A longitudinal study of change in domain-specific self-efficacy among older adults

Association between diversity levels of member composition in group activities of older adults and the occurrence of need for care: the JAGES 2013-2019 longitudinal study

BACKGROUND

Participating in groups with diverse members is associated with improved health among older adults. The study examined the relationship between diversity of group members and needed support or long-term care.

METHODS

We conducted a longitudinal study for the Japan Gerontological Evaluation Study with 61,281 participants aged ≥ 65 years who were surveyed in 2013 and followed-up for six years. We assessed three dimensions of the diversity of the participating members (sex, age, and region of residence). We then graded the diversity level into four categories: level 0 (not in any group), level 1 (in a group without diversity or in a group with diversity in one of the three factors), level 2 (in a group with diversity in two of the three factors), or level 3 (in a group with diversity across all factors). We adjusted for 12 covariates using Cox hazard survival analysis models with hazard ratios (HRs) and 95% confidence intervals (CIs) estimated for the association between group members' diversity levels and needed support or long-term care. The same study was conducted when stratified by employment status at baseline.

RESULTS

Participants in social participation groups with more diverse group members had a lower incidence of needed support or long-term care as compared to their counterparts. Compared to those with no participation group, HR decreased by 14% to 24% with increasing levels of diversity. The HR for the level of care needed for participants in the social participation group with high residential diversity was 0.89 (95% CI: 0.84-0.94). For participants who were currently unemployed, HR reductions ranged from 16%-28% with increasing levels of diversity compared to the non-participating group. No association was found for employed participants.

CONCLUSIONS

The reason the HRs of Japanese elderly people certified as needing support or care are lower when the diversity of participating groups is higher could be owing to the presence of a variety of people and the diversification of social networks, which facilitates the building of bridging social relational capital. Public health policies that encourage participation in diverse organizations will be important in the future.

Self-motivated and directed learning across the lifespan

Self-motivated and directed learning is integral to knowledge base expansion for learners of all ages. Both motivational and cognitive processes drive self-motivated and directed lifelong learning, yet how these different processes operate together from childhood through adulthood is largely unknown. In this review, we discuss the role of personal motivators, such as beliefs in self-efficacy and personality traits in self-motivated and directed learning across the lifespan. We then consider the role of cognitive processes that contribute to knowledge base expansion in learners of all ages, specifically executive functions. We focus on working memory, inhibitory control, and task switching as potential determinants of lifelong learning. Finally, we integrate the two literatures, to discuss ways in which personal motivators may influence deployment of executive functions under self-motivated and directed conditions as a learner advances along a developmental trajectory. We also suggest ways to move the study of self-motivated and directed learning beyond observation and self-report measures thus affording experimental control. We aim to provide a more comprehensive understanding and novel insight to the mechanisms and processes of self-motivated and directed learning across the lifespan.

Sleep-related parenting self-efficacy and parent-reported sleep in young children: A dyadic analysis of parental actor and partner effects

OBJECTIVES

The role of positive cognitions, particularly domain-specific sleep-related parenting self-efficacy (SPSE), for young children's sleep has received limited attention so far. The present study investigates possible interdependencies between maternal/paternal SPSE and parent-reported sleep problems in infants and toddlers.

DESIGN AND SETTING

Mother-father dyads participated in this cross-sectional German study and filled out questionnaires.

PARTICIPANTS

One hundred thirty-one parental dyads with children aged between 2 and 47 months (M = 19.4; standard deviation = 10.6) participated in the study.

MEASUREMENTS

Parents answered a questionnaire about their own SPSE and the Children's Sleep Habits Questionnaire-Infant Version about their child's sleep. Paired sample t tests and correlations were used to investigate parental differences and agreement. An actor-partner interdependence model to examine the relationship between maternal/paternal SPSE and parent-reported child sleep problems was estimated, controlling for child age and co-sleeping.

RESULTS

The results reveal no differences between parents regarding their own SPSE and between mother- and father-reported child sleep problems. Mothers and fathers showed significant agreement regarding their children's sleep problems. For both parents, significant actor effects between SPSE and child sleep emerged, with higher SPSE being related to fewer child sleep problems. For fathers, also partner effects were significant with higher paternal SPSE being related to fewer child sleep problems in the maternal report.

CONCLUSION

This study underlines the importance of considering mothers' and fathers' nonindependence in dyadic data analysis. Parenting self-efficacy might play a specific role in the context of young children's sleep and could be used for early intervention and prevention programs.

Are Thoughts About the Future Associated With Perceptions in the Present?: Optimism, Possible Selves, and Self-Perceptions of Aging

Despite much literature pointing to the saliency of self-perceptions of aging (SPA) to aging processes, limited research offers empirical analysis on what shapes SPA. In order to identify possible antecedents to SPA, we conducted an exploratory analysis to analyze whether two future-oriented constructs-optimism and self-efficacy associated with possible selves-were associated with SPA. We ran hierarchical linear regressions, with optimism and self-efficacy of possible selves predicting SPA among 244 middle-aged and older adults. Higher optimism, higher self-efficacy to achieve hoped-for selves, and higher self-efficacy to avoid feared selves were associated with higher overall SPA. Results from our study suggest that how someone appraises their future older self impacts how they perceive their current older self.

How Investors Attitudes Shape Stock Market Participation in the Presence of Financial Self-Efficacy

The purpose of this study is to investigate how investor’s money attitudes shape their stock market participation (SMP) decisions. This study followed the theory of planned behavior (TPB), and a survey was conducted to collect the responses from active investors. Structural equation modeling (SEM) was used for the analysis of proposed relationships among the constructs, and a confirmatory factor analysis (CFA) was conducted to check the interrelation of the variables and validity of the constructs. This research has concluded that investor’s money attitudes are significant to affect their stock market participation decisions. Further, it was found that risk attitudes partially mediate the relationship between money attitudes and stock market participation. Moreover, financial knowledge and financial self-efficacy positively moderated the relationship between money attitudes and stock market participation. This research is one of the early attempts at studying the money attitudes of investors and introduces financial self-efficacy as a moderating construct between money attitudes and stock market participation. The sample size for this study was 250 respondents which can be increased in future research, and the same relationships can be tested by using a larger sample. Moreover, this study has used money attitudes as predictors of stock market participation. Still, many other variables, like personal value, can also be taken to investigate their influence on stock market participation.

General vs health-specific consideration of immediate and future consequences to explain eating and exercise behavior in a Norwegian student population: A randomized survey experiment

Over several decades, the consideration of future consequences (CFC) construct has been used to explain and predict health behaviors. However, the reported associations between CFC and health behaviors are relatively weak, leading to the low explanatory power of the models. Recent research suggests that CFC can be a domain-specific construct. In this study, we explored the psychometric properties of the Norwegian CFC-general and CFC-health questionnaires in terms of factor structure and discriminant and convergent validity and tested the association between the general and domain-specific CFC and exercise and eating behaviors. In a randomized survey experiment, 1,001 university students were assigned to either a CFC-general or a CFC-health questionnaire. In the tested models, two dimensions of CFC, consideration of immediate consequences (CFC-I) and consideration of future consequences (CFC-F), were independent variables. The exercise and eating behaviors, measured both as self-evaluated behaviors and self-reported frequency measures, were dependent variables. The results showed that in both CFC-general and CFC-health, CFC-I and CFC-F are distinct dimensions that differentially explain variance in health behaviors. A domain-specific CFC-health explained a significantly higher amount of variance in self-reported eating and exercising behaviors than a general CFC. Self-evaluated health behaviors were better explained by CFC than self-reported behavioral frequencies. Practical implications of the findings and avenues for future research are discussed.

Longitudinal relationships among depressive symptoms and three types of memory self-report in cognitively intact older adults

OBJECTIVES

The current study examined whether self-reported memory problems among cognitively intact older adults changed concurrently with, preceded, or followed depressive symptoms over time.

DESIGN

Data were collected annually via in-person comprehensive medical and neuropsychological examinations as part of the Einstein Aging Study.

SETTING

Community-dwelling older adults in an urban, multi-ethnic area of New York City were interviewed.

PARTICIPANTS

The current study included a total of 1,162 older adults (Mage = 77.65, SD = 5.03, 63.39% female; 74.12% White). Data were utilized from up to 11 annual waves per participant.

MEASUREMENTS

Multilevel modeling tested concurrent and lagged associations between three types of memory self-report (frequency of memory problems, perceived one-year decline, and perceived ten-year decline) and depressive symptoms.

RESULTS

Results showed that self-reported frequency of memory problems covaried with depressive symptoms only in participants who were older at baseline. Changes in perceived one-year and ten-year memory decline were related to changes in depressive symptoms across all ages. Depressive symptoms increased the likelihood of perceived ten-year memory decline the next year; however, perceived ten-year memory decline did not predict future depressive symptoms. Additionally, no significant temporal relationship was observed between depressive symptoms and self-reported frequency of memory problems or perceived one-year memory decline.

CONCLUSION

Our findings highlight the importance of testing the unique associations of different types of self-reported memory problems with depressive symptoms.

Self-esteem and self-efficacy in the status attainment process and the multigenerational transmission of advantage

Despite considerable evidence of the importance of self-esteem and self-efficacy for agentic, goal-oriented behavior, little attention has been directed to these psychological dimensions in the status attainment literature. The present research uses data from the longitudinal, three-generation Youth Development Study (N = 422 three-generation triads) to examine the extent to which adolescent self-esteem and economic self-efficacy affect adult educational and income attainment, and whether these psychological resources are transmitted from one generation to the next, accumulating advantage across generations. We present evidence indicating that both self-esteem and economic self-efficacy are implicated in the attainment process. Adolescent economic self-efficacy had a direct positive effect on adult educational attainment and an indirect effect through educational plans. The influence of self-esteem on adult educational attainment was entirely indirect, through school achievement. We also find evidence that economic self-efficacy was transmitted from parents to children. We conclude that future research should more broadly consider psychological resources in attainment processes from a longitudinal multigenerational perspective.

Linked Lives: Dyadic Associations of Mastery Beliefs With Health (Behavior) and Health (Behavior) Change Among Older Partners

Objectives

Mastery beliefs are known to contribute to healthy aging. However, it is an open question whether individual mastery-health associations impact the health of close long-term partners.

Method

We applied actor-partner interdependence models to 4-wave, 6-year longitudinal dyadic data from married and cohabitating partners in the Health and Retirement Study (N = 1,981 partners; age at baseline: M = 67 years, SD = 8.93, range 50-94 years).

Results

Higher individual mastery beliefs were associated with better individual physical health and health behaviors. Higher mastery beliefs were associated with subsequent increases in light physical activity. Having a partner with higher levels of mastery was uniquely associated with fewer functional limitations, better self-rated health, and more physical activity. Actor × Partner interaction effects for functional limitations indicated multiplicative associations of actor and partner mastery with health. Of note, mastery-health associations for individuals and their partners were invariant across age, gender, education, employment status, perceived stress over one's own and partner's health, and cognition.

Discussion

Findings suggest that partner mastery beliefs matter for the health (behaviors) of older adults. We discuss possible mechanisms underlying partner interrelations in mastery and health, their age invariance, and consider implications arising from our results.

Control diversity: How across-domain control beliefs are associated with daily negative affect and differ with age

Domain-specific control beliefs typically buffer the influence stressors have on people's negative affect (affective stressor reactivity). However, little is known about the extent to which individuals' control beliefs vary across stressor types and whether such stressor-related control diversity is adaptive for affective well-being. We thus introduce a control diversity construct (a person-level summary of across-domain control beliefs) and examine how control diversity differs with age and relates to negative affect and affective stressor reactivity. We apply a multilevel model to daily diary data from the National Study of Daily Experiences (NSDE; N = 2,022; mean age = 56 years; 33-84; 57% women). Our findings indicate that above and beyond average control beliefs, people whose control is spread over fewer stressor domains (less control diversity) have lower negative affect and less affective stressor reactivity. Older adults are more likely than younger adults to have their control beliefs concentrated in one domain. Additionally, associations between control diversity and negative affect and affective stressor reactivity were age invariant. Moderation effects indicated that when people with low average control beliefs are faced with stressors, having control beliefs focused on fewer domains rather than spread broadly across many domains is associated with less negative affect. Our findings suggest that control diversity provides unique insights into how control beliefs differ across adulthood and contribute to affective well-being. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Feasibility, Acceptability and Effects of a Home-Based Exercise Program Using a Gerontechnology on Physical Capacities after a Minor Injury in Community-Living Older Adults: A Pilot Study

CONTEXT

Several studies have demonstrated that physical activity can help limit decline in functional capacities of older adults. Nevertheless, many adults aged 65 and over are inactive.

OBJECTIVE

To explore the feasibility, the acceptability and the effects of a home-based exercise program (HEP) using a motion capture gerontechnology in independent community-living older adults at risk of function decline.

DESIGN

Interventionnal clinical trial.

PARTICIPANTS

Sixteen previously independent individuals aged 65 and older recruited at the Emergency Department after being treated for a minor injury and discharged home were assigned to a home-based exercise program group (HEP=8) or to a control group (CONTR=8). Twelve participants completed the study, 6 in each group Setting: Canadian Community-dwelling in Montreal area.

INTERVENTION

The HEP group engaged in a twelve-week physical activity intervention using a gerontechnology while the CONTR group continued with discharge plan from ED.

MEASUREMENTS

Participants were evaluated for functional status using validated questionnaires and objective physical measures at baseline, three and six months later. Feasibility and acceptability of the HEP was assessed using data reports from the gerontechnology and from self-reported assessments.

RESULTS

There was no differences between groups at baseline except for the fallrelated self-efficacy: HEP=8.33/28±1.51 vs CONTR=7/28±0 p=0.022. The HEP was found to be feasible and acceptable (adherence rate at 86% and average quality of movements at 87.5%). Significant improvement in walking speed on 4m was observed three months after baseline for HEP vs CONTR group (+0.25 vs +0.05 m/sec, p=0.025). Effects remained at follow-up. Only CONTR group resulted in a significant increase in SF-36 global score.

CONCLUSION

This twelve-week HEP intervention using the Jintronix® gerontechnology is feasible, acceptable and safe for community-living older adults who sustained a minor injury. This intervention could increase walking speed, the most important predictor of adverse events in the elderly population, and that the improvement could be maintained over time.

The Relationship Between Emotional Support and Health-Related Self-Efficacy in Older Prisoners

Objective: To determine whether emotional support, and proportion of emotional support provided by specific sources (e.g., family, other prisoners, clinicians), is associated with health-related self-efficacy among older prisoners. Method: Cross-sectional study of 140 older prisoners age ≥50 with chronic medical illness who completed face-to-face interviews. Logistic regression, controlling for demographic, incarceration, and clinical/behavioral factors evaluated the association between emotional support, operationalized as a score and as a proportion of total emotional support from specific sources, and health-related self-efficacy. Results: Higher emotional support scores, and greater proportion of support from clinicians, were associated with lower likelihood of poor health-related self-efficacy. Those with >50% of their emotional support coming from other prisoners had higher likelihood of poor self-efficacy. Discussion: Among older prisoners with chronic illness, higher emotional support, particularly from clinicians, is associated with lower likelihood of poor self-efficacy; relying on other prisoners for emotional support is associated with poor health-related self-efficacy.

The Stress Process among Dementia Spouse Caregivers

This study examines the relationship between the demands of providing care to a spouse with dementia and caregiver health behaviors, specifically exercise, sleep patterns, weight maintenance, smoking, and alcohol consumption. Structural equation modeling was used to test a model predicting health behavior change from personal and environmental characteristics, perceived stress, social support, and depressive symptoms in a sample of 233 spouse caregivers of dementia patients and to examine gender differences in these relationships. Results support the hypothesis that caregiving negatively influences health behaviors. Among both women and men, health behavior change is directly influenced by depressive symptoms and objective burden. In addition, depressive symptoms mediate the effects of self-efficacy and objective burden on health behavior change. These results support the notion that health behavior change may represent one mechanism by which caregiving stress leads to adverse health outcomes.

Stressful Life Events and Depressive Symptoms: Social Support and Sense of Control as Mediators or Moderators?

Depression is quite common among the elderly members of the Hong Kong Chinese society. This study examined the impact of a series of common stressful life events (SLEs) on change in depressive symptoms among the older people. The respondents were 411 people aged sixty years or older from a survey of a representative community sample of the elderly population in Hong Kong. Using multiple regression models, the authors found that sense of control acted as a mediator in the linkage between the number of SLEs and depressive symptoms, even after controlling sociodemographic, and physical health status were applied. In addition, the social support measured by Lubben Social Network Scale moderated the influence of the exposure to SLEs on depression. Findings suggest that sense of control and social support play distinguished and important roles in the stress-outcome relationship. Service implications were discussed based on these findings.

Frailty modifies effectiveness of psychosocial intervention in recovery from stroke

Objective : To evaluate the impact of a psychosocial intervention on instrumental activities of daily living, physical performance, cognition and mortality after stroke.

Design : A randomized clinical trial.

Setting : Patients were recruited from hospitals and rehabilitation centres; the intervention took place in subjects' homes.

Subjects : Two-hundred and ninety-one stroke survivors over age 45. One-hundred and forty-six subjects were assigned to the intervention and 145 subjects were assigned to usual care.

Intervention : Up to 16 meetings conducted over six months in the patient's home (approximately weekly for 12 weeks, followed by tri-weekly sessions for another 12 weeks). Sessions lasted approximately 1 hour and included, when possible, the entire support system (stroke survivor, primary caregiver, additional family and friends, and professional caregivers).

Main outcome measures : Instrumental activities of daily living, physical performance, and cognition were assessed six months post stroke; mortality was assessed at an average of 47 months post stroke.

Results : No significant differences in outcomes were observed between the intervention and usual care groups when analysing the total study population. Among non-frail participants (n = 156), subjects randomized to treatment had better scores on instrumental activities of daily living (mean score among treated = 12.4 (standard deviation (SD) = 2.1), mean score among usual care subjects = 11.3 (SD = 2.9), P-value for difference in means = 0.01) and reduced risk of mortality (P = 0.03) than subjects randomized to usual care.

Conclusion : While there is evidence that the treatment benefited healthier subgroups, results also show evidence that the treatment was not effective, and possibly harmful, in frail subgroups.

Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies

BACKGROUND

The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear.

OBJECTIVE

We undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke.

METHODS

Sixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models.

RESULTS

Of the 35 925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21 years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender.

CONCLUSIONS

Our findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries.

STUDY REGISTRATION NUMBER

CRD42014010225.

Differential Vulnerability to Early-Life Parental Death: The Moderating Effects of Family Suicide History on Risks for Major Depression and Substance Abuse in Later Life

Only a portion of those individuals exposed to parental death in early life (PDE) develop behavioral health disorders. We utilized demographic pedigree data from the Utah Population Database to test for differential vulnerability to PDE by creating a risk score of familial susceptibility to suicide (FS) at the population level. Using logistic panel regression models, we tested for multiplicative interactions between PDE and FS on the risks of major depressive disorder (MDD) and substance abuse (SA), measured using Medicare claims, after age 65. The final sample included 155,983 individuals (born 1886-1944), yielding 1,431,060 person-years at risk (1992-2009). Net of several potential confounders, including probability of survival to age 65, we found an FS × PDE interaction for females, in which PDE and FS as main effects had no impact but jointly increased MDD risk. No statistically significant main or interactive effects were found for SA among females or for either phenotype among males. Our findings are consistent with a differential vulnerability model for MDD in females, in which early-life stress increases the risk for poor behavioral health only among the vulnerable. Furthermore, we demonstrate how demographic and pedigree data might serve as tools for investigating differential vulnerability hypotheses.

Are self-efficacy beliefs and subjective task demand related to apathy in aging?

OBJECTIVE

Apathy, defined as a reduction in voluntary goal-directed behaviors (GDBs), is common in aging, but the processes underlying apathy are still unclear. Self-efficacy beliefs are likely to play a key role in GDBs, by influencing goal setting, perceived difficulty, and the necessary amount of effort to achieve goals. The aim of this study was to examine the relationships between apathy and perceived self-efficacy.

METHOD

Sixty-three healthy elderly participants worked on a memory task without fixed performance standard ('do your best') and indicated perceived difficulty and effort investment after performing the task. They also completed two short scales assessing general self-efficacy and negative mood. In addition, a close relative of each participant completed the Initiative Interest Scale, a new questionnaire assessing apathetic manifestations in aging.

RESULTS

The main results showed that subjective task demand (i.e., perceived difficulty and estimated effort) operated as a mediator between self-efficacy beliefs and apathy. These results suggest that elderly people with low self-efficacy beliefs who face a challenge judge the task to be highly difficult and effort demanding, which might result in GDB reduction.

CONCLUSION

These results shed new light on the processes related to apathy in aging and open up an interesting prospect for psychological interventions.

Coping and depression in old age: a literature review

BACKGROUND/AIMS

The interest in the relation between coping and depression in older persons is growing, but research on the concepts and instruments of coping in relation to depression among older persons is scarce and systematic reviews are lacking. With this background, we wanted to gain a systematic overview of this field by performing a systematic literature search.

METHODS

A computer-aided search in MEDLINE, CINAHL, PsycINFO, Embase, PubMed and www.salutogenesis.fi was conducted. We systematically searched for studies including coping and depression among persons 60 years of age and above. The included studies were evaluated according to predefined quality criteria.

RESULTS

Seventy-five studies, 38 clinical and 37 community settings, were included. Of these, 44 were evaluated to be of higher quality. Studies recruiting samples of older persons with a major depressive disorder, moderate or severe cognitive impairment or those who were dependent on care were scarce, thus the research is not representative of such samples. We found a huge variety of instruments assessing resources and strategies of coping (55 inventories). Although we found the relation between resources and strategies of coping and depression to be strong in the majority of studies, i.e. a higher sense of control and internal locus of control, more active strategies and positive religious coping were significantly associated with fewer symptoms of depression both in longitudinal and cross-sectional studies in clinical and community settings.

CONCLUSION

Resources and strategies of coping are significantly associated with depressive symptoms in late life, but more research to systematize the field of coping and to validate the instruments of resources and strategies of coping in older populations is required, especially among older persons suffering from major depression and cognitive decline.

Substantial changes in mastery perceptions of dementia caregivers with the placement of a care recipient

OBJECTIVES

The current study examined how a key component of caregiving stress processes, global mastery perceptions, changes with placing the care recipient in a nursing home or institution. We also explored the role of primary stressors in accounting for mastery changes with placement and whether characteristics of the caregiver and care recipient moderate reactions to placement.

METHOD

We applied multiphase growth curve models to prospective longitudinal data from 271 caregivers in the Caregiver Stress and Coping Study who experienced placement of their care recipient.

RESULTS

Using a time-to/from-placement metric, we found that caregivers typically experienced declines in mastery preceding placement, followed by a significant increase within 1 year after placement and further increases thereafter. Corresponding changes in primary stressors (role overload) mediated the placement-related increase in mastery. Caregivers who reported more depressive symptoms and activities of daily living/instrumental activities of daily living dependencies of the care recipient were more likely to experience larger placement-related increases in mastery perceptions.

DISCUSSION

Our findings suggest that placement alters psychological resources of caregivers and this effect is driven by corresponding changes in primary stressors. Findings also underscore the importance of examining change processes across salient life events and transitions.

Long-term antecedents and outcomes of perceived control

Perceived control plays an important role in shaping development throughout adulthood and old age. Using data from the adult lifespan sample of the national German Socio-Economic Panel (SOEP; N > 10,000, covering 25 years of measurement), we explored long-term antecedents, correlates, and outcomes of perceived control and examined if associations differ with age. Targeting correlates and antecedents of control, findings indicated that higher concurrent levels of social participation, life satisfaction, and self-rated health as well as more positive changes in social participation over the preceding 11 years were each predictive of between-person differences in perceived control. Targeting health outcomes of control, survival analyses revealed that perceived control predicted 14-year hazard ratio for disability (n = 996 became disabled) and mortality (n = 1,382 died). The effect for mortality, but not for disability, was independent of sociodemographic and psychosocial factors. Overall, we found very limited support for age-differential associations. Our results provide further impetus to thoroughly examine processes involved in antecedent-consequent relations among perceived control, facets of social life, well-being, and health.

Examining dynamic links between perceived control and health: longitudinal evidence for differential effects in midlife and old age

Perceived control and health are often closely linked in adulthood and old age. Little is known, however, about their time-ordered interplay at various phases of adult life. By applying dynamic models to four waves of data over 15.5 years from the Americans' Changing Lives Study, we examined time-ordered relations between perceived control and health in midlife and old age. Results revealed that levels of perceived control predict subsequent changes in health over time in old age (65+ years of age; n = 1,238) but not in midlife (25-64 years of age; n = 2,364). No evidence was found for predictive effects of health for changes in perceived control in either age group. These age-differential findings were corroborated with nested-model comparisons. Predictive effects of perceived control for health were attenuated to the null in models covarying for sociodemographic and psychosocial factors (physical activity, memory, emotional support, and depressive symptoms), suggesting that these variables play an important role in control-health relations. Our discussion focuses on the importance of perceived control for healthy living in old age and the differential implications of perceived control for health in midlife and old age.

Antecedent-consequent relations of perceived control to health and social support: longitudinal evidence for between-domain associations across adulthood

OBJECTIVES

To examine antecedent-consequent relations of perceived control to health and social support across adulthood and old age.

METHODS

We applied (multigroup) change score models to two waves of data collected 9 years apart from 6,210 participants of the Midlife in the United States survey (MIDUS, 24-75 years at baseline). We used composite measures of perceived control (personal mastery and constraints), health (chronic conditions, acute conditions, and functional limitations), and social support (support and strain associated with spouse/partner, family, and friends).

RESULTS

Analyses revealed evidence for direct and independent multidirectional accounts. Greater initial control predicted weaker declines in health and stronger increases in support. In turn, increases in control were predicted by better initial health and more support. Changes in control were also accompanied by concurrent changes in the other two domains, and relations involving control were larger in size than those between health and support. We found only small sociodemographic differences across age, gender, and education group.

DISCUSSION

We conclude that perceiving control may serve as both a precursor and an outcome of health and social support across the adult age range and suggest routes for further inquiry.

Optimism and well-being in older adults: the mediating role of social support and perceived control

To investigate how psychosocial resources may improve well-being for older adults, this study explored the relationship among questionnaire measures of optimism, social support and perceptions of control in predicting subjective well-being (measured with the positive affect subscale of the Affect Balance Scale) (Bradburn, 1969) and psychological well-being (measured with the purpose in life scale of the Ryff Psychological Well-being scales) (Ryff, Lee, Essex, & Schmutte, 1994) among older adults. The potential mediating roles of perceived social support and perception of control were also explored. Participants were 225 adults aged from 65 to 94 years. Optimism was found to be a predictor of both subjective and psychological well-being, and perceived social support was found to mediate the relationship between optimism and subjective well-being, but not psychological well-being. In contrast, perception of control was found to mediate the relationship between optimism and psychological well-being, but not subjective wellbeing. Longitudinal research is needed to confirm these pathways.

Validation of the RIS Eldercare Self-Efficacy Scale

This paper presents psychometric data on a new, three-dimensional measure of self-efficacy for caregivers of older adults. Based on a sample of family caregivers of persons with dementia and a longitudinal study design (Time 1: N = 134; Time 2: N = 103), the RIS Eldercare Self-Efficacy Scale assesses relational self-efficacy, instrumental self-efficacy, and self-soothing efficacy. These three dimensions show strong internal consistency and moderate test-retest reliability. Their construct validity is demonstrated by their zero-order correlations with a set of standardized indicators of the caregivers' health and morale, personality characteristics, and personal resources. Multivariate analyses suggest that the three dimensions are more strongly trait- than state-linked. Use of this measure as a clinical screening tool and in intervention research is discussed.

Burnout among care staff for older adults with dementia

People working in the helping professions have been found to be vulnerable to the development of burnout and research has suggested a relationship between dementia care and burnout. Literature suggests that the development of burnout may be linked to a number of factors, including lack of reciprocity, low self-efficacy and organizational factors. The study explored burnout in staff for older people with dementia and examined the roles of reciprocity, self-efficacy and organizational factors and aimed to identify which of these variables was the greatest predictor of burnout. Sixty—one members of staff in continuing care homes for people with dementia completed self-report questionnaires. Self-efficacy was found to be the greatest predictor of burnout. Findings from the study also emphasized the connections of reciprocity, occupational commitment, demographic factors and self-efficacy with burnout. The clinical implications of the study, methodological considerations and recommendations for future research are discussed.

The role of coping humor in the physical and mental health of older adults

OBJECTIVES

This study examined the associations among coping humor, other personal/social factors and the health status of community-dwelling older adults.

METHOD

Survey questionnaires were completed with 73 community-dwelling older adults. Included were measures of coping humor, spirituality, self-efficacy, social support and physical and mental health status.

RESULTS

Correlations across all variables showed coping humor to be significantly associated with social support, self-efficacy, depression and anxiety. Forward stepwise regression analyses showed that coping humor and self-efficacy contributed to outcome variance in measures of mental health status. Contrary to expectation, neither social support nor spirituality contributed to the total outcome variance on any of the dependent measures.

CONCLUSION

The importance of social support, self-efficacy and spirituality in determining the quality of life of older adults is well supported in the literature. Coping humor as a mechanism for managing the inevitable health stresses of aging has received less attention. This study shows that coping humor and self efficacy are important factors for explaining health status in older adults. Correlations among coping humor, self efficacy and social support suggest that a sense of humor may play an important role in reinforcing self-efficacious approaches to the management of health issues.

Engagement in a cohesive group and higher-level functional capacity in older adults in Japan: A case of the Mujin

The Mujin is a traditional Japanese rotating saving and credit association (RoSCA) that provided financial aid for the lower-middle class in Japan until the postwar reconstruction period. The traditional Mujin has disappeared from most regions, and the surviving Mujin provides more of a social networking than a financial function for its members. We investigated the association between level of participation in the Mujin and the capacity for independent living in older adults. Baseline data of an ongoing cohort study of 581 self-sufficient older adults were analyzed. The Tokyo Metropolitan Institute of Gerontology Index of Competence was used to measure higher-level functional capacity, and the level of engagement in the Mujin was determined by a score derived by factor analysis. We found that a higher level of engagement in the Mujin was associated with greater functional capacity, especially social role performance, the highest-level function. We conclude that the Mujin provides a venue for community interaction that serves to increase the social capital of the community and may have psychosocial benefits for its members due to strong membership ties and mutual trust. Further investigation of the causal relationship between participation in the Mujin and functional capacity, and the psychosocial effects of similar financial mutual-aid systems in other social contexts is warranted.

Age and decline in role-specific feelings of control

OBJECTIVES

The purpose of this study was to see if feelings of control over highly valued social roles decline across late life. I also made an effort to see if two types of social support explained age-related decline in control.

METHODS

Harris Interactive of New York conducted interviews with a nationwide longitudinal sample of older adults. Survey questions assessed feelings of control over the most highly valued role, anticipated support (i.e., the belief that support will be forthcoming if needed), and enacted support.

RESULTS

The data suggested that feelings of control over the most highly valued role tend to decline across late life. The results also revealed that anticipated support is associated with a stronger sense of control over time, but I observed this relationship only through age 75. Beyond that point, anticipated support was less helpful. In contrast, enacted support did not appear to help older people maintain a strong sense of role-specific control at any age.

DISCUSSION

Current research has largely been concerned with age-related change in feelings of control over life as a whole. The findings from this study suggest that it may also be helpful to consider control over the most highly valued role while studying this process.

Explaining cross-state differences in elderly suicide rates and identifying state-level public policy responses that reduce rates

Elderly Americans commit suicide at higher rates than other age groups. We contend that macro- and micro-social variables contribute distinct aspects to explanations of this tragic loss: the former focus on circumstances that affect overall rates, the latter reveal why certain individuals succumb to suicide. Our analysis focuses on the macro-social end of a causal sequence including variables at both levels. We describe how elderly suicide rates vary among states, show that macrosocial indicators of social integration contribute to cross-state variation in elderly suicide rates, and explain how selected aspects of state-level public policy contribute to reducing elderly suicide rates.

Social capital, the miniaturisation of community, traditionalism and first time acute myocardial infarction: A prospective cohort study in southern Sweden

This longitudinal study investigates the impact of social participation, trust and the combinations of social participation and trust on the incidence of first time acute myocardial infarction (AMI) in the population of Scania, southern Sweden. It is based on the cross-sectional 2000 public-health survey in Scania with a 59% participation rate and 13,604 participants, and prospective morbidity/mortality data collected for three years (January 2000-December 2002). The study cohort was followed prospectively to examine first ever AMI. Hazard rate ratios (HRR) for first time AMI in the social participation, trust and social participation/trust combinations were calculated in a Cox regression model with adjustments for age, sex, education, economic stress, daily smoking, leisure time physical activity, body mass index (BMI), and self-reported health. The prevalence of low social participation was 32.8% among men and 31.5% among women. The prevalence of low trust was 40.0% among men and 44.2% among women. The three-year first time AMI rate was significantly higher among people with higher age, low education, daily smoking, poor self-reported health (among men), low social participation, and the combinations of low social participation/high trust and low social participation/low trust. The results show that low social participation but not trust was significantly associated with first time AMI after adjustment for age and sex. The positive association between low social participation and myocardial infarction remained significant after further adjustments for education, economic stress, daily smoking, physical activity and BMI, and became not significant only after additional adjustment for self-reported health, HRR 1.3 (0.9-2.0). High trust in combination with low social participation as well as low social capital (low trust/low social participation) were significantly associated with AMI, but after multiple adjustments only the low social participation/high trust category remained significant, HRR 1.6 (1.0-2.6).

Everyday competence and depressive symptoms: social support and sense of control as mediators or moderators?

Depression is common among the elderly members of Hong Kong Chinese society. The objectives of the present study are to assess the relationship between everyday competence and depressive symptoms and to test whether sense of control and social support mediate and moderate the impact of deterioration in everyday competence on depressive symptoms. The respondents were 393 people aged 60 years and older from a cross-sectional study of a representative community sample of the elderly population in Hong Kong and they were interviewed using a structured questionnaire. In multiple regression analyses, we found that everyday competence was significantly and negatively related to depressive symptoms (beta = -0.26, p < 0.01) after we had adjusted age, gender, marital status, years of education, self-rated health status, and number of chronic illnesses. Moreover, both sense of control and social support were mediators in the linkage between everyday competence and depression. However, neither sense of control nor social support moderated the effect of everyday competence on depression. Findings suggest that both sense of control and social support play important roles in the relationship between everyday competence and depression.

The Families In Recovery From Stroke Trial (FIRST): primary study results

OBJECTIVE

Social support and family ties are strong predictors of functional recovery after stroke; however, development of successful psychosocial intervention programs has been difficult. This study examined whether a family-systems intervention designed to influence social support and self-efficacy affects functional outcome in older stroke patients.

METHODS

Two hundred ninety-one community-residing survivors of ischemic stroke or nontraumatic cerebral hemorrhage from eight acute-care hospitals and rehabilitation centers were randomized to either psychosocial intervention (PSI) or usual care (UC). PSI involved up to 16 sessions conducted in the home by a mental health worker. Functional recovery (measured by the Barthel Index [BI] at 6 months postrandomization, inability to assess functioning because of illness or death) was the primary end point.

RESULTS

Functional recovery did not differ between UC and PSI in intention-to-treat analyses. In adjusted logistic regression, the odds of being functionally independent at 6 months was 60% higher in the intervention group, but this difference was not statistically significant (p = .31). Subgroup analyses revealed that PSI may be more effective in subjects with better psychologic and cognitive functioning and who required less inpatient rehabilitation.

CONCLUSION

This study does not provide evidence for the efficacy of psychosocial intervention to improve functional recovery in stroke. Although PSI showed greater improvement than UC, the differences were not statistically significant.

Health literacy, social support, and health: a research agenda

Amid increased concerns about the adverse consequences of low health literacy, it remains unclear how health literacy affects health status and health service utilization. Moreover, studies have shown significant variation in individual adaptation to health literacy problems. This article proposes research hypotheses to address two questions: (1) What are the causal pathways or intermediate steps that link low health literacy to poor health status and high utilization of expensive services such as hospitalization and emergency care? (2) What impact does social support have on the relationships between health literacy and health service utilization? Empirical studies of health literacy are reviewed to indicate the limitations of current literature and to highlight the importance of the proposed research agenda. In particular, we note the individualistic premise of current literature in which individuals are treated as isolated and passive actors. Thus, low health literacy is considered simply as an individual trait independent of support and resources in an individual's social environment. To remedy this, research needs to take into account social support that people can draw on when problems arise due to their health literacy limitations. Examination of the proposed agenda will make two main contributions. First, we will gain a better understanding of the causal effects of health literacy and identify missing links in the delivery of care for patients with low health literacy. Second, if social support buffers the adverse effects of low health literacy, more effective interventions can be designed to address differences in individuals' social support system in addition to individual differences in reading and comprehension. More targeted and more cost-efficient efforts could also be taken to identify and reach those who not only have low health literacy but also lack the resources and support to bridge the unmet literacy demands of their health conditions.

Age, aging, and the sense of control among older adults: a longitudinal reconsideration

OBJECTIVES

The purpose of this study was to first estimate the crude cross-sectional and longitudinal associations between age and the sense of control, and then to partition any joint variance attributable to a theoretically specified set of potential confounders.

METHODS

Sense of control was measured at baseline and at each of six bimonthly follow-up interviews among 1,662 patients at two medical centers. Potential confounders were measured at baseline. Analyses include descriptive assessments of level and normative stability, repeated measures analysis of covariance, and hierarchical multiple linear and change score regressions.

RESULTS

Although the sense of control is relatively stable between any two successive waves of data collection, significant gradual changes are observed over a 1-year period. Compelling evidence is found for statistically and substantively significant associations between age and the sense of control at baseline, and between age and changes in the sense of control over time. The only other major predictor of the sense of control is mental well-being.

DISCUSSION

Longitudinal studies with repeated assessments over prolonged observation periods are now needed to elucidate age-related trajectories in the sense of control.

Strategies used by families to simplify tasks for individuals with Alzheimer's disease and related disorders: psychometric analysis of the Task Management Strategy Index (TMSI)

PURPOSE

Little is known about the specific behavioral strategies used by families to manage the physical dependency of persons with Alzheimer's disease and related disorders (ADRD). This study reports the psychometric properties of the Task Management Strategy Index (TMSI), a measure designed to identify actions taken by caregivers to simplify everyday self-care tasks for persons with ADRD. Relationships between use of these strategies and caregiver and care-recipient characteristics were also examined.

DESIGN AND METHODS

A pool of 20 items was developed and initially tested with 202 family caregivers (Sample 1) recruited for a dementia-management intervention study. Principal axis factor analysis was performed to determine scale structure. Convergent and discriminant evidence was examined using Pearson cor-relation and multiple regression analyses with a separate sample of 255 family caregivers (Sample 2) recruited for the Philadelphia site of the National Institutes of Health multisite initiative, Resources for Enhancing Alzheimer's Caregiver Health.

RESULTS

Exploratory principal axis factoring yielded one general factor accounting for 60.2% of variance in the first sample. Nineteen items, loading at.3 or above, constituted the final scale (Cronbach's alpha =.81 in Sample 1 and.74 in Sample 2). In Sample 2, TMSI scores were significantly associated with greater functional dependency of ADRD patients, high self-efficacy, and greater use of positive coping strategies. As expected, caregiver upset with disruptive behaviors and caregiver use of criticism-based strategies were not associated with TMSI scores. Higher caregiver education was significantly associated with greater use of task strategies.

IMPLICATIONS

Results provide preliminary evidence that the TMSI is an easily administered, reliable, valid scale. Caregivers with lower education may benefit from instruction in the use of these strategies.

Social comparison in Chinese older adults

Depression is quite common among the elderly members of Hong Kong Chinese society. This study examined the role of social comparison in the relationship between depressive symptoms and four key life domains including: physical health, financial situation, relationships with adult children, and social support from friends. The respondents were 411 people aged 60 years or older from a survey of a representative community sample of the elderly population in Hong Kong. Using multiple regression models, the authors found that social comparison mediated the effect of support from friends on depressive symptoms and social comparison was the partial mediator in the linkage between financial strain and depressive symptoms. Moreover, social comparison also moderated the effect of physical health and support from friends on depressive symptoms. Lastly, we found that self-efficacy and self-esteem were moderators in the relationship between depressive symptoms and all four key life domains including physical health, financial situation, relationship with adult children, and social support from friends, whereas sense of control over physical health and sense of control over support from friends moderated the effect of social comparison on physical health and support from friends, respectively, on depressive symptoms.

A randomized, controlled trial of a home environmental intervention: effect on efficacy and upset in caregivers and on daily function of persons with dementia

PURPOSE OF STUDY

The authors determined short-term effects of a home environmental intervention on self-efficacy and upset in caregivers and daily function of dementia patients. They also determined if treatment effect varied by caregiver gender, race, and relationship to patient.

DESIGN AND METHODS

Families (N = 171) of dementia patients were randomized to intervention or usual care control group. The intervention involved 5 90-min home visits by occupational therapists who provided education and physical and social environmental modifications.

RESULTS

Compared with controls, intervention caregivers reported fewer declines in patients' instrumental activities of daily living (p = .030) and less decline in self-care and fewer behavior problems in patients at 3 months post-test. Also, intervention spouses reported reduced upset (p = .049), women reported enhanced self-efficacy in managing behaviors (p = .038), and women (p = .049) and minorities (p = .037) reported enhanced self-efficacy in managing functional dependency.

IMPLICATIONS

The environmental program appears to have a modest effect on dementia patients' IADL dependence. Also, among certain subgroups of caregivers the program improves self-efficacy and reduces upset in specific areas of caregiving.

Financial strain and depressive symptoms in Hong Kong elderly Chinese: the moderating or mediating effect of sense of control

For many Hong Kong Chinese elderly, depression and financial strain are quite a common occurrence. This study examines the mediating and moderating effect of sense of control in the relationship between financial strain and depressive symptoms. The data came from a survey of a representative community sample of 411 elderly respondents in Hong Kong. Using multiple regression models, the authors found that generalized sense of control mediated and moderated the linkage between financial strain and depressive symptoms even after controlling socio-demographic variables but sense of control over finances did not. Findings suggest that generalized sense of control should be enhanced to protect older people under chronic financial strain from depression.

Continence efficacy intervention program for community residing women with stress urinary incontinence in Japan

Many women in Japan have lived with urinary incontinence (UI). These women are not willing to visit the hospital with their problem of incontinence. Even if the women consent to a hospital visit, continence education is often very limited and patients may immediately stop looking for further treatment. Programs of effective education are needed. The Continence Efficacy Intervention Program (CEIP) was developed for patients and was designed to circumvent many of the obstacles common to stopping exercise. In this study, a randomized trial was conducted to compare the effectiveness of this program to conventional intervention on exercise continuity. This report describes the study design, intervention program, and outcomes. Subjects were 48 women with stress urinary incontinence (SUI): the mean age was 53.5, the mean weight was 56.6 kg, and the average prevalent year was 6.5 years. The CEIP phone interviews improved exercise continuity and urine loss symptom. Findings suggest that this intervention program is effective and readily available to the community-residing women with SUI.

From social integration to health: Durkheim in the new millennium

It is widely recognized that social relationships and affiliation have powerful effects on physical and mental health. When investigators write about the impact of social relationships on health, many terms are used loosely and interchangeably including social networks, social ties and social integration. The aim of this paper is to clarify these terms using a single framework. We discuss: (1) theoretical orientations from diverse disciplines which we believe are fundamental to advancing research in this area; (2) a set of definitions accompanied by major assessment tools; and (3) an overarching model which integrates multilevel phenomena. Theoretical orientations that we draw upon were developed by Durkheim whose work on social integration and suicide are seminal and John Bowlby, a psychiatrist who developed attachment theory in relation to child development and contemporary social network theorists. We present a conceptual model of how social networks impact health. We envision a cascading causal process beginning with the macro-social to psychobiological processes that are dynamically linked together to form the processes by which social integration effects health. We start by embedding social networks in a larger social and cultural context in which upstream forces are seen to condition network structure. Serious consideration of the larger macro-social context in which networks form and are sustained has been lacking in all but a small number of studies and is almost completely absent in studies of social network influences on health. We then move downstream to understand the influences network structure and function have on social and interpersonal behavior. We argue that networks operate at the behavioral level through four primary pathways: (1) provision of social support; (2) social influence; (3) on social engagement and attachment; and (4) access to resources and material goods.

Control and Efficacy as Interdisciplinary Bridges

Control and efficacy are ideally suited as “bridges” or linking constructs for social scientists working at different levels of analysis. Control and efficacy depend on the fit between individuals and the social systems in which they are embedded, and control and efficacy have measurable effects on neurotransmitter levels and endocrine responses. This article presents an interdisciplinary perspective on control and efficacy. The authors survey the history of control-related constructs in psychology, from their roots in animal learning to the present cognitive focus on beliefs about control. They then point out connections “up” to the sociological level and “down” to the physiological level. They propose a taxonomy of 6 useful constructs organized into 3 perspectives: motivational, cognitive, and systemic. Such a multilevel, multidisciplinary approach may be particularly useful for approaching large real-world problems such as improving schools or neighborhoods.