Lighten UP! A Community-Based Group Intervention to Promote Eudaimonic Well-Being in Older Adults: A Multi-Site Replication with 6 Month Follow-Up

Evaluation of a psychosocial group program for older adults: The Healthy Ageing Service Wellbeing Skills Group

ObjectiveTo conduct a quality assurance study assessing the implementation of the Healthy Ageing Service Wellbeing Skills Group Program (HAS-WSGP), a novel psychosocial skills group designed to support older adults' mental health.MethodsEligible participants were aged 65 years or older, presenting with mild-moderate mental health symptoms or interested in learning skills to enhance their emotional wellbeing, and living in community and residential aged care settings. Sessions were conducted weekly and facilitated by mental health clinicians and a peer support worker. Data collection involved a combination of demographic variables, outcome measures, and feedback surveys.ResultsA total of 40 consumers participated in the HAS-WSGP during the study period. Overall, participants demonstrated improvements in psychiatric, social, and occupational functioning, however no improvements in depressive and anxiety symptoms were observed. Improvements in self-reported knowledge of group program topics were observed, and participants endorsed the program as relevant, supportive, and helpful for improving their overall wellbeing.ConclusionsIt is feasible to run a psychosocial group program with older adults, and older adults report good benefits from this form of service provision. Further research will be needed to determine the efficacy of these programs on improving older adults' mental health.

The Long-Lasting Effect of Multidisciplinary Interventions for Emotional and Social Loneliness in Older Community-Dwelling Individuals: A Systematic Review

BACKGROUND

Loneliness can occur at any age, but it is more prevalent among older adults due to the associated risk factors. Various interventions exist to improve this situation, but little is known about their long-term effects. Our aims were to determine if these interventions have long-lasting effects and for how long they can be sustained. Additionally, we aimed to analyze if the interventions carried out by volunteers affected the outcomes regarding loneliness and psychological impact.

METHODS

A systematic review was performed by searching the literature in the MEDLINE PubMed, SCOPUS, Web of Science, PsycINFO, and Web of Science databases for interventions focused on the lonely population. The inclusion criteria for this review were the assessment of loneliness using a validated tool, and loneliness being the primary or secondary outcome. The CASPe checklist was used to assess the risk of bias in the selected studies, and the PRISMA-ScR recommendations were followed to present and synthesize the results.

RESULTS

Thirty articles were included. The interventions identified were classified into five categories: psychosocial, technological, health promotion, physical exercise, and multicomponent interventions. Loneliness improved in 24 studies during the post-intervention analysis. Social connectivity and depressive symptoms also improved in most interventions. Long-term follow-ups were conducted with positive results in a total of 16 interventions. Depressive symptoms and social connectivity were also improved. Eight of the interventions were carried out by volunteers and showed good results regarding loneliness.

CONCLUSIONS

The results obtained in this work suggested that multidisciplinary interventions can reduce loneliness, but more controlled clinical studies are needed.

Intergenerational or intragenerational learning? The relationship between interpersonal neural synchrony and older adult's learning acquisition

OBJECTIVES

Lifelong learning facilitates active ageing, and intragenerational learning-the process by which older adults learn from their peers-is an effective means of achieving this goal. The present research aims to elucidate the mechanisms and differences between intergenerational and intragenerational learning models for older adults as evidenced by brain-to-brain synchrony.

METHODS

Fifty-six instructor-learner dyads completed a study comparing intergenerational and intragenerational learning models, as well as task difficulty. The study utilized a block puzzle task and functional near-infrared spectroscopy (fNIRS) for hyperscanning.

RESULTS

The instructor-learner dyads showed greater interpersonal neural synchrony (INS) and learning acquisition in the intragenerational learning model in the difficult task condition (t (54) = 3.49, p < 0.01), whereas the two learning models yielded similar results in the easy condition (t (54) = 1.96, p = 0.06). In addition, INS and self-efficacy mediated the association between learning models and learning acquisition in older adults (b = 0.14, SEM = 0.04, 95 % CI [0.01 0.16]).

DISCUSSION

This study is the first to provide evidence of interbrain synchrony in an investigation of the intragenerational learning model in older adults. Our findings suggest that intra-learning is as effective as traditional inter-learning and may be more effective in certain contexts, such as difficult tasks. Encouraging intra-learning in community service or educational activities can effectively mitigate the challenge of limited volunteers and enhance learning acquisition among older adults.

When I am sixty-four… evaluating language markers of well-being in healthy aging narratives

Natural language use is a promising candidate for the development of innovative measures of well-being to complement self-report measures. The type of words individuals use can reveal important psychological processes that underlie well-being across the lifespan. In this preregistered, cross-sectional study, we propose a conceptual model of language markers of well-being and use written narratives about healthy aging (N = 701) and computerized text analysis (LIWC) to empirically validate the model. As hypothesized, we identified a model with three groups of language markers (reflecting affective, evaluative, and social processes). Initial validation with established self-report scales (N = 30 subscales) showed that these language markers reliably predict core components of well-being and underlying processes. Our results support the concurrent validity of the conceptual language model and allude to the added benefits of language-based measures, which are thought to reflect less conscious processes of well-being. Future research is needed to continue validating language markers of well-being across the lifespan in a theoretically informed and contextualized way, which will lay the foundation for inferring people's well-being from their natural language use.

Purpose in Daily Life: Considering Within-Person Sense of Purpose Variability

Sense of purpose refers to the extent to which one feels that they have personally meaningful goals and directions guiding them through life. Though this construct predicts a host of benefits, little is known regarding the extent to which sense of purpose fluctuates within an individual and the affective changes tied to those fluctuations. The current study uses daily diary data to addresses this gap by exploring (1) how much sense of purpose and different components of purpose fluctuate from one day to the next, (2) the extent to which these fluctuations correlate with positive and negative affect, and (3) whether dispositional sense of purpose and age correlate with greater variability. Participants (N = 354) reported on their sense of purpose and positive and negative affect every day for 10 days. Results suggest that approximately 45-61% of the variability in sense of purpose scores occurs between-person depending on how it is assessed. Furthermore, the within-person variability in sense of purpose is more strongly correlated with changes in positive affect relative to negative affect. Finally, higher levels of dispositional sense of purpose and age do not appear to be associated with how much variability an individual experiences in their purposefulness from one day to next. The discussion focuses on what these findings mean for the trait-like nature of sense of purpose, short-term sense of purpose measurement, lifespan development, and intervention efforts.

Higher purpose in life and education were associated with better cognition among older adults

BACKGROUND

 With aging, some cognitive abilities change because of neurobiological processes. Cognition may also be influenced by psychosocial aspects.

OBJECTIVE

 To describe the relationship between a measure of neuroticism, depression symptoms, purpose in life, and cognitive performance in community-dwelling older adults.

METHODS

 This was a cross-sectional analysis based on the data from the second wave of the Frailty in Brazilian Older Adults (FIBRA) study, carried out between 2016 and 2017. The sample consisted of 419 older people (≥ 72 years old) cognitively unimpaired and mostly with low education. The variables of interest were sociodemographic, Neuroticism domain from the NEO-PI-R, Geriatric Depression Scale (GDS), Purpose in Life (PiL) scale, and a cognitive composite score which included the Mini-Mental State Examination (MMSE), and the scores for the sub-items of the Mini-Addenbrooke's Cognitive Examination (M-ACE), namely, Verbal Fluency (VF) - Animal, Clock Drawing Test (CDT), Episodic Memory (name and address).

RESULTS

 There was a greater number of women (70%), with older age (median = 80 years, IQR = 77-82), and low education (median = 4 years, IQR = 2-5). In the bivariate correlations, years of education (ρ = 0.415; p < 0.001) and PiL (ρ = 0.220; p < 0.001) were positively associated with cognition. Neuroticism (ρ = -0.175; p < 0.001) and depression symptoms (ρ = -0.185; p < 0.001) were negatively associated with cognition. In the logistic regression, after including confounding variables, the associations between cognition and PiL (OR = 2.04; p = 0.007) and education (OR = 1.32; p < 0.001) remained significant.

CONCLUSION

 Low PiL and low education levels were associated with worse cognition among older adults. Such results may be of relevance in programs that aim to improve cognition among older adults.

Spiritual care for older people living in the community: A scoping review

BACKGROUND

The population of older people should be supported to enjoy optimal quality of life. Health professionals should consider a range of interventions that support the older population to maintain their quality of life. One such interventional approach involves spiritual care.

OBJECTIVE

To explore what is known about spiritual care approaches for older people living in the community.

METHODS

Scoping review informed by Joanna Briggs Institute guidelines. Eight electronic databases were searched: CINAHL, Ageline, PubMed, ProQuest Nursing & Allied Health, PsycINFO, Scopus, Garuda, and Neliti. The review included quantitative and qualitative primary peer-reviewed research studies focusing on spiritual care interventions for older people living in the community published between 2011 and 2021 in English or Bahasa Indonesia. The search was uploaded into an electronic citation manager and imported into Covidence for screening.

RESULTS

A total of 29 studies were included in the review. While the studies were conducted in five continents, most were reported from the Asian continent. Five key issues based on the outcome of interventions were found namely psychological, physical, spiritual, multidisciplinary approach, and social connection.

CONCLUSION

This scoping review identifies spiritual interventions conducted across many countries have been implemented for older people living in the community. Although there are review limitations and further research is needed, these spiritual interventions, both faith-based and non-faith-based, are identified as useful to support the well-being of older people.

Contributions of Eudaimonic Well-Being to Mental Health Practice

Purpose

Synergies between a eudaimonic model of psychological well-being (Ryff, 1989) and mental health practice are examined. The model grew out of clinical, developmental, existential, and humanistic perspectives that emphasized psychological strengths and capacities, in contrast to the focus on emotional distress and dysfunction in clinical psychology.

Design/Approach

Conceptual foundations of the eudaimonic approach are described, along with the six components positive functioning that are used to measure well-being. These qualities may be important in facilitating the recovery experiences, which are of interest in Mental Health and Social Inclusion.

Findings

Four categories of empirical evidence about eudaimonia are reviewed: (1) how it changes with aging, (2) how it matters for health, (3) what are its biological and neurological underpinnings, and (4) whether it can be promoted. Major contemporary forces against eudaimonia are also considered, including ever-widening inequality, the enduring pandemic, and world-wide strife. In contrast, encounters with the arts and nature are put forth as forces for eudaimonia. The relevance of these ideas for mental health research and practice is considered.

Originality

Mental health is often defined as the absence of mental illness. The novelty of the eudaimonic approach is to define mental health as the presence of well-being, assessed with different components of positive functioning.

Practical Implications

Enormous suffering defines our contemporary world. Such realities call for greater attention to factors that undermine as well as nurture the realization of human potential, the core of eudaimonic well-being.

Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial)

Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region.

Unpacking Psychological Vulnerabilities in Deaths of Despair

Recent demographic findings show increased rates of death due to suicide, drug addictions, and alcoholism among midlife white adults of lower socioeconomic status (SES). These have been described as "deaths of despair" though little research has directly assessed psychological vulnerabilities. This study used longitudinal data from the Midlife in the U.S. (MIDUS) study to investigate whether low levels of eudaimonic and hedonic well-being predict increased risk of deaths of despair compared to other leading causes of death (cancer, heart disease). The investigation focused on 695 reported deaths with cause of death information obtained from 2004 to 2022 via NDI Plus. Key questions were whether risk for deaths due to despair (suicide, drug addiction, alcoholism) compared to deaths due to cancer or heart disease were differentially predicted by deficiencies in well-being, after adjusting for sociodemographic variables. Low levels of purpose in life, positive relations with others, personal growth and positive affect predicted significantly greater likelihood of deaths of despair compared to deaths due to heart disease, with such patterns prominent among better-educated adults. The findings bring attention to ongoing intervention efforts to improve psychological well-being.

Does cumulative psychosocial stress explain frailty disparities in community-dwelling older adults?

OBJECTIVE

Frailty is a leading predictor of adverse outcomes in older adults. Although disparities in frailty are well-documented, it is unclear whether psychosocial stressors explain these disparities. This study aimed to examine the potential mediating role of psychosocial stress.

METHODS

This cross-sectional study included 7,679 community-dwelling older adults (≥ 65) from Health and Retirement Study in the US (2006 and 2008). We used six dichotomized psychosocial stressors: a) loneliness, b) discrimination, c) financial strain, d) low subjective status, e) poor neighborhood cohesion, and f) traumatic life events to compute cumulative psychosocial stress. The Fried frailty phenotype defined frailty based on three features: slowness, poor strength, weight loss, fatigue, and low physical activity. Multivariable regressions were used to examine the structural determinants (gender, education, race, and ethnicity) frailty relationship and test whether cumulative psychosocial stress has a mediating role.

RESULTS

The frailty prevalence was 22%. Females, Hispanics, Blacks, and those with less education had higher odds of frailty (p<.01). Race and ethnic minorities and non-college graduates experienced greater cumulative psychosocial stress relative to their White and college graduate counterparts (p<.05), respectively. Greater cumulative psychosocial stress was associated with increased odds of frailty (p < .001); however, it did not mediate the structural determinants and frailty relationship.

CONCLUSION

Contrary to expectations, cumulative psychosocial stress did not mediate the relationship between structural determinants and frailty. Rather, high cumulative psychosocial stress was independently associated with frailty. Further research should examine other psychosocial mediators to inform interventions to prevent/delay frailty.

The PATHS to Purpose: A New Framework Toward Understanding Purpose Development

Academic and lay interest has accrued over recent years with respect to how people develop a purpose in life. However, few theoretical models exist for understanding this developmental process as well as how to connect one’s overarching purpose in life to their daily feelings of purposefulness. The current article presents the PATHS (Purpose As Trait, Habit, and State) model, borrowing from clinical and personality development literatures. This framework allows researchers to consider purpose as a more enduring life direction (trait level), as an automatized routine acting in accordance with one’s goals (habit level), and as a more momentary reflection or feeling that one is engaged in purposeful pursuits (state level). Using this framework provides researchers with a valuable tool toward explaining how people progress toward purpose, via natural development or intervention, as well as the potential influences in this process.

Relationship of Purpose in Life to Dementia in Older Black and White Brazilians

OBJECTIVES

To test the hypothesis that higher level of purpose in life is associated with lower likelihood of dementia and mild cognitive impairment (MCI) in older Brazilians.

METHODS

As part of the Pathology, Alzheimer's and Related Dementias Study (PARDoS), informants of 1,514 older deceased Brazilians underwent a uniform structured interview. The informant interview included demographic data, the Clinical Dementia Rating scale to diagnose dementia and MCI, the National Institute of Mental Health Diagnostic Interview Schedule for depression, and a 6-item measure of purpose in life, a component of well-being.

RESULTS

Purpose scores ranged from 1.5 to 5.0 with higher values indicating higher levels of purpose. On the Clinical Dementia Rating Scale, 940 persons (62.1%) had no cognitive impairment, 121 (8.0%) had MCI, and 453 (29.9%) had dementia. In logistic regression models adjusted for age at death, sex, education, and race, higher purpose was associated with lower likelihood of MCI (odds ratio = .58; 95% confidence interval [CI]: .43, .79) and dementia (odds ratio = .49, 95% CI: .41, .59). Results were comparable after adjusting for depression (identified in 161 [10.6%]). Neither race nor education modified the association of purpose with cognitive diagnoses.

CONCLUSIONS

Higher purpose in life is associated with lower likelihood of MCI and dementia in older black and white Brazilians.

Purpose in life and 8-year mortality by gender and race/ethnicity among older adults in the U.S

We examined the associations between a sense of purpose and all-cause mortality by gender and race/ethnicity groups. Data were from the Health and Retirement Study, a nationally representative cohort study of U.S. adults aged >50 (n = 13,159). Sense of purpose was self-reported at baseline (2006/2008), and risk of all-cause mortality was assessed over an 8-year follow-up period. We also formally tested for potential effect modification by gender and race/ethnicity. We observed the associations between higher purpose and lower all-cause mortality risk across all gender and race/ethnicity groups. There was modest evidence that the highest level of purpose (versus lowest quartile) was associated with even lower risk of all-cause mortality among women (risk ratio = 0.66, 95% confidence interval: 0.56, 0.77) compared to men (risk ratio = 0.80, 95% confidence interval: 0.69, 0.93; p-value for multiplicative effect modification =0.07). However, we observed no evidence of effect modification by race/ethnicity. Having a higher sense of purpose appears protective against all-cause mortality regardless of gender and race/ethnicity. Purpose, a potentially modifiable factor, might be a health asset across diverse populations.

Effects of a Multi-Component Psychological Intervention to Cultivate Mental Health in Older Adults

Introduction

Psychological interventions to cultivate mental health in older adults are scarce and tend to focus on and use a limited number of activities.

Objective

The aim of this study was to test the effects of an intervention based on Keyes' concept of positive mental health.

Methods

The intervention was conducted with 24 self-selected participants, while 34 were part of the control group. Positive mental health and distress outcomes were measured at baseline and at the end of the intervention. ANCOVA analysis and effect sizes were calculated.

Results

Results showed that the intervention increased mental health (F= 18.22, p<0.001, η²= 0.334, d= 1.45, power 0.986) and decreased psychiatric symptomatology in the experimental group versus the control group (F= 7.07, p= 0.011, η²= 0.16, d= 0.87, power= 0.736), which showed no change.

Discussion

Despite study limitations, the intervention effectively promoted older people's well-being. Future research, should evaluate the long-term effects of the intervention with varied older adult populations.

Theorizing the notion of well-being in Islam: An update of Ryff's theory of eudaimonic psychological well-being

Prior studies suggest that knowledge about workers' psychological well-being is overly focused on materialism or biologically-based understanding, not taking into account the role of spirituality in one's well-being. Drawing on Ryff's (1989) psychological well-being framework and using an interdisciplinary approach, this paper offers a model of 'well-being in Islam' through theorizing this concept from an Islamic lens and contextually studying the implications of Islamic practices and spiritual facilities for employees' psychological well-being in workplaces. Drawing on qualitative data collected from 22 employees, our model (findings) shows that worshipping Allah, contemplative practices, and patience are key elements of one's well-being. This paper also points towards the important role of specific spiritual provisions (e.g., designated rooms for prayer, prayer time and ablution facilities) and contemplative practices (e.g., ritualistic-cyclic, creative process, generative, movement practices, stillness, activist, relational) for Ryff's six dimensions of employees' eudaimonic well-being. This study is unique as it integrates the notion of well-being in Islam into management and organization studies and offers a novel and contextual extension of Ryff's theory by integrating a spiritual notion of well-being. In the end, theoretical and practical implications are offered.

BigMove: A Group Intervention for People with Physical and Mental Health Conditions

Introduction:

This article describes an innovative, integrated care intervention, called BigMove, which aims to improve the functioning, capabilities and quality of life of people with a combination of physical and mental health conditions.

Description:

Theoretical frameworks reflected in the intervention are the Capability Approach (CA) and Self-Determination Theory (SDT). Essential elements of the intervention included to expand participants’ behavioural repertoire are motivational interviewing; functional goal setting (using the International Classification of Functioning, Disability and Health (ICF); cognitive behavioural therapy; enjoyment; support of the group; and physical activity. The design combines individual sessions and group sessions.

Discussion:

By integrating the CA and the SDT, the intervention enables participants to make self-directed and value-driven choices in life and change their behaviour accordingly to strengthen their functioning and capabilities. To foster person-centred, integrated care, it is crucial to reform the interaction between professionals and patients and to re-structure the organisation and financing of care to enable the provision of complex integrated care interventions.

Conclusion:

For people with physical and mental health conditions, the intervention BigMove provides an innovative integrated care approach that addresses aspirations people have regarding their functioning and focuses on individual goal setting and behaviour change.

Positive interventions for stress-related difficulties: A systematic review of randomized and non-randomized trials

The effectiveness of positive psychology interventions in the treatment of stress-related difficulties have not been well established. To estimate the effectiveness of positive psychology interventions on the reduction of stress-related symptoms, a systematic review using PubMed, Scopus, Wiley, Psychinfo, Cochrane and Sage databases with no limitation of date of publication was conducted. We identified additional studies by searching positive psychology reviews and academic books. Only studies trying positive interventions that included measures of anxiety, stress, or posttraumatic stress disorder symptoms were reviewed. We extracted data using predefined data fields and study quality was assessed with the National Institutes of Health study quality assessment tools. Twenty-nine records were included in this study: 23 controlled trials and six pre-post studies. Every study showed significant improvement in at least one dimension. Several studies reported improvements in well-being as well. This review shows promising results of positive psychology interventions as a treatment for stress-related difficulties. However, important methodological biases and strong heterogeneity among the studies highlight the need for replication and better validation of positive psychology interventions.

Ikigai and subsequent health and wellbeing among Japanese older adults: Longitudinal outcome-wide analysis

BACKGROUND

Having a purpose in life has been linked to improved health and wellbeing; however, it remains unknown whether having "Ikigai"-a related but broader concept in Japan-is also beneficial for various physical and psychosocial outcomes.

METHODS

Using data from a nationwide longitudinal study of Japanese older adults aged ≥65 years, we examined the associations between having Ikigai in 2013 and a wide range of subsequent outcomes assessed in 2016 across two databases (n = 6,441 and n = 8,041), including dimensions of physical health, health behavior, psychological distress, social wellbeing, subjective wellbeing, and pro-social/altruistic behaviors. We adjusted for sociodemographic characteristics and the outcome values (whenever data were available) in the prior wave (2010).

FINDINGS

Having Ikigai (vs. not having Ikigai) was associated with a 31% lower risk of developing functional disability [95% confidence interval (CI) for risk ratio: 0.58, 0.82] and 36% lower risk of developing dementia [95% CI for risk ratio: 0.48, 0.86] during the three-year follow-up. Having Ikigai was associated with decreased depressive symptoms and hopelessness as well as higher happiness, life satisfaction, instrumental activity of daily living, and certain social outcomes (e.g., more frequent participation in hobby clubs). Some of these associations were stronger for men than women, and among individuals with high socioeconomic status (p-values for effect measure modification < 001).

INTERPRETATION

Having Ikigai may promote health and wellbeing outcomes among Japanese older adults, but particularly men and individuals with high socioeconomic status.

FUNDING

NIH, John Templeton Foundation, JSPS, AMED, MHLW, MEXT, and WPE Foundation.

Psychological well-being, education, and mortality

OBJECTIVES

Research on older adults often focuses on mitigating health risks, and less is known about protective factors that contribute to longer, healthier lives. We examine longitudinal associations between psychological well-being and mortality among a national sample of older adults and test competing hypotheses about whether the education/mortality association depends on the level of psychological well-being.

METHOD

We use six waves (2006-2016) of the Health and Retirement Study, a national sample of adults over age 50 (n = 21,172), with 14 years of mortality follow-up. Psychological well-being is measured up to three times and includes positive affect, life satisfaction, purpose in life, social support, and optimism. Discrete-time survival models examine (a) the association between time-varying psychological well-being and mortality, and (b) interactions between psychological well-being and education on mortality.

RESULTS

Higher purpose in life, positive affect, optimism, social support, and life satisfaction predicted lower mortality. A 1 SD increase in most measures of psychological well-being was associated with a 2-4 year increase in life expectancy at age 50. Positive affect and purpose in life moderated the education/mortality association-the inverse association between education and mortality was stronger for those with high psychological well-being.

CONCLUSIONS

We find strong evidence that psychological well-being predicts lower mortality risk and modifies the association between education and mortality. The inverse association between education and mortality becomes stronger at higher levels of purpose in life and positive affect. Therefore, efforts to promote life satisfaction, social support, and optimism may support longer lives without widening education disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Pickleball, Personality, and Eudaimonic Well-Being in Middle-Aged and Older Adults

This study explored how personality and serious leisure activities, such as playing pickleball, contribute to eudaimonic well-being in middle-aged and older adults. Data were collected at pickleball events at the 2017 Huntsman World Senior Games from a convenience sample of 250 players aged between 50 and 91 years (M = 65.11, SD = 7.49). Of the five personality dispositions examined, conscientiousness (β = 0.32, p < .001), neuroticism (β = −0.22, p < .01), and openness to experience (β = 0.18, p < .01) were discovered to be significant predictors of eudaimonic well-being. Serious leisure also contributed to eudaimonic well-being (β = 0.28, p < .01). The findings of this study enhance the understanding of the behaviors exhibited by older adults and elucidate the positive impact exerted on eudaimonic well-being by personality and serious leisure.

The protective effect of mindfulness and compassion meditation practices on ageing: Hypotheses, models and experimental implementation

Alzheimer's disease (AD) represents a major health and societal issue; there is no treatment to date and the pathophysiological mechanisms underlying this disease are not well understood. Yet, there is hope that AD risk factors and thus the number of AD cases can be significantly reduced by prevention measures based on lifestyle modifications as targeted by non-pharmacological preventive interventions. So far, these interventions have rarely targeted the psycho-affective risk factors related to depression, stress, anxiety, and feeling of loneliness, which are all prevalent in ageing. This paper presents the hypothesis that the regular practice of mindfulness meditation (MM) and loving-kindness and compassion meditation (LKCM) in the ageing population constitutes a lifestyle that is protective against AD. In this model, these practices can promote cognition, mental health, and well-being by strengthening attention control, metacognitive monitoring, emotion regulation and pro-social capacities. Training these capacities could reduce the risk of AD by upregulating beneficial age-related factors such as cognitive reserve, and down-regulating detrimental age-related factors, such as stress, or depression. As an illustration, we present the Medit-Ageing study (public name Silver Santé Study), an on-going European project that assesses the impact and mechanisms of non-pharmacological interventions including meditation, in the ageing population.

The Association of Psychological Well-Being With Sensory and Cognitive Function and Neuronal Health in Aging Adults

OBJECTIVES

Psychological well-being (PWB) may be a potential modifiable risk factor of age-related diseases. We aimed to determine associations of PWB with sensorineural and cognitive function and neuronal health in middle-aged adults.

METHODS

This study included 2039 Beaver Dam Offspring Study participants. We assessed PWB, hearing, visual acuity, contrast sensitivity impairment, olfactory impairment, cognition, and retinal (macular ganglion cell inner-plexiform layer, mGCIPL) thickness. Age-sex-education-adjusted multivariable linear, logistic regression, and generalized estimating equation models were used and then further adjusted for health-related confounders.

RESULTS

Individuals with higher PWB had better hearing functions, visual acuity, and thicker mGCIPL and reduced odds for hearing, contrast sensitivity and olfactory impairment in age-sex-education-adjusted models. Effects on mGCIPL and visual and olfactory measures decreased with adjustment. Higher PWB was associated with better cognition, better combined sensorineural-cognitive function, and decreased cognitive impairment.

DISCUSSION

Psychological well-being was associated with sensorineural-cognitive health indicating a potential of PWB interventions for healthy aging.

Fostering Positive Communities: A Scoping Review of Community-Level Positive Psychology Interventions

Historically, positive psychology research and practice have focused on studying and promoting well-being among individuals. While positive psychology interventions focusing on the well-being of communities and marginalized groups have recently been developed, studies reporting on their nature and characteristics are lacking. The aim of this paper is to examine the nature of community-level positive psychology interventions. It reviews the target populations, intervention modalities, objectives, and desired effects of 25 community-level positive psychology interventions found in 31 studies. This scoping review shows that community-level programs based on positive psychology vary greatly in all these aspects. However, most interventions are aimed at individual-level changes to achieve target group outcomes. Contextual issues such as social conditions, values, and fairness affecting well-being are rarely considered. Discrepancies between community-level positive psychology interventions and community psychology in terms of values and social change are discussed.

Sense of Purpose in Life and Subsequent Physical, Behavioral, and Psychosocial Health: An Outcome-Wide Approach

PURPOSE

Growing evidence indicates that a higher sense of purpose in life (purpose) is associated with reduced risk of chronic diseases and mortality. However, epidemiological studies have not evaluated if change in purpose is associated with subsequent health and well-being outcomes.

DESIGN

We evaluated if positive change in purpose (between t₀; 2006/2008 and t₁;2010/2012) was associated with better outcomes on 35 indicators of physical health, health behaviors, and psychosocial well-being (at t₂;2014/2016).

SAMPLE

We used data from 12,998 participants in the Health and Retirement study-a prospective and nationally representative cohort of U.S. adults aged >50.

ANALYSIS

We conducted multiple linear-, logistic-, and generalized linear regressions.

RESULTS

Over the 4-year follow-up period, people with the highest (versus lowest) purpose had better subsequent physical health outcomes (e.g., 46% reduced risk of mortality (95% CI [0.44, 0.66])), health behaviors (e.g., 13% reduced risk of sleep problems (95% CI [0.77, 0.99])), and psychosocial outcomes (e.g., higher optimism (β = 0.41, 95% CI [0.35, 0.47]), 43% reduced risk of depression (95% CI [0.46, 0.69]), lower loneliness (β = -0.35, 95% CI [-0.41, -0.29])). Importantly, however, purpose was not associated with other physical health outcomes, health behaviors, and social factors.

CONCLUSION

With further research, these results suggest that sense of purpose might be a valuable target for innovative policy and intervention work aimed at improving health and well-being.

Sense of Purpose Promotes Resilience to Cognitive Deficits Attributable to Depressive Symptoms

Objective

Individuals higher in depressive symptoms commonly present with neuropsychological deficits including poorer memory performance. Sense of purpose in life has been shown to promote resilience to cognitive impairment in older adulthood, but it is unclear whether it may also protect against cognitive deficits associated with higher depressive symptoms.

Method

Cognitive functioning among 4599 older American adults (M_age = 74.33 years, range = 65–104 years, 56.84% female) was examined across a 12-year follow-up period. Depressive symptomatology was assessed at each wave using the 8-item Center for Epidemiologic Studies Depression Scale. Multilevel models assessed the influence of depressive symptoms and the interaction with sense of purpose in life on changes in memory performance and mental status.

Results

Higher depressive symptoms were associated with poorer memory performance at baseline, but did not predict rate of change over time. A negative interaction was observed between sense of purpose in life and depressive symptoms such that individuals higher in purpose experienced a less negative association between depressive symptoms and baseline memory performance. No significant interaction of sense of purpose and depressive symptoms was observed on mental status.

Conclusion

Having a sense of purpose in life may help protect older adults from memory deficits associated with higher depressive symptoms. The present findings underscore the potential for sense of purpose to promote cognitive reserve in older adulthood, allowing individuals to maintain cognitive performance in the face of accruing neurological insults.

Mean Levels and Variability in Psychological Well-Being and Associations With Sleep in Midlife and Older Women

BACKGROUND

Disturbed sleep is prevalent in older adulthood and particularly among women. Greater psychological well-being (PWB) is associated with better sleep, but intraindividual variability in PWB has not been examined.

PURPOSE

The current study examined whether mean levels and variability in PWB were associated with sleep disturbances in midlife and older women.

METHODS

Participants (N = 189) completed up to seven daily diaries and an end of the week assessment every 3 months for nine waves. Participants answered questions about their nightly sleep disturbances and reported their PWB using Ryff's six dimensions of PWB.

RESULTS

Regression models indicated that greater variability in one aspect of PWB, positive relations with others, was related to greater sleep disturbance even after adjusting for mean levels of well-being. Greater variability in environmental mastery, purpose in life, and self-acceptance were also associated with sleep disturbance, but these associations were no longer significant after adjusting for mean levels of well-being.

CONCLUSIONS

Results suggest that fluctuations in positive relations with others are related to sleep in adult women above and beyond mean levels of well-being. Results highlight the importance of considering variability in addition to mean levels of PWB.

POSITIVE PSYCHIATRY INTERVENTIONS IN GERIATRIC MENTAL HEALTH

PURPOSE OF REVIEW

Positive psychiatry shifts the focus of geriatric mental healthcare beyond studying disorders and psychopathology to studying factors that contribute to mental well-being and successful aging. An increasing number of interventional studies are using treatments that target modifiable positive psychosocial characteristics (PPCs) and study their impact on mental health. Here we provide an overview of the literature on positive psychiatry interventions using illustrative examples of interventions targeting social connectedness, meaning in life, wisdom, and resilience.

RECENT FINDINGS

There is growing evidence that PPCs are modifiable constructs that may be associated with improved well-being, physical health, and mental health outcomes.

SUMMARY

The preliminary evidence summarized in this narrative review indicates that positive psychiatry interventions targeting social connectedness, meaning in life, wisdom, and resilience can improve overall well-being and other positive health outcomes amongst older adults. The effect sizes of these interventions reported in RCTs and meta-analyses are typically small to medium, but occasionally large effect sizes are also reported. Current literature is restricted by heterogeneous methodology, limiting clinicians' abilities to extrapolate these principles of positive psychiatry into everyday practice. With the expanding body of evidence, positive psychiatry may have the potential to transform the landscape of geriatric mental health.

Mediterranean Lifestyle to Promote Physical, Mental, and Environmental Health: The Case of Chile

Chile is currently experiencing a progressive epidemiological transition towards chronic diseases. In this country, >50% of annual deaths are attributed to cardiovascular disease and cancer. Moreover, health surveys have shown high prevalence of obesity, diabetes, hypertension, and elevated cardiovascular disease risk. In addition, mental health issues are also frequent among Chilean adults. On the other hand, the agri-food system contributes to 21-37% of greenhouse gases emissions worldwide. Overall, current health and food chain situation calls out for design and implementation of evidence-based feasible and effective nutritional interventions needed to promote physical and mental health along with addressing food sustainability in Chile. Nowadays, the Mediterranean diet is recognized as one of the healthiest dietary patterns based on observational and interventional studies linked to a wide variety of health outcomes. However, a Mediterranean lifestyle goes well beyond food intake: it includes promotion of psychosocial resources, community life as well as cultural traditions. Indeed, Mediterranean lifestyle is a true modus vivendi that integrally promotes physical, mental, and social well-being. In addition, the Mediterranean diet stands out for its environmental sustainability because it is characterized mainly as a plant-based dietary pattern with low carbon and water footprints. Remarkably, Central Chile has a Mediterranean-like setting with plant and animal food production and availability patterns comparable to those present in countries located around the Mediterranean Sea. Therefore, this article reviews how promotion of Mediterranean lifestyle adherence in Chile offers great potential for management of the ongoing epidemiological transition to chronic diseases as well to promote psychological well-being within a unique food system and dietary sustainability vision for this Latin American country.

Elder Mistreatment and Psychological Well-Being among Older Americans

Elder mistreatment is a major public health issue both in the US and around the globe. While extensive research has elucidated the association between elder mistreatment and health in older adults, little is known about the relationship between elder mistreatment and more eudaimonic measures of psychological well-being. Using data from the 2011 wave of the Wisconsin Longitudinal Study, this project examined the association between older adults’ experience with varied forms of elder mistreatment and eudaimonic dimensions of psychological well-being including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Ordinary least squares regression analyses found significant associations between experiences of elder mistreatment and psychological well-being. In particular, older adults who reported feeling that someone was too controlling over their daily lives and older adults who reported making donations to organizations they later worried were not legitimate reported significantly lower scores on all six psychological well-being dimensions. The results of this study suggest the negative effects of elder mistreatment can extend to more eudaimonic feelings of well-being, and programs designed to treat victims of elder mistreatment should incorporate strategies that help strengthen psychological well-being.

Optimal Well-being, Depression, and Caregiving: An Explorative Investigation

OBJECTIVES

Recent studies documented the protective role of hedonic and psychological well-being for mental and physical health of aging individuals. However, the combination of these two dimensions of well-being (conceptualized as optimal well-being) has been rarely evaluated in association with providing caregiving. This exploratory investigation aimed to: (1) cluster a group of community dwellers according to levels of hedonic and psychological well-being (low well-being-LWB; moderate well-being-MWB; high well-being HWB); and (2) to identify their psychosocial correlates of their optimal well-being, including providing daily caregiving.

METHODS

217 community dwellers (60-90 years) completed questionnaires concerning psychological well-being, life satisfaction, and caregivers' distress. They were classified into three groups (LWB, MWB, HWB), following a k mean cluster analysis. Chi-square and GLM were used to compare the three clusters. Regression analyses were performed to evaluate the correlates of hedonic and psychological well-being.

RESULTS

Fifty-two individuals belonged to the HWB cluster, 68 to the LWB cluster and 97 to the MWB cluster. Individuals in the LWB cluster showed higher levels of anxiety and depression, and 61 of them reported to provide caregiving. Members of the HWB cluster were the oldest. Psychological and hedonic well-being negatively correlated with depression and caregiving.

CONCLUSIONS

These results indicate that only a small proportion of community dwellers reported optimal well-being.

CLINICAL IMPLICATIONS

Addressing depression and alleviating caregiver distress may constitute ingredients for promoting optimal well-being among older community dwellers.

Effects of a Community-Based Multicomponent Positive Psychology Intervention on Mental Health of Rural Adults in Ghana

BACKGROUND

There is growing evidence that positive psychology interventions (PPIs) enhance positive mental health and lead to a decrease in symptoms of psychopathology. This study examines the effectiveness of a 10-week multicomponent PPI (the Inspired Life Program; ILP) in promoting positive mental health and reducing symptoms of depression and negative affect in a sample of rural poor adults in Ghana.

METHODS

Using a quasi-randomized controlled trial design, participants from four rural poor communities were randomly allocated to intervention (n = 40) or control (n = 42) conditions. The intervention group participated in the 10-week ILP. Both groups completed a battery of mental health measures, including the Mental Health Continuum-Short Form, at pre-intervention, immediately after the intervention, and at 3 months follow-up. Hierarchical linear modeling was applied to evaluate whether the intervention was effective.

RESULTS

There was a greater improvement in positive mental health, with a marked reduction in symptoms of depression in the intervention group compared to the control group, immediately and 3 months after the intervention. There were also larger increases in the proportion of flourishers in the intervention group compared to the control group, immediately and three months after the intervention.

CONCLUSIONS

The observed effects of the ILP intervention program suggest that group-based PPIs can promote positive mental health and buffer against psychopathology among people living in rural poor communities in sub-Saharan Africa.