Couples' Shared Beliefs About Aging and Implications for Future Functional Limitations

At the Heart of Resilience: Empowering Women's Agency in Navigating Cardiovascular Disease

Cardiovascular disease (CVD) is the leading cause of death among women globally, emphasizing the need for a healthcare approach that empowers women through agency. This review focuses on the critical role of women's agency in navigating CVD, integrating insights from various fields, including medicine, education, psychology, and sociology. The review highlights the shift toward patient-centred care, a framework in which women are recognized as key decision-makers, a crucial change given the historical underemphasis on women's health issues in medical practice. The diagnosis of CVD in women often involves emotional and psychological challenges. Unexpected diagnoses significantly disrupt perceived well-being, and prolonged diagnostic processes lead to professional skepticism and neglect of symptoms, resulting in delayed or inaccurate diagnoses and strained healthcare relationships. Effective management of CVD necessitates continuous self-management and a holistic approach to care, particularly for those with trauma who are at increased risk of cardiac incidents. Empowerment for women with CVD involves promoting self-confidence, autonomy, and active patient participation in healthcare. Implementing comprehensive care models is crucial for improving chronic CVD management, highlighting the need for healthcare systems that prioritize patient agency and empowerment. From the perspective of a woman with lived experience, this article examines the impact of CVD on women's agency throughout the diagnostic journey. By highlighting women's agency rather than particular behavioural changes, this review offers a comprehensive analysis that can shape policy, stimulate new research, and foster a more equitable, efficient, and empathetic healthcare system for women with CVD.

Correlates of felt age in caregivers of people with dementia: findings from the IDEAL study

Objective

Family relationships influence how people appraise their own aging and how their appraisals impact their health. We analyzed felt age (FA) among family caregivers of people with dementia.

Methods and measures

We used a stratified sample of 1,020 spousal and 202 adult-child caregivers from the IDEAL study. We estimated cross-sectional associations and bidirectional influences between caregivers' FA and their health and wellbeing (depression, number of health conditions, stress, positive aspects of caregiving) over 2 years.

Results

Among spousal caregivers, 25% had a younger FA and 36% had an older FA. Among adult-child caregivers, 21.8% had a younger FA and 36.1% had an older FA. In spousal and adult-child caregivers an older FA was cross-sectionally associated with higher depression, number of health conditions, and stress, and fewer positive aspects of caregiving. In spousal caregivers, hours of care per day moderated the association between FA and depression, and FA was associated with stress 1 year later.

Conclusion

Caregiving may impact FA and its relationship with health. We urge continued research on the connections between caregiving and FA, and how interventions might support caregivers' positive views on their own aging, which will translate views on aging scholarship to meaningfully improve caregivers' lives.

Longitudinal effects of subjective aging on health and longevity: An updated meta-analysis

This article updates and extends an earlier meta-analysis (Westerhof et al., 2014) on the longitudinal effects of subjective aging (SA) on health outcomes. A systematic search in different databases (APA PsycInfo, PubMed, Web of Science, and Scopus) resulted in 99 articles, reporting on 107 studies. Participants: Studies had a median sample size of 1,863 adults with a median age of 66 years. A randomized effect meta-analysis showed a significant, small effect (likelihood ratio = 1.347; 95% confidence interval [1.300, 1.396]; p < .001), similar in magnitude to the previous meta-analysis of 19 studies. Although the results showed high heterogeneity in the longitudinal link between SA and health outcomes, there were no differences in effects according to chronological age of participants, welfare state status (more or less developed social security system), length of follow-up, type of health-related outcome, or quality of the study. Effects were stronger for multiitem measures of self-perceptions of aging than for the frequently used single-item measures assessing subjective age, especially for indicators of physical health. Based on this meta-analysis, building on five times more studies than the 2014 review, we consider the associations of measures of SA with health and longevity across time as robust, albeit small in size. Future research should concentrate on the clarification of pathways mediating the relation between SA and health outcomes, as well as potential bidirectional effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How Do Marital Transitions Affect Self-Perceptions of Aging?

OBJECTIVES

We analyzed whether marital status and experiences of marital loss or gain were associated with self-perceptions of aging (SPA), a major psychosocial mechanism of healthy aging.

METHOD

We used data from 7028 participants of the Health and Retirement Study. Participants reported their marital status and their positive and negative SPA on two occasions 4 years apart. We ran general linear models to analyze differences in SPA between men and women who remained married, became divorced or widowed, or remarried following divorce or widowhood.

RESULTS

Participants who experienced marital loss had lower positive SPA than participants who remained marred. Participants who experienced marital gain had lower negative SPA than participants who remained married. None of the associations differed between men and women.

DISCUSSION

Results suggest that it may not be marital status itself, but rather the transition into or out of marriage, that impacts how people appraise their own aging.

Sexual Activity and Satisfaction in Older Adult Dyads: The Role of Perceptions of Aging

BACKGROUND AND OBJECTIVES

This study assessed the associations between perceptions of aging (POA) and sexual frequency and satisfaction in older adult dyads.

RESEARCH DESIGN AND METHODS

Using dyadic data from up to 1,122 different-sex married and cohabiting couples ages 50-89 (Mmen = 66.63 [7.40]; Mwomen = 64.43 [7.27]), we estimated 2 actor-partner interdependence models. We first examined the association between men's and women's POA and each partner's reports of frequency of partnered sexual activity (e.g., intercourse, oral sex, kissing, petting, and fondling). Then, we tested the link between POA and each partner's sexual satisfaction.

RESULTS

Actor effects were detected in both models. Both men's and women's positive POA were associated with their own reports of more frequent sexual activity and greater satisfaction with their sex lives.

DISCUSSION AND IMPLICATIONS

These findings provide insight into how positive views on aging relate to older couples' sexuality. Future research should consider how attitudes shape later-life sexuality over time.

Longitudinal Dyadic Effects of Aging Self-Perceptions on Health

OBJECTIVES

Adults' perceptions of aging are known to affect their mental and physical health. However, not much is known about how perceptions of aging within the couple-unit affect each member of the unit. Therefore, the current study explores the effects of husbands' and wives' self-perceptions of aging (SPA) on each other's physical and mental health, both directly and indirectly, through impacting each other's SPA.

METHOD

The study used data from the Health and Retirement Study, focusing on couples aged 50 and older. Self-rated health and Center for Epidemiological Studies Depression scale (CES-D) were used as indicators of physical and mental health. SPA was measured using the "Attitudes toward aging" subscale of the "Philadelphia Geriatric Center Morale Scale." An actor-partner interdependence mediation model was used to examine the effects of the 2008 SPA of couples on each other's 2012 SPA and 2016 health.

RESULTS

The SPA of both husbands and wives was associated with their own future mental and physical health in 2016, but not with that of their partner. However, their SPA was associated with their partner's health indirectly, by influencing the SPA of the partner. That is, the SPA of both husbands and wives in 2008 impacted their partner's SPA in 2012, which was subsequently related to that partner's mental and physical health in 2016.

DISCUSSION

Older couples can influence each other's health indirectly, by affecting each other's SPA. This indicates that adults' SPA are interconnected, and thus, the entire couple-unit should be targeted to enhance positive SPA.

Views on ageing: a lifespan perspective

Views on ageing (VoA) have special relevance for the ageing process by influencing health, well-being, and longevity. Although VoA form early in life, so far, most research has concentrated on how VoA affect later middle-aged and older adults. In this theoretical article, we argue that a lifespan approach is needed in order to more fully understand the origins of VoA, how they change over ontogenetic time, and how they shape development across the full breadth of the lifespan. We begin by explicitly linking VoA to fundamental principles of lifespan development. We review existing theories of VoA and discuss their respective contributions and limitations. We then outline a lifespan approach to VoA that integrates existing theories and addresses some of their limitations. We elaborate on three core propositions of a lifespan approach to VoA: (1) VoA develop as the result of a dynamic, ongoing, and complex interaction between biological-evolutionary, psychological, and social-contextual factors; however, the relative importance of different sources changes across the lifespan; (2) VoA impact development across the whole lifespan; however, different outcomes, mechanisms, and time frames need to be considered in order to describe and understand their effects; and (3) VoA are multidimensional, multidirectional, and multifunctional throughout life, but their complexity, meaning, and adaptivity change across the lifespan. We conclude with recommendations for future lifespan research on VoA.

The More We Are in Control, the Merrier? Partner Perceived Control and Negative Affect in the Daily Lives of Older Couples

OBJECTIVES

It is well established that daily perceived control is closely associated with lower negative affect (NA) among older adults. However, it is an open question whether control perceptions of one's partner are also uniquely associated with one's own NA.

METHOD

To examine such associations in dyads of older long-term partners, we make use of data obtained 6 times a day over 7 consecutive days as participants went about their everyday lives (N = 87 couples; mean age = 75 years; mean relationship length = 46 years). Our multilevel actor-partner models for dyadic data analyses covary for relevant individual and couple differences in sociodemographic characteristics, self-reported physical health, and cognitive functioning.

RESULTS

Corroborating and extending earlier reports, results reveal that higher momentary perceived control was associated with lower NA. Most importantly, we found that higher momentary perceived control of the partner is additionally and uniquely associated with lower NA of the actor.

DISCUSSION

We discuss possible mechanisms and underlying pathways of how perceived control may help both partners downregulate their negative emotions in daily life. We close by considering conceptual and practical implications.

Optimism, pessimism, and health biomarkers in older couples

OBJECTIVE

Studies have demonstrated the importance of optimism in predicting perceived general health. However, the handful of studies focusing on cardiovascular biomarkers show inconsistent effects. Additionally, no study examined whether spousal levels of optimism and pessimism affect an individual's biological markers of cardiovascular health. Thus, our objectives were to examine whether partners' optimism and pessimism affect individual biological markers, differentiating between between-dyad associations and within-dyad predictive processes.

METHODS

Three waves of the Health and Retirement Study collected in 2006, 2010, and 2014 were used to test actor and partner effects of optimism and pessimism on C-reactive protein (CRP) and high-density lipoprotein. Multilevel longitudinal actor-partner models were used to examine the contribution of a partner's optimism and pessimism to each biomarker, adjusting for respondent's age, sex, depression, body mass index, daily activity levels, and a summary score of respondent's doctor-diagnosed chronic conditions.

RESULTS

Partners' pessimism and optimism levels were moderately associated. Results for within-person effects were all non-significant, both within and across waves. Associations at the between-person level were also non-significant, with the exception of a positive association between husbands' pessimism and their own CRP, and husbands' optimism and their wives' CRP.

CONCLUSIONS

Results suggest that optimism and pessimism may not play a pertinent role in within variability of biomarkers of cardiovascular diseases and have a minor role in predicting to between-person variability of biomarkers of cardiovascular diseases.

Early Cognitive Decline and its Impact on Spouse's Loneliness

Background

Loneliness is common in dementia caregivers as cognitive impairment (CI) alters marital and social relationships. Unexplored is how an individual's loneliness is affected at earlier, more ambiguous, periods of their spouse's CI.

Methods

Using the Health and Retirement Study, our study participants included 2,206 coupled individuals with normal cognitive function at the 2006/8 baseline. Loneliness outcomes at baseline, 4-year and 8-year follow-up are assessed by the status of transition to cognitive impairment no dementia (TCIND) (2010/12 & 2014/16) using linear mixed models.

Results

Individual's loneliness was stable when their spouse's cognition remained normal, but increased with the spouse's TCIND. The increase in loneliness did not vary by gender.

Conclusions

Loneliness, a key risk factor for reduced life quality and increased depression, increases even at early stages of a partner's CIND. This work suggests the potential impact of early intervention and social support for partners of individuals with CIND.

Concurrent and enduring associations between married partners' shared beliefs and markers of aging

Beliefs about aging are grounded in social experience. This study considered the extent to which married older adults' shared beliefs about aging and markers of aging maintain a concurrent and enduring association with their partners' beliefs about and markers of aging. Data from the 2010/2012 and 2014/2016 waves of the Health and Retirement Study provided measures of husbands' and wives' (3,779 couples) positive and negative beliefs about aging and internal (Cystatin C) and external (grip strength) markers of aging at 2 time points. Latent dyadic models parsed beliefs and markers into partners' individual and shared variances, which were connected both cross-sectionally and longitudinally. Longitudinal analysis showed that the cross-sectional associations between shared beliefs and markers of aging were stable over 4 years. Partners' shared beliefs and markers of aging were found to have enduring associations with each other over time. The enduring association between grip strength and future negative beliefs remained significant after accounting for partner selection and similarity in health. Model comparisons across marriage duration and emotional closeness showed partners' beliefs to be more similar in marriages that were either long established or emotionally close. In all groups, shared beliefs and markers of aging were associated with each other over time. The association between positive beliefs and future grip strength was stronger in long-established than in recent marriages. In summary, this study provides evidence that, within older couples, beliefs about aging are shaped in part through experiences of aging together. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Global reach of ageism on older persons' health: A systematic review

OBJECTIVE

Although there is anecdotal evidence of ageism occurring at both the structural level (in which societal institutions reinforce systematic bias against older persons) and individual level (in which older persons take in the negative views of aging of their culture), previous systematic reviews have not examined how both levels simultaneously influence health. Thus, the impact of ageism may be underestimated. We hypothesized that a comprehensive systematic review would reveal that these ageism levels adversely impact the health of older persons across geography, health outcomes, and time.

METHOD

A literature search was performed using 14 databases with no restrictions on region, language, and publication type. The systematic search yielded 13,691 papers for screening, 638 for full review, and 422 studies for analyses. Sensitivity analyses that adjusted for sample size and study quality were conducted using standardized tools. The study protocol is registered (PROSPERO CRD42018090857).

RESULTS

Ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. The studies reported ageism effects in all 45 countries, 11 health domains, and 25 years studied, with the prevalence of significant findings increasing over time (p < .0001). A greater prevalence of significant ageism-health findings was found in less-developed countries than more-developed countries (p = .0002). Older persons who were less educated were particularly likely to experience adverse health effects of ageism. Evidence of ageism was found across the age, sex, and race/ethnicity of the targeters (i.e., persons perpetrating ageism).

CONCLUSION

The current analysis which included over 7 million participants is the most comprehensive review of health consequences of ageism to date. Considering that the analysis revealed that the detrimental impact of ageism on older persons' health has been occurring simultaneously at the structural and individual level in five continents, our systematic review demonstrates the pernicious reach of ageism.

Actor, partner, and similarity effects of personality on global and experienced well-being

The current study examined actor, partner, and similarity effects of personality on a variety of well-being indices, including both global and experiential measures of well-being in 2,578 heterosexual couples (N = 5,156 individuals; M age = 51.04, SD = 13.68) who completed the 2016 Wellbeing and Daily Life supplement to the Panel Study of Income Dynamics (PSID). Among actor effects, those for conscientiousness, agreeableness, extraversion, and neuroticism were the most robust predictors of well-being. Among partner effects, conscientiousness and neuroticism were the most robust predictors of well-being. Consistent with past research, similarity effects on well-being were generally small and not always significant. The results are discussed in the context of experiential conceptualizations of well-being and operationalizing similarity in relationship research.