Adaptation to disability among middle-aged and older adults: the role of assimilative and accommodative coping

Profiles of centenarians' functioning: linking functional and cognitive capacity with depressive symptoms

BACKGROUND

Despite most centenarians facing age-related declines in functional and cognitive capacities, the severity of these declines varies among individuals, as does the maintenance of good mental health (e.g., depressive symptoms) despite these declines. This study aims to examine this heterogeneity in centenarians from the Second Heidelberg Centenarian Study, which collected data from 112 centenarians living in Germany. In our study, we focus on a subsample of 73 centenarians who provided self-reports for our measures of interest (M age = 100.4, SD age = 0.55).

METHODS

We examined correlations between functional capacity (i.e., PADL, IADL), cognitive capacity (i.e., MMSE), and depressive symptoms (i.e., GDS), and the existence of different profiles using hierarchical clustering.

RESULTS

Higher functional capacity was related to higher cognitive capacity and to fewer depressive symptoms. Yet, higher cognitive capacity was associated with more depressive symptoms. Hierarchical clustering analysis elucidated this contradiction by identifying three profiles: low-capacity individuals (i.e., 24 individuals had low functional and cognitive capacities, with low depressive symptoms), high-capacity individuals (i.e., 33 individuals with high functional and cognitive capacities, with low depressive symptoms), and low-functional-high-cognitive-capacity individuals (i.e., 16 individuals showed low functional but high cognitive capacity, with high depressive symptoms). Our post-hoc analyses highlighted arthritis and pain as risk factors for functional dependence and depression.

CONCLUSIONS

Our findings emphasize the importance of identifying centenarian subgroups with specific resource- and risk profiles to better address their needs, and of treating pain to improve functional capacity and mental health in centenarians.

Exploring student teachers' latent coping profiles and their relations to perceived stress and stressors

As coping profiles can offer concrete intervention opportunities, the goal of the present study is to explore latent coping profiles in a sample of 316 student teachers at a German university, using the Brief COPE inventory (Carver, 1997). Furthermore, we aim to test the extent to which students with specific coping profiles differ in the levels of stress (PSS; Schneider et al., 2020) and stressors they perceive. Latent profile analysis (LPA) reveals that a six-profile solution shows the optimal fit, with high entropy. The six profiles include two more support-seeking coping profiles (networking and disengaged copers), withdrawn, cognitive restructuring, avoidant and repertoire-oriented copers. Both more support-seeking coping profiles used in particular strategies concerning seeking social and emotional support, and are associated with less stress. Avoidant and withdrawn copers show unfavourable perceptions of stress levels and stressors. Thus, programs to promote social-emotional support should be implemented in teacher training courses.

Employment and retirement among workers who develop vision loss in midlife

BACKGROUND

Vision loss increases with age and is thus more likely to happen later in one's career. With more individuals working beyond typical retirement age, the possibility of experiencing vision loss while working has increased.

OBJECTIVE

The purpose of this study was to investigate how developing vision loss during midlife affects employment and retirement.

METHOD

Using longitudinal Health and Retirement Study data, we identified a sample of 167 workers, 44 to 64 years old, who developed vision loss and a matched comparison sample of 800 workers who did not. We explored job retention and retirement differences between the groups and differences between people with vision loss who retained jobs versus those who did not.

RESULTS

Vision loss was associated with leaving the labor force, although there was a clear trend over time of increasing likelihood of job retention. Occupational category was associated with job retention and people who continued working had more favorable financial situations. Retirees with vision loss were more likely to report involuntary retirement and dissatisfaction with retirement.

CONCLUSIONS

The decreasing likelihood of leaving the labor market after vision loss is an encouraging finding of this study. Workers who left the labor force after vision loss were more likely to be in precarious financial positions, and retirees did not have positive experiences with retirement. Assisting workers with vision loss to remain in the labor force is of vital importance, and increasing awareness and usage of free services for this population may reduce involuntary retirement and its negative consequences.

Disability acceptance and depressive symptoms: the moderating role of social support

Purpose: This study aims to estimate (a) the relationship between disability acceptance and depressive symptoms, and (b) how the quality and quantity of social support might moderate the link between disability acceptance and depressive symptoms.Materials and methods: The data for this study included information from 5165 individuals with disability who participated in 3 waves of the Disability and Life Dynamic Panel spanning years 2018 to 2020. This study employed fixed effects models to estimate the association between disability acceptance and depressive symptoms. Interaction models were used to assess the moderating effects of both the quantity and quality of social support.Results: A lower acceptance of disability was positively associated with depressive symptoms. Moreover, both the quantity and quality of social support were associated with a decrease in depressive symptoms. Only the quality of social support played a significant role in moderating the relationship between disability acceptance and depressive symptoms.Conclusion: A lower acceptance of disability increases depressive symptoms in individuals with disabilities. This study underscores the need for interventions to focus on enhancing the quality of social support to mitigate the link between disability acceptance and depressive symptoms.

Explaining Variation in Individual Aging, Its Sources, and Consequences: A Comprehensive Conceptual Model of Human Aging

We define aging as a characteristic deterioration in one (or more) observable attributes of an organism that typically occurs during later life. With this narrow functional definition, we gain the freedom to separate aging from other processes of age-related change (e.g., maturation, growth, illness, terminal decline). We introduce a structural model that distinguishes between (1) the phenomenon of aging, (2) the subjective experience of aging, (3) sources of aging, and (4) consequences of aging. A core focus of the model is on the role of buffering mechanisms of biological repair and personal adaptation that regulate the relations between sources of aging, aging proper, and its consequences. The quality and level of functioning of these buffering mechanisms also varies across the life span, which directly affects the sources of aging, resulting in either resilience against or accelerated aging, and thus can be considered to be a major source of the variation in aging processes among different individuals. External factors comprising attributes of the physical environment and sociocultural characteristics are considered as contexts in which aging occurs. These contextual factors are assumed to feed into the various components of the model. Our model provides an interdisciplinary account of human aging, its sources and consequences, and also its subjective experience, by integrating biological, psychological, lifestyle, and sociocultural factors, and by specifying their interrelations and interactions. The model provides a comprehensive understanding of individual human aging, its underlying processes, and modulating factors. It allows for the derivation of empirically testable hypotheses, and it helps practitioners to identify elements that lend themselves to targeted intervention efforts aimed at increasing the resilience of individuals against aging and buffering its negative consequences.

Coping Patterns in Advanced Old Age: Findings from the Fordham Centenarian Study

INTRODUCTION

Research on coping in advanced old age is scarce. In the present study, we explored coping patterns in near-centenarians and centenarians, and characteristics associated to using a specific coping pattern.

METHODS

We analyzed the frequency with which participants (N = 87, MAge = 99.05; SDage = 2.6; age range 95-107) reported using specific coping strategies (i.e., coping strategy use) and the relative preference for specific strategies (i.e., relative coping preferences) in data from the Fordham Centenarian Study. Moreover, we applied cluster analysis to detect coping patterns, and we compared cluster characteristics.

RESULTS

Very old individuals reported using emotion control and acceptance the most. Cluster analysis further revealed two distinct groups: The high coping group reported significantly higher coping strategy use than the low coping group (p < 0.001). The two groups also favored different strategies (p < 0.001), with the high coping group showing significantly higher relative preferences than the low coping group for active problem-solving, proactive prevention, and strategic planning (all ps < 0.05). The groups furthermore differed significantly in psychological strengths (i.e., personality, self-efficacy, ps < 0.001) and well-being outcomes (i.e., life satisfaction, p = 0.05).

DISCUSSION

This study provides evidence for a general preference for acceptance and emotion control in very old individuals, supporting theories of a developmental coping shift in old age, yet our findings also document the existence of groups with different coping patterns. More frequent coping use, and particularly continued use of active problem-solving and proactive prevention, may enable well-being in very old age.

Awareness of age-related change, future time perspective, and implications for goal adjustment in older adulthood

OBJECTIVES

How people adjust their goals is central to adaptation across the lifespan. However, little is known about individual difference characteristics that predict how and why people use different self-regulatory strategies. The present study investigated associations of perceived age-related gains and losses, and their interaction, as predictors of goal adjustment in older adulthood. Furthermore, we examined whether future time perspective (FTP) mediated relationships between awareness of age-related change (AARC) and goal adjustment.

METHOD

A community-based sample of 408 adults (aged 60-88 years) was recruited via an internet-based research platform. Participants completed questionnaire measures of AARC, FTP, goal disengagement, and goal re-engagement. A flexibility index reflecting tendencies toward use of both goal disengagement and goal re-engagement strategies was also analyzed.

RESULTS

Although AARC-losses was associated with lower goal re-engagement and goal flexibility, this association was weaker among those with higher AARC-gains, indicating AARC-gains may be protective in the relationship between AARC-losses and goal adjustment. The association between AARC and goal adjustment was also shown to be mediated by FTP. Higher AARC-gains was associated with more expansive FTP, which was associated with lower goal disengagement and higher goal re-engagement. On the other hand, higher AARC-losses was associated with more restricted FTP, which was associated with higher goal disengagement and lower goal re-engagement.

DISCUSSION

Results have implications for how we conceptualize the combined effects of age-related gains and losses on developmental outcomes relevant to adaptive aging. Furthermore, perceptions of future time with advancing age may be implicated in processes linking AARC with goal adjustment.

Gender Differences in the Association between Physical Inactivity and Mental-Health Conditions in People with Vision or Hearing Impairment

This study aimed to examine associations between physical inactivity and mental health in Spanish adults with vision or hearing difficulties and explored differences between men and women. Data from the Spanish National Health Survey in 2017 were analyzed (n = 23,089 adults, 15−103 years, mean age 53.4 ± 18.9 years, 45.9% men). Physical inactivity (exposure) was evaluated with the International Physical Activity Questionnaire Short Form. Participants self-reported whether they had previously suffered from depression, chronic anxiety and other mental-health complications (outcomes). Associations between physical inactivity and mental-health complications were assessed with multivariable logistic regression in people with difficulty seeing and hearing, after grouping by gender and adjusting for age, body-mass index, education level, living as a couple, smoking and alcohol consumption. The overall multivariable logistic-regression analyses showed that women with vision impairment showed significant associations between physical inactivity and depression (OR 1.403, 95% CI 1.015−1.940) and other mental-health complications (OR 2.959, 95% CI 1.434−6.104). In the overall analyses, there were no significant associations in men and in people with hearing impairment. The age-stratified analyses showed that inactive people with visual impairment who were <65 years old had a higher risk of mental-health conditions. In conclusion, physical activity has been shown to be important in the prevention of mental-health complications. Healthcare practitioners and policy makers should look at appropriate strategies to increase levels of physical activity in people with vision loss, especially in women and in those <65 years old.

Attitudes toward aging, active coping, and depressive symptoms among middle-aged and older Korean adults: How do they differ by age group?

BACKGROUND

Despite the adverse health outcomes of holding negative attitudes toward aging, little attention has been paid to these attitudes' role in mental health among the aging population.

OBJECTIVES

Drawing on the stress coping theory, this study examines whether negative attitudes toward aging and low levels of active coping are associated with greater depressive symptoms, and whether active coping attenuates the increased risk of depression caused by negative aging attitudes. We also investigate how these associations differ in middle-aged and older adults.

METHODS

A nationwide sample of 500 Koreans aged 55 or above was analyzed. Multivariate linear regression analyses were performed separately by age groups to investigate the independent effects of attitudes toward aging and active coping as well as their interactive effects on depressive symptoms.

RESULTS

Our findings showed that more negative attitudes toward aging were related to higher levels of depressive symptoms. There were age group differences in the independent and moderating effects of active coping. For the middle-aged, those with higher levels of active coping had fewer depressive symptoms, while no such significant association was found among older adults. On the contrary, active coping buffered the adverse effects of endorsing negative aging attitudes on depressive symptoms only for the older adult group.

LIMITATIONS

A causality cannot be inferred by our findings due to the cross-sectional design.

CONCLUSIONS

The findings provide some of the first insights into how one's aging attitudes and coping style may protect against the risk of depression and how it differs by age group.

Psychological changes among working-age adults with acquired vision impairment: The need for psychological intervention?

This study investigates the psychological impacts of acquiring a vision impairment during working-age phase of adulthood and the potential negative effect on participation in community activities were highlighted. Adopting a qualitative and interpretive phenomenological approach, eight semi-structured in-depth interviews were conducted with eight adult users of vision rehabilitation services. Three broad themes were identified: (1) reduced participation in education, employment, and community activities, (2) feelings of hopelessness and depression from vision loss, and (3) psychological adjustment to vision loss over time. Findings are discussed in the context of the international literature, and recommendations that may enhance the vision rehabilitation services are made.

Longitudinal association of midlife vision impairment and depressive symptoms: the study of Women's Health Across the Nation, Michigan site

OBJECTIVE

Poor vision affects physical health but the relationship with depressive symptoms among midlife adults (40-65 y), who often present with early stage vision impairment (VI), is not well understood. The goal of this study was to assess the impact of vision on depressive symptoms during midlife.

METHODS

The Michigan site of the Study of Women's Health Across the Nation conducted assessments of distance visual acuity at six consecutive, near-annual follow-up visits. At each visit, depressive symptoms (Center for Epidemiological Studies-Depression Scale) were assessed. VI was defined as mild (20/30-20/60) or moderate-severe (20/70 or worse). Multivariable logistic regression models using generalized estimating equations were used to assess the association of VI and reporting of depressive symptoms at the subsequent visit.

RESULTS

At analytic baseline, the mean age of participants (N = 226) was 50.0 years (standard deviation = 2.6). More than half (53.5%) of women had mild VI and 8.0% had moderate-severe VI. Adjusting for age, preexisting depressive symptoms, race, education, economic strain, body mass index, and smoking, participants with mild and moderate-severe VI had 68% (95% C (0.97-2.90)) and 2.55-fold (95% CI 1.13-5.75) higher odds of reporting depressive symptoms at their subsequent study visit as compared with women without VI. Further adjustment for diabetes, hypertension, and osteoarthritis attenuated the estimates and the associations were no longer statistically significant.

CONCLUSION

VI was associated with increased odds of future depressive symptoms among mid-life women. Timely detection and appropriate correction of VI may be important to consider in maintaining the mental health status of midlife women.

Persistence and Disengagement in Personal Goal Pursuit

Persistence in and timely disengagement from personal goals are core components of successful self-regulation and therefore relevant to well-being and performance. In the history of motivation psychology, there has been a clear emphasis on persistence. Only recently have researchers become interested in goal disengagement, as mirrored by the amount of pertinent research. In this review, we present an overview of the most influential motivational theories on persistence and disengagement that address situational and personal determinants, cognitive and affective mechanisms, and consequences for well-being, health, and performance. Some of these theories use a general approach, whereas others focus on individual differences. The theories presented incorporate classical expectancy-value constructs as well as contemporary volitional concepts of self-regulation. Many of the theoretical approaches have spread to applied fields (e.g., education, work, health). Despite numerous important insights into persistence and disengagement, we also identify several unresolved research questions. Expected final online publication date for the Annual Review of Psychology, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Flexible goal adjustment moderates the link between self-rated health and subjective well-being. Findings from the general population

OBJECTIVES

To determine whether flexible goal adjustment moderates the link between self-rated health and subjective well-being longitudinally.

METHOD

Longitudinal data from 2002 to 2011 taken from a nationally representative sample of middle aged and older adults (≥ 40 years) - the German Ageing Survey. A single-item measure was used to assess self-rated health (ranging from 1 = very good to 5 = very bad). Flexible goal adjustment was measured using a scale developed by Brandstaedter and Renner. Subjective well-being was quantified using the Positive and Negative Affect Schedule and the Satisfaction with Life Scale.

RESULTS

Fixed effects (FE) regressions showed that worsening self-rated health is associated with a decrease in positive affect (β=-.07, p<.001) and life satisfaction (β=-.09, p<.001) as well as an increase in negative affect (β=.04, p<.001). Flexible goal adjustment significantly moderated the link between self-rated health and positive (β=.03, p<.05) as well as negative affect (β=-.05, p<.01), i. e., the higher flexible goal adjustment is, the weaker the link is between self-rated health and well-being.

CONCLUSION

Study findings suggest that strategies to enhance flexible goal adjustment may be useful in maintaining well-being among older adults suffering from worsening self-rated health.

Pain, symptom distress, and pain barriers by age among patients with cancer receiving hospice care: Comparison of baseline data

OBJECTIVES

Age group differences have been reported for pain and symptom presentations in outpatient and inpatient oncology settings, but it is unknown if these differences occur in hospice. We examined whether there were differences in pain, symptom distress, pain barriers, and comorbidities among three age groups (20-64 years, 65-84 years, and 85+) of hospice patients with cancer.

MATERIALS AND METHODS

Participants were recruited from two hospices. Half were women; 49% White and 34% Black. 42% were 20-64 y, 43% 65-84 y, and 15% 85+ y. We analyzed baseline data for 230 hospice patients with cancer (enrolled 2014-2016, mean age 68.2 ± 14.0, 20-100 years) from a stepped-wedge randomized controlled trial. Measures were the Average pain intensity (API, 0-10: current, least and worst pain intensity during the past 24 h), Symptom Distress Scale (SDS, 13-65), Barriers Questionnaire-13 (BQ-13, 0-5), and comorbid conditions. Descriptive, bivariate association, and multiple regression analyses were performed.

RESULTS

Mean API scores differed (p < .001) among the three age groups (5.6 ± 2.0 [20-64 years], 4.7 ± 2.0 [65-84 years], and 4.4 ± 1.8 [85+], as did the mean SDS scores (36.1 ± 7.3, 33.5 ± 8.1, and 31.6 ± 6.6, p = .004). BQ-13 mean scores (2.6 ± 0.9, 2.7 ± 0.8, and 2.5 ± 0.7) and comorbidities were not significantly different across age groups. In multiple regression analyses, age-related differences in API and SDS remained significant after adjusting for gender, race, cancer, palliative performance score, and comorbidities. Comorbidities were positively associated with SDS (p = .046) but not with API (p = .64) in the regression model.

CONCLUSION

Older hospice patients with cancer reported less pain and symptoms than younger patients, but all groups reported similar barriers to pain management. These findings suggest the need for age- and race-sensitive interventions to reduce pain and symptom distress levels at life's end.

Lessons in Resilience: Initial Coping Among Older Adults During the COVID-19 Pandemic

Background and Objectives

In addition to increased physical health risks, older adults may also experience risks to their mental health and social wellbeing due to COVID-19. Yet, older adults may be uniquely able to cope given their life experiences and coping mechanisms. This study explores older adults’ coping experiences and strategies during the initial weeks of the COVID-19 pandemic.

Research Design and Methods

A Midwestern sample of 76 older adults aged 70-97 completed a phone interview about their experiences with social distancing due to COVID-19. Interviews were conducted during early weeks of regional social distancing (March 28–April 20, 2020). Participants rated their level of perceived coping and responded to open-ended questions about their daily life and coping.

Results

Mean perceived coping level (on a scale from 1-10) was 7.9, with 87% of participants rating their coping positively. Primary themes that emerged included: 1) staying busy, 2) seeking social support, and 3) having a positive mindset. These emotion-focused coping strategies appeared adaptive in the early weeks of the pandemic for most older adults.

Discussion and Implications

Contrary to predominant messaging about the vulnerability of older adults, these findings highlight the resilient nature of older adults in terms of their psychological coping and adaptability during COVID-19. Future research should build upon these findings to better understand and promote late-life coping during crises. Practitioners should seek to support older adults’ engagement in such proactive coping, and social policies should be developed to acknowledge the variable needs of older adults.

What couples say about living and coping with sensory loss: a qualitative analysis of open-ended survey responses

The current study reports the results of open-ended questions from a follow-up survey of adults with sensory loss and their spouses who had previously taken part in an online study. In total, 111 participants completed the survey (72 adults with a sensory loss and 39 spouses). Open-ended questions asked about the overall experience of living with sensory loss, sensory loss-related challenges, and support and coping mechanisms. Thematic analysis was used to identify dominant themes in participants' responses. Three core themes capturing their overall experience emerged: (1) sensory loss-related challenges, (2) support and coping, and (3) adjustment and readjustment. Sensory loss was characterized as a challenging experience, causing communication and emotional disturbances. Coping strategies reported by both partners included the use of assistive technology, positive re-appraisal, acceptance and/or denial of the loss, while support strategies were mostly derived from the comments of spouses (for AWSLs), family members and peer networks (for both partners). Finally, respondents described sensory loss as an adventurous learning experience. Our findings underscore the significance of considering sensory loss from a social relational/family perspective and highlight the importance of addressing the needs of both adults with sensory loss and their partners in treatment and rehabilitation.Implications for rehabilitationStudy highlights the need to consider sensory loss from a relational/family perspective.Healthcare professionals should try to increase the involvement of significant others and close family members (e.g., spouses, parents, children) into the rehabilitation process.Greater emphasis should be placed on exploring and reinforcing positive experiences and attitudes associated with sensory loss during counselling/rehabilitation sessions.Improved education about sensory loss for both the general public and health care professionals could minimize the adverse outcomes associated with sensory loss.

Letting nature take its course: A qualitative exploration of the illness and adjustment experiences of Hong Kong Chinese people with Parkinson's disease

Parkinson's disease (PD) is a chronic condition that results in not only physical deterioration but also a spectrum of psychosocial outcomes that demand continuous adjustment and coping. Previous qualitative research into the illness experiences has been conducted mainly in Western populations, yet little is known about Chinese PD patients' adjustment. The aims of this qualitative description study were to (a) understand the illness and adjustment experiences, (b) explore the reasons for psychological distress and (c) discern the adjustment strategies adopted along the course of illness, from the perspective of Hong Kong Chinese PD patients. Individual semi-structured interviews were conducted with 14 patients from January to June, 2016. Data were analysed using thematic analysis. Two themes emerged from the interviews: confronting the changes caused by Parkinson's disease and adjusting to living with Parkinson's disease. Participants reported experiencing turmoil due to progressive loss of functions and abilities, changes in role and identity and unattended emotional needs in the course of their illness. Considering the chronic and fluctuating nature of PD, rehabilitation programs should be applied to address not only the physical symptoms but also the psychological needs of PD patients. Behavioral strategies facilitating active health behaviours and accommodative psychological adjustment are salient to facilitate the holistic well-being of PD patients.

The moderating role of flexible goal adjustment in the link between pain and depressive symptoms: findings based on a nationally representative sample of older adults

BACKGROUND

Pain is a frequent phenomenon in old age. It has been shown that increases in pain are longitudinally associated with depressive symptoms. This strong link can be attenuated by coping strategies like resilience. However, to date, there is a lack of longitudinal studies, based on nationally representative samples that have examined whether flexible goal adjustment moderates the relation between pain and depressive symptoms. Thus, the purpose of this study was to identify whether there is a longitudinal association between pain and depressive symptoms, and to examine whether flexible goal adjustment moderates this link.

METHODS

Longitudinal data (wave 3 and wave 4; 5582 observations) were taken from a sample (German Ageing Survey) which is nationally representative for middle-aged and older adults (40 years and over). A widely used pain measurement (single-item measure) served as the key independent variable. An instrument created by Brandstaedter and Renner was used to quantify flexible goal adjustment. The 15-item version of the Centre for Epidemiologic Studies Depression Scale was used to measure depressive symptoms.

RESULTS

Linear fixed effects regressions demonstrated that an increase in pain was associated with an increase in depressive symptoms (β = 0.42, P < 0.001). Moreover, flexible goal adjustment significantly moderated this association (β = -0.39, P < 0.01). With regard to potential confounders, an increase in depressive symptoms was associated with increasing age and worsening self-rated health.

CONCLUSION

The study findings showed that increasing pain leads to more depressive symptoms using a longitudinal approach. In addition, flexible goal adjustment moderated this link. Therefore, programs aiming at improving flexible goal adjustment may assist in avoiding an increase in depressive symptoms alongside pain increases among older adults.

Physical activity and quality of life predictors among university students with polio in India: A cross-sectional study

BACKGROUND

Quality of life (QoL) assessments measure the overall well-being of a person. Available data suggest an estimated 10-20 million polio survivors worldwide. Few studies have investigated the physical activity and the QoL of these patients in India.

AIM

The present cross-sectional study attempted to measure the physical activity and QoL of polio survivors and to evaluate the relationship between physical activity and QoL, among other factors.

METHODS

The study was conducted in 96 students (64 women and 32 men with a mean age of 22.1±3.7 years). QoL, physical activity, fatigue, and pain were measured by the World Health Organization QoL measure - abbreviated version (WHOQOL-BREF), physical activity scale for individuals with physical disabilities (PASIPD), multidimensional fatigue symptom inventory-short form (MFSI-SF), and numerical rating scale.

RESULTS

The mean metabolic equivalent score was 27.10 h/day. Low mean scores were observed for the physical health, psychological well-being, social relationships, and environmental domains of QoL (25.2±3.3, 21.8±3.0, 12.0±1.8, and 23.0±4.3, respectively). There was a weak negative association between physical activity levels and the physical health domain of QoL (P<0.05), whereas no associations were identified between physical activity levels and other QoL domains (P>0.05). Regression analysis identified female gender, fatigue, and physical activity as predictors of the physical health domain, and female gender, number of sites affected, and assistive devices used as predictors of the psychological health domain of QoL.

CONCLUSIONS

Low physical activity levels and QoL were noted among students with poliomyelitis in Uttar Pradesh, India.

RELEVANCE FOR PATIENTS

Considering the inverse relationship between physical activity and QoL, physical activities should be modified or protected in polio survivors. Female polio survivors may be referred to psychological counseling to learn coping strategies, even during periods of relative stability.

Goal Pursuit, Goal Adjustment, and Pain in Middle-Aged Adults Aging With Physical Disability

Objective: Aging with physical disability disrupts one's ability to achieve valued goals due to changes in symptoms and function. It is unclear how to cope optimally in this context. This study examined whether two possible strategies-tenacious goal pursuit (TGP) and flexible goal adjustment (FGA)-were associated with reduced pain interference and depressive symptoms and greater well-being, and protected against pain intensity, and FGA was more protective with increasing age and worse physical function. Method: Middle-aged adults with muscular dystrophy, multiple sclerosis, post-polio syndrome, or spinal cord injury (N = 874; M_AGE = 58.3 years, range = 46-68; M_{DISEASEDURATION} = 26.2 years, range = 2-67) completed two questionnaires, a year apart. Results: TGP and FGA use was associated with greater well-being. FGA use predicted decreased depressive symptoms. Concurrent use of both predicted decreased pain interference. Discussion: Adults with disability employ a variety of goal management strategies. Findings support TGP and FGA as potential intervention targets for healthy aging with disabilities.

Tenacious Goal Pursuit, Flexible Goal Adjustment, and Life Satisfaction Among Chinese Older Adult Couples

We aimed to examine the roles of tenacious goal pursuit (TGP) and flexible goal adjustment (FGA), mediated by positive self-perceptions of aging (PSA), in Chinese older couples' life satisfaction. Using a cross-sectional design, 245 Chinese older couples (age range: 55-93 years) completed measures of TGP, FGA, PSA, and life satisfaction. The results showed that (a) spousal interrelations existed for TGP and FGA; (b) TGP and FGA had significant actor effects on life satisfaction, with FGA having a stronger effect; (c) although the partner effect of FGA did not differ between husbands and wives, husbands' TGP was positively associated with wives' life satisfaction, but not vice versa; and (d) PSA mediated the effects of TGP and FGA on life satisfaction at the actor and partner levels. These results have implications for developing couple-based interventions to enhance successful aging, with a focus on promoting both partners' accommodative coping and positive age beliefs.

Assimilative and accommodative coping in older adults with and without sensory impairment: four-year change and prospective relations with affective well-being

Objectives: Sensory impaired older adults may be particularly dependent on coping strategies such as assimilation (or tenacious goal pursuit [TGP]) and accommodation (or flexible goal adjustment [FGA]) to secure high levels of well-being. We investigated if late-life changes in these coping strategies and prospective associations of TGP and FGA with affective well-being vary according to sensory impairment status. Method: Our study sample consisted of 387 adults aged 72-95 years (M = 82.50 years, SD =4.71 years) who were either visually impaired (VI; n = 121), hearing impaired (HI; n = 116), or sensory unimpaired (UI; n = 150). One hundred sixty-eight individuals were reassessed after approximately 4 years. Results: Both VI and HI revealed a decrease in TGP, whereas TGP remained stable in UI. For FGA, a significant increase in HI was observed, whereas a significant decline emerged in UI. Controlling for age, gender, and cognitive abilities, higher TGP at baseline was significantly associated with higher negative affect 4 years later in VI. Moreover, the positive association between baseline FGA and subsequent positive affect was stronger in HI than in UI older adults. Conclusion: Our findings suggest that older adults with sensory impairments reveal trajectories of assimilative and accommodative coping and associations of TGP and FGA with affective well-being that are different from sensory unimpaired individuals.

Developmental Regulation and Awareness of Age-Related Change: A (Mostly) Unexplored Connection

Objectives

Linkages between developmental regulation and awareness of aging-although suggested by theoretical considerations-have not found much empirical consideration. To address this gap, we examined associations between two established modes of developmental regulation, that is, assimilation and accommodation, and awareness of age-related change (AARC) in midlife and old age, while considering the role of chronological age as a moderator.

Method

Data are based on a cross-sectional sample of 356 adults (aged 42-100 years). A newly developed measure of AARC was used to assess perceived gain- and loss-related aging experiences.

Results

AARC was associated with assimilation and accommodation over and above a range of control variables. Individuals who perceived many loss-related aging experiences were less likely to use assimilation and accommodation. Individuals perceiving many gain-related aging experiences were more likely to make use of these strategies. The effects remained stable when controlling for subjective age and self-efficacy, except for the association between gain-related aging experiences and assimilation. No moderation effect of calendar age was found.

Discussion

Results suggest that multidimensional subjective aging constructs may enrich our understanding of how developmental regulation modalities are used by aging individuals.

Psychobiological factors of resilience and depression in late life

In contrast to traditional perspectives of resilience as a stable, trait-like characteristic, resilience is now recognized as a multidimentional, dynamic capacity influenced by life-long interactions between internal and environmental resources. We review psychosocial and neurobiological factors associated with resilience to late-life depression (LLD). Recent research has identified both psychosocial characteristics associated with elevated LLD risk (e.g., insecure attachment, neuroticism) and psychosocial processes that may be useful intervention targets (e.g., self-efficacy, sense of purpose, coping behaviors, social support). Psychobiological factors include a variety of endocrine, genetic, inflammatory, metabolic, neural, and cardiovascular processes that bidirectionally interact to affect risk for LLD onset and course of illness. Several resilience-enhancing intervention modalities show promise for the prevention and treatment of LLD, including cognitive/psychological or mind-body (positive psychology; psychotherapy; heart rate variability biofeedback; meditation), movement-based (aerobic exercise; yoga; tai chi), and biological approaches (pharmacotherapy, electroconvulsive therapy). Additional research is needed to further elucidate psychosocial and biological factors that affect risk and course of LLD. In addition, research to identify psychobiological factors predicting differential treatment response to various interventions will be essential to the development of more individualized and effective approaches to the prevention and treatment of LLD.

Agency and Motivation in Adulthood and Old Age

This review addresses conceptual and empirical research about how individual agency and motivation influences development during adulthood and old age. The major life-span approaches to individual agency and developmental regulation are discussed, with a focus on the motivational theory of life-span development. Developmental agency unfolds through action cycles of pursuing long-term goals for optimal development. Individuals differ in their capacity to regulate their goal engagements effectively within the age-graded structure of opportunities and constraints in their life courses. We discuss a set of research examples about specific developmental challenges, such as transition to adulthood, biological aging, illness, and societal transformation, and show how individuals, as agents in their own development, navigate change for better or worse. We conclude with suggestions for future research.

Cyr N, Siddarth P. Resilience predicts remission in antidepressant treatment of geriatric depression

OBJECTIVES

With the world population rapidly aging, it is increasingly important to identify sociodemographic, cognitive, and clinical features that predict poor outcome in geriatric depression. Self-report measures of resilience-ie, the ability to adapt and thrive in the face of adversity-may identify those depressed older adults with more favorable prognoses.

METHODS

We investigated the utility of baseline variables including 4 factors of resilience (grit, active coping self-efficacy, accommodative coping self-efficacy, and spirituality) for predicting treatment response and remission in a 16-week randomized controlled trial of methylphenidate, citalopram, or their combination in 143 adults over the age of 60 with MDD.

RESULTS

Final logistic regression models revealed that greater total baseline resilience (Wald χ²  = 3.8, P = 0.05) significantly predicted both treatment response and remission. Specifically, a 20% increase in total resilience predicted nearly 2 times greater likelihood of remission (OR = 1.98, 95% CI = [1.01, 3.91]). Examining the individual factors of resilience, only accommodative coping self-efficacy (Wald χ²  = 3.7, P = 0.05; OR = 1.41 [1.00-2.01]) was significantly associated with remission. We found no relation between baseline sociodemographic factors (age, sex, race, education level) or measures of cognitive performance and posttreatment depressive symptoms.

CONCLUSIONS

Self-reported resilience may predict greater responsivity to antidepressant medication in older adults with MDD. Future research should investigate the potential for resilience training-and in particular, interventions designed to increase accommodative coping-to promote sustained remission of geriatric depression.

A goal management intervention for patients with polyarthritis and elevated levels of depressive symptoms: a quasiexperimental study

Purpose: Goal was to establish whether an intervention that aims to increase goal management competencies is effective in decreasing elevated levels of depressive symptoms and increasing well-being in patients with polyarthritis.Materials and methods: Eighty-five persons with polyarthritis and elevated levels of depressive symptoms participated in the goal management intervention consisting of six group-based meetings. A quasiexperimental design with baseline measurement, follow-up at 6 months and a reference group of 151 patients from an observational study was applied. Primary outcome was depression; secondary outcomes were anxiety, purpose in life, positive affect, satisfaction with participation, goal management strategies, and arthritis self-efficacy. A linear mixed model procedure was applied to evaluate changes in outcomes.Results: No improvement was found for depressive symptoms and no changes were found for the secondary outcomes, except for positive affect that improved in the intervention group. This increase was mediated by an increase in goal adjustment. Furthermore, goal maintenance decreased and self-efficacy for other symptoms increased in the intervention group.Conclusion: This study indicates that interventions designed to aid patients with arthritis with goal management skills are potentially helpful for increasing positive affect, although further studies are needed.Implications for rehabilitationPeople with polyarthritis have to manage their disease in combination with possibly conflicting roles and personal goals, resulting in an ongoing process of finding equilibrium in a constantly changing situation.Based on a person-focused view, the program Right on Target focused on coping with threatened activities and life goals due to arthritis.The program consisted of six group-based meetings led by a trained nurse and a personal trajectory wherein participants were stimulated to try out various behavioral options related to an own threatened activity in concordance with their personal goals.The program seemed effective in increasing flexible goal adjustment and self-efficacy and participants experienced more positive affect directly after the program and at 6-month follow-up.

Predictors of depression and life satisfaction in visually impaired people

BACKGROUND

Visual impairment can lead loss of functional ability, necessity of accommodations and assistive technologies or having to rely on others for help. This can bring about feelings of sadness, dependency, inadequacy, and fear, which can put a person at risk for depression and affect one's satisfaction with life.

PURPOSE

The aim of this study was to examine the effects of socio-demographic factors, disability-related factors, optimism, pessimism, self-esteem and social support on depression, and life satisfaction in visually impaired people.

METHODS

A total of 94 visually impaired people completed the measures of socio-demographic and disability-related characteristics, optimism and pessimism, self-esteem, social support, depression and life satisfaction, administered by the authors. Correlational and hierarchical regression analysis was used to examine the relations and test the model for predicting depression and life satisfaction.

RESULTS

The results have shown that depression was negatively related to the level of education, optimism, self-liking, self-competence, support from friends, family and coworkers, and positively related to comorbidity and pessimism. Life satisfaction was positively related to education, socio-economic status, optimism, self-liking, self-competence and support from friends, family and coworkers, and negatively to pessimism. Results have further shown that depression levels were predicted by education, comorbidity, optimism and self-liking, and that self-liking mediated the relationship between optimism and depression. Life satisfaction was predicted by optimism, pessimism, self-liking, friends' support, and depression. Further analysis suggested that the path from optimism to life satisfaction goes through self-liking, friends' support, and depression. Pessimism showed indirect effects through self-liking but also had direct effects on life satisfaction.

CONCLUSIONS

Focusing on optimism, pessimism, self-esteem, and social functioning of visually impaired is important in preventing depression and promoting life satisfaction, and should be a part of rehabilitation practices. Implications for Rehabilitation Screening for depression and mental health problems should be a part of rehabilitation process. Changes in the perception of future outcomes should be monitored and addressed throughout rehabilitation process in order to boost realistic optimism and prevent discouragement and hopelessness. Frequent feedback and positive reinforcement about a persons' progress and ability should be given throughout rehabilitation process in order to promote positive view of oneself and prevent self-esteem problems. Visually impaired people should be encouraged to socialise outside of their families and participate in social activities. This can be integrated in rehabilitation process as a part of everyday homework.

Correlates and Predictors of Well-being in Montreal

With and without mental disorders, low levels of positive mental health are associated with limitations in daily life and with an economic burden in developed countries. We aimed to assess the correlates and predictors of high levels of well-being (WB) in Keyes' model of mental health. A four-year longitudinal population-based study was administered, in Montreal, Canada. At baseline, 1828 participated in wave 1, and 1303 in wave 2. WB was measured by the Mental Health Continuum Short Form, and data were collected by direct interviews. 17 variables were correlated with WB. Seven variables were predictors of having excellent WB. Stress/coping variables like ability to handle difficult problems or having the personal ability to deal with stress showed the strongest effects (respectively, OR = 1.790, 95% CI 1.232-2.601, OR = 2.118, CI 95% 1.324-3.387). This study underscores the importance of testing a multidimensional model accounting for a spectrum of relevant variables relating to WB.

Longitudinal Patterns of Stability and Change in Tenacious Goal Pursuit and Flexible Goal Adjustment among Older People over a 9-Year Period

Using the dual-process model of assimilative-tenacity (TGP) and accommodative-flexibility (FGA), the study aims to identify trajectories of TGP and FGA over five time points within a 9-year period, explore the relationships between the trajectories of TGP and FGA, and explore if participants from distinct TGP and FGA trajectories differed in indicators of well-being and depression. Latent class growth analysis was used in a five-wave longitudinal design among an older population of 747 participants over 65 years. Results highlight (1) emergence of four trajectories for flexibility (low and increasing, moderate and increasing, moderately high and stable, and high and stable trajectories) and three trajectories for tenacity (low and stable, moderate and stable, and high and decreasing trajectories), (2) that older people belonging to particular trajectories of FGA are not more likely to belong to particular trajectories of TGP, and (3) that participants from the high and decreasing TGP and high or moderately high and stable FGA trajectories were characterized by high score of perceived health, satisfaction with life, and self-esteem and low score of depression moods. These results highlight that the heterogeneity in longitudinal TGP and FGA scores throughout the life span needs to be accounted for in future research.

Personal resilience and coping with implications for work. Part I: A review

BACKGROUND

Interest in resilience has increased in recent years. The U.S. military focus is on personal health and adaptation following exposure to battle, while the civilian interest centers on adjustments subsequent to disastrous events. Coping skills are also relevant, yet the relationships between coping and resilience are unclear.

OBJECTIVE

This brief review examines personal resilience and individual coping strategies, exploring definitions of each, along with their potential relationships to one another. Their potential contributions within a work setting are described.

METHODS

A literature review was conducted using search terms of resilience, resiliency, personal resilience, coping and resilient coping.

RESULTS

Coping refers to one's using purposeful actions to handle life situations. Coping techniques can be functional or dysfunctional and the situations one copes with may be acute or long term, severe or minor. Resilience refers to positive and functional handling of oneself and ones' life, referring to the ability to recover, recuperate, and regenerate following tragic events.

CONCLUSIONS

While coping and resilience are related to one another, they are distinct concepts. Positive coping techniques may contribute to resilience. However, which coping techniques improve resilience, and in what circumstances, are questions for future research.

Sensory functioning and personality development among older adults

Deficits in sensory functioning, such as poor vision and hearing, take a significant toll on quality of life. Little is known, however, about their relation with personality development across adulthood. This study examined whether baseline and change in vision and hearing were associated with personality change over a 4-year period. Participants (N = 7,471; Mage = 66.89; 59% women) were drawn from the Health and Retirement Study. They provided data on vision, hearing, and personality both at baseline and 4 years later. Poor vision and hearing at baseline and declines in vision and hearing over time were independently related to steeper declines in extraversion, agreeableness, openness, and conscientiousness, and less decline in neuroticism, controlling for demographic factors, disease burden, and depressive symptoms. Sensory functioning was generally a stronger predictor of personality change than disease burden or depressive symptoms. Consistent with evidence that poor and worsening sensory functions compromise individuals' interactions with the social and physical environment, this study found deficits in hearing and vision were also associated with maladaptive personality trajectories in older adults. (PsycINFO Database Record

Life resources and personal goals in old age

It has been theorized that life resources influence goal engagement. The aim of the present study was to examine whether personal characteristics, and socio-economic, social and health resources are associated with personal goal content in old age. The participants were 824 community-dwelling people aged 75-90 from the Life-Space Mobility in Old Age project. Personal goals were elicited using a revised version of the Personal Project Analysis in a structured interview. Cross-sectional bi- and multivariate analyses using logistic regression modelling were conducted. The results showed that the most commonly reported goals were health maintenance related. People with better health resources were more likely to report goals related to leisure-time, social and physical activities and less likely to report goals related to recovery of health. Those with poor social resources were at risk for having no personal goals in their lives. The results are in line with theorizing on the influence of life resources on goal setting in old age. Further longitudinal studies are needed on whether resource loss precedes goal modification, and how goal setting strategies influence both mental and physical well-being in old age.

The role of flexible goal adjustment in the effect of informal caregiving on depressive symptoms: Evidence of a large population-based longitudinal study in Germany from 2002 to 2011

OBJECTIVES

To determine the role of flexible goal adjustment in the impact of informal caregiving on depressive symptoms, using a longitudinal approach.

METHOD

Data were gathered from the German Ageing Survey. This is a population-based longitudinal study among community-dwelling individuals aged 40 and above in Germany. Data were derived from the second (2002), third (2008) and fourth (2011) wave, drawing on 10,994 observations. Flexible goal adjustment was assessed using a scale by Brandstädter and Renner. Informal caregiving was measured by asking the individuals whether they provide informal care. Depressive symptoms were quantified by using the Center for Epidemiological Studies Depression scale.

RESULTS

Adjusting for several potential confounders, fixed effects regressions showed that the onset of informal caregiving markedly increased depressive symptoms. Furthermore, regressions revealed that this effect was significantly moderated by flexible goal adjustment.

DISCUSSION

Our results highlight the importance of informal caregiving for depressive symptoms. Furthermore, the importance of flexible goal adjustment in the relation between informal caregiving and depressive symptoms should be emphasized. Efforts to increase flexible goal adjustment might be beneficial in reducing depressive symptoms among informal caregivers.

Resilience and Coping as Predictors of Well-Being in Adults

Well-being is one of the keys to successful and optimal development across the lifespan. Based on the idea that development involves changes in individuals' adaptive capacity to meet their needs over time, the changes that occur in the second half of life require effort to adapt to the new reality. This study used a structural model to test the effects of coping strategies and resilience on well-being in a sample of 305 mid-life adults. Several constructs were measured: coping strategies, resilience, and well-being. A final model was obtained with good fit indices; psychological well-being was positively predicted by resilience and negatively by emotional coping. Moreover, positive reappraisal and avoidance form part of both coping strategies (problem-focused and emotion-focused). Considering the characteristics of the model, educational intervention programs could be developed to promote skills that favor good adaptation at this stage in the life cycle and contribute to promoting successful aging.

The effect of rehabilitation service use on coping patterns over time among older adults with age-related vision loss

Objective: To enhance our understanding of coping and rehabilitation in the context of adaptation to disability by examining how coping may change over a two-year time period, and how different vision rehabilitation services may affect coping over time.

Design: Longitudinal two-wave study (baseline and two-year follow-up).

Setting: Vision rehabilitation agency.

Subjects: Older adults with visual impairment.

Method: In-person interviews using structured assessments of functional vision loss and functional disability, rehabilitation service use and coping strategies.

Results: Ninety-five people participated in both study waves. Findings showed change in patterns of coping over the two-year period of the study, as participants adjusted to living with age-related vision loss. Although instrumental coping was the only coping mode with evidence for average change (a decrease), affective and escape/distraction strategies showed individual variation in change over time. Rehabilitation use explained variance in coping at time 2 over and above impairment status and coping at time 1. Those who used a greater number of assistive aids between time points were likely to report more instrumental coping at time 2, and those who used counselling between time points were likely to report more affective coping at the two-year follow-up. Finally, those who used more optical aids were likely to report more escape/distraction coping at time 2, whereas those who saw a low vision specialist tended to report less of this type of coping over time.

Conclusions: Findings suggest that rehabilitation interventions can affect coping patterns over time, and that direction and magnitude of such an effect may depend on the type of rehabilitation received.

Optimizing rehabilitation for adults with visual impairment: attention to life goals and their links to well-being

Objective: To examine the importance of different life goals among working-age adults with vision impairment, the extent to which vision impairment interfered with goals, and how rehabilitation addressed these life goals.

Design: Cross-sectional descriptive study.

Setting: Vision rehabilitation agency.

Subjects: Working-age adults with visual impairment.

Method: Telephone interviews using structured and open-ended assessments of life goal importance, goal interference due to vision loss, the role of goals in rehabilitation, and indicators of well-being.

Results: Eighty-six people participated. The life domains most frequently rated as extremely important were finances (60), residential and domestic arrangements (55), family (51), partner (48), and personal care (48). The extent to which vision loss interferes with these life goals was extreme for finances (46), residential and domestic arrangements (36), partner (27), family (25), and personal care (14). A life goal was addressed in rehabilitation: residential/domestic arrangements (41), work (39), finances (31), leisure/hobbies (28), personal care (24), family (17), partner (16), friends (10), and religion/life philosophy (8). Reports of a life goal being addressed in ineffective ways emerged for functional life goals, but not for relationship and religion/life philosophy goals. Goal interference was significantly correlated with well being indicators across life domains. In contrast only partner and family relationship importance were significantly linked with well-being indicators.

Conclusions: Relationship-related goals were a top priority for this study population, but functional compared to relationship goals were more commonly addressed in vision rehabilitation services.

Tenacious goal pursuit and flexible goal adjustment in older people over 5 years: a latent profile transition analysis

BACKGROUND

previous research has shown that tendencies to tenaciously pursue goals (TGP) and flexibly adapt goals (FGA) relate to well-being of older people.

OBJECTIVES

this study aimed to identify subpopulations of elderly people with different coping profiles, describe change in participants' profiles over time and determine the influence of coping profiles on well-being over a 5-year period.

METHODS

latent profile transition analysis (LPTA) was used in a three-wave longitudinal data collection measuring flexibility, tenacity, depression, self-rated health and life satisfaction among an elderly population over 65 years old.

RESULTS

three coping profiles were identified. Profile 1 was characterised by participants with high flexibility and tenacity scores, Profile 2 with moderate flexibility and low tenacity scores and Profile 3 with low flexibility and moderate tenacity scores. Results indicate stability of these profiles over time, with Profile 1 being the most adaptive in terms of ageing well.

CONCLUSION

high flexibility and tenacity in older people is a stable coping profile that is associated with successful ageing.

The longitudinal relation between patterns of goal management and psychological health in people with arthritis: The need for adaptive flexibility

OBJECTIVES

Due to their disease, patients with polyarthritis face the task of reconciling their threatened personal goals with their capabilities. Previous cross-sectional research on patients with chronic disease related higher levels of goal management strategies to lower levels of distress and higher levels of well-being. This study was the first to focus longitudinally on goal management patterns that combined strategies originating from different goal management theories. Our first study objective was to identify patterns that consisted of various strategies of goal management among patients with polyarthritis. Subsequently, the cross-sectional and longitudinal relationships between these patterns and the psychological health of the patients were studied.

METHODS

A longitudinal questionnaire study with three measurements of goal management and psychological health was conducted among 331 patients with polyarthritis. Stability of goal management over time was analysed with ANOVAs. Patterns were identified using cluster analysis at baseline, based on the following strategies: Goal maintenance, goal adjustment, goal disengagement, and goal reengagement. Longitudinal relationships between the patterns and psychological health (specifically: Depression, anxiety, purpose in life, positive affect, and social participation) were analysed using a generalized estimating equations analysis.

RESULTS

Three goal management patterns were found: 'Moderate engagement', 'Broad goal management repertoire', and 'Holding on'. Patients with the 'Broad goal management repertoire' pattern had the highest level of psychological health. The 'Holding on' pattern was identified as the most unfavourable in terms of psychological health. Over time, stable differences in levels of psychological health between the patterns were found.

CONCLUSIONS

This study was the first to reveal patterns of several goal management strategies and their longitudinal relationship to psychological health. Psychosocial support for arthritis patients with lower psychological health should focus on helping patients to become familiar with a broad range of goal management strategies when dealing with threatened goals.

STATEMENT OF CONTRIBUTION

What is already known on this subject? Polyarthritis is a collective term for a variety of disorders associated with autoimmune pathologies that may affect all aspects of a person's physical, psychological, and social functioning. Patients often experience difficulties in maintaining and achieving goals in several domains of life due to disease symptoms. The process of emotional adaptation to polyarthritis is characterized by searching equilibrium between desires and constraints and reacting constructive to stressors. Goal management strategies are ways to minimize the perceived disparity between the actual and the preferred situation with regard to personal goals and are applied both consciously and unconsciously. Cross-sectional, higher levels of goal management strategies have been related to lower levels of distress and higher levels of well-being both in patients with polyarthritis and in other patient groups. What does this study add? Contributes to our understanding of how combinations of goal management strategies relate to psychological health. Identifies patterns of goal management that are longitudinally related to psychological health. Provides clear guidance for improving psychological health of people with polyarthritis.

Goal disengagement capacities and severity of disease across older adulthood

This study examined age-related associations between goal disengagement capacities, emotional distress, and disease severity across older adulthood. Given that an age-related increase in the experience of stressors might render important goals unattainable, it is expected that goal disengagement capacities would predict a decrease in the severity of experienced illness (i.e., the common cold) by preventing emotional distress (i.e., depressive symptoms), particularly so among individuals in advanced (as compared to early) old age. This hypothesis was tested in a 6-year longitudinal study of 131 older adults (age range = 64 to 90). Regression analyses showed that goal disengagement capacities buffered 6-year increases in older adults’ cold symptoms, and that this effect was significantly pronounced among older-old participants. Mediation analyses further indicated that changes in depressive symptoms exerted an indirect effect on the age-related association between goal disengagement and changes in cold symptoms. The study’s findings suggest that goal disengagement capacities become increasingly important for protecting emotional well-being and physical health as older adults advance in age.

Function Self-Efficacy Scale—FSES

This article describes the development and validation of the Function Self-Efficacy Scale (FSES) for assessing the degree of confidence in self-functioning while facing decline in health and function (DHF). The FSES was evaluated in two studies of older Israelis, aged 75+ years. Data were collected by structured home interviews. Exploratory factor analyses conducted in both studies clearly revealed two underlying factors: emotion self-efficacy and action self-efficacy. Confirmatory factor analyses resulted in acceptable model fit criteria. The shortened final 13-item FSES had good internal consistency and satisfactory criterion and convergent validity. Multiple regression analyses, conducted to predict subjective well-being in each of the studies, showed that function self-efficacy had a positive and significant contribution to the explanation of well-being, while controlling for general self-efficacy, self-rated health, and sociodemographic variables. We propose that appropriate interventions can strengthen function self-efficacy, thus improving the well-being of elderly persons and their ability to cope with DHF.

Influence of visual acuity on anxiety, panic and depression disorders among young and middle age adults in the United States

BACKGROUND

Previous research, albeit limited, has demonstrated an association of visual acuity with depression and anxiety. However, these studies are limited in that they have focused on older adults, used a convenient sample, and/or used a subjective assessment of visual function. As a result, the purpose of this study was to examine the association of objectively-measured visual acuity with depression and anxiety (and panic disorder) among a national sample of young- and middle-age U.S. adults (20-39 years).

METHODS

Using data from the 2003-2004 NHANES (n=602), the presence of anxiety, depression, and panic disorders was assessed from a diagnostic interview. Visual acuity was assessed from a vision exam using the Nidek Auto Lensmeter Model (LM-990A) and expressed as LogMAR units.

RESULTS

After adjusting for age, gender, race-ethnicity, body mass index, mean arterial pressure, cotinine, diabetes, and physical activity, visual acuity was not associated with panic disorder (p=0.71) or depression disorder (p=0.20), but for every 0.1 LogMAR unit change in vision, participants had a 14% (OR=1.14; p=0.04) higher odds of having an anxiety disorder.

LIMITATIONS

The main limitation of this study was the cross-sectional design.

CONCLUSION

Young- and middle-age U.S. adults with worse visual function are at increased odds of having an anxiety disorder. Strategies to prevent and treat anxiety among those with worse visual function are needed.

Activity limitations, use of assistive devices or personal help, and well-being: variation by education

OBJECTIVES

This study examined the associations among self-care or mobility limitations, use of assistive devices or personal help, and well-being while giving special attention to 3 dimensions of well-being and older adults' educational attainment.

METHOD

The analysis was based on 4,456 community-dwelling older adults with self-care or mobility limitations who completed interviews in the first round of the National Health and Aging Trends Study. Path models were estimated to examine the associations among limitations, use of assistive devices or personal help, and 3 dimensions of well-being (positive affect, self-realization, and self-efficacy) for different educational groups of older adults.

RESULTS

Self-care or mobility limitations had a negative association with 3 dimensions of well-being. The use of assistive devices was positively related, but the use of personal help was negatively related to well-being. Older adults with more education demonstrated weaker associations between assistive devices and well-being and stronger inverse associations between personal help and well-being than those with less education.

DISCUSSION

The use of coping strategies to address self-care or mobility limitations is not necessarily associated with better well-being, and education does not seem to play a protective role once limitations develop. More research is needed to unpack population heterogeneity in the association between coping strategies and well-being.