females received more financial, emotional as well as material support, and were more involved in social activities than their male counterparts. This study will facilitate a better understanding of gender differences in social support for older adults in Nigeria. This could, in turn, inform inclusive social policies guided by social workers which have greater focus on the needs of older adults.

Association of vision loss and depressive symptomatology in older adults assessed for ocular health in senior living facilities

PURPOSE

People with vision loss are at increased risk for major depressive disorder (MDD) and subclinical depression. However, screening for depression is rarely done in eye care settings or among groups in the general population known to have vision disorders.

METHODS

We examined the prevalence of depression, using the Patient Health Questionnaire - 2 (PHQ-2), among a group of older adults (N = 204; mean age = 82.15) at two senior living facilities (SLFs) and determined the relationships between severity of depression and objective visual findings, visual function, beliefs about taking an active role in one's own eye care (i.e., patient activation) and level of social support.

RESULTS

Approximately 50% of the sample had impaired vision in at least one eye, and close to 30% of the sample obtained a score on the PHQ-2 indicating the likely presence of major depressive disorder. Visual testing findings were related to visual function (e.g., ability to read), but not to depression. Patient activation was also not significantly related to the level of depression. However, impaired visual functioning and less social support were both strong predictors of depression. These two variables and their interaction accounted for 17% of the total PHQ-2 score variance.

CONCLUSIONS

These data indicate the potential utility of screening for depression as part of vision care in populations likely to have significant vision loss. The findings also suggest that a comprehensive approach to depression prevention and/or reduction in SLF and similar populations may require interventions to address reduced visual functioning and methods to strengthen social networks.

Strength of social ties and perceived tangible support: distinct characteristics and gender differences of older adults' social circles

Social connections have been found to promote wellbeing among older adults. Studies note gender differences in older adults' social network characteristics and aspects of social support. The present study examined gender differences in the association of social network characteristics (number of strong social ties) and perceived tangible support among a sample of elders (n = 278). Older men reported higher levels of perceived tangible support, while older women had more strong social ties. The number of strong social ties was associated with older women's, but not men's, increased sense of tangible support. Implications for cultivating elders' wellbeing respective of gender particularities are discussed.

Proactive Personality and Social Support With Pre-retirement Anxiety: Mediating Role of Subjective Career Success

The main objective of this paper is to investigate the mediating role of subjective career success (SCS) in the relationship between proactive personality, social support (SS), and pre-retirement anxiety. Using a two-wave longitudinal design, 624 pre-retirees were sampled (M = 56.49 years; SD = 4.56); of these, 237 (37.98%) were males and 387 (62.02%) were females. Measurement model and mediation test were performed using the SmartPLS and IBM SPSS Amos software. The result indicated that proactive personality, SS, and SCS showed negative relationships with the dimensions of pre-retirement anxiety (financial preparedness, social obligation, and social alienation). Subjective career success mediated the relationship between proactive personality and pre-retirement anxiety.

Associations between life course marital biography and late-life memory decline

Late-life marital status is associated with cognitive aging; however, the influence of life course marital biography (i.e., changes in marital status) on late-life cognitive trajectories, as well as gender differences in the effects of marital biography, remain to be explored. Associations between (a) marital status at study baseline (currently married, previously married, never married) and (b) retrospectively reported life course marital biography (i.e., age at first marriage, time spent unmarried following initial marriage, history of divorce, history of widowhood) and up to 20 years of subsequent episodic memory trajectories were examined using latent growth curve models in 3,061 participants aged 51 + in the Health and Retirement Study 2017 Life History Mail Survey. Gender differences were examined with multiplicative interaction terms and stratified models. Participants who were married at study baseline demonstrated higher initial memory than previously and never married individuals. Older age at first marriage and shorter duration spent unmarried were each associated with better initial episodic memory among previously married individuals only; longer duration spent unmarried was associated with slower memory decline. Stratified models suggested that these associations may be driven by women. These results highlight the importance of considering multiple aspects of marital biography, not just current marital status, in cognitive aging research. Marital biography may have an enduring influence on cognitive aging, particularly among previously married older women. Future work is needed to identify mechanisms (e.g., socioeconomic resources, cognitive stimulation, self and spousal health, emotional support) through which marital histories influence cognitive aging. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Can Less Ever Be More? A Model of Emotion Regulation Repertoire of Social Support (ERROSS)

Do people really fare better if they can rely on many social ties? Research suggests that benefits of interpersonal emotion regulation (ER) can be derived from both large and small social networks. Building on the intrapersonal regulatory flexibility model, we propose the emotion regulation repertoire of social support (ERROSS) model that views effective socioemotional support as the combination of network size and ER strategies, resulting in a repertoire of ER resources one can draw on. Best outcomes in mental health should follow from both a large network and a diverse repertoire of strategies. ERROSS is applied as an example in the context of bereavement, and specific contributions of the model are highlighted.

Gender Specificity of Spousal Concordance in the Development of Chronic Disease among Middle-Aged and Older Chinese Couples: A Prospective Dyadic Analysis

This study aimed to explore the gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. Data of 3420 couples were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression was used to analyze the incidence of chronic disease development over 4 years, conditional on the spousal baseline chronic disease status; and stepwise adjusting for the couples’ sociodemographic characteristics (i.e., age, education, retirement status and household income), and their individual lifestyle (i.e., smoking, drinking, exercise, social participation and BMI) all measured at baseline. The incidence of chronic diseases after 4 years of follow-up was 22.95% in the husbands (605/2636) and 24.71% in the wives (623/2521). Taking the couples’ baseline sociodemographic and lifestyle covariates into account, husbands whose wife had chronic diseases at baseline showed an increased risk of developing chronic diseases over 4 years (OR_adjusted = 1.24, 95%CI: 1.02, 1.51), but this risk was not statistically-significant for wives (OR_adjusted = 0.88, 95%CI: 0.71, 1.08). Our study identified gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. This finding may contribute to the design of couple-based intervention for disease prevention and management for community-dwelling older adults.

Cognitive reappraisal and the association between depressive symptoms and perceived social support among older adults

OBJECTIVES

There is an association between depression and diminished social support; indeed, interpersonal dysfunction is often a central feature of depression. The purpose of this study is to examine the role that an emotion regulation (ER) strategy, cognitive reappraisal, plays in influencing the association between depressive symptoms and perceived social support in older adults.

METHOD

Data for this cross-sectional study come from a community-based survey of older adults (60+, N = 910). We examined the effects of depressive symptoms and cognitive reappraisal on perceived social support. We then examined the potential moderating role of cognitive reappraisal on the association between depressive symptoms and perceived social support.

RESULTS

Depressive symptoms were associated with lower levels of perceived social support. Cognitive reappraisal was associated with higher levels of perceived social support. Cognitive reappraisal moderated the negative consequences of depressive symptoms on perceived social support. Whereas depressive symptoms had a negative effect on perceived social support, the negative effect was greater for those with lower levels of cognitive reappraisal compared to those with higher levels of cognitive reappraisal.

DISCUSSION

ER strategies may play a role in attenuating the negative consequences of depressive symptoms on social support in older age. It may be possible to help individuals maintain social support in later life, even in the face of mental health challenges, if they cultivate ER skills.

How Does Perceived Health Status Affect Depression in Older Adults? Roles of Attitude toward Aging and Social Support

Objectives: This study aims to test the mediating effect of attitude toward aging and the moderating effect of social support in the association between perceived health status and depression in older adults. Methods: The study hypotheses were tested by using quantitative data collected from 6485 Chinese older adults. SPSS macro PROCESS was employed to analyze the data. Results: The results show that the relationship between perceived health status and depression in older adults is mediated by their attitude toward aging. In addition, both direct and indirect impacts of perceived health status on depression are significantly buffered by social support. Conclusions: This study suggests a potential mediating role of attitude toward aging and a moderating role of social support in the association between physical health and mental health among older adults. Clinical Implications: The findings of the study suggest that clinicians might need to consider attitudes toward aging along with social support as they work with older adults with comorbid physical illnesses and depression. The findings also reveal that social support is not only about the external resources that older adults need to cope with stressful life events, but also serves as an inner sustenance to make older adults less sensitive to the deleterious effects of poor health status and negative attitude toward aging.

Social Network Characteristics and Their Associations With Stress in Older Adults: Closure and Balance in a Population-Based Sample

OBJECTIVES

Integration into social networks reduces stress during adverse life events and improves coping with disability in late life. The aim was to investigate whether social network closure (frequent contact among ties) and balance (positive contact among ties) are associated with perceived stress. We expect lowest stress for older adults with highly closed and balanced networks.

METHOD

Panel data on self-reported egocentric networks stem from the population-based Chicago Health, Aging, and Social Relations Study. Five waves were collected between 2002 and 2006, with 708 observations from 160 participants aged 50-68 years at baseline. Data include information on the participants' social relationships, that is, interaction frequency and relationship quality, for ego-alter ties and alter-alter ties, and participants' perceived stress. The analytical strategy used fixed- and random-effects models.

RESULTS

Participants reporting the highest number of balanced relationships (positive ties among alters) experience least stress. This effect holds independently of sociodemographic confounders, loneliness, and network size.

DISCUSSION

The absence of a stress-reducing effect from network closure suggests that balance matters more. Future research would benefit from considering balance when examining the characteristics of social networks that impinge on mental health outcomes in older adults.

Life satisfaction among older adults in urban China: does gender interact with pensions, social support and self-care ability?

In urban China, the social welfare system and the family structure have changed dramatically, while gender norms are still deep-rooted, particularly among older adults. Under this social, demographic and cultural context, this study aims to take a gender-specific perspective to investigate whether and how gender moderates the roles of pensions, social support and self-care ability on older adults’ life satisfaction. Based on the survey data collected from 2,047 older adults aged 65 years and over in urban China in 2018, multiple linear regressions were applied to explore the moderation effects. The results show that the pension is important to older adults’ life satisfaction regardless of gender. For social support, the association between family support and life satisfaction is stronger for older men than for older women; interdependent social support, especially being a confidant, matters more to women than to men. The interaction between self-care ability and gender reveals some interesting patterns: self-care ability is found to have a positive association with women's life satisfaction but a negative association with men's. This study contributes to the existing literature by demonstrating how gender intertwines with the most important factors of older adult's life satisfaction in China – a society with strong gender norms and a patriarchal culture. These findings could be relevant to other Asian societies.

Knowing you are there makes the difference: perceived social support, preferences for using support, and health

Using cluster analysis, we investigated whether perceived social support and individual differences in preferences to use support combined to form distinct profiles. Self-report data were collected from U.S. adults (N = 454; aged 40-90, M_age = 55.37, SD = 9.73). Four profiles were identified: disengaged, interpersonally connected, isolated independent, and connected independent. Profiles characterized by high perceived support were associated with better overall health, even among those who preferred not to use support; men and those not married or cohabiting were less likely to be in these profiles. Implications for understanding associations between social support and health and the identification of at-risk groups are discussed.

Implications of relationships with family, friends, and neighbors for changes in women's well-being in late life

This study examined whether relationships with family, friends, and neighbors (both satisfaction and number in the social network) were associated with older women's well-being concurrently and over two years. Additionally, age differences among older women were explored. Women aged 60+ (N = 224, M_age = 80) were sampled from the Social Integration and Aging Study. Greater family and friend satisfaction were positively associated with well-being; number in network was not. Age-related effects for family and friend relationships suggested potential protective effects for the oldest women. Findings highlight unique facets of older women's relationships, suggesting future directions addressing age and support source.

Marital Quality and Well-Being Among Older Adults: A Typology of Supportive, Aversive, Indifferent, and Ambivalent Marriages

A large body of work has linked marital quality to the health and well-being of older adults, but there is a lack of agreement on how to best measure dimensions of marital quality. Drawing on a stress-process life course perspective, we construct a typology of marriage type that captures the synergistic relationship between positive and negative marital qualities and health. Using data from Wave 1 (2005/2006) and Wave 2 (2010/2011) of the NSHAP survey from the United States, we examine the association between supportive, aversive, ambivalent, and indifferent marriages for older adults that remained married over the study period on multiple indicators of well-being (depression, happiness, and self-rated health; N = 769 males and 461 females). Results suggest that older adults in aversive marriages reported lower happiness (men and women) and physical health (men). There was less evidence that those in ambivalent and indifferent marriages reported worse well-being.

Family Ties and Aging in a Multiethnic Cohort

Objective: Lack of social support is linked to lower cognitive function and cognitive decline. We investigated the effects of a specific type of social relationship, family ties, on cognitive trajectories in non-Hispanic whites, non-Hispanic blacks, and Hispanics. Methods: Using multiple-group latent growth curve models, we analyzed associations between the number of children/grandchildren/siblings/other relatives contacted within the past month at baseline and cognitive trajectories in 1420 older adults who were nondemented at baseline. Language, memory, and visuospatial abilities were assessed at baseline and at 18- and 24-month follow-ups for up to six visits. Inferential analyses assessed the differential effects of sex/gender and race/ethnicity for each family tie. Results: Independent of all covariates, contact with more relatives was associated with better initial memory (b = .01) and language functioning (b = .01) across race/ethnicity and sex/gender. Conclusion: The size of peripheral rather than immediate family networks may be more likely to affect cognitive function in older adults.

Association of food insecurity with psychological disorders: Results of a population-based study among older people in Ghana

OBJECTIVE

Food insecurity has been related to poor health, and the effect may be heightened in later life. This study examines age and gender differences in the association of food insecurity with psychological disorders (PD) in older people in Ghana.

METHODS

Ordinary Least Squares (OLS) regressions separately examined the associations between food insecurity and PD score using data from the 2016-2017 AgeHeaPsyWel-HeaSeeB Study. PD was assessed with the Kessler Psychological Distress Scale (K10) whilst food insecurity was assessed with past 30-day hunger (H), breakfast skipping (BS) and time of first daily meal.

RESULTS

Among 1,200 individuals aged ≥50 years, the prevalence of food insecurity indicators of hunger (36%), skipped breakfast (29%) and late intake of first daily meal (5%) were revealed. After full adjustment, moderate (H: β = 0.705, p < 0.001; BS: β = 0.824, p < 0.001) and severe (H: β = 1.813, p < 0.001; BS: β = 1.096, p < 0.001) food insecurity significantly increased PD score compared to no food insecurity. Moreover, having late daily meal was associated with increased the risk of PD (β = 1.035, p < 0.001). These associations were moderated by gender and age (men and 65+ age group had increased risk of PD compared to women and 50-64 age cohorts).

CONCLUSIONS

Food insecurity independently increases PD in older people. These findings are relevant for public health and policy interventions aimed at improving mental health of older people.

Predictors of loneliness incidence in Chinese older adults from a life course perspective: a national longitudinal study

Objectives: We aim to examine what factors are predictive of loneliness incidence from a life course perspective and whether predictors differ between women and men based on a nationally representative longitudinal dataset in China. Method: A total of 5,043 older adults aged 65 or above from the Chinese Longitudinal Healthy Longevity Survey who were not lonely in the 2008 wave were included in the analysis. Logistic regression models were applied to examine what factors in the 2008 wave predicted loneliness incidence in the 2011 wave. Analyses were also stratified by gender to examine gender differences.Results: Older ages and self-rated poor health increased the odds, whereas receiving one or more years of schooling, rural-urban migration, living with family members, having a white-collar job, having a good family economic status, being currently married, having a higher resilience and social support decreased the odds of loneliness incidence. We also found gender differences: socioeconomic factors were significant only for older men, whereas self-rated health, resilience, and social support were significant only for older women.Conclusion: This study offers insights into disentangling the complexity of factors associated with loneliness incidence in Chinese older adults from a life course perspective and from a gendered perspective.

Perceived Health and Life Satisfaction of Elderly People: Testing the Moderating Effects of Social Support, Attitudes Toward Aging, and Senior Privilege

As health declines with age, it is critical to explore moderators that could buffer the impact of declining health on life satisfaction of elderly people. This study aims to test the moderating effects of social support, attitudes toward aging, and senior privilege on the relationship between perceived health and life satisfaction among elderly people. The study used a sample of 5809 Chinese elderly people. Multiple regression analyses were performed to test the moderating effects of the study variables along with gender difference. The results show that social support and attitudes toward aging do not moderate the relationship between perceived health and life satisfaction; senior privilege however, amplifies the impact of perceived health on life satisfaction for female elderly people. The findings recommend personalized provision of senior privilege based on health status and types of diseases, rather than only based on age; and suggest tailored female-oriented social services such as psychological counseling and humanistic care.

Impact of food insecurity with hunger on mental distress among community-dwelling older adults

BACKGROUND

Hunger frequently and persistently occur in older populations in low-income countries especially in sub-Sahara Africa. The aim of this study was to examine the associations between food insecurity with hunger and psychological distress among older people in Ghana.

METHODS

A total of 1200 individuals aged ≥50 years were recruited during 2016/2017 Ageing, Health, Psychological Well-being and Health-seeking Behavior Study. Associations between psychological distress (assessed with the Kessler Psychological Distress Scale) and hunger (assessed with a 30-day subjective scale) were evaluated using linear regression modeling.

RESULTS

The overall prevalence of food insecurity was 36% with approximately 27% and 9% respectively for moderate and severe levels of hunger whilst the mean score of psychological distress was 9.5 (±4.10). Persons experiencing moderate hunger (β = 0.71, SE = 0.160, p < 0.001) and severe hunger (β = 1.81, SE = 0.280, p < 0.001) significantly reported increased psychological distress outcome compared to those without hunger. These associations varied between women (β = 1.59, SE = 0.359 p < 0.001) and men (β = 2.33, SE = 0.474, p < 0.001) as well as 50-64 age group (β = 1.48, SE = 0.368, p < 0.005) and 65+ age group (β = 2.51, SE = 0.467, p < 0.001).

CONCLUSIONS

The results suggest that experiencing hunger is associated with psychological distress and the effect may be aggravated with advancing age and in men. These findings may inform social policy initiatives and health programmatic interventions for older people exposed to food insecurity.

Marital Quality, Loneliness, and Depressive Symptoms Later in Life: The Moderating Role of Own and Spousal Functional Limitations

Loneliness is a mechanism through which marital quality relates to older adults' mental health. Links between marital quality, loneliness, and depressive symptoms, however, are often examined independent of older adults' functional health. The current study therefore examines whether associations between marital quality, loneliness, and depressive symptoms are contextually dependent on individuals' own (or their spouse's) functional limitations, as well as on gender. Data came from couples (N = 1084) who participated in the Health and Retirement Study (HRS), a nationally representative dataset of older adults (age 50+). We utilized data from the 2014 leave-behind psychosocial questionnaire to measure spousal support/strain and loneliness, and interview data from 2014 to measure baseline depressive symptoms and demographic covariates (e.g., race and education). Depressive symptoms in 2016 served as the focal outcome variable. Findings from a series of path models estimated in MPLUS indicated that loneliness is a mechanism through which spousal support predicts older adults' depressive symptoms. Such linkages, however, were dependent on individuals' own functional limitations and gender. For functionally limited males in particular, spousal support was shown to reduce depressive symptoms insofar as it was associated with lower levels of loneliness; otherwise, it was associated with higher levels of depressive symptoms. Such findings reinforce the importance of taking a contextualized approach when examining associations between support and emotional well-being later in life.

Gender-stratified analyses reveal longitudinal associations between social support and cognitive decline in older men

Objectives: Research has extensively examined the relationship between social support and health outcomes in older adults. Little is known, however, about the longitudinal associations between distinct dimensions of perceived social support and incident cognitive decline. The current longitudinal study examined whether dimensions of perceived social support were associated with increased risk of cognitive decline, and if the relationship differed by gender. Methods: 493 community-residing non-demented older adults were assessed for baseline social support via the Medical Outcomes Study-Social Support Survey (MOS-SSS). Incident cognitive impairment was determined using a 1 standard deviation below age and education adjusted total score on the Repeatable Battery for the Assessment of Neuropsychological Status Cox proportional-hazard models were used to analyze incident risk of cognitive impairment. Results: Higher perceived support, overall and in specific domains, at baseline was associated with increased risk of incident cognitive impairment. Further gender-stratified analyses revealed that higher perceived support at baseline was associated with increased risk of incident cognitive impairment only among males. Conclusion: Contrary to previous research, results from this longitudinal study suggest that perceived support might be an important risk factor for cognitive decline, notably in males, and should be integrated into multifactorial risk assessment and intervention procedures.

Depressive Symptoms Among Aging Hispanic Americans: Longitudinal Effects of Positive Spousal Support and Previous Depressive Symptoms

Objective: We aimed to investigate the longitudinal effects of spousal support on aging Hispanic Americans' depressive symptoms using population-based data from the Health and Retirement Study (HRS). Method: Using hierarchical multiple regressions, we investigated whether baseline positive spousal support and previous depressive symptoms were significant predictors of depressive symptoms 8 years later in a sample of 264 aging Hispanic Americans. Results: We discovered that previous depressive symptoms, baseline chronic conditions, and positive spousal support were all significant predictors of long-term depressive symptoms. Discussion: Our findings underline the need to address persistent depression and chronic diseases in the aging Hispanic population. We also highlight the potential benefits of empowering spouses as a resource for promoting mental health in this group. These findings are also encouraging for future studies in depression, aging, and comorbidity, especially in the vastly increasing population of aging Hispanic Americans.

Psychological Distress Transmission in Same-sex and Different-sex Marriages

Ample work stresses the interdependence of spouses' psychological distress and that women are more influenced by their spouse's distress than men. Yet previous studies have focused primarily on heterosexual couples, raising questions about whether and how this gendered pattern might unfold for men and women in same-sex marriages. We analyze 10 days of diary data from a purposive sample of men and women in same-sex and different-sex marriages ( n = 756 individuals from 378 couples) to examine psychological distress transmission between spouses and how this process may differ for men and women in same-sex and different-sex marriages. We find that women are more strongly influenced by their partners' distress than men, regardless of whether they are married to a man or a woman, and that this relationship is particularly strong for women with male spouses.

Depression predicts longitudinal declines in social support among women with newly diagnosed breast cancer

OBJECTIVE

Among breast cancer survivors, low social support is associated with adverse clinical and psychosocial outcomes. This study prospectively examined longitudinal trends in perceived social support in women with newly diagnosed breast cancer as a function of depression status prior to initiation of cancer treatment.

METHODS

One hundred ten patients with newly diagnosed breast cancer and 59 age-matched noncancer controls completed behavioral measures at four assessments: prior to treatment and at 1 month, 1 year, and 2 years post-treatment. Participants reported their perceived tangible and emotional/informational support using the Medical Outcomes Study Social Support Survey and were categorized as "depressed" or "non-depressed" based on the Brief Symptom Inventory-18 (BSI-18). Analyses first compared longitudinal trends in support between patients and controls and then examined differences in longitudinal trends as a function of depression status in patients only, controlling for key covariates.

RESULTS

Both tangible and emotional/informational support decreased among breast cancer patients but increased or remained unchanged among noncancer controls across the assessments. Among patients, depressed individuals experienced a significant decline in both tangible (P = 0.004) and emotional/informational support (P = 0.013) between 1 month and 1 year post-treatment, which remained unchanged between 1 year and 2 years post-treatment. In contrast, nondepressed individuals had stable levels across all assessments. Depressed patients also had lower levels of both support types compared with nondepressed patients across all assessments.

CONCLUSIONS

Breast cancer patients with depressive symptomatology have an elevated risk for declines in perceived social support over time.

The Association between Social Support and Incident Dementia: A 10-Year Follow-Up Study in Japan

Social support is important for the health of elderly populations. However, its longitudinal effect on incident dementia is unclear. We used the Aichi Gerontological Evaluation Study (AGES) project data to investigate the longitudinal effect of social support on dementia onset. Functionally independent older people at baseline (n = 14,088) in 10 municipalities were followed from 2003 to 2013 using National Long-term Care Insurance System data. Social support was assessed by the following support sources: co-residing family, family or relatives living apart, and friends or neighbors. Cumulative incidence of dementia was 14.6% and 18.7% for men and women, respectively. Cox proportional hazard models were employed by gender to investigate the association between social support and dementia onset adjusting for age, health status, health behaviors, subjective cognitive complaints, depression, and other socioeconomic factors. Gender differences were observed in the association between social support and incident dementia. Support from co-residing family members was protective among men, whereas among women, no effect of social support on dementia was observed. Among other social factors, community engagement was protective for women, while for men, being married was associated with lower incidence of dementia. The association between social support and dementia seems to differ by gender. When we design programs to promote social interactions among the elderly, we need to take into account such gender differences.

Dynamic Longitudinal Associations Between Social Support and Cognitive Function: A Prospective Investigation of the Directionality of Associations

Objective

To investigate the reciprocity of social support and cognitive function in late life.

Method

Analyses were based on three parallel repeat measures of social support and cognition from the Whitehall II cohort, providing 10-year follow-up of 6,863 participants (mean age 55.8 years, SD 6.0 at baseline). Alternative hypotheses were evaluated via four bivariate dual change score models: Full coupling model estimated mutual influences of social support and cognition on subsequent changes in each other; social causation model assumed a unidirectional influence from social support onto changes in cognition, while the opposite assumption was tested by health selection model; last, no coupling model suggested independent growth of these two sets of variables.

Results

A better cognition at the preceding stage was related to less positive changes in confiding support and less negative changes in practical support. In contrast, influences from social support on subsequent changes in cognition were not detected.

Discussion

This empirical study provides some evidence for the health selection mechanism, such that cognition modified changes in social support. The hypothesized neuroprotective effect of social support was not detectable.

Specificity of the Association between Marital Discord and Longitudinal Changes in Symptoms of Depression and Generalized Anxiety Disorder in the Irish Longitudinal Study on Ageing

This longitudinal study was conducted to evaluate actor and partner effects of marital discord on changes in symptoms of depression and generalized anxiety disorder (GAD) in a large population sample of Irish adults (N = 1,445 couples), adjusting for the potential confounds of quality of other social relationships and other psychopathology symptoms. The Actor-Partner Interdependence Model was used to examine actor and partner effects of marital discord on changes in symptoms of depression and GAD at a 2-year follow-up. Additional models examined these associations adjusting for family and friend discord and symptoms of the other type of psychopathology (depressive or GAD symptoms). Actor effects of marital discord on depressive and anxiety symptoms were greater for men than for women. There were significant, positive actor effects of marital discord on depressive symptoms for husbands and wives, which remained significant when adjusting for family and friend discord and GAD symptoms. There were significant, positive actor effects of marital discord on GAD symptoms for husbands, which remained significant when adjusting for family and friend discord and depressive symptoms. Results demonstrate that longitudinal associations between marital discord and depressive symptoms (for wives and husbands) and GAD symptoms (for husbands) are incremental to other rival explanations (family and friend discord and the other set of symptoms). Findings provide evidence for a potential causal association leading from marital discord to symptoms of depression and GAD.

A genetically informative analysis of the association between dyadic adjustment, depressive symptoms, and anxiety symptoms

BACKGROUND

Prior research has found a reliable and robust association between poor dyadic (e.g., marital) adjustment and depression and anxiety. However, it is possible that this association may be due, at least in part, to confounding variables (i.e., variables that are causally associated both with marital adjustment and psychopathology and could account for their covariation). The present study was conducted using a genetically informative sample of twins to examine the association between dyadic adjustment and symptoms of depression and anxiety, accounting for unmeasured genetic and shared environmental confounds.

METHODS

A Swedish sample of monozygotic and dizygotic twins (218 female twin pairs and 321 male twin pairs) and their spouse or long-term partner completed self-report measures of dyadic adjustment, depressive symptoms, and anxiety symptoms.

RESULTS

Results suggest that dyadic adjustment was significantly and negatively associated with depressive symptoms and anxiety symptoms in twins, and nonshared environmental influences largely accounted for this association. Furthermore, results obtained from partners' reports of dyadic adjustment were largely consistent with those obtained from twins' reports, suggesting that results were not a function of shared method variance.

LIMITATIONS

Longitudinal research in genetically informative samples would provide a stronger test of the causal association between dyadic adjustment and psychopathology.

CONCLUSIONS

The pattern of findings suggest that common nonshared environmental influences, such as partners' characteristics, may lead to poorer dyadic adjustment and depression and anxiety. Therefore, couple-based interventions that improve dyadic adjustment may be effective in preventing and treating psychopathology in relationship partners.

Social Support and Strain Across Close Relationships: A Twin Study

Social relationships play a critical role in health and well-being throughout life. We analyzed the genetic and environmental variance co-variance structure for social support and strain across four sets of relationships including with one’s co-twin, spouse/partner, family and friends. The sample included 5288 Norwegian twins aged 40–80. Older people reported less support from their co-twin and friends and less strain from their family and friends. Genetic influences contribute importantly to variation across all the measures, with estimates ranging from 0 to 58%; variance due to shared environmental influences was most important for the twin-relationship, ranging from 0.11 to 0.42%. Social support was negatively correlated with social strain across all sets of relationships. With the exception of the co-twin relationship, these associations were primarily mediated by genetic and non-shared environmental effects.

Social Support and Pain Outcomes After Trauma Exposure Among Older Adults: A Multicenter Longitudinal Study

OBJECTIVES

Certain forms of social support have been shown to improve pain-coping behaviors and pain outcomes in older adults with chronic pain, but little is known about the effect of social support on pain outcomes in older adults following trauma exposure.

METHODS

We analyzed data from a prospective longitudinal study of adults aged 65 years and older presenting to an emergency department after a motor vehicle collision (MVC) to characterize the relationship between perceived social support and MVC-related pain after trauma overall and by subgroups based on sex, depressive symptoms, and marital status.

RESULTS

In our sample (N=176), patients with low perceived social support had higher pain severity 6 weeks after MVC than patients with high perceived social support after adjustment for age, sex, race, and education (4.2 vs. 3.2, P=0.04). The protective effect of social support on pain severity at 6 weeks was more pronounced in men and in married individuals. Patients with low social support were less likely to receive an opioid prescription in the emergency department (15% vs. 32%, P=0.03), but there was no difference in opioid use at 6 weeks (22% vs. 20%, P=0.75).

DISCUSSION

Among older adults experiencing trauma, low perceived social support was associated with higher levels of pain at 6 weeks.

Joint Trajectories of Spousal Social Support and Depressive Symptoms in Older Age

Objective: We describe changes in depressive symptoms and positive and negative social support from the spouse/partner in a representative sample of older people in England. Method: Men and women aged 50+ (N = 7,171) from the English Longitudinal Study of Ageing reported social support and depressive symptoms (Center for Epidemiologic Studies Depression Scale) on up to five occasions between 2002-2003 and 2010-2011. Parallel process latent growth models estimated their bidirectional associations, adjusted for gender, wealth, education, and limiting illness. Results: In age- and gender-adjusted models, positive spousal support decreased and negative support increased over time, especially among women. Greater increases over time in depressive symptoms were seen in those with lower positive support or higher negative support at baseline. More baseline depressive symptoms predicted greater declines in positive support and greater increases in negative support from the spouse. Discussion: Improving older couple’s relationship quality may help reduce depressive symptoms.

Financial strain, dyadic coping, relationship satisfaction, and psychological distress: A dyadic mediation study in Greek couples

Financial strain typically has a severe impact on a couple's functioning and the well-being of its members. In this study, we examined the indirect relation of financial strain to partners' relationship satisfaction and psychological distress, using dyadic coping as a mediator, in a sample of Greek couples. One hundred and eighteen couples participated in a cross-sectional study. Perceived material loss in the past and perceived threat of loss in the future were used as financial strain indices. The actor-partner interdependence mediation model was employed to test for the mediation hypotheses. According to the results, the complete mediation (i.e., only indirect) effects models showed an unsatisfactory fit to the data and were rejected. The partial mediation actor-partner interdependence mediation model revealed several statistically significant direct and indirect (actor and partner) effects of the financial strain indices. The results provide more support to the hypothesized mediated impact of financial strain on partners' relationship satisfaction than on psychological distress. The findings underline the importance of dyadic coping for couple's adaptation to financial strain. They also point to the need to examine responses to stress at a dyadic level.

Association of Social Support and Cognitive Aging Modified by Sex and Relationship Type: A Prospective Investigation in the English Longitudinal Study of Ageing

We examined whether between-persons differences and within-person changes in levels of social support were associated with age-related cognitive decline and whether these associations varied by sex and by relationship type. Executive function and memory scores over 8 years (2002–2010) were analyzed by mixture models among 10,241 adults aged ≥50 years in the English Longitudinal Study of Ageing. Between-persons differences and within-person changes in positive social support and negative social support were independently associated with cognitive decline in different ways according to sex and relationship type. Among men, higher-than-average positive social support from a spouse/partner was associated with slower cognitive decline (for executive function, β_{person-mean×time-in-study} = 0.005, 95% CI: 0.001, 0.010; for memory, β_{person-mean×time-in-study} = 0.006, 95% CI: 0.000, 0.012); whereas high negative social support from all relationship types was associated with accelerated decline in executive function (for all relationships combined, β_{person-mean×time-in-study} = −0.005, 95% CI: −0.008, −0.002). For women, higher-than-average positive social support from children (β = 0.037, 95% CI: 0.010, 0.064) and friends (β = 0.115, 95% CI: 0.081, 0.150)—but not from a spouse/partner (β = −0.034, 95% CI: −0.059, −0.009) or extended family (β = −0.035, 95% CI: −0.064, −0.006)—was associated with higher executive function. Associations between social support and age-related cognitive decline vary across different relationship types for men and women.

Variations Between Sources of Social Support and Cancer Screen Behaviors in U.S. Chinese Older Adults

BACKGROUND

Social support is a key indicator of utilization of preventive health care among older adults, but we have limited knowledge on these associations in U.S. Chinese older adults. This study aims to examine the association between sources of social support and cancer screening behaviors among Chinese older adults in the greater Chicago area.

METHODS

Data were drawn from the Population Study of Chinese Elderly in Chicago. Social supports were measured by asking the frequency of receipt of support from spouse, non-spouse family members, and friends. Use of cancer screenings were evaluated by asking the history of utilization of colon, breast, cervical, and prostate cancer screenings.

RESULTS

After adjusting for covariates, results indicated significant association between higher social support and higher utilization of cancer screenings. Regarding to different sources of social support, higher levels of social supports from family members (odds ratio [OR], 1.15 [1.07, 1.25]) and friends (OR, 1.14 [1.06, 1.23]) were associated with higher utilization of breast cancer screening. However, higher levels of social support from family members (OR, 0.94 [0.88, 0.99]) and friends (OR, 0.94 [0.88, 1.00]) were associated with lower utilization of colon cancer screening. No associations were found between social support and prostate cancer screening.

CONCLUSIONS

This study provides evidence that different types of social support were associated with variations in the utilization of cancer screenings. Future longitudinal studies are needed to explore the causal relationship between social support and cancer screening use.