Psychological and social resources relate to biomarkers of allostasis in newly admitted nursing home residents

Association of positive psychological well-being with circulating inflammatory markers: A systematic review and meta-analysis

Accumulating evidence shows a protective effect of positive psychological well-being (PPWB) on health outcomes. However, the underlying mechanisms remain poorly understood. One pathway relates to enhanced immune functioning (Boehm, 2021). The aim of this project was to conduct a systematic review and meta-analysis of the association between PPWB and circulating inflammatory biomarkers and determine the magnitude of this association. After examining 748 references, 29 studies were included. Results from over 94'700 participants revealed a significant association between PPWB and reduced levels of interleukin (IL)-6 (r=-0.05; P<.001) and C-reactive protein (CRP) (r=-0.06; P<.001) with a heterogeneity of I² = 31.5% and I² = 84.5%, respectively. Only the association of PPWB with CRP was independent of co-variates included in the individual studies (r=-0.04; P=.027),. The findings of this systematic review and meta-analysis suggest that PPWB is associated with lower levels of inflammatory biomarkers IL-6 and CRP in the circulation. Such relationships with inflammatory biomarkers may partly explain positive effects of PPWB on health.

Acute Effects of Low- and High-Speed Resistance Exercise on Cognitive Function in Frail Older Nursing-Home Residents: A Randomized Crossover Study

Aim

The present study investigated the acute effects of low- and high-speed resistance exercise on the cognitive function of frail older women living in nursing home.

Materials and Methods

Ten institutionalized frail older women were recruited. Rey Auditory Verbal Learning Test and Stroop test were performed before, immediately after, 1 h after, and 24 h after the end of the experimental session. Participants randomly performed low- and high-speed resistance exercise and a control session. Exercise sessions were composed of 4 resistance exercises with 4–8 sets of 4–10 repetitions at moderate intensity.

Results

Results indicated that the performance of Rey Auditory Verbal Learning Test was similarly increased immediately after both low- and high-speed resistance exercises. However, only improvements elicited by low-speed resistance exercise remained significant 1 h after the end of the exercise session. No acute effects of resistance exercise were observed on Stroop performance.

Conclusion

Our findings indicated that both low- and high-speed resistance exercises acutely increased episodic memory in frail older women, whereas no changes on Stroop were observed.

An Exploratory Study of Correlates of Allostatic Load in Older People Living With HIV

BACKGROUND

Older people living with HIV (PLWH) experience poorer outcomes than seronegative counterparts. Allostatic load (AL) markers have shown utility as indicators of cumulative wear-and-tear of stress on biological systems. However, little is known about correlates of AL in PLWH.

METHODS

Ninety-six PLWH aged 50+ completed a comprehensive neurobehavioral assessment and blood draw. Select AL markers (ie, 10 blood markers) were available for a subset (n = 75) of seronegative controls. AL was operationalized as a sum of markers in the highest risk quartile for: cortisol, DHEA, IL-6, TNF-alpha, C-reactive protein, glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, albumin, systolic and diastolic blood pressure, and body mass index.

RESULTS

PLWH had higher risk levels than seronegatives with small-medium effect sizes for several biomarkers. Among HIV+ African Americans (84% of PLWH), higher AL was associated with lower psychological resilience (rho = -0.27, P = 0.02), less physical activity (rho = -0.29, P < 0.01), poorer neurocognitive functioning (rho = -0.26, P = 0.02), greater basic activity of daily living complaints (P < 0.01), and diabetes (P < 0.01). Multivariable regressions within African American PLWH for significant AL-outcome associations (ie, neurocognitive function, basic activity of daily living complaints, diabetes) showed that associations with AL remained significant when adjusting for relevant covariates. Mediation analysis suggested that the association between socioeconomic status and neurocognitive function was mediated by AL.

CONCLUSIONS

These exploratory findings are consistent with the larger aging literature, suggesting that lower AL may serve as a pathway to better health and functional outcomes, particularly in African American PLWH. Furthermore, resilience and physical activity may reduce AL in this population.

Effects of Yangsaeng (Health Management) Therapy for Korean Older Adults in Nursing Home

The number of older adults admitted to nursing homes is steadily increasing, and the health management for them is a very important issue in Korean society. This study aimed to examine the effects of Yangsaeng (health management) therapy on physical health status, depression, life satisfaction, and Yangsaeng (health management) of Korean older adults in nursing homes. A quasi-experimental study design using a pretest-posttest control group was employed. Study participants were a total of 80 older adults (intervention: n = 40, control: n = 40) in a nursing home in Seoul, South Korea. Yangsaeng therapy as an intervention consisted of the Meridian therapy and Qi-gong therapy. Yangsaeng therapy was conducted for 50 min per one time, twice a week, and for 10 weeks. Measures were general characteristics of study participants, Cornell Medical Index, Geriatric Depression Scale, life satisfaction scale, and Yangsaeng scale. Data were collected from April 2018 to March 2019. There were statistically significant differences on physical health status, depression, life satisfaction, and Yangsaeng between the two groups. Yangsaeng therapy was an effective intervention for improving physical health status, life satisfaction, and Yangsaeng, and for decreasing depression of older adults in nursing homes. Health care providers need to pay attention to Yangsaeng therapy as a Korean traditional intervention method for the health management of the older adults residing in nursing homes.

Reliability and Validity of the Adult Hope Scale among Nursing Home Residents with and without Cognitive Impairment

Objectives: The current study aims to examine the reliability and validity of the Adult Hope Scale among older adults with and without cognitive impairment who were recently admitted to a nursing home.Methods: Sixty-four recently admitted nursing home residents, 32 of whom had cognitive impairment, were administered the Adult Hope Scale and measures of concurrent and divergent validity.Results: In this sample, the Adult Hope Scale demonstrated good to excellent reliability. The Adult Hope Scale also correlated as expected with measures of concurrent and divergent validity, thus supporting the validity of the scale to measure hope in older adults despite level of cognitive functioning.Conclusions: This study shows that the Adult Hope Scale is a reliable and valid measure of hope in this sample of older adults with and without cognitive impairment who were recently admitted to a nursing home. Given the small sample size, additional research on the psychometric properties of the utility of the Adult Hope Scale in older adults with and without cognitive impairment is warranted.Clinical Implications: These preliminary findings allow future researchers and clinicians to consider administration of the Adult Hope Scale to individuals with and without cognitive impairment living in long-term care facilities. Gathering additional data on the psychometrics of this measure will enable new directions in research involving self-report measures for older adults with cognitive impairment, and in the development of interventions involving hope to improve physical and mental health in long-term care residents.

When Is Hope Enough? Hopefulness, Discrimination and Racial/Ethnic Disparities in Allostatic Load

Hopefulness is associated with better health and may be integral for stress adaptation and resilience. Limited research has prospectively examined whether hopefulness protects against physiological dysregulation or does so similarly for U.S. whites, blacks and Hispanics. We examined the association between baseline hopefulness and future allostatic load using data from the Health and Retirement Study (n = 8,486) and assessed differences in this association by race/ethnicity and experiences of discrimination. Four items measured hopefulness and allostatic load was a count of seven biomarkers for which a respondent's measured value was considered high-risk for disease. A dichotomous variable assessed whether respondents experienced at least one major act of discrimination in their lifetime. We used Poisson regression to examine the association between hopefulness and allostatic load and included a multiplicative interaction term to test racial/ethnic differences in this association. Subsequent analyses were stratified by race/ethnicity and tested the interaction between hopefulness and discrimination within each racial/ethnic group. Hopefulness was associated with lower allostatic load scores, but its effects varied significantly by race/ethnicity. Race-stratified analyses suggested that hopefulness was protective among whites and not associated with allostatic load among Hispanics irrespective of experiencing discrimination. Hopefulness was associated with lower allostatic load among blacks reporting discrimination but associated with higher allostatic load among those who did not. Findings suggest that hopefulness plays differing roles for older whites, blacks and Hispanics and, for blacks, its protective effects on physiological dysregulation are intricately tied to their experiences of discrimination.

Effects of Facility Adaptation Promotion Program for Korean Older Adults in Nursing Home

BACKGROUND

The purpose of this study was to examine the effects of facility adaptation promotion program on self-esteem, depression, relationship, life satisfaction, and adaptation to facility of Korean older adults in nursing home.

METHODS

A quasi-experimental pretest-posttest control group design was employed. Study participants were a total of 73 older adults aged 65 yr and older (Experimental: n=36, Control: n=37) who were living at nursing home in Seoul, South Korea in 2016. They were recruited through convenient sampling. Measures were Self-esteem scale, Korean Geriatric Depression Scale, Relationship Change Scale, life satisfaction scale, and facility adaptation scale. Data were analyzed using the SPSS version 21.0 with descriptive statistics, the Chi-squared test, and independent t-test.

RESULTS

Facility adaptation promotion program increased self-esteem (t=19.067, P<0.001), relationship (t=24.533, P<0.001), life satisfaction (t=16.501, P<0.001), and adaptation to facility (t=24.328, P<0.001), and decreased depression (t=14.491, P<0.001) of Korean older adults in nursing home.

CONCLUSION

Facility adaptation promotion program can be implied for improving self-esteem, relationship, life satisfaction, and adaptation to facility, and for decreasing depression of Korean older adults in nursing home.

Self-perceived coping resources of middle-aged and older adults - results of a large population-based study

OBJECTIVES

Psychosocial resources (personal resources, social resources, and other) are important for coping with aging and impairment. The aim of this study was to describe the resources of older adults and to compare subgroups with frailty, complex health care needs, and/or mental disorders.

METHOD

At the third follow-up of the large population-based German ESTHER study, 3124 elderly persons (aged 55-85) were included. Psychosocial resources were assessed during a home visit by trained study doctors by using a list of 26 different items. Resources were described for the total group, separated by sex, and for the three subgroups of persons with frailty, complex health care needs, and mental disorders.

RESULTS

Family, self-efficacy, and financial security were the most frequently reported resources of older adults. Women and men showed significant differences in their self-perceived resources. Personal resources (self-efficacy, optimism, mastery), social resources, and financial security were reported significantly less frequently by frail persons, persons with complex health care needs, and mentally ill older adults compared to non-impaired participants. Apart from external support, patients who experienced complex health care needs reported resources less frequently compared to frail and mentally ill patients.

CONCLUSION

Coping resources in older adults are associated with sex and impairment. Evaluation and support of personal resources of frail or mentally ill persons or individuals with complex health care needs should be integrated in the therapeutic process.

The development of positive psychology outcome measures and their uses in dementia research: A systematic review

Positive psychology is gaining credence within dementia research but currently there is a lack of outcome measures within this area developed specifically for people with dementia. Authors have begun adopting positive psychology measures developed with other populations but there is no consensus around which are more appropriate or psychometrically robust. A systematic search identified measures used between 1998 and 2017 and an appraisal of the development procedure was undertaken using standardised criteria enabling the awarding of scores based on reporting of psychometric information. Twelve measures within the constructs of identity, hope, religiosity/spirituality, life valuation, self-efficacy, community and wellbeing were identified as being used within 17 dementia studies. Development procedures were variable and scores on development criterion reflected this variability. Of the measures included, the Herth Hope Index, Systems of Belief Inventory and Psychological Wellbeing Scale appeared to be the most robustly developed and appropriate for people with dementia.