Transitions in intrinsic capacity among community-dwelling older people and their associated factors: a multistate modelling analysis

OBJECTIVES

Trajectory of intrinsic capacity (IC) can be non-linear and discontinuous, which traditional linear models may not be able to handle. This study thus aimed to model the trajectory of IC as transitions between different IC states and examine their associated factors.

METHODS

Longitudinal data from a sample of community-dwelling older people aged 60 years or above (n = 1,588) was analysed. A set of 14 self-reported items representing different domains of IC were administered annually to measure IC at four time points. Based on the number of impaired IC domains (i.e., cognitive, locomotor, vitality, sensory, and psychological), participants at each time point were classified into one of three IC states, namely state 1 (0 impaired domain), state 2 (1-2 impaired domains), and state 3 (3-5 impaired domains). Multistate modelling was used to identify factors associated with the transitions from one state to another.

RESULTS

The mean age of participants was 75.0 years, and 77.4% of them were female. At baseline, 12.4% were in state 1, 51.8% were in state 2, and 35.8% were in state 3. 62.8% of participants experienced at least one transition between states, among which 12% experienced a transition every year. The transitions occurred mostly between adjacent IC states and could take place back and forth. Age, sex, marital status, perceived financial adequacy, number of chronic diseases, and self-rated health were the factors associated with the transitions.

CONCLUSION

Findings may serve as a valuable reference for guiding future policies to optimize IC and promote healthy ageing using a person-centred approach.

The mediating roles of optimism, loneliness, and psychological distress in the association between a sense of community and meaning in life among older adults

A sense of community is known to be a protective factor for the well-being of older adults and meaning in life associated with positive mental outcomes. Nevertheless, there is a need to expand the knowledge of the role of a sense of community in meaning in life, particularly among older adults. Intending to broaden the empirical understanding from this perspective, the current study examined the mediating roles of optimism, loneliness, and psychological distress in the association between a sense of community and meaning in life. Participants included 740 community dwelling Israeli older adults (M = 71.96; SD = 5.81). Participants completed questionnaires on a sense of community, optimism, loneliness, psychological distress, meaning in life, and sociodemographic characteristics. A positive association was found between a sense of community with optimism, and a negative association with loneliness. A negative association between optimism with psychological distress and a positive link between loneliness with psychological distress was found, while a higher level of psychological distress was associated with a lower level of meaning in life. Practitioners should focus interventions with older adults on developing a sense of community, with the aim to promote optimism and, at the same time, reduce loneliness and thus decrease psychological distress while strengthening meaning in life.

Sources of meaning in life among older adults during the COVID-19 pandemic: A qualitative study

AIM

This study aims to explore the sources of meaning in life (MIL) and its impact on South Korean older adults during the coronavirus disease 2019 (COVID-19) pandemic.

DESIGN

This study had a qualitative descriptive study design.

METHODS

The study participants included 18 older adults. Six focus group interviews were conducted. Data were analysed using content analysis.

RESULTS

The subcategories 'Continued learning and growth', 'Self-transcending practices' and 'Efforts to maintain good health' were extracted under the category 'Sources of MIL for older adults'. Similarly, the subcategories 'Tremendous changes brought about by the virus' and 'Varying patterns of adjustment to the pandemic' were extracted under the category 'Changes in the sources of MIL since the COVID-19 outbreak'.

PUBLIC CONTRIBUTION

Our study provides an in-depth understanding of the changed sources of MIL for older adults during the COVID-19 pandemic. The findings serve as useful guidance for planning interventions for older adults to lead meaningful lives during the COVID-19 pandemic and post-pandemic crises.

Cross-Lagged Associations Between Physical Activity, Self-Rated Health, and Psychological Resilience Among Older American Adults: A 3-Wave Study

The current study examined the reciprocal association between psychological resilience, physical activity, and self-rated health in older America adults. A 3-wave cross-lagged panel design was employed using data sampled from the Health and Retirement Study 2010, 2014, and 2018. In total, 8380 older adults, age ranged between 56 and 95 years at the baseline (mean age = 68.06, SD = 7.77), were analyzed. Using structural equation modeling, standardized path coefficients were estimated to determine the relationship between physical activity, self-rated health, and psychological resilience across 2 follow-up points. Cross-lagged analysis revealed that higher levels of physical activity at T1 and T2 were significantly associated with higher levels of self-rated health at T2 and T3, respectively. Self-rated health at T1 and T2 were significantly associated with physical activity at T2 and T3, respectively. Self-rated health and psychological resilience were positively related to one another at each time point. However, relationship between physical activity and psychological resilience was complex across time. Study findings support reciprocal prospective relationship between physical activity and self-rated health and the relationship between self-rated health and psychological resilience.

Investigating the Link Between IADL and Depressive Symptoms in Older Adults: A Cross-Sectional Serial Mediation Model

OBJECTIVES

There is a dearth of research on the psychological processes that underlie the negative relation between impaired instrumental activities of daily living (IADL) and depressive symptoms in older adults. Drawing on the stress process model and the resilience framework, we investigated whether purpose in life and resilience serially mediate the relationship between impaired IADL and depressive symptoms.

METHODS

We recruited 111 cognitively healthy community-dwelling older adults (ages 54-85; M = 66.5) who scored a minimum of 25 points on the Mini-Mental State Examination.

RESULTS

We found that purpose in life and resilience serially mediated the relationship between IADL and depressive symptomatology in older adults. This association held true when we controlled for covariates. Additional sensitivity analyses also supported these findings.

CONCLUSIONS

This study extends our understanding of how IADL limitations contribute to depressive symptoms. Using a community-dwelling, cognitively healthy sample, we demonstrate that functional limitations indirectly influence older adults' depressive symptoms through a decreased sense of purpose in life and decreased resilience.

CLINICAL IMPLICATIONS

Our findings have implications for intervention programs that aim to alleviate IADL limitations and mental health issues in an aging population and promote healthy aging by improving psychosocial resources (i.e., purpose in life and resilience).

University students' mental well-being during COVID-19 pandemic: The mediating role of resilience between meaning in life and mental well-being

The current study aims to examine (a) the mental well-being of university students, who were taking online classes, and (b) and test whether resilience would mediate the relationship between meaning in life and mental well-being. The sample of 302 university students (M_age = 20.25 years; 36.1% men, 63.9% women) was taken from the universities of Punjab, Pakistan. The participants were recruited online and they completed a cross-sectional survey comprising the scales of meaning in life, resilience, and mental well-being during COVID-19. Findings from the study indicated that participants had a normal to a satisfactory level of overall mental wellbeing during COVID-19. Resilience acted as a mediator for both the presence of meaning in life, the search for meaning in life, and mental well-being. Demographic variables including family size were significantly and positively related to resilience while the availability of personal room showed a significant positive relationship with mental well-being. These findings suggest that meaning in life and resilience supports mental well-being during the COVID-19 pandemic and that effective steps should be taken to make the lives of university students more meaningful and resilient.

Comparison of cognitive status of diabetic and non-diabetic elderly in the last ten years in primary health care in Iran

Introduction. Cognitive disorders and chronic diseases such as diabetes are common problems of aging. The aim of this study was to determine and compare the cognitive status of diabetic and non-diabetic elderly in the past ten years in primary health care in Iran. Method: This cross-sectional study was performed on people aged 60 years and older in Kerman, Iran in 2020. In total, this study was performed on 200 patients (100 diabetic and 100 non-diabetic) meeting inclusion criteria. The Short Mental Status Questionnaire (MMSE) and The Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) were used to assess cognitive function. The validity and reliability of the questionnaires were confirmed in this study. Data were analyzed using Chi-square, T-test, and ANOVA analysis in SPSS 21 software. Results. The results showed that there was a statistically significant difference between diabetic and non-diabetic groups in the current cognitive status and cognitive status in the last ten years. The mean scores of cognitive function from the short mental status questionnaire in the diabetic group were lower than in the non-diabetic group (p = 0.001). The mean scores of the cognitive deficit screening questionnaire in diabetic elderly were higher than in non-diabetic elderly (p < 0.001). Conclusion. Based on the results of this study, health care providers and family physicians should focus on controlling diabetes and identifying any cognitive impairment in the early stages of comprehensive care of diabetic patients.

Development of resilience scale for older adults

OBJECTIVES

Older adults are more likely to encounter adverse life events and have protective factors that are different from other populations. Currently, there is no resilience scale designed exclusively for older adults. This study aims at developing a new measurement scale for assessing resilience of older adults.

METHODS

Items of Resilience Scale for Older Adults (RSOA) was generated from thorough literature review. A multiple stage method was applied to examine the psychometric properties of the scale. In pretesting, items that did not meet the psychometric criteria were removed. A sample of 368 older adults was collected in the main survey to perform preliminary item selection and removal, reliability and construct validity analyses. Another survey on 76 samples was then conducted to assess test-retest reliability of the scale.

RESULTS

RSOA that comprised four constructs (personal strength, meaning and purpose of life, family support, and social support) with a total of 15 items was developed with good reliability and validity. Cronbach's α of the scale was 0.882. All the four constructs were found significantly correlated with life satisfaction of older adults.

CONCLUSIONS

The RSOA is a reliable means of assessing psychological and physical resilience of older people as well as predicting their satisfaction with life. The study may also provide important information about elderly coping with adversity.