Positive attitude toward life, emotional expression, self-rated health, and depressive symptoms among centenarians and near-centenarians

Mental health among centenarians living in Switzerland

BACKGROUND

Given the increasing number of people achieving exceptionally long lifespans, there is an urgent need for a better understanding of mental health in centenarians. This study aimed to understand the prevalence of mental health conditions-depressive symptoms, anxiety, sleep disturbances, disinhibition, and aberrant motor behaviour-among centenarians in Switzerland.

METHODS

Data were collected from N = 169 participants via telephone interviews or paper questionnaires, either directly from centenarians or through proxy informants. Half the data were collected during a period when protective measures were imposed due to the COVID-19 pandemic, and half were collected after the measures were lifted.

RESULTS

Mental health conditions were prevalent in our sample, particularly depressive symptoms (44.51%) and anxiety (42.17%). Significant positive associations were found between depressive symptoms and anxiety, and between disinhibition and aberrant motor behaviour. Furthermore, we identified statistical predictors for the occurrence of mental health conditions. Notably, institutionalised living increased the odds of depressive symptomatology, while those with higher education levels or an absence of cognitive impairment experienced more sleep disturbances. Finally, cognitive impairment was linked to increased disinhibition and aberrant motor behaviour.

CONCLUSIONS

The high prevalence of mental health conditions underscores the need for proactive mental health care strategies in advanced old age. Moreover, it is vital to consider the interconnected nature of mental health conditions and to prioritise vulnerable groups, such as centenarians in institutional settings.

The association among thriving in life, quality of life, and suicidal ideation in Chinese urban older adults: the moderating effects of attitude toward own aging

BACKGROUND

As the global trend of population aging intensifies, the health and well-being of the older population has gradually become a focus of attention for the global community. This study assessed the status of thriving in life among Chinese urban older adults and identified its relationship with attitude toward own aging and quality of life (QoL). It also tested whether attitude toward own aging moderates the association between thriving in life and Qol or between thriving in life and suicidal ideation.

METHODS

Primary data were collected through a cross-sectional survey among urban older adults from three provinces in China. They were invited to complete an anonymous survey using face-to-face interviews from December 2019 to January 2020. Data from 764 older adults were analyzed.

RESULTS

Approximately 44.39% of participants reported positive responses toward the four domains of thriving in life. Thriving in life and attitude toward own aging had a significant association with QoL. Thriving in life was a protective factor for suicidal ideation for older adults. Moreover, attitude toward own aging moderated the association between thriving in life and QoL and that between thriving in life and suicidal ideation.

CONCLUSIONS

Chinese urban older adults were reportedly thriving in life, which contributed to increased QoL and reduced suicidal ideation. Notably, the study revealed that more positive attitudes towards own aging were associated with higher levels of thriving in life, better QoL, and reduced suicidal ideation. Targeted interventions for older adults should be devised to promote thriving in life and prevent negative attitudes of older people towards their own aging, further raising QoL and reducing suicidal ideation.

Mental health, gender, and higher education attainment

We compared the mental health of higher education students with that of nonstudents. Moreover, we examined whether the mental health of students predicts their probability of obtaining a higher education degree, and whether the extent to which mental health affects educational attainment varies by gender. Drawing on a risk and resilience framework, we considered five facets of mental health that may be implicated in distinct ways in the educational attainment process: positive attitude towards life, self-esteem, self-efficacy, negative affectivity, and perceived stress. We used data from a nationally representative panel study from Switzerland (Nstudents = 2070, 42.8% male; Nnonstudents = 3755, 45.9% male). The findings suggest that overall, the mental health of higher education students was relatively similar to that of nonstudents, although students exhibited slightly higher self-esteem, slightly weaker self-efficacy, greater negative affectivity, and higher levels of perceived stress. The effects of different facets of mental health on higher education degree attainment were mostly statistically and/or practically insignificant. However, positive attitudes towards life had a substantial positive effect on the probability of being awarded a higher education degree. Mental health was equally important for male and female students' educational attainment.

Supplementary Information

The online version of this article (10.1007/s11618-023-01187-3) contains supplementary material, which is available to authorized users.

Impact of assistive devices use on levels of depression in older adults: Evidence from China

The purpose of this study is to evaluate the effect of assistive devices on the level of depression among older adults. Using data from the 2015 and 2018 waves of China Health and Retirement Longitudinal Studies (CHARLS), we analysed this effect through the PSM-DID model and verified the mechanism of the effect through Hayes' mediating effect model. The results showed that assistive devices increased depression levels in older adults. Moreover, there were significant differences among different groups of older adults. The use of assistive devices in developed areas, women, people under 75 years old, and socially active older people had a deeper impact on the level of depression. Differences in the type and number of assistive devices used also affect the level of depression in older people. Furthermore, assistive devices use in older adults increases depression levels by decreasing health satisfaction. This study provides new evidence to explore the relationship between the use of assistive devices and depression levels in older adults. Meanwhile, our research illustrates the importance of developing products and services with age-friendly technology.

Intergenerational relationship quality, sense of loneliness, and attitude toward later life among aging Chinese adults in Hong Kong

A positive attitude toward later life is crucial for wellbeing among older adults. Maintaining a healthy relationship with adult children can help reduce older parents’ sense of loneliness and nurture a positive life attitude. This study aimed to investigate the associations between multidimensional intergenerational relationship quality and attitudes toward later life among aging Chinese adults in Hong Kong and examine the mediating effects of a sense of loneliness. Representative survey data were collected from 801 participants (aged 50 years and over) with at least one adult child. Multiple linear regression was employed to investigate the associations between overall intergenerational relationship quality with a sense of loneliness as well as the attitude toward later life. To examine the mediating effects of a sense of loneliness, causal mediational analyses were performed. Results demonstrated that overall intergenerational relationship quality was positively associated with aging parents’ attitude toward later life, and this relationship could be partially mediated by a sense of loneliness. Among the four subdomains of intergenerational relationship quality, the influences of structural-associational solidarity and intergenerational conflict on attitude toward later life were almost fully mediated by a sense of loneliness, whereas the influences of consensual-normative solidarity and affectual closeness were partially mediated. These findings contributed to an improved understanding of the relationship between intergenerational relationship quality, sense of loneliness, and attitude toward later life, and could inform future policies and service programs that promote aging adults’ social integration and positive aging.

The Association Between Depression and Death Anxiety Among Older Adults: Moderating Effect of Ego-Integrity

This study verifies the relationship between depression and death anxiety in older adults and the moderating effect of ego-integrity on this relationship. The survey was conducted with 236 participants aged 65 years and older through a combination of online and offline surveys. The final data were analyzed using the PROCESS macro for SPSS 2.16. The main findings of this study are as follows: First, depression in old age was positively related to anxiety about death. Second, the moderating effect of ego-integrity was observed on the relationship between depression and death anxiety. Third, on examining the moderating effect of each sub-variable of ego-integrity, the moderating effect of satisfaction with one's life was observed to be significant. Conversely, the moderating effect of attitude toward life and acceptance of old age was not significant. The results of this study are meaningful in examining the moderating effect of ego-integrity on the relationship between depression and death anxiety. Furthermore, the results of this study can provide basic data for the development and application of psychological intervention programs for older adults experiencing psychological problems due to depression and death anxiety in old age.

Relationships Between Aging Attitudes and Successful Aging Outcomes in Middle-age and Older Women

OBJECTIVES

This study aimed to explore the relationships between aging attitudes and the outcomes of successful aging, including whether aging attitudinal types moderate psychological adjustment in the context of medical and mental health diagnoses.

METHODS

In total, 409 community-dwelling women aged 40-79 years in Australia completed the Reactions to Aging Questionnaire (RAQ), Geriatric Depression Scale, Center of Epidemiological Studies Depression Scale, and Geriatric Anxiety Inventory. Information about medical and mental health diagnoses were collected.

RESULTS

Overall, aging attitudes and all three RAQ subscales were negatively correlated with scores on measures of depression and anxiety, and number of medical diagnoses. Attitudinal types toward aging were found to moderate the relationship between the number of mental health diagnoses and scores on the psychological measures of depression but not anxiety. Unique RAQ domain-specific relationships were found with the number of mental health diagnoses.

CONCLUSIONS

The findings support the link between aging attitudes and psychological outcomes, the potential clinical value of RAQ attitudinal typologies classification as well as a multidimensional conceptualization of aging attitudes.

CLINICAL IMPLICATIONS

The findings reinforce the need for efforts to reduce ageism on a societal level, as well as informing clinical decision-making with older clients.

The Relationship of Breathing and COVID-19 Anxiety When Using Smart Watches for Guided Respiration Practice: A Cross-Sectional Study

COVID-19 mortality rates are increasing worldwide, which has led to many highly restrictive precautionary measures and a strong sense of anxiety about the outbreak for many people around the world. There is thus an increasing concern about COVID-19 anxiety, resulting in recommending approaches for effective self-care. From a positive psychology perspective, it is also important for people to have positive affect when dealing with this pandemic. According to previous literature, respiration is considered to be an effective way to enhance people’s mental health. Among all the wearable devices, Apple Watch has the largest market share, so this study recruited Chinese users that use respiration exercise function on Apple Watch; a total of 316 valid data were retrieved. Meanwhile, to understand one approach related to using Apple Watch to practice respiration to reduce COVID-19 anxiety about being infected during the COVID-19 outbreak, this study used a web-based cross-sectional survey to examine anxiety about being infected by COVID-19 among Chinese people who had been using the Apple Watch to practice respiration during the period of the COVID-19 outbreak. The study was based on the Health Theoretical Model, and the model was developed with four dimensions and was validated with structural equation modeling. The results of this study showed that practicing few minutes had a positive relationship on positive attitude, and positive attitude had a negative relationship on pandemic anxiety and a positive relationship on continuance use intention. Anxiety about the pandemic had a negative relationship on the intention to continue using the function. This showed that respiration practice can help to suppress the increase in anxiety levels regarding this pandemic.

Association Between Self-Perceived Stigma and Quality of Life Among Urban Chinese Older Adults: The Moderating Role of Attitude Toward Own Aging and Traditionality

Background

Ageism is a global challenge, which leads to a range of adverse outcomes for elderly people worldwide, which maybe more severe among urban older adults in a competitive society. However, how self-perceived ageism influences the quality of life in a sample of urban older adults remains inconclusive.

Objectives

The current study aims to assess the status of self-perceived stigma among urban Chinese older adults, identify its relationship with quality of life, and further explore whether both attitude toward own aging and traditionality moderate this relationship.

Materials and Methods

Primary data were collected through cross-sectional surveys among urban older adults in three provinces of China from October 2019 to December 2020. A total of 764 urban older adults were valid participants (effective response rate = 81.28%) and completed questionnaires via anonymous face-to-face interviews. Socio-demographic factors, self-perceived stigma, attitude toward own aging, traditionality, and quality of life were assessed using questionnaires that included the Self-perceived Stigma, Attitude Toward Own Aging, Traditionality, and SF-8 Scales.

Results

For urban Chinese older adults, the average score of self-perceived stigma was 2.041 ± 0.726. Self-perceived stigma (β = −0.391, p < 0.05) and attitude toward own aging (β = −0.211, p < 0.05) both influenced quality of life. Additionally, attitude toward own aging (β = −0.530, p < 0.05) and traditionality (β = −0.525, p < 0.05) moderated the association between self-perceived stigma and quality of life. Simple slope analysis revealed that when the level of negative attitude toward own aging and traditionality was higher, the strength of the influence of self-perceived stigma on quality of life was stronger.

Conclusion

Urban Chinese older adults were aware of the self-perceived stigma, which contributes to decreased quality of life. Attitude toward own aging and traditionality could moderate the association between self-perceived stigma and quality of life. When negative attitudes toward own aging and traditionality are higher, self-perceived stigma has a greater effect on the quality of life. More interventions related to relieving self-perceived stigma, traditionality, and negative attitude toward own aging should be considered to build a new modern society that emphasizes health, friendliness, well-being, and dignity for all ages.

Examination of Home Quarantine Experiences of Individuals Diagnosed With COVID-19 Living in Turkey

The primary purpose of this research is to examine the experiences of individuals diagnosed with COVID-19 regarding the quarantine process. This research was carried out in a phenomenological design, one of the qualitative research approaches. A total of 212 volunteers, 153 women (72.2%) and 59 men (27.8), took part in this research via an online questionnaire. As a data collection tool, an online questionnaire prepared by the researcher was used. The data were analyzed within the framework of content analysis. In the findings of the research, 4 themes named as being diagnosed with COVID-19, quarantine process, worst-case scenario and coping with uncertainty were got. Based on the research findings, in staying in quarantine at home, besides the physiological effects of the virus, it can be concluded that individuals are trying to struggle with the emotional burden of the situation they are in. For this reason, it is of great importance to provide mental health support to individuals who are in quarantine at home, considering the social, psychological, and economic effects of the COVID-19 pandemic.

Longitudinal validity of self-rated health: the presence and impact of response shift

Objective: This paper aimed to examine the longitudinal validity of self-rated health (SRH) and whether it would be affected by possible changes in evaluation standards (i.e., response shift) over time.Design: Data are from a longitudinal survey of a nationally representative sample in China. Analytical sample was restricted to respondents aged 45 and above (n = 15,893). Individual fixed effects models were used to analyze changes in ratings on health anchoring vignettes and self-rated health over time.Main outcome measures: SRH at two time points with a -two-year span.Results: Both SRH and anchoring vignettes ratings displayed changes over a two-year span for all the studied age groups. Compared with the self-assessed change in health ("How would you rate your health as compared to that of last year?"), changes in SRH reported over time displayed a more stable and optimistic pattern. SRH responded to doctor diagnosed chronic disease and changes in functional limitation, before and after adjusting for evaluation standards.Conclusion: SRH is responsive to the newly diagnosed chronic disease and functional limitation, regardless of whether we consider response shift within the same respondents over time.

To Live or Die: What to Wish at 100 Years and Older

Previous research has shown that will to live is a strong predictor for survival among older people, irrespective of age, gender, and comorbidities. However, research on whether life at age 100 is perceived as worth living is limited. The available literature has presented evidence for good levels of positive attitudes and life satisfaction at such an advanced age, but it has also suggested that a longing for death is common. This study aimed to add to the existing data on this matter by exploring centenarians' will to live and the associated factors. The sample comprised 121 centenarians (mean age, 101 years; SD, 1.63 years), 19 (15.7%) of whom were males, from two centenarian studies (PT100). Answers to open questions were analyzed to identify the centenarians' will to live and the reasons behind it. Three groups were created (willing to live longer, not willing to live longer, no clear positioning) and further analyzed in terms of sociodemographic characteristics, health status, social functioning, and well-being. Of the total sample, 31.4% expressed willingness to live longer, 30.6% did not, and 38% presented no clear positioning. The presence of the Catholic religion (God) was referred for centenarians in all three groups. Annoyance, uselessness, loss of meaning, disconnection, and loneliness were the most common justifications for being reluctant to live longer. Positive valuation of life and good self-rated health, followed by having a confidant and reduced pain frequency, were the factors associated with being willing to live longer. The results of the study contribute to the understanding of the psychological functioning of individuals with exceptional longevity, particularly concerning the factors behind willingness to live at such an advanced age.

Nature Versus Nurture: What Can be Learned from the Oldest-Old's Claims About Longevity?

Beneficial genetic or environmental factors that influence the length and quality of life can be evaluated while studying supercentenarians. The oldest-old can withstand serious/fatal illnesses more than their peers and/or their aging rate is decreased. Supercentenarians are an interesting group of individuals whose lifestyle is not particularly healthy according to the common guidelines, namely some of them seem to have similar harmful behaviors, but still manage to stay healthier for longer, and while eventually dying from the same degenerative diseases as the general population, they develop symptoms 20-30 years later. As there are not many supercentenarians by definition, it is worthwhile to diligently collect their data to enable future meta-analyses on larger samples; much can be learned from supercentenarians' habits and lifestyle choices about the aging process. Contributions of genetics, lifestyle choices, and epigenetics to their extended life span are discussed here.

Physical and mental health in the oldest-old: a mixed-methods study on a southern Italy sample

BACKGROUND

The world's aging population has been constantly increasing in the last decades, causing the number oldest-old individuals to increase.

AIMS

The present study aims to explore the different variables that contribute to the oldest-old wellbeing using a mixed-methods approach, including self-reports, standardized measures, and semi-structured interviews.

METHODS

Thirty-nine oldest-old (90-103) from southern Italy were involved in the study, together with a control sample of younger individuals (51-71) from the same families.

RESULTS

Data suggest that the oldest-old have better mental health, higher resilience, and more optimism than younger individuals. High resilience seems to be the key variable that promotes the overall wellbeing.

DISCUSSION

The oldest-old tend to have better mental health, higher resilience and more optimism than younger individuals.

CONCLUSIONS

Wellbeing in the oldest-old appeared to be promoted by the sense of belonging and life purpose.

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.

Do Quarantine Experiences and Attitudes Towards COVID-19 Affect the Distribution of Mental Health in China? A Quantile Regression Analysis

While quarantine has become a widely used control strategy during the outbreak of the 2019 novel coronavirus disease (COVID-19), empirical research on whether and to what extent quarantine and attitudes towards COVID-19 affect mental health is scant. Using a cross-sectional online survey, this paper is the first from the Chinese outbreak to investigate how quarantine experiences and attitudes towards COVID-19 are related to mental health, and how these relationships change across the distribution of mental health scores. Using quantile regression analysis, we found that home self-quarantine is associated with a decrease in depression and an increase in happiness, while community-level quarantine is associated with decreased happiness, especially for those in the lower happiness quantile. We also found that favorable attitudes towards COVID-19 regarding the credibility of real-time updates and confidence in the epidemic control are associated with lower levels of depression and higher levels of happiness. These effects are stronger in the upper quantile of depression and the median quantile of happiness.

Subjective health, general medicine beliefs and social desirability response among older hospital outpatients in Hong Kong

Objectives

The aim of this study was to investigate any association between self-rated health (SRH) and general perception about medicines using the Beliefs About Medicine Questionnaire-General (BMQ-G) in Hong Kong hospital outpatients. Moreover, the study aims to demonstrate any association between social desirability bias or response (SDR) and BMQ-G, SRH reporting in this population.

Methods

Seven hundred and sixty-nine outpatients, who satisfied the selection criteria, were cordially invited to participate in this study by completing a combined questionnaire of demographic information, BMQ-G, SRH and SDR Set-5 in person, while waiting to collect their medications outside a Hong Kong hospital pharmacy. Results were analysed statistically.

Key Findings

The number of valid questionnaires returned for statistical analysis was 698.

Logistic regressions indicated age groups, gender and SRH were significant predictors for BMQ-G reporting. Patients aged over 62, male or those with high SRH were less likely to present high BMQ-G scores, compared to patients aged under 45, female or those with low SRH, respectively (OR 0.43, 0.73 and 0.66, respectively, all CIs 95%). Logistic regressions also demonstrated overall BMQ-G, and SRH reporting was unlikely to be associated with SDR (all P &gt; 0.05) although age was a significant predictor for SDR reporting (OR = 1.10; CI 95%).

Conclusions

This study illustrated age groups, gender and self-rated health significantly associated with general medicine beliefs reporting. The possible association between socially desirable bias and general medicine beliefs or self-rated health reporting was insignificant.

A comparison of the four healthy days measures (HRQOL-4) with a single measure of self-rated general health in a population-based health survey in New York City

Background

Data on health-related quality of life (HRQOL) can be used to track health disparities, assess the impact of chronic diseases, and predict mortality. The Centers for Disease Control and Prevention’s “Healthy Days Measures” (HRQOL-4) assesses four key domains: self-rated general health, physical health, mental health, and activity limitations. The domains are not easily combined to summarize overall HRQOL, and some evidence suggests that self-rated general health may be an adequate proxy indicator for overall HRQOL. This study compares self-rated general health as a solitary measure of HRQOL with two summary indices of the HRQOL-4 as a predictor of adverse health conditions in a representative sample of adult New York City residents.

Methods

The 2017 NYC Social Determinants of Health survey implemented by the New York City Department of Health and Mental Hygiene collected data from a representative sample of New Yorkers (n = 2335) via phone, mail, and web. We compared the information criteria and predictive power of self-rated general health with two alternative summary indices of the HRQOL-4 in predicting self-reported health conditions (hypertension, diabetes, obesity, non-specific psychological distress, and a summary indicator for at least one those four morbidities).

Results

Overall, 19.1% (95% CI: 16.9, 21.5) of respondents reported that they had fair or poor general health. Self-rated general health was significantly associated with days of poor physical health, poor mental health, and activity limitations (p < 0.001 for each). While the Akaike and Bayesian information criteria suggested that the summary indices of the HRQOL-4 produced marginally better models for predicting adverse health conditions, self-rated general health had slightly higher predictive power than did the summary indices in all models of physical health outcomes as measured by Tjur’s pseudo-R² and the area under the curve.

Conclusion

We found very small differences between self-rated general health and the summary indices of the HRQOL-4 in predicting health conditions, suggesting self-rated general health is an appropriate proxy measure of overall HRQOL. Because it can be measured with a single question rather than four, it might be the most simple, efficient, and cost-effective method of summarizing HRQOL in large population-based surveys.

The differences in self-perceptions of aging, health-related quality of life and their association between urban and rural Chinese older hypertensive patients

Background

Most hypertensive clients are elderly, whose health-related quality of life (HRQL) may be associated with self-perceptions of aging (older individuals’ beliefs about their own aging). Meanwhile, culture and health disparities between rural and urban populations are substantial. Whether there are differences in self-perceptions of aging, HRQL, and their association among elderly hypertensive clients in urban and rural areas remains unknown. The objective of this study was to investigate and compare self-perceptions of aging and HRQL and their association among urban and rural older Chinese hypertensive clients.

Methods

A cross-sectional investigation was conducted in 15 urban community clinics and 22 village clinics from Suzhou, China. Older hypertensive adults were invited to complete a self-administered questionnaire addressing socio-demographic and clinical information, HRQL and self-perceptions of aging.

Results

There were 492 urban participants and 537 rural participants included in the analyses. The physical (40.0 ± 12.1 vs. 30.9 ± 8.9, P <  0.001) and mental (51.5 ± 8.3 vs. 46.0 ± 7.8, P <  0.001) HRQL scores of urban participants were all higher than those of rural ones. Urban participants’ scores on dimensions of “timeline cyclical”, “consequences negative”, and “control negative” of self-perceptions of aging questionnaire (APQ) were lower than those of rural participants (P <  0.001, respectively), while the scores on dimensions of “consequences positive” and “control positive” were higher (P <  0.001, respectively). Adjusted multivariate linear regression showed that participants who had worse self-perceptions of aging had poorer HRQL. Some APQ dimensions associated with urban or rural hypertensive elders’ HRQL were different.

Conclusions

Older hypertensive clients in rural areas have poorer self-perceptions of aging and HRQL than those in urban areas. Health care professionals should pay more attention to HRQL and self-perceptions of aging of older hypertensive clients in rural areas.

Structure of self-rated health among the oldest old: Analyses in the total population and those living with dementia

No previous study has explored the structure of self-rated health (SRH), a measure holding strong predictive value for future health events, in the oldest old or in individuals with dementia. The aim was to construct a structural equation model of SRH for oldest old in general and for oldest old with dementia, and to explore direct and indirect associations between health-related factors and SRH. Cross-sectional data from the Vitality 90+, a population-based study in the city of Tampere, Finland, was used. Data were gathered by a mailed questionnaire in 2014. Altogether 1299 nonagenarians, of which 408 had self-reported dementia or cognitive decline, were included. Structural equation models were constructed for all participants and separately for participants with dementia. Diseases (heart disease, stroke, diabetes, arthritis, hip fracture, cancer and dementia for the model for all), dizziness, hearing, vision, mobility, activities of daily living, fatigue, depression and SRH were included in the models. Among all participants, fatigue, depression, problems in mobility, dizziness, deficits in vision and heart disease were directly associated with poor SRH. Among participants with dementia, only fatigue, dizziness and deficits in vision were directly associated with poor SRH. Among all participants, dementia and arthritis were indirectly associated with poor SRH through problems in mobility, depression and fatigue. Among the oldest old, the effects of diseases on SRH were mainly manifested through the consequences of diseases, namely fatigue, dizziness, deficits in vision and problems in mobility. Depression has an important direct and indirect role, and dementia and arthritis an important indirect role in the structure of SRH. Dementia weakens many of the direct and indirect associations for SRH.

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First study to explore structure of self-rated health in oldest old and persons with dementia.

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Fatigue, depression, mobility, dizziness, vision and heart disease directly affect health-rating in oldest old.

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Dementia, depression and arthritis affect health rating indirectly through various routes in oldest old.

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Dementia weakens many of the associations between objective indicators of health with self-rated health.

The prevalence and predictors of anxiety and depression in near-centenarians and centenarians: a systematic review

BACKGROUND

Current research on the psychological health of near-centenarians (95-99 years old) and centenarians remains limited. Existing studies have mainly characterized their physical, cognitive, and social health. Results on the anxiety and depression of near-centenarians and centenarians (more than 95 years old) have been mixed with some studies, finding higher rates of anxiety and depression among those older than 95 years and others reporting no difference in rates compared with younger age groups. This study aims to synthesize the existing literature on the prevalence and predictors of anxiety and depression in near-centenarians and centenarians.

METHOD

A systematic review was conducted using Ovid Medline, Embase, PsycINFO, CINAHL, SCOPUS, and the Cochrane database. Common and conflicting findings among the literature were examined.

RESULTS

Thirty-eight studies met the inclusion criteria. Six studies examined the prevalence and predictors of anxiety, and 37 studies investigated the prevalence and predictors of depression. Five studies examined both anxiety and depression in the same sample. Prevalence data on anxiety and depression varied significantly, as did comparisons with rates in younger populations. Findings on predictors of anxiety and depression were contradictory.

CONCLUSION

There is a large degree of heterogeneity among studies of centenarians' psychological status. Findings conflict on the prevalence and predictors of anxiety and depression and rates compared with younger age groups. Variation in findings may result from the different inclusion criteria, sampling methods, and measurement tools. Better harmonization of centenarian study methodologies may improve consistency of findings to aid in developing clinical interventions.

The psychological health of 207 near-centenarians (95-99) and centenarians from the Sydney Centenarian Study

OBJECTIVE

While near-centenarians (95-99) and centenarians are the fastest growing sectors of the population in many countries, few studies have investigated their psychological health. We aimed to compare levels of psychological distress and life satisfaction in individuals aged 95 or above (95+) with younger age groups and identify the factors associated with psychological distress and life satisfaction in near-centenarians and centenarians.

METHODS

We assessed the physical, cognitive, social and psychological health of 207 participants aged 95+ in the Sydney Centenarian Study. Psychological distress and life satisfaction were rated on the Kessler Psychological Distress Scale (K10) and Satisfaction with Life Scale, respectively. Cross-sectional univariate comparisons were performed with participants aged 70-90 years from the Sydney Memory and Ageing Study. Factors associated with psychological distress and life satisfaction among Sydney Centenarian Study participants were examined using multiple regression analyses.

RESULTS

In Sydney Centenarian Study and Memory and Ageing Study, mean K10 scores were 15.3 (±5.9) and 13.4 (±3.6), and clinical levels of psychological distress (K10 ⩾ 20) were 19% and 7%, respectively. Sydney Centenarian Study participants demonstrated significantly higher levels and rates of psychological distress (t = 3.869, p < 0.001; χ² = 27.331, p < 0.001). In Sydney Centenarian Study, more psychotropic medications and having fewer relatives and friends were associated with higher psychological distress. Sydney Centenarian Study participants reported significantly higher levels of life satisfaction than Memory and Ageing Study participants, mean scores 6.0 (±1.5) and 5.6 (±1.3); t = 5.835, p < 0.001. Lower Mini-Mental State Examination scores and having fewer relatives and friends were associated with lower life satisfaction in Sydney Centenarian Study.

CONCLUSION

Despite showing higher levels of psychological distress in the prior 4 weeks than younger age groups, near-centenarians and centenarians remained highly satisfied with their overall lives. The identification of risk and protective factors for psychological distress and life satisfaction provides opportunities for interventions to maintain good psychological health in this vulnerable population.

Self-rated health and medicine beliefs among older hospital outpatients in Hong Kong

Objectives

(1) To identify any demographic characteristics, which predict medicines adherence by reporting Necessity-Concern Differential (NCD) and Self-Reported Health (SRH) scores among Hong Kong hospital outpatients. (ii) To investigate any association between SRH and NCD in this cultural group.

Methods

A total of 709 outpatients completed a questionnaire consisting demographic information, SRH and Belief about Medicines Questionnaire. Findings were analysed statistically.

Key findings

Descriptive statistics suggested that older participants (mean age &gt; 64 years) tended to report low SRH, but high NCD compared to younger respondents (mean age &lt; 53 years). Males were more likely to return high SRH and NCD scores than females (56.9 versus 42.2% and 74.8 versus 64.6%, respectively). Chi-squared tests demonstrated that socio-economic status was not significantly associated with SRH and NCD reporting (P &gt; 0.05). Logistic regressions indicated gender and age groups (young-old and old-old) were significant predictors of SRH reporting (P &lt; 0.001). Moreover, patients with high SRH were more likely to report high NCD than those with low SRH (P = 0.02; OR = 1.53; 95%CI 1.07–2.20). This indicates that regular administration of the SRH item followed by specific questioning could enhance early identification of potential medicine non-believers and, subsequently, non-adherent patients who may require urgent interventions or monitoring.

Conclusions

Demographic characteristics and significant association between SRH and NCD reporting support our claim that SRH opens new opportunities for prompt identification of potentially non-adherent patients. However, further interviews to determine the cause(s) of non-adherence are necessary to validate such findings.

Sensory perception of dead conspecifics induces aversive cues and modulates lifespan through serotonin in Drosophila

Sensory perception modulates health and aging across taxa. Understanding the nature of relevant cues and the mechanisms underlying their action may lead to novel interventions that improve the length and quality of life. We found that in the vinegar fly, Drosophila melanogaster, exposure to dead conspecifics in the environment induced cues that were aversive to other flies, modulated physiology, and impaired longevity. The effects of exposure to dead conspecifics on aversiveness and lifespan required visual and olfactory function in the exposed flies. Furthermore, the sight of dead flies was sufficient to produce aversive cues and to induce changes in the head metabolome. Genetic and pharmacologic attenuation of serotonergic signaling eliminated the effects of exposure on aversiveness and lifespan. Our results indicate that Drosophila have an ability to perceive dead conspecifics in their environment and suggest conserved mechanistic links between neural state, health, and aging; the roots of which might be unearthed using invertebrate model systems.

Ten Secrets to a Long Life

For centuries there has been an ongoing search to identify the secrets of long life and healthy aging. Recently, multiple factors have been identified, including genetics, the introduction of antibiotics, vaccines, and public health, effective management of cardiovascular risk factors, advances in surgery, eliminating or modifying high-risk behaviors, family and social supports, eliminating wars and poverty, luck, exercise and nutrition, and psychological factors such as optimism and conscientiousness. To increase a maximum life span now estimated to be 115-120 years will involve manipulation of genes and the body's stem cells and the potential use of senolytic drugs (that kill old cells), which will need to be investigated. This is a worthy pursuit if these interventions will also maintain or enhance quality of life.

Perceptive costs of reproduction drive ageing and physiology in male Drosophila

Costs of reproduction are thought to result from natural selection optimizing organismal fitness within putative physiological constraints. Phenotypic and population genetic studies of reproductive costs are plentiful across taxa, but an understanding of their mechanistic basis would provide important insight into the diversity in life history traits, including reproductive effort and aging. Here we dissect the causes and consequences of specific costs of reproduction in male Drosophila melanogaster. We find that key survival and physiological costs of reproduction arise from perception of the opposite sex, and they are reversed by the act of mating. In the absence of pheromone perception, males are free from reproductive costs on longevity, stress resistance, and fat storage. Both the costs of perception and the benefits of mating are mediated by evolutionarily conserved neuropeptidergic signaling molecules, as well as the transcription factor dFoxo. These results provide a molecular framework in which certain costs of reproduction arise as a result of self-imposed ‘decisions’ in response to perceptive neural circuits, which then orchestrate the control of life-history traits independent of physical or energetic effects associated with mating itself.

Cognitive status in the oldest old and centenarians: a condition crucial for quality of life methodologically difficult to assess

Human life expectancy and the number of the oldest old are rapidly increasing worldwide. Advanced age is the main risk factor for dementia, representing one of the major causes of disability/dependency among older people with a strong impact on their families/caregivers. Centenarians have reached the extreme limits of human life escaping or delaying the major age-related diseases. Thus, these extraordinary individuals embody the best model to answer the crucial question if cognitive decline and dementia are progressive and unavoidable occurrences of increasing age. Despite a growing amount of data underlines the importance of cognitive function for quality of life and survival in old age, studies on centenarians have paid more attention to their physical condition rather than the assessment of their actual cognitive abilities. Accordingly, this work aims to summarize available data on the prevalence of dementia in centenarians and to critically address topics which can have a relevant impact on the cognitive assessment/status of the oldest old: (i) lack of standardized tools for cognitive assessment; (ii) criteria and threshold to establish the presence of dementia; (iii) influence of birth cohort and education; (iv) role of depression or positive attitude towards life; (v) gender differences.

Depression Moderates the Frailty-Subjective Health Link among Chinese Near Centenarians and Centenarians

OBJECTIVE

Very old adults may be physically frail, but they do not necessarily experience poor subjective health. The authors hypothesized that the relationship between frailty and subjective health is moderated by depression for very old people.

METHODS

In a cross-sectional study, a survey administered was by a face-to-face interview to 129 community-dwelling older adults aged 95-108. Measurements included the five-item FRAIL scale, the Geriatric Depression Scale Short-Form (GDS), and a subjective health rating. Hierarchical multiple regressions were conducted to test the moderation effects, adjusting for age, gender, living arrangement, perceived socioeconomic status, and cognition.

RESULTS

The interaction effect between frailty and depression was significant. Inspection of the simple slopes revealed that those who were more depressed had a more negative frailty-subjective health relationship. There was no significant moderation effect for a withdrawal-apathy-vigor dimension of the GDS.

CONCLUSION

Our findings suggest a protective psychological mechanism may enable very old adults to maintain an optimistic view of their health despite their increasing physical and functional limitations.