Accelerating Progress Towards the 2030 Neglected Tropical Diseases Targets: How Can Quantitative Modeling Support Programmatic Decisions?

Over the past decade, considerable progress has been made in the control, elimination, and eradication of neglected tropical diseases (NTDs). Despite these advances, most NTD programs have recently experienced important setbacks; for example, NTD interventions were some of the most frequently and severely impacted by service disruptions due to the coronavirus disease 2019 (COVID-19) pandemic. Mathematical modeling can help inform selection of interventions to meet the targets set out in the NTD road map 2021-2030, and such studies should prioritize questions that are relevant for decision-makers, especially those designing, implementing, and evaluating national and subnational programs. In September 2022, the World Health Organization hosted a stakeholder meeting to identify such priority modeling questions across a range of NTDs and to consider how modeling could inform local decision making. Here, we summarize the outputs of the meeting, highlight common themes in the questions being asked, and discuss how quantitative modeling can support programmatic decisions that may accelerate progress towards the 2030 targets.

Daily Caregiving Appraisals, Future Self-Views, and Physical Activity Goals Among Adult-Daughter Dementia Caregivers

OBJECTIVES

Caregiving dynamics may shape caregivers' views on their own aging in ways that affect their (de)motivation to improve their current and future health and well-being. In this study, we investigated within-person associations of daily positive and negative caregiving appraisals, future self-views (physical functioning, cognitive, and overall health domains), and physical activity goal pursuit among adult-daughter dementia caregivers.

METHODS

Data came from 33 middle-aged caregivers (M = 55.03) who participated in a 30-day microlongitudinal study of caregiving (N of occasions = 855). We used multilevel modeling to analyze within-person associations.

RESULTS

Daily positive caregiving appraisals were not associated with daily future self-views. However, on days when caregivers reported higher negative caregiving appraisals, they thought more negatively about their future older selves in all domains. In turn, on days when caregivers thought more negatively about their future older selves in all domains, they reported lower physical activity goal pursuit. Future self-views in all domains mediated the association between negative caregiving appraisals and physical activity goal pursuit. Future self-views did not mediate the association between positive caregiving appraisals and physical activity goal pursuit. However, cognitive future self-views moderated the association between positive caregiving appraisals and physical activity goal pursuit.

DISCUSSION

Results suggest that one pathway through which subjective caregiving experiences, especially negative caregiving appraisals, affect caregivers' physical activity goal pursuit is through future self-views. Thus, this study offers a deeper theoretical understanding of caregivers' self-regulatory health behavior and new empirical information on how caregiving might affect life-span developmental motivation.

Individual differences in frequency and impact of daily memory lapses: results from a national lifespan sample

BACKGROUND

Everyday memory problems are believed to increase with age, leading many researchers to focus on older ages when examining reports of memory lapses. However, real world memory lapses are ubiquitous across the adult lifespan, though less is known about the types of problems and their impacts at younger ages. The current study examined occurrence and impacts of memory lapses using daily diaries in a broad age range and whether characteristics of lapses varied across age, gender, or education level.

METHODS

Using an 8-day daily diary protocol, 2,018 individuals (ages 25-91) provided reports of their experiences of two types of daily memory lapses (retrospective and prospective) as well as the impact those lapses had on their emotional and functional well-being that day. Using multilevel modeling, we examined the likelihood of reporting memory lapses and their impacts on daily life and whether these depended on age, gender, or education level.

RESULTS

Participants reported lapses on approximately 40% of days; retrospective memory lapses were significantly more likely than prospective lapses. Older ages and higher education level were related to greater likelihood of reporting retrospective lapses. Women (compared to men) were more likely to report prospective memory lapses. Women also tended to report greater impacts of their memory lapses. Lower education levels were related to greater impacts of memory lapses compared to higher education levels. Interestingly, age was not related to impacts of lapses.

DISCUSSION

Our results indicate that memory lapses are common across the lifespan and that those individuals more likely to report lapses are not necessarily those that experience the greatest impacts of those lapses on daily life. Additional work is needed to understand the daily experience of memory lapses and how they differentially affect individuals regardless of age, gender, and education.

CONCLUSIONS

Memory lapses are an important aspect of daily life across the lifespan and require measurement in an individual's real-world environments. Better measurement of these experiences will allow the development of more sensitive measures of changes in cognitive functioning that may impact an individual's ability to live independently.

Daily Stress Processes as Potential Intervention Targets to Reduce Gender Differences and Improve Mental Health Outcomes in Mid- and Later Life

The current study examines daily stress processes as risk factors for comprised mental health in midlife and later life, specifically for gender differences in depression risk. Using data from the Midlife in the United States (MIDUS) study and the National Study of Daily Experiences (NSDE), we examine (1) gender differences in depression; (2) the prospective effects of differential exposure and affective responses on 10-year depression status; (3) gender differences in daily stress-depression links. Furthermore, we explore whether the protective factor of help-seeking behavior moderates the effects of daily stress on depression. Participants included 1289 (mage = 55; SD = 12; range = 34-83; 56% female) individuals who completed the second waves of MIDUS and the 8-day NSDE daily diary protocol and participated in the third wave of MIDUS approximately 10 years later. Respondents completed assessments of depression and their seeking assistance from a psychiatrist, mental health professional, counselor, or religious leader. Covariate-adjusted logistic regression analyses revealed increased odds of depression among women compared to men, but no significant gender difference after taking daily stress into account. Higher levels of stressor exposure, negative affect, and affective reactivity were associated with increased odds of depression for both men and women. Compared to those who did not engage in help-seeking behavior, those who did had significantly greater odds of depression, and there were asymmetric patterns of daily stress effects across groups. These findings highlight differential exposure, negative affect, and affective responses to daily stress as potentially accessible intervention targets for reducing stress in daily life and mitigating longer-term depression risk during mid- and later life.

Affective Reactions to daily interpersonal stressors: Moderation by family involvement and gender

The goal of this study was to examine whether family involvement and gender moderated daily changes in affect associated with interpersonal stressors. Adults (N = 2022; M _age = 56.25, Median = 56, SD = 12.20, Range = 33-84) from the second wave of the National Study of Daily Experiences participated in eight consecutive daily diaries. Each day they reported whether a daily interpersonal stressor occurred, whether family was involved, and their positive and negative affect. Results from multilevel models indicated that family involvement did not significantly moderate daily interpersonal stressor-affect associations; however, gender was a significant moderator in some instances. Women showed greater increases in negative affective reactivity to arguments and avoided arguments compared to men. Further, compared to men, women reported larger decreases in positive affective reactivity, but only for avoided arguments. Neither family involvement, gender, nor the interaction between family involvement and gender predicted affective residue. Gender differences in daily interpersonal stressors and affective reactivity may be attributable to overarching gender norms and roles that are still salient in the U.S. Our results suggest that daily interpersonal stressors may be detrimental to affective well-being, regardless of family involvement. Future work should explore associations between daily interpersonal stressors and family involvement by specific relationship roles, such as mother or spouse, for a more comprehensive understanding of what stressor characteristics impact daily affective well-being.

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.

Computing Components of Everyday Stress Responses: Exploring Conceptual Challenges and New Opportunities

Repeated assessments in everyday life enables collecting ecologically valid data on dynamic, within-persons processes. These methods have widespread utility and application and have been extensively used for the study of stressors and stress responses. Enhanced conceptual sophistication of characterizing intraindividual stress responses in everyday life would help advance the field. This article provides a pragmatic overview of approaches, opportunities, and challenges when intensive ambulatory methods are applied to study everyday stress responses in "real time." We distinguish between three stress-response components (i.e., reactivity, recovery, and pileup) and focus on several fundamental questions: (a) What is the appropriate stress-free resting state (or "baseline") for an individual in everyday life? (b) How does one index the magnitude of the initial response to a stressor (reactivity)? (c) Following a stressor, how can recovery be identified (e.g., when the stress response has completed)? and (d) Because stressors may not occur in isolation, how can one capture the temporal clustering of stressors and/or stress responses (pileup)? We also present initial ideas on applying this approach to intervention research. Although we focus on stress responses, these issues may inform many other dynamic intraindividual constructs and behaviors (e.g., physical activity, physiological processes, other subjective states) captured in ambulatory assessment.

Linking widowhood and later-life depressive symptoms: Do childhood socioeconomic circumstances matter?

Objectives: Widowhood and adverse childhood socioeconomic circumstances (CSC) have both been linked to increased levels of depressive symptoms in old age. Beyond their independent impact on depressive symptoms, experiencing adverse CSC may also trigger a cascade of cumulative adversity and secondary stressors across the life course that shapes how individuals weather stressful life events later on.Method: We examine whether exposure to adverse CSC moderates the relationship between later-life widowhood and depressive symptoms using data from the Survey of Health, Ageing and Retirement in Europe (2004-2017).Results: Mixed-effects models revealed that both widowhood and adverse CSC were associated with increased levels of depressive symptoms among men and women. Associations between widowhood and depressive symptoms, however, were not moderated by CSC for both genders.Conclusion: Persisting differences in the levels of mental health in response to later-life widowhood did not further widen in the presence of disparities experienced early in the life course. This may reflect the life-altering impact of this age-normative, yet stressful life event across the social strata.

Maturation or disruption? Conscientiousness development in the transition into adolescence

Research to date has shown longitudinal changes in conscientiousness during early and middle adolescence, but most studies have been conducted in Western countries. The present study aimed to examine the pattern of mean-level conscientiousness change at the transition into early adolescence among a Chinese sample using curve of factors (CUFFS) models. Four waves of data from 661 Chinese children aged 8 years old at baseline in the China Family Panel Studies were used. Parents were asked to rate their children’s level of conscientiousness every 2 years. On average, mean-level conscientiousness showed a decelerating increase. Girls had higher average conscientiousness levels than boys, but they did not differ in change patterns. The inconsistency between the current study and previous research indicates that conscientiousness development may depend, in part, on cultural factors.

Age differences in allostatic load among veterans: The importance of combat exposure

The current study examinedage differences in allostatic load among nonveterans, noncombat veterans, and combat veterans. Participants included 280 individuals from the Midlife Development in the United States (MIDUS) survey, including 164 veterans (n = 48 combat veterans; n = 116 noncombat veterans) and 116 nonveterans. Age differences in allostatic load were similar among nonveterans and noncombat veterans, B = 0.002, SE = .011, p = .878, with older adults showing higher levels of allostatic load than their comparatively younger counterparts. Among combat veterans, however, a different pattern emerged. In this group, levels of allostatic load were similar across age, seemingly due to higher levels of allostatic load among younger combat veterans, B = -0.029, SE = .014, p = .031, ƞ_p ²  =  .022. Results reveal the importance of considering combat exposure when examining health outcomes of military veterans, particularly in the context of age.

Resolution Status and Age as Moderators for Interpersonal Everyday Stress and Stressor-Related Affect

OBJECTIVES

To examine stressor characteristics (i.e., stressor resolution) and individual differences (i.e., age) as moderators of affective reactivity and residue associated with everyday interpersonal stressors, including arguments and avoided arguments.

METHOD

A sample of 2,022 individuals participated in the second wave of the National Study of Daily Experiences (meanage = 56.25, range = 33-84). Over 8 consecutive evenings, participants completed the Daily Inventory of Stressful Experiences and self-report measures of stressor resolution status and daily negative affect (NA) and positive affect (PA). Using multilevel modeling, we examined whether increases in daily NA and decreases in daily PA associated with arguments and avoided arguments occurring on the same day (i.e., reactivity) or the day before (i.e., residue) differed depending on resolution of the interpersonal stressor. We further examined whether such stressor resolution effects were moderated by age.

RESULTS

Resolution significantly dampened NA and PA reactivity and residue associated with arguments; NA reactivity associated with avoided arguments (ps < .05). Older age was associated with being more likely to resolve both arguments and avoided arguments (ps < .05) and did reduce reactivity associated with avoided arguments. Older age did not moderate PA reactivity or NA or PA residue associated with either arguments or avoided arguments (ps > .05).

DISCUSSION

Unresolved everyday arguments and avoided arguments are differentially potent in terms of affective reactivity and residue, suggesting resolution may be crucial in emotional downregulation. Future work should focus on exploring resolution of other everyday stressors to garner a comprehensive understanding of what characteristics impact stressor-affect associations and for whom.

Creation and validation of a polysocial score for mortality among community-dwelling older adults in the USA: the health and retirement study

BACKGROUND

the interrelatedness between social determinants of health impedes researchers to identify important social factors for health investment. A new approach is needed to quantify the aggregate effect of social factors and develop person- centred social interventions.

METHODS

participants ([n = 7,383], 54.5% female) were aged 65 years or above who complete an additional psychosocial questionnaire in the health and retirement study in 2006 or 2008. Social determinants of health encompassed five social domains: economic stability, neighbourhood and physical environment, education, community and social context, and healthcare system. We used the forward stepwise logistic regression to derive a polysocial score model for 5-year mortality. Indices of goodness-of-fit, discrimination and reclassification were used to assess model performance. We used logistic regression to identify the association between polysocial score and mortality. Subgroup analyses were conducted to examine sex- and race-specific association.

RESULTS

polysocial score was created using 14 social determinants of health. In the training cohort, the C-statistic was 0.71 for the reference model (only age, sex and race/ethnicity) and increased to 0.75 for the continuous and categorical polysocial score. Compared with the reference model, the integrated discrimination index for adding the continuous or categorical polysocial score was both 0.03 (P values < 0.001). Participants with an intermediate (odds ratio [OR] = 0.69; 95% confidence interval [CI], 0.51-0.82) or high (OR = 0.48; 95% CI, 0.38-0.60) polysocial score had lower odds of death than those in the low category in the fully adjusted model, respectively.

CONCLUSIONS

the polysocial approach may offer possible solutions to monitor social environments and suggestions for older people to improve their social status for specific health outcomes.

Women's Self-Relevant Goal Pursuit in the Presence of Physical Pain: An Intraindividual Variability Approach

OBJECTIVES

Pursuing personal goals that are relevant to one's sense of self is important for adjusting to age-related changes. Experiences of physical pain, however, are thought to threaten both people's sense of self and their pursuit of personal goals. Although a majority of older women experience physical pain, little is known about their day-to-day regulation of their self-relevant goals in the presence of physical pain. The objectives of this study were to explore associations between physical pain and health goal pursuit on a daily basis for women who identified health as a part of their possible selves.

METHODS

We took an intraindividual variability approach to analyze whether there were within- and between-person differences in associations between daily pain and daily health goal progress among 62 women who provided data over the course of 100 days, yielding 4,150 occasions of data.

RESULTS

At the between-person level, women with higher pain on average had lower health goal pursuit on average. At the within-person level, days of higher-than-average pain were associated with lower same-day health goal progress.

DISCUSSION

Our results suggest that pain interrupts regulation of a self-relevant goal at a within-person-not just between-person-daily level. Future work should consider how these daily, within-person, disruptions affect broader identity processes and overall well-being.

Neighborhood safety concerns and daily well-being: A national diary study

People living in unsafe neighborhoods often report poor health. The reasons for this are multi-faceted, but one possibility is that unsafe neighborhoods create a situation of chronic stress, which may deplete people's resources to cope with the daily stressors of life. How people respond to daily stressors (e.g., with increased self-reported negative affect and physical symptoms) is positively associated with health problems and may thus be one pathway linking perceptions of neighborhood safety to poor health. The current study investigated the relationship between neighborhood safety concerns, daily stressors, affective well-being, and physical health symptoms in a national sample of adults from the Midlife in the United States Study II (n = 1748). In 2004, participants reported neighborhood safety concerns and history of chronic stress exposure. Across eight days, they also reported daily stressors, physical symptoms and negative affect. Greater neighborhood safety concerns were associated with higher negative affect and more physical symptoms, adjusting for other sources of chronic stress. Moreover, lower perceived neighborhood safety was related to greater increases in negative affect and physical symptoms on days during which stressors were reported, even after accounting for established interactions between daily stressors and other sources of chronic stress. Exposure to neighborhoods perceived as unsafe is associated with poorer daily well-being and exacerbated responses to daily stressors, which may serve as an individual-level pathway contributing to poorer health among people living in neighborhoods perceived as unsafe.

Daily linkages among high and low arousal affect and subjective cognitive complaints

Objectives: Subjective cognitive complaints may be an early indicator of Alzheimer's disease pathology and related dementias that can be detectable prior to objective, performance-based decline. Negative and positive affective states (NA and PA, respectively) are established psychosocial correlates of cognition in older adulthood and have demonstrated capacity for meaningful within-person fluctuations based on person-environment interactions, age, and measurement approach.Method: We utilized data from a 100-day, microlongitudinal study of 105 community-dwelling older adults (M_age = 63.19, SD = 7.80, Range = 52-88) to explore within- and between-person associations between high and low arousal NA and PA, and memory- and attention-related complaints.Results: For memory-related complaints, those who reported experiencing greater NA-high arousal had increased forgetfulness (OR = 2.23, 95%CI: 1.11-4.49, p < .05). Within persons, reporting more NA-high arousal than usual was associated with increased forgetfulness (OR = 1.01, 95%CI: 1.004-1.018, p < .01). For attention-related complaints, those who reported experiencing greater NA-low arousal had increased trouble staying focused (OR = 2.34, 95%CI: 1.17-4.66, p < .05). Within persons, reporting more NA-low arousal (OR = 1.02, 95%CI: 1.01-1.03, p < .001) and less PA-high arousal (OR = 0.96, 95%CI: 0.95-0.97, p < .001) than usual was associated with increased trouble staying focused. Additionally, reporting more PA-low arousal than usual was associated with decreased trouble staying focused among those with higher levels of conscientiousness (OR = 0.72, 95%CI: 0.57-0.92, p < .01).Conclusion: Results from this study offer a means to maximize resource allocation and personalized cognitive health efforts by pinpointing for whom and on which days boosting PA and/or reducing NA may both serve as pathways to benefit daily subjective cognition.

Religious and Spiritual Development from Adolescence to Early Adulthood in the U.S.: Changes over Time and Sexual Orientation Differences

Adolescence is a critical time in the U.S. for religious development in that many young people eschew their religious identity as they enter adulthood. In general, religion is associated with a number of positive health outcomes including decreased substance use and depression. The current study compared the developmental patterns of religiosity and spirituality in heterosexual and sexual minority youth. The design was a secondary data analysis of the first five waves of the Longitudinal Study of Adolescent Health and Wellness (N = 337, 71.8% female). Using multilevel linear (for spirituality) and quadratic (for religiosity) growth models, the initial level and change over time in religiosity and spirituality, as well as the correlations between growth processes, were compared between heterosexual and sexual minority individuals. The heterosexual group had significantly higher initial religiosity levels than the sexual minority group. Religiosity decreased over time at a similar rate for the heterosexual and sexual minority groups. Spirituality significantly increased over time for the sexual minority group but not for the heterosexual youth. The change over time in religiosity and spirituality were significantly and positively correlated for heterosexual individuals but were uncorrelated for sexual minority individuals. Results indicate there are differences in religious development based on sexual minority status. Future research should take into account how these differential religious and spiritual developmental patterns seen in heterosexual and sexual minority youth might predict various health outcomes.

A socially-engaged lifestyle moderates the association between gait velocity and cognitive impairment

Objective: Cognitive status has been linked to impaired gait velocity, and diminished social and physical engagement. To date, the potential moderating influence of lifestyle engagement on gait-cognitive status associations has not been systematically explored. The present investigation examines whether a socially- or physically-engaged lifestyle moderates the association between diminished gait velocity and likelihood of amnestic mild cognitive impairment (a-MCI) classification.Methods: Participants (aged 65+, M_age=73 years) were classified as either healthy controls (n = 30) or a-MCI (n = 24), using neuropsychological test scores and clinical judgement. Gait velocity was indexed using a GAITRite computerized walkway, engaged lifestyle (social and physical subdomains) were measured using a well-validated self-report measure, the revised Activity Lifestyle Questionnaire.Results: Logistic regression, evaluating likelihood of a-MCI classification, yielded a significant interaction between a socially-engaged lifestyle and gait velocity (b=.01, SE=.003, p=.015). Follow-up simple effects were derived for two levels (+/-1SD) of social engagement; for individuals 1 SD below the mean, the association between gait velocity and increased likelihood of a-MCI classification was exacerbated (probability of a-MCI classification for those with slower gait velocity was 60% higher for individuals 1 SD below vs 1 SD above the mean of social engagement). Physically-engaged lifestyle did not significantly moderate the gait-cognitive status association.Conclusions: The significant moderating influence of social engagement has several implications, including the likelihood that distinct mechanisms underlie the relationships of social engagement and gait velocity to cognitive function, the value of social variables for well-being, and the potential utility of socially-based interventions that may prevent/delay a-MCI onset.

Associations Between Control Beliefs and Response Time Inconsistency in Older Adults Vary as a Function of Attentional Task Demands

OBJECTIVE

Control beliefs are established correlates of cognitive aging. Despite recent demonstrations that response time inconsistency (RTI) represents a proxy for cognitive processing efficiency, few investigations have explored links between RTI and psychosocial correlates. We examined associations among RTI and control beliefs (perceived competence and locus of control) for two choice-response time (RT) tasks varying in their attentional demands.

METHOD

Control beliefs and RTI were measured weekly for 5 weeks in a sample of 304 community-dwelling older adults (Mage = 74.11 years, SD = 6.05, range = 64-92, 68.58% female).

RESULTS

Multilevel models revealed that for the attentionally demanding task, reporting higher perceived competence than usual was associated with lower RTI for relatively younger participants and greater RTI for relatively older participants. For the less attentionally demanding task, reporting higher perceived competence than usual was associated with lower RTI for relatively older participants. Links between locus of control and RTI were comparatively scant.

DISCUSSION

Our findings suggest that control beliefs may have adaptive and maladaptive influences on RTI, depending on dimension of control beliefs, individual differences in level of control beliefs and age, as well as attentional task demands. Both for whom and when control beliefs can be leveraged to optimize cognitive aging are discussed.

A Coordinated Analysis of Variance in Affect in Daily Life

Despite widespread interest in variance in affect, basic questions remain pertaining to the relative proportions of between-person and within-person variance, the contribution of days and moments, and the reliability of these estimates. We addressed these questions by decomposing negative affect and positive affect variance across three levels (person, day, moment), and calculating reliability using a coordinated analysis of seven daily diary, ecological momentary assessment (EMA), and diary-EMA hybrid studies (across studies age = 18-84 years, total Npersons = 2,103, total Nobservations = 45,065). Across studies, within-person variance was sizeable (negative affect: 45% to 66%, positive affect: 25% to 74%); in EMA more within-person variance was attributable to momentary rather than daily level. Reliability was adequate to high at all levels of analysis (within-person: .73-.91; between-person: .96-1.00) despite different items and designs. We discuss the implications of these results for the design of future intensive studies of affect variance.

Aging-Related Changes in the Association between Negative Affect and Response Time Inconsistency in Older Adulthood

Negative affect (NA) and positive affect (PA) are established modifiable psychosocial correlates of cognitive health and have demonstrated capacity for meaningful within-person fluctuations based on person-environment interactions, age, and measurement approach. Previous research has shown NA is associated with increased response time inconsistency (RTI), an early performance-based indicator of cognitive health and aging. It is unclear, however, whether PA is associated with RTI, and whether affect-RTI associations exist within persons over time or change as individuals get older. We utilized data from a measurement burst study (Cognition, Health and Aging Project) to explore within- and between-person associations between affect and RTI in community-dwelling older adults (N=111, M=80.04 years, SD=6.30). Affect and RTI were assessed on six days over a two-week period, every six months for two years. Results revealed a significant association between NA-low arousal and RTI within persons over time. RTI was higher on sessions when NA-low arousal was higher than usual (b=0.21, 95%CI=0.08 to 0.35, p<.01). This association decreased in magnitude over time (b=-0.09, 95%CI=-0.14 to - 0.03, p<.001), ultimately resulting in increased NA-low arousal being associated with decreased RTI two years later (b=-.14, 95%CI=-0.27 to -0.01, p<.05). No PA-RTI associations emerged. The results suggest efforts focused on maximizing resource allocation and personalizing cognitive health efforts should consider for whom and when mitigating NA may be maximally beneficial to daily cognition, whereas additional work is needed to determine influences from PA.

The Ups and Downs of Cognitive Function: Neuroticism and Negative Affect Drive Performance Inconsistency

OBJECTIVES

Response time inconsistency (RTI)-or trial-to-trial variability in speeded performance-is increasingly recognized as an indicator of transient lapses of attention, cognitive health status, and central nervous system integrity, as well as a potential early indicator of normal and pathological cognitive aging. Comparatively, little research has examined personality predictors of RTI across adulthood.

METHODS

We evaluated the association between the personality trait neuroticism and RTI in a community-dwelling sample of 317 adults between the ages of 19-83 and tested for two indirect pathways through negative affect (NA) and cognitive interference (CI).

RESULTS

The personality trait neuroticism predicted greater RTI independent of mean response time performance and demographic covariates; the results were age-invariant. Furthermore, NA (but not CI) accounted for this association and moderated mediation model results indicated that older adults were more vulnerable to the adverse effects of NA.

DISCUSSION

Neuroticism predicts greater RTI irrespective of mean performance and this effect is driven largely by heightened negative emotionality that may be particularly detrimental for older adults.

Longitudinal changes in response time mean and inconsistency exhibit predictive dissociations for risk of cognitive impairment

OBJECTIVE

Although mean response time (RT) is a commonly used indicator of cognitive function, trial-to-trial variability (RT inconsistency [RTI]) represents a dissociable dimension of performance arguably more sensitive for characterizing cognitive status. The present study explores whether (a) RT mean or inconsistency reflects a more dispositional characteristic of an individual, particularly with increased cognitive impairment; (b) RT mean and inconsistency exhibit comparable patterns of change across a 4-year period; and (c) these rates of change differentially predict cognitive status.

METHOD

A sample of 304 adults (64-92 years) at baseline completed a choice RT task weekly for 4-5 weeks, repeating this protocol and a basic neuropsychological assessment annually for 4 years. Three cognitive status subgroups were identified at baseline and Year 4: healthy controls (HCs), as well as cognitively impaired-not-demented (CIND) status based upon single (CIND-S) and multiple (CIND-M) domains.

RESULTS

RTI was disproportionately stable among cognitively compromised individuals at baseline, suggesting that increased RTI is a dispositional characteristic reflecting underlying changes in psychological process or neurological function. Notably, 4-year trajectories of change for RT mean versus RTI were dissociable; whereas the HC and CIND-S groups exhibited faster mean RTs over time, CIND-M individuals exhibited significant RTI increases. Multinomial logistic regressions demonstrated that greater RTI at baseline (OR = 2.58, p < .01) and steeper 4-year increases (OR = 4.40, p < .01) were linked to increased likelihood of CIND-M classification at Year 4, independent of age, education, chronic health conditions, and mean RT.

CONCLUSIONS

RT mean and RTI confer distinct sources of information about cognitive function and status. Overall, RTI holds promise as an early indicator of normal and pathological cognitive aging. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

AGING-RELATED CHANGES IN MENTAL, PHYSICAL, AND COGNITIVE HEALTH: THE IMPACT OF THE RETIREMENT TRANSITION

Retirement is an important transition in later life, associated with changes in social roles. It is unclear, however, whether the retirement transition modifies aging-related changes in mental, physical, and cognitive health. Using data from the Health and Retirement Study, we examined changes in depressive symptoms, self-rated health, and memory prior to, at, and after the retirement transition among 6,830 participants (Ages=50-97, 58% female) assessed biennially up to 10 times from 1992-2010. Preliminary results indicate a sudden and significant increase in depressive symptoms and decreases in self-rated health and memory at the transition to retirement (ps&lt;.05). These effects increased among individuals retiring at older ages (ps&lt;.01). Further, aging-related increases in depressive symptomatology became faster after retirement (p&lt;.01). Aging-related decreases in self-rated health and memory were unchanged by the transition. Discussion will focus on the contribution of transitions to understanding trajectories of mental, physical, and cognitive health in later life.

A MICROLONGITUDINAL APPROACH TO STUDYING GRANDMOTHER-GRANDCHILD DAILY INTERACTIONS

Research suggests that grandparent-grandchild dyads shift in degree of solidarity over extended periods of time (e.g. Moorman & Stokes, 2016), but no work has considered grandparent-grandchild interactions microlongitudinally. This study utilized microlongitudinal data with an emphasis on intraindividual variability to examine the daily processes associated with relational aspects of grandparenting. Using data from 24 grandmothers in the Personal Understandings of Life and Social Experiences (PULSE) project, we explored how grandmother-reported satisfaction with grandchild interactions impacted grandmothers’ same-day positive and negative affect over 100 days. We first justified the need for microlongitudinal analyses by assessing the degree to which there were within-person shifts in interaction satisfaction over time. Intra-class correlations indicated 86% of the variation in interaction satisfaction was within-persons, warranting an intraindividual variability approach. As such, we then employed multi-level models to examine the within-person and between-person effects of interaction satisfaction predicting same day positive and negative affect. At the within-person level, on days when grandmothers reported higher than their average interaction satisfaction, they reported more positive affect (Estimate = 0.09, SE = 0.03, p = 0.009) and lower negative affect overall that day (Estimate = -0.08, SE = 0.02, p = 0.005). At the between-person level, grandmothers who had, on average, higher interaction satisfaction had more positive affect (Estimate = 0.63, SE = 0.09, p<.0001) and lower negative affect on average (Estimate = -0.53, SE = 0.11, p<.0001).

LINKING FAMILY TRANSITIONS AND LATER-LIFE DEPRESSION: DOES LIFE-COURSE SOCIOECONOMIC STANDING MATTER?

Research documented the impact of marital transitions—particularly marital loss—on depression in old age, yet its severity depends multiple factors. Individuals’ capability to cope with transitions depends on available resources and previous exposure to stressors, such as early-life adversity, which buffers or aggravates the impact of marital transitions on later-life depression. Although studies documented the pivotal link between early-life adversity and negative health trajectories, our study is the first attempt to examine whether early-life adversity influences the relationship between prospectively-tracked, later-life marital transitions and depression. We drew data from SHARE, which samples individuals aged 50+ across Europe (N = 13,258; 2004-2016). Using multilevel linear models, we found that women who became widowed had higher levels of depression compared to coupled and single women, but experienced lower increases in depression over time. After adjusting for early-life and adulthood SES, losing a partner remained significantly associated with depression. Life-course SES was associated with levels of depression, yet interactions between marital transitions and SES were not, with some exceptions: single women who reported difficulties in their ability to make ends meet experience higher increases of depression over time. Overall, results were similar for men. Interactions between family transitions and SES were again not significant, with a few exceptions for single men: those born in more childhood conditions, and those with high education, had lower levels of depression. We interpret and discuss our findings through the lens of life-course and stress-resiliency perspectives and in light of changing family dynamics for this age group.

Age, Daily Stress Processes, and Allostatic Load: A Longitudinal Study

Objective: The present study examined age differences in the association between daily stressors and allostatic load. Method: Participants consisted of 317 adults (34-84 years) who participated in Waves 1 (1996-1997) and 2 (between 2005 and 2009) of the Midlife Development in the United States Survey. During Wave 1, participants reported the stressors they encountered across eight consecutive days. Within-person affective reactivity slopes indexing change in negative affect from a nonstressor day to a stressor day were calculated for each participant. Affective reactivity and stressor exposure scores at Wave 1 were used to predict allostatic load at Wave 2. Results: Heightened levels of affective reactivity at Wave 1 predicted elevated levels of allostatic load at Wave 2 but only among older adults who also reported high levels of stressor exposure. No significant associations emerged for younger adults. Discussion: Daily stress processes may be one pathway through which age-related physical health declines occur.

A New Brief Measure of Executive Function: Adapting the Head-Toes-Knees-Shoulders Task to Older Adults

BACKGROUND AND OBJECTIVES

Executive function (EF) abilities are recognized as components of cognition most likely to show age-related declines. Measurement of EF in older adults is often computer-based, takes place in a laboratory setting, and thus lacks ecological validity. We sought to investigate a new way of measuring EF in older adults by adapting a brief, behavioral measure of EF in children, the Head-Toes-Knees-Shoulders task (HTKS).

RESEARCH DESIGN AND METHODS

A sample of 150 community-dwelling older adults (Mean age = 68.55, SD = 6.34) completed the HTKS, NIH Toolbox: Cognition Battery (NIHTB-CB) and Positive and Negative Affect Schedule.

RESULTS

The HTKS showed adequate internal consistency, α = .84. Significant associations between HTKS variables and measures of attention and inhibitory control were robust to the influences of age, processing speed, and subjective health ratings. HTKS completion time exhibited the strongest associations to NIHTB-CB measures, suggesting that the time it takes older adults to complete the HTKS may be a better measure of EF than the total score. Nonsignificant associations between HTKS variables and positive and negative affect demonstrated discriminant validity.

DISCUSSION AND IMPLICATIONS

These results provide initial evidence for use of the HTKS as a brief, low-cost, easy to administer measure of EF in older adults. Further research is needed to determine its potential to identify individuals at risk for poor cognitive outcomes. A brief, valid measure may allow for wider screenings aimed at early intervention, when cognitive interventions are most effective.

A Comprehensive Comparison of Quantifications of Intraindividual Variability in Response Times: A Measurement Burst Approach

OBJECTIVES

To formally identify and contrast the most commonly-employed quantifications of response time inconsistency (RTI) and elucidate their utility for understanding within-person (WP) and between-person (BP) variation in cognitive function with increasing age.

METHOD

Using two measurement burst studies of cognitive aging, we systematically identified and computed five RTI quantifications from select disciplines to examine: (a) correlations among RTI quantifications; (b) the distribution of BP and WP variation in RTI; and (c) the comparability of RTI quantifications for predicting attention switching.

RESULTS

Comparable patterns were observed across studies. There was significant variation in RTI BP as well as WP across sessions and bursts. Correlations among RTI quantifications were generally strong and positive both WP and BP, except for the coefficient of variation. Independent prediction models indicated that slower mean response time (RT) and greater RTI were associated with slower attention switching both WP and BP. For selecting simultaneous prediction models, collinearity resulted in inflated standard errors and unstable model estimates.

DISCUSSION

RTI reflects a novel dimension of performance that is a robust and theoretically informative predictor of BP and WP variation in cognitive function. Among the plenitude of RTI quantifications, not all are interchangeable, nor of comparable predictive utility.

The influence of social support and perceived stress on response time inconsistency

OBJECTIVES

Lack of social support and high levels of stress represent potentially modifiable risk factors for cognitive aging. In this study we examined the relationships between these two risk factors and response time inconsistency (RTI), or trial-to-trial variability in choice response time tasks. RTI is an early indicator of declining cognitive health, and examining the influence of modifiable psychosocial risk factors on RTI is important for understanding and promoting cognitive health during adulthood and old age.

METHODS

Using data from a community sample study (n = 317; M_age = 49, range = 19-83), we examined the effects of social support, including size of network and satisfaction with support, global perceived stress, and their interactions on RTI.

RESULTS

Neither size of network nor satisfaction with support was associated with RTI independent of perceived stress. Stress was positively associated with increased RTI on all tasks, independent of social support. Perceived stress did not interact with either dimension of social support to predict RTI, and perceived stress effects were invariant across age and sex.

CONCLUSION

Perceived stress, but not social support, may be a unique and modifiable risk factor for normal and pathological cognitive aging. Discussion focuses on the importance of perceived stress and its impact on RTI in supporting cognitive health in adulthood and old age.

Understanding stress reports in daily life: a coordinated analysis of factors associated with the frequency of reporting stress

Although stress is a common experience in everyday life, a clear understanding of how often an individual experiences and reports stress is lacking. Notably, there is little information regarding factors that may influence how frequently stress is reported, including which stress dimension is measured (i.e., stressors-did an event happen, subjective stress-how stressed do you feel, conditional stress-how stressful a stressor was) and the temporal features of that assessment (i.e., time of day, day of study, weekday vs. weekend day). The purpose of the present study was to conduct a coordinated analysis of five independent ecological momentary assessment studies utilizing varied stress reporting dimensions and temporal features. Results indicated that, within days, stress was reported at different frequencies depending on the stress dimension. Stressors were reported on 15-32% of momentary reports made within a day; across days, the frequency ranged from 42 to 76% of days. Depending on the cutoff, subjective stress was reported more frequently ranging about 8-56% of all moments within days, and 40-90% of days. Likewise, conditional stress ranged from just 3% of moments to 22%, and 11-69% of days. For the temporal features, stress was reported more frequently on weekdays (compared to weekend days) and on days earlier in the study (relative to days later in the study); time of day was inconsistently related to stress reports. In sum, stress report frequency depends in part on how stress is assessed. As such, researchers may wish to measure stress in multiple ways and, in the case of subjective and conditional stress with multiple operational definitions, to thoroughly characterize the frequency of stress reporting.

Age differences in everyday stressor-related negative affect: A coordinated analysis

Advancing age is often characterized by preserved or even enhanced emotion regulation, which is thought to manifest in terms of age-related reductions in the within-person association between stressors and negative affect. Existing research from ecological momentary assessment and end-of-day daily diary studies examining such age-related benefits have yielded mixed results, potentially due to differences in samples, design, and measurement of everyday stressors and negative affect. We conducted a coordinated analysis of 5 ecological momentary assessments and 2 end-of-day daily diary studies to examine adult age differences in the within-person association between everyday stressors and negative affect. Reported stressor occurrences are robustly associated with higher negative affect, regardless of study design and sample characteristics. Across studies, interactions between age and everyday stressors predicting negative affect revealed a pattern of age-related decreases in the stressor-negative affect association, but this interaction was only significant for 2 studies. Further, examination of statistical power of the included studies suggests that, despite differences in the number of repeated assessments, power to detect within-person stressor-negative affect associations is quite good. In contrast, despite possessing wider age ranges, observed age differences were relatively small in magnitude, and studies are potentially underpowered to detect age differences in these within-person associations. We discuss the importance of study design, interval of repeated assessments and number of participants for examining age differences in everyday stressors and negative affect, as well as the virtue of coordinated analyses for detecting consistent direction of associations, but inconsistent patterns of statistical significance. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Marital Transitions and Depressive Symptoms among Older Adults: Examining Educational Differences

BACKGROUND

Later decades of the life course have undergone rapid transformations due to demographic changes in ageing societies, such as more frequent occurrences of later-life marital transitions. Adaption to these transitions, even when welcomed, brings novel chances and challenges in negotiating new social roles in old age, which could reinforce preexisting disparities in the acquisition and mastery of resources, social ties, and coping strategies.

OBJECTIVES

Because the ability to weather later-life marital transitions may depend on the long arm of education acquired earlier in the life course, the present study aims to identify and track trends in the prevalence of marriage, divorce/separation, and widowhood among sociodemographic subgroups; link the occurrence of those transitions with mental health; and test the influence of educational attainment on these associations.

METHODS

We employ an intraindividual, within-person approach to quantify the occurrence of marital transitions and their impact using data from the Health and Retirement Study (n = 22,013; 1992-2010). Measures of transition occurrence, depressive symptoms, and educational attainment were available across up to 10 biennial assessments.

RESULTS

Individuals with less than a high school diploma displayed the highest likelihood of losing their significant other through divorce/separation or death. Marital loss was associated with increasing, and marital gain with decreasing, depressive symptoms. Compared to those with less than a high school diploma, individuals with a high school or general equivalency diploma exhibited larger increases in depressive symptoms associated with widowhood, even though their average levels of depressive symptoms were lower in the absence of this transition.

CONCLUSIONS

Our findings revealed a predictable educational gradient for the occurrence of marital transitions and later-life mental health. Yet higher, formalized education did not protect the participants from increased depression in the presence of a loss-related transition, which could suggest that the strains of spousal loss may to some degree function as a leveler of the preexisting social inequalities of stratified life courses. We conclude that the benefits conferred by education are not necessarily ubiquitous, and its impact on the adaptation to spousal loss may be more complex and nuanced depending on the range of prior experiences and available coping strategies.

Mean and variability in functional brain activations differentially predict executive function in older adults: an investigation employing functional near-infrared spectroscopy

OBJECTIVE

although the preponderance of research on functional brain activity investigates mean group differences, mounting evidence suggests that variability in neural activity is beneficial for optimal central nervous system (CNS) function. Independent of mean signal estimates, recent findings have shown that neural variability diminishes with age and is positively associated with cognitive performance, underscoring its adaptive nature. The present investigation sought to employ functional near infrared spectroscopy (fNIRS) to derive two operationalizations of cerebral oxygenation, representing mean and variability [using standard deviation (SD)] in neural activity, and to specifically contrast these mean- and SD-oxyhemoglobin (HbO) estimates as predictors of cognitive function.

METHOD

a total of 25 older adults (71 to 81 years of age) completed a test of cognitive interference (Multisource Interference Task) while undergoing fNIRS recording using a multichannel continuous-wave optical imaging system (TechEn CW6) over bilateral prefrontal cortex (PFC). Time-varying covariation models were employed to simultaneously estimate the within- and between-person effects of cerebral oxygenation on behavioral performance fluctuations.

RESULTS

mean effects were predominantly observed at the between-person level and suggest that greater concentrations of HbO are associated with slower and less accurate performance. Greater HbO variability at the between-person level was associated with slower performance, but was associated with faster performance at the within-person level.

CONCLUSIONS

these findings are in keeping with assertions that mean and variability confer complementary (as opposed to redundant) sources of information regarding the effective functioning of a neural system and suggest that fNIRS is a viable methodology for capturing meaningful variance in the hemodynamic response that is characteristic of adaptive CNS function.

Everyday stress response targets in the science of behavior change

Stress is an established risk factor for negative health outcomes, and responses to everyday stress can interfere with health behaviors such as exercise and sleep. In accordance with the Science of Behavior Change (SOBC) program, we apply an experimental medicine approach to identifying stress response targets, developing stress response assays, intervening upon these targets, and testing intervention effectiveness. We evaluate an ecologically valid, within-person approach to measuring the deleterious effects of everyday stress on physical activity and sleep patterns, examining multiple stress response components (i.e., stress reactivity, stress recovery, and stress pile-up) as indexed by two key response indicators (negative affect and perseverative cognition). Our everyday stress response assay thus measures multiple malleable stress response targets that putatively shape daily health behaviors (physical activity and sleep). We hypothesize that larger reactivity, incomplete recovery, and more frequent stress responses (pile-up) will negatively impact health behavior enactment in daily life. We will identify stress-related reactivity, recovery, and response in the indicators using coordinated analyses across multiple naturalistic studies. These results are the basis for developing a new stress assay and replicating the initial findings in a new sample. This approach will advance our understanding of how specific aspects of everyday stress responses influence health behaviors, and can be used to develop and test an innovative ambulatory intervention for stress reduction in daily life to enhance health behaviors.

Daily positive events and diurnal cortisol rhythms: Examination of between-person differences and within-person variation

Growing evidence from field studies has linked daily stressors to dysregulated patterns of diurnal cortisol. Less is known about whether naturally-occurring positive events in everyday life are associated with diurnal cortisol. The objectives of this study were to evaluate daily positive events as predictors of between-person differences and within-person (day-to-day) variations in diurnal cortisol parameters, in addition to daily positive events as buffers against the associations between daily stressors and cortisol. In the National Study of Daily Experiences, 1657 adults ages 33-84 (57% female) reported daily experiences during telephone interviews on 8 consecutive evenings. Saliva samples were collected 4 times per day on 4 interview days and assayed for cortisol. Multilevel models were used to estimate associations of daily positive events with cortisol awakening response (CAR), diurnal cortisol slope, and area under the curve (AUC). At the between-person level, people who experienced more frequent positive events exhibited a steeper diurnal cortisol slope, controlling for daily stressors, daily affect, and other covariates. At the within-person level, positive events in the morning (but not prior-night or afternoon/evening events) predicted steeper decline in cortisol across that day; positive events were also marginally associated with lower same-day AUC. Associations were not mediated by daily positive affect, and positive events did not buffer against stressor-related cortisol alterations. These findings indicate that individual differences and day-to-day variations in daily positive events are associated with diurnal cortisol patterns, independent of stressors and affect.

Comparing executive function, evoked hemodynamic response, and gait as predictors of variations in mobility for older adults

OBJECTIVE

Falls represent a major concern for older adults and may serve as clinically salient index events for those presenting in the prodromal stages of mild cognitive impairment. Declines in executive function performance and in gait consistency have shown promise in predicting fall risk; however, associated neurophysiological underpinnings have received less attention. In this study, we used a multimodal approach to assess fall risk in a group of older adults with and without a previous fall history.

METHOD

Processing speed, inductive reasoning, verbal fluency, crystallized ability, episodic memory, and executive functioning were assessed using standardized neuropsychological tests. Cognitive interference was assessed using the Multi-Source Interference Task. Spatiotemporal gait parameters were assessed with and without cognitive load using a 6.4-m instrumented walkway. Hemodynamic responses were measured using functional near-infrared spectroscopy.

RESULTS

Whereas no group differences were observed in cognitive behavioral performance, during a cognitive interference task fallers displayed more oxygenated hemoglobin across the prefrontal cortex than nonfallers, suggesting that engaging in the cognitive task was more effortful for them overall, therefore eliciting greater cortical activation. Between-group differences in spatial as well as temporal gait parameters were also observed.

CONCLUSIONS

These results are in keeping with assertions that diminished executive control is related to fall risk. Notably, the group differences observed in prefrontal cortical activation and in gait parameters may ultimately precede those observed in cognitive behavioral performance, with implications for measurement sensitivity and early identification.

Visit-to-Visit Blood Pressure Variability and Mortality and Cardiovascular Outcomes Among Older Adults: The Health, Aging, and Body Composition Study

BACKGROUND

Level of blood pressure (BP) is strongly associated with cardiovascular (CV) events and mortality. However, it is questionable whether mean BP can fully capture BP-related vascular risk. Increasing attention has been given to the value of visit-to-visit BP variability.

METHODS

We examined the association of visit-to-visit BP variability with mortality, incident myocardial infarction (MI), and incident stroke among 1,877 well-functioning elders in the Health, Aging, and Body Composition Study. We defined visit-to-visit diastolic BP (DBP) and systolic BP (SBP) variability as the root-mean-square error of person-specific linear regression of BP as a function of time. Alternatively, we counted the number of considerable BP increases and decreases (separately; 10mm Hg for DBP and 20mm Hg for SBP) between consecutive visits for each individual.

RESULTS

Over an average follow-up of 8.5 years, 623 deaths (207 from CV disease), 153 MIs, and 156 strokes occurred. The median visit-to-visit DBP and SBP variability was 4.96 mmHg and 8.53 mmHg, respectively. After multivariable adjustment, visit-to-visit DBP variability was related to higher all-cause (hazard ratio (HR) = 1.18 per 1 SD, 95% confidence interval (CI) = 1.01-1.37) and CV mortality (HR = 1.35, 95% CI = 1.05-1.73). Additionally, individuals having more considerable decreases of DBP (≥10mm Hg between 2 consecutive visits) had higher risk of all-cause (HR = 1.13, 95% CI = 0.99-1.28) and CV mortality (HR = 1.30, 95% CI = 1.05-1.61); considerable increases of SBP (≥20mm Hg) were associated with higher risk of all-cause (HR = 1.18, 95% CI = 1.03-1.36) and CV mortality (HR = 1.37, 95% CI = 1.08-1.74).

CONCLUSIONS

Visit-to-visit DBP variability and considerable changes in DBP and SBP were risk factors for mortality in the elderly.

Cognitively-Impaired-Not-Demented Status Moderates the Time-Varying Association between Finger Tapping Inconsistency and Executive Performance

OBJECTIVE

Response time inconsistency (RTI) in cognitive performance predicts deleterious health outcomes in late-life; however, RTI estimates are often confounded by additional influences (e.g., individual differences in learning). Finger tapping is a basic sensorimotor measure largely independent of higher-order cognition that may circumvent such confounds of RTI estimates. We examined the within-person coupling of finger-tapping mean and RTI on working memory, and the moderation of these associations by cognitive status.

METHOD

A total of 262 older adults were recruited and classified as controls, cognitively-impaired-not-demented (CIND) unstable or CIND stable. Participants completed finger-tapping and working-memory tasks during multiple weekly assessments, repeated annually for 4 years.

RESULTS

Within-person coupling estimates from multilevel models indicated that on occasions when RTI was greater, working-memory response latency was slower for the CIND-stable, but not for the CIND-unstable or control individuals.

CONCLUSIONS

The finger-tapping task shows potential for minimizing confounds on RTI estimates, and for yielding RTI estimates sensitive to central nervous system function and cognitive status.

Daily Smoking and Subjective Health Complaints in Adolescence

INTRODUCTION

Using data from the Health Behaviour in School-aged Children survey, this study used a repeated cross-sectional design to examine associations between daily smoking, gender, and self-reported health complaints in five cohorts of adolescents over a 16-year period.

METHODS

Data were from nationally representative cohorts of 15-year-old youth in Norway in 1993/1994, 1997/1998, 2001/2002, 2005/2006, and 2009/2010 (n _total = 7761). Dependent variables were psychological, somatic, and total health complaints. A mixed GLM model examined main and interaction effects of smoking (daily, intermittent, nonsmoking), year, and gender in predicting complaints. Time periods were segmented to compare trends across smoking groups in specific periods.

RESULTS

Prevalence of daily smoking declined from 15.5% (1993/1994) to 6.0% (2009/2010). All health complaint scores were significantly higher for smokers and for girls (vs. boys). Smoking status by year interactions were significant for all complaint variables during the period of sharpest decline of daily smoking prevalence (2001/2002-2005/2006), with daily smokers experiencing increases in health complaints while intermittent and nonsmokers did not. Smoking status by gender interactions were significant for all health complaint variables, indicating that the main effect for gender (females higher) was even stronger among smokers compared with nonsmokers. Using year as unit of analysis, the size of mean differences between daily smokers and intermittent/nonsmokers in total complaints was significantly negatively correlated with daily smoking prevalence (-.963, n = 5, p < .01).

CONCLUSIONS

As prevalence of daily smoking declined, daily smokers reported higher levels of complaints, suggesting increasing health problems within this group. Girls who smoke daily had particularly elevated levels of complaints.

IMPLICATIONS

This study indicates that the relationship between daily smoking and concurrent health symptomatology in adolescents is changing over time, with higher levels of health complaints reported as overall smoking prevalence declines. To our knowledge, this finding has not previously been reported. If youth are smoking to cope with distress, pain, or other health concerns, tobacco control objectives will be increasingly difficult to achieve with adolescents. Levels of health complaints are particularly high among girls who are daily smokers. The findings suggest that restrictive measures and persuasive communications may not be sufficient tobacco prevention strategies for adolescent populations. Young smokers may need counseling and support.

Association of retirement age with mortality: a population-based longitudinal study among older adults in the USA

BACKGROUND

Retirement is an important transitional process in later life. Despite a large body of research examining the impacts of health on retirement, questions still remain regarding the association of retirement age with survival. We aimed to examine the association between retirement age and mortality among healthy and unhealthy retirees and to investigate whether sociodemographic factors modified this association.

METHODS

On the basis of the Health and Retirement Study, 2956 participants who were working at baseline (1992) and completely retired during the follow-up period from 1992 to 2010 were included. Healthy retirees (n=1934) were defined as individuals who self-reported health was not an important reason to retire. The association of retirement age with all-cause mortality was analysed using the Cox model. Sociodemographic effect modifiers of the relation were examined.

RESULTS

Over the study period, 234 healthy and 262 unhealthy retirees died. Among healthy retirees, a 1-year older age at retirement was associated with an 11% lower risk of all-cause mortality (95% CI 8% to 15%), independent of a wide range of sociodemographic, lifestyle and health confounders. Similarly, unhealthy retirees (n=1022) had a lower all-cause mortality risk when retiring later (HR 0.91, 95% CI 0.88 to 0.94). None of the sociodemographic factors were found to modify the association of retirement age with all-cause mortality.

CONCLUSIONS

Early retirement may be a risk factor for mortality and prolonged working life may provide survival benefits among US adults.

Comparing individual differences in inconsistency and plasticity as predictors of cognitive function in older adults

INTRODUCTION

Recent theorizing differentiates key constraints on cognition, including one's current range of processing efficiency (i.e., flexibility or inconsistency) as well as the capacity to expand flexibility over time (i.e., plasticity). The present study uses intensive assessment of response time data to examine the interplay between markers of intraindividual variability (inconsistency) and gains across biweekly retest sessions (plasticity) in relation to age-related cognitive function.

METHOD

Participants included 304 adults (aged 64 to 92 years: M = 74.02, SD = 5.95) from Project MIND, a longitudinal burst design study assessing performance across micro and macro intervals (response latency trials, weekly bursts, annual retests). For two reaction time (RT) measures (choice RT and one-back choice RT), baseline measures of RT inconsistency (intraindividual standard deviation, ISD, across trials at the first testing session) and plasticity (within-person performance gains in average RT across the 5 biweekly burst sessions) were computed and were then employed in linear mixed models as predictors of individual differences in cognitive function and longitudinal (6-year) rates of cognitive change.

RESULTS

Independent of chronological age and years of education, higher RT inconsistency was associated uniformly with poorer cognitive function at baseline and with increased cognitive decline for measures of episodic memory and crystallized verbal ability. In contrast, predictive associations for plasticity were more modest for baseline cognitive function and were absent for 6-year cognitive change.

CONCLUSIONS

These findings underscore the potential utility of response times for articulating inconsistency and plasticity as dynamic predictors of cognitive function in older adults.

Selective attrition and intraindividual variability in response time moderate cognitive change

OBJECTIVES

Selection of a developmental time metric is useful for understanding causal processes that underlie aging-related cognitive change and for the identification of potential moderators of cognitive decline. Building on research suggesting that time to attrition is a metric sensitive to non-normative influences of aging (e.g., subclinical health conditions), we examined reason for attrition and intraindividual variability (IIV) in reaction time as predictors of cognitive performance.

METHOD

Three hundred and four community dwelling older adults (64-92 years) completed annual assessments in a longitudinal study. IIV was calculated from baseline performance on reaction time tasks. Multilevel models were fit to examine patterns and predictors of cognitive change.

RESULTS

We show that time to attrition was associated with cognitive decline. Greater IIV was associated with declines on executive functioning and episodic memory measures. Attrition due to personal health reasons was also associated with decreased executive functioning compared to that of individuals who remained in the study.

DISCUSSION

These findings suggest that time to attrition is a useful metric for representing cognitive change, and reason for attrition and IIV are predictive of non-normative influences that may underlie instances of cognitive loss in older adults.

Loneliness in a day: activity engagement, time alone, and experienced emotions

The experience of chronic loneliness has been associated with poorer physical health and well-being, including declines in cardiovascular health and higher levels of distressed affect. Given the long-term effects of loneliness on health and well-being, much research has focused on loneliness in older age. The purpose of the current study was to obtain a more detailed picture of the experience of loneliness in midlife and older adulthood by incorporating the context of a day's activities. We use a modified day reconstruction task to examine the activities in which middle-age and older adults engaged, the amount of time they spent alone, and the emotions experienced while engaging in a day's activities. Lonely individuals did not participate in different daily activities or spend more time alone during the day; however, loneliness was associated with engaging in more activities alone than with others. In regards to emotional experiences, daily activities yield a different profile of positive emotional experiences for lonelier individuals. The social context of daily activities was an important factor in understanding the effects of loneliness on experienced negative emotions. The results of this study provide insight into the influence of loneliness on the structure of a day and context for understanding the emotional experiences of lonely older adults.

A Double-Edged Sword: Race, Daily Family Support Exchanges, and Daily Well-Being

This study contributes to research on race and family ties by exploring racial differences in the direct effects of family support exchanges on daily well-being and the extent to which family support buffers/exacerbates stressor reactivity. African Americans and European Americans aged 34 to 84 (N = 1,931) from the National Study of Daily Experiences (NSDE) reported on family support exchanges (i.e., support received/support provided), daily stressors, and negative affect during 8 days of telephone interviews. On a daily basis, receiving family support was not associated with well-being, whereas providing family support was associated with compromised well-being among African Americans. As expected, receiving family support buffered reactivity to daily tensions for both races, whereas providing emotional support to family exacerbated African Americans' reactivity to daily tensions. Together, our findings suggest that even after considering the benefits of receiving family support, providing family support takes an emotional toll on African Americans.

Associations among daily stressors and salivary cortisol: findings from the National Study of Daily Experiences

While much research has focused on linking stressful experiences to emotional and biological reactions in laboratory settings, there is an emerging interest in extending these examinations to field studies of daily life. The current study examined day-to-day associations among naturally occurring daily stressors and salivary cortisol in a national sample of adults from the second wave of the National Study of Daily Experiences (NSDE). A sample of 1694 adults (age=57, range=33-84; 44% male) completed telephone interviews detailing their stressors and emotions on eight consecutive evenings. Participants also provided saliva samples upon waking, 30min post-waking, before lunch and before bed, on four consecutive interview days resulting in 5995 days of interview/cortisol data. Analyses revealed three main findings. First, cortisol AUC was significantly higher on stressor days compared to stressor-free days, particularly for arguments and overloads at home, suggesting that daily stressors are associated with increased cortisol output, but that not all daily stressors have such an influence. Second, individuals reporting a greater frequency of stressor days also exhibited a steeper diurnal cortisol slope. Finally, daily stressor-cortisol associations were unaltered after adjustment for daily negative affect and physical symptoms. Our discussion focuses on the influence of naturally occurring daily stressors on daily cortisol and the role of daily diary approaches for studying healthy cortisol responses to psychosocial stressors outside of traditional laboratory settings.

Emotional Reactivity and Mortality: Longitudinal Findings From the VA Normative Aging Study

OBJECTIVES

Evidence suggests a predictive association between emotion and mortality risk. However, no study has examined dynamic aspects of emotion in relation to mortality. This study used an index of emotional reactivity, defined as changes in positive or negative affect in response to daily stressors, to predict 10-year survival.

METHODS

An 8-day daily diary study was conducted in 2002 on 181 men aged 58-88. Multilevel models were employed to estimate emotional reactivity coefficients, which were subsequently entered into a Cox proportional hazards model to predict mortality.

RESULTS

Results indicated that positive emotional reactivity, that is, greater decreases in positive affect in response to daily stressors, increased mortality risk. Negative emotional reactivity did not predict mortality.

DISCUSSION

Findings highlight the potential importance of dynamic aspects of positive affect in prediction of physical health outcomes such as mortality.

Between-person and within-person associations among processing speed, attention switching, and working memory in younger and older adults

BACKGROUND/STUDY CONTEXT: Theories of cognitive aging predict associations among processes that transpire within individuals, but are often tested by examining between-person relationships. The authors provide an empirical demonstration of how associations among measures of processing speed, attention switching, and working memory are different when considered between persons versus within persons over time.

METHODS

A sample of 108 older adults (M (age) = 80.8, range = 66-95) and 68 younger adults (M (age) = 20.2, range = 18-24) completed measures of processing speed, attention switching, and working memory on six occasions over a 14-day period. Multilevel modeling was used to examine processing speed and attention switching performance as predictors of working memory performance simultaneously across days (within-person) and across individuals (between-person).

RESULTS

The findings indicates that simple comparison and response speed predicted working memory better than attention switching between persons, whereas attention switching predicted working memory better than simple comparison and response speed within persons over time. Furthermore, the authors did not observe strong evidence of age differences in these associations either within or between persons.

CONCLUSION

The findings of the current study suggest that processing speed is important for understanding between-person and age-related differences in working memory, whereas attention switching is more important for understanding within-person variation in working memory. The authors conclude that theories of cognitive aging should be evaluated by analysis of within-person processes, not exclusively age-related individual differences.