Change in psychological control in visually impaired older adults over 2 years: role of functional ability and depressed mood

Engagement with six major life domains during the transition to retirement: Stability and change for better or worse

Active engagement with multiple life domains (cross-domain engagement) is associated with adaptation throughout the adult life span. However, less is known about the role of cross-domain engagement during significant life course transitions that can challenge motivational resources, such as the shift to retirement. Based on the motivational theory of life span development (Heckhausen, Wrosch, & Schulz, 2010, 2019), the present study used 9-year data from the national Midlife in the United States Study (MIDUS; n = 1,301, M age = 57, SD = 6.96, 56% female) to identify profiles of cross-domain engagement and to assess stability and change in these profiles during the transition to retirement. We also examined whether stability and change in the engagement profiles had implications for psychological adjustment. Results of latent profile analyses showed that three profiles of cross-domain engagement emerged both before and after retirement (high engagement, low work engagement, moderate engagement). Latent transition analyses indicated that most participants remained in their preretirement profiles at postretirement, with the majority classified in a profile defined by stable high engagement with multiple life domains. Results of ANCOVAs showed this stable high engagement profile was associated with the most adaptive 9-year changes in cross-domain perceived control, cross-domain situation quality, and cross-dimension eudaimonic well-being. Findings advance the literature by showing that cross-domain profiles of engagement can be identified and that stability and change in these profiles have consequences for longitudinal psychological adjustment in retirement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Detrimental Consequences of Overestimating Future Health in Late Life

OBJECTIVES

Although forecasting a positive future can be adaptive, it may not be when expectations are unmet. Our study examined whether such inaccurate expectations about future health status (overestimation) were maladaptive for older adults who commonly experience late life declines in physical functioning.

METHOD

We analyzed data from the nationally representative German Aging Survey (DEAS; 1996-2011; n = 2,539; age range 60-85 years) using multilevel growth models that assessed the influence of inaccurate health expectations on older adults' physical functioning over a 9-year period.

RESULTS

Overestimating future health status predicted reduced day-to-day physical functioning when age, gender, and self-rated health were controlled. A Time × Overestimation interaction indicated that the negative effects of overestimation on physical functioning became more pronounced over the 9-year period.

DISCUSSION

Results suggest that repeatedly unmet health expectations may undermine motivational resources and accelerate late life declines in physical functioning.

Conditions for pets to prevent depression in older adults

OBJECTIVE

The study aims to determine if and how pet availability and engagement predicted depression in older adults. The prediction can be unconditional or independent of the sociodemographic characteristics of the older adult and/or conditional or dependent on the characteristics. These predictions rest on the contribution of resources pooled from older adults, their spouses, and pets, according to ecological theory.

METHOD

The present study analyzed the effects of pet availability and engagement based on a survey of 340 older adults in Hong Kong, China.

RESULTS

Pet engagement but not pet availability manifested a significant negative effect on depression unconditionally. In addition, pet availability and engagement indicated some significant negative effects conditionally, including living with the spouse as a condition.

CONCLUSION

For preventing depression in older adults, promoting their pet availability and engagement is promising. Particularly, the promotion would be more effective for older adults living with their spouses and being more resourceful than for others.

What Do We Need at the End of Life? Competence, but not Autonomy, Predicts Intraindividual Fluctuations in Subjective Well-Being in Very Old Age

Objectives

Self-determination theory (SDT) suggests that fulfillment of the universal psychological needs for autonomy, competence, and relatedness is essential for well-being of all humans. However, it is not clear whether this prediction also holds in advanced old age. The present study aims to test SDT for the two less researched needs in advanced old age: the needs for competence and autonomy.

Method

A total of 111 very old adults (age range at first measurement occasion 87-97 years) were assessed up to 6 times over the course of about 4 years.

Results

Competence, but not autonomy, predicted subjective well-being at the within-person level of analysis. At the between-person level, only negative affect was predicted by autonomy and competence, whereas positive affect and life satisfaction were predicted by competence only.

Discussion

Results challenge the life-span universality of the needs for competence and autonomy postulated by SDT in very old adults and suggest that the high vulnerability in this life phase may change the importance of these needs for well-being.

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

OBJECTIVES

To review systematically the evidence of age-related macular degeneration (AMD) affecting real-world visual ability and quality of life (QoL). To explore trends in specific topics within this body of the literature.

DESIGN

Systematic review.

METHODS

A systematic literature search was carried out using MEDLINE, EMBASE, CINAHL, PsycINFO, PsychARTICLES and Health and Psychosocial Instruments for articles published up to January 2015 for studies including people diagnosed with AMD, assessing real-world visual ability or QoL as an outcome. Two researchers screened studies for eligibility. Details of eligible studies including study design, characteristics of study population and outcomes measured were recorded in a data extraction table. All included studies underwent quality appraisal using the Mixed Methods Appraisal Tool 2011 Version (MMAT).

RESULTS

From 5284 studies, 123 were eligible for inclusion. A range of approaches were identified, including performance-based methods, quantitative and qualitative patient-reported outcome measures (PROMs). AMD negatively affects tasks including mobility, face recognition, perception of scenes, computer use, meal preparation, shopping, cleaning, watching TV, reading, driving and, in some cases, self-care. There is evidence for higher rates of depression among people with AMD than among community dwelling elderly. A number of adaptation strategies have been associated with AMD of varying duration. Much of the research fails to report the type of AMD studied (59% of included studies) or the duration of disease in participants (74%). Of those that do report type studied, the breakdown is as follows: wet AMD 20%, dry AMD 4% and both types 17%.

CONCLUSIONS

There are many publications highlighting the negative effects of AMD in various domains of life. Future research should focus on delivering some of this research knowledge into patient management and clinical trials and differentiating between the types of AMD.

Anxiety and depression in patients with advanced macular degeneration: current perspectives

Age-related macular degeneration (AMD) - despite advances in prevention and medical treatment options - remains prevalent among older adults, often resulting in functional losses that negatively affect the mental health of older adults. In particular, the prevalence of both anxiety and depression in patients with AMD is high. Along with medical treatment options, low vision rehabilitation and AMD-specific behavioral and self-management programs have been developed and have demonstrated effectiveness in improving the mental health of AMD patients. This article reviews the prevalence of anxiety and depression in patients with advanced AMD, discusses potential mechanisms accounting for the development of depression and anxiety in AMD patients, presents the state-of the-art of available interventions for addressing anxiety and depression in AMD patients, and delineates recommendations for eye care professionals regarding how to screen for these two prevalent mental health problems and how to facilitate appropriate treatment for patients with AMD.

Motivation-focused thinking: Buffering against stress-related physical symptoms and depressive symptomology

Developmental transitions are experienced throughout the life course and necessitate adapting to consequential and unpredictable changes that can undermine health. Our six-month study (n = 239) explored whether selective secondary control striving (motivation-focused thinking) protects against the elevated levels of stress and depressive symptoms increasingly common to young adults navigating the challenging school-to-university transition. Path analyses supplemented with tests of moderated mediation revealed that, for young adults who face challenging obstacles to goal attainment, selective secondary control indirectly reduced long-term stress-related physical and depressive symptoms through selective primary control and previously unexamined measures of discrete emotions. Results advance the existing literature by demonstrating that (a) selective secondary control has health benefits for vulnerable young adults and (b) these benefits are largely a consequence of the process variables proposed in Heckhausen et al.'s (2010) theory.

Critical success factors in awareness of and choice towards low vision rehabilitation

PURPOSE

The goal of the current study was to examine the critical factors indicative of an individual's choice to access low vision rehabilitation services.

METHODS

Seven hundred and forty-nine visually impaired individuals, from the Montreal Barriers Study, completed a structured interview and questionnaires (on visual function, coping, depression, satisfaction with life). Seventy-five factors from the interview and questionnaires were entered into a data-driven Classification and Regression Tree Analysis in order to determine the best predictors of awareness group: positive personal choice (I knew and I went), negative personal choice (I knew and did not go), and lack of information (Nobody told me, and I did not know).

RESULTS

Having a response of moderate to no difficulty on item 6 (reading signs) of the Visual Function Index 14 (VF-14) indicated that the person had made a positive personal choice to seek rehabilitation, whereas reporting a great deal of difficulty on this item was associated with a lack of information on low vision rehabilitation. In addition to this factor, symptom duration of under nine years, moderate difficulty or less on item 5 (seeing steps or curbs) of the VF-14, and an indication of little difficulty or less on item 3 (reading large print) of the VF-14 further identified those who were more likely to have made a positive personal choice. Individuals in the lack of information group also reported greater difficulty on items 3 and 5 of the VF-14 and were more likely to be male.

CONCLUSIONS

The duration-of-symptoms factor suggests that, even in the positive choice group, it may be best to offer rehabilitation services early. Being male and responding moderate difficulty or greater to the VF-14 questions about far, medium-distance and near situations involving vision was associated with individuals that lack information. Consequently, these individuals may need additional education about the benefits of low vision services in order to make a positive personal choice.

Conflicted goal engagement: undermining physical activity and health in late life

OBJECTIVES

Pursuing health goals in very old age is a challenging task that may be undermined by conflicted goal engagement involving mismatched primary (behavior-focused) and secondary (motivation-focused) control striving. Our study explored whether one potentially detrimental combination of control strategies (low primary control/high secondary control) compromised 3-year indicators of everyday physical activity and blood oxygen saturation.

METHOD

We analyzed data from a representative sample of very old adults (n = 107) using simple slope regression analyses that tested the conditional effects of control striving on everyday physical activity and blood oxygen saturation.

RESULTS

We found a conflicted engagement effect wherein primary control predicted our outcomes only when secondary control was high. The lowest levels of everyday physical activity and blood oxygen saturation were found for older adults high in secondary control but low in primary control. A supplemental mediation analysis suggested everyday physical activity was the mechanism through which conflicted engagement undermined blood oxygen saturation.

DISCUSSION

Employing health maintenance strategies that promote motivation-focused thinking but discourage goal-directed behaviors (conflicted engagement) may compromise physical activity and health among very old adults. Further research is needed to determine whether control-enhancing interventions promote harmonious goal engagement and better health among these high-risk individuals.

The psychological challenge of late-life vision impairment: concepts, findings, and practical implications

The intention is to summarize the body of evidence speaking to the psychological challenges faced by visually impaired older adults, as well as their coping efforts. This evidence is substantiated by a rich set of concepts, theories, and empirical findings that have accumulated under the umbrella of age-related psychoophthalmology (APO). I introduce the field of APO and continue with a discussion of important concepts and theories for a better understanding of adaptational processes in visually impaired older adults. I then summarize the most relevant and most recent data from four areas: (1) everyday competence, (2) cognitive functioning, (3) social functioning, and (4) subjective well-being-related outcomes, depression, and adaptational processes. Thereafter, major insights related to the current state-of-the art psychosocial interventions with visuallyimpaired older adults are reviewed. I close with the need that the public health community should become more aware of and address the psychosocial needs of visually impaired older adults.