Emotional well-being predicts subsequent functional independence and survival

Negative affective responsivity to daily stressors in young adults: The influence of depressive symptom severity

BACKGROUND

Evidence suggests that adults with major depressive disorder appraise daily stressor events as more severe and report stronger stressor-related negative emotions than non-depressed adults. Despite the growing number of young adults (~18-25 yrs) experiencing depressive symptoms in the absence of a formal clinical diagnosis, limited studies have examined whether current depressive symptom severity influences affective responsivity to daily stressors in young men and women. We tested the hypotheses that greater depressive symptom severity would be related to greater negative stressor appraisal characteristics and greater affective responsivity to daily stressors but not to stressor exposure frequency. We further hypothesized that the relations between depressive symptom severity and daily stress processes would be sensitized in young females compared to males.

METHODS

Depressive symptom severity (Patient Health Questionnaire-9) and daily stress processes (8-day daily dairy) were assessed in 235 young adults (18-30 yrs.; 166 females).

RESULTS

Greater depressive symptom severity was related to greater likelihood of daily stressor exposure, intensity of feelings of anger and shame following a stressor event, and negative and positive affective responsivity to daily stressors. Self-reported biological sex moderated the association between depressive symptom severity and positive (but not negative) affective responsivity to daily stressors.

LIMITATIONS

Causality cannot be established from this daily diary study design.

CONCLUSIONS

These data demonstrate that daily stressors are more pervasively reported and worsen negative affect to a greater extent in young adults currently experiencing more severe symptoms of depression, which may contribute to an increased risk of developing future chronic disease.

Greater negative affective responsivity to daily stressors is positively related to urinary norepinephrine excretion in middle-aged adults

Despite mounting evidence that greater affective responsivity to naturally occurring daily stressors is associated with increased risk of cardiovascular diseases (CVDs), few studies have examined dysregulation of the sympathetic nervous system as a potential mechanism. We hypothesized that greater affective responsivity to daily stressful events would be related to increased urinary catecholamine excretion. Daily stress processes (8-day daily diary) were assessed in 715 middle-aged adults (56 ± 11 yr; 57% female) from the Midlife in the United States Study. Urinary norepinephrine and epinephrine concentrations were also measured (24 h; normalized to creatinine). Multilevel modeling was used to calculate negative and positive affective responsivity (i.e., the slope of the within-person differences in negative and positive affect on stressor days compared with stressor-free days). Analyses controlled for relevant covariates (e.g., sex, age, affect on stressor-free days, etc.). On stressor days, negative affect increased (0.1 ± 0.2 stressor-free days vs. 0.3 ± 0.4 au stressor days; P < 0.0001) and positive affect decreased (2.8 ± 0.7 stressor-free days vs. 2.6 ± 0.8 au stressor days; P < 0.0001). Greater negative affectivity responsivity to daily stressors was related to increased urinary norepinephrine (B = 0.42, SE = 0.14, P = 0.003), but not epinephrine (P = 0.142), excretion. Positive affective responsivity to daily stressors was not related to either urinary norepinephrine (B = -0.33, SE = 0.29, P = 0.24) or epinephrine (P = 0.626) excretion. Heightened negative affective responsivity to daily stressors was associated with greater urinary norepinephrine excretion, suggesting that sympathetic overactivation may contribute to the link between emotional vulnerability to daily stressors and increased CVD risk.NEW & NOTEWORTHY Few studies have examined sympathetic dysregulation as a potential mechanism linking affective responsivity to daily stressors to future cardiovascular diseases. Using a large national sample, our findings show that amplified negative affective responsivity to daily stressors is related to increased urinary norepinephrine excretion independent of the frequency of stressor occurrence. These data suggest that chronic sympathetic overactivation may contribute to the link between emotional vulnerability to daily stressors and increased risk of future cardiovascular comorbidities.

Positive life experiences and physical health: Associations and mediating pathways

Engagement in positive experiences in everyday life has been associated with better long-term survival, but research assessing associations with other measures of long-term physical health is limited. In the current study, data collected from the Midlife in the US Study (N=1,182) in 2004-2017 were used to examine whether frequency of engagement in a range of positive experiences is associated with three domains of health (subjective, functional, and morbidity) over an average seven-year follow-up period. Potential cognitive-affective and physiological mediators of these associations were assessed. Greater positive experience frequency was associated with better self-rated health (SRH), less difficulty in performing basic activities of daily living (BADLs), and lower comorbidity (count of dichotomous indicators assessing history of lung-related, autoimmune, blood pressure, blood glucose, and neurological disorders). Cognitive-affective factors (positive affect, depression, and perceived stress) mediated the associations with SRH and BADLs. Positive experiences may impact long-term physical health and warrant further study.

Risk Predictors and Cognitive Outcomes of the Psychosocial Functioning of North American Older Adults During the COVID-19 Pandemic

Background: The COVID-19 pandemic caused a global mental health deterioration. The disruption of older adults' psychosocial functions is particularly concerning given their social support and technology use barriers. Despite a close relationship between social engagement and cognitive function in older adults, little is known about the cognitive consequences of older adults' disrupted psychosocial functions in the context of the pandemic. Aims: This study aims to identify sociodemographic and COVID-19-related predictors for psychosocial functioning in North American older adults and to examine their associated cognitive outcomes. Methods: A sample of 95 older adults aged 60 and older (M = 68.85, SD = 6.458) completed an online study from January to July 2021, including a questionnaire on sociodemographic and COVID-19-related experiences, the Kessler-10 (K10) to assess psychological distress, Satisfaction with Life Scale (SWLS) and the UCLA Loneliness Scale Revised (UCLA) to index social function, and the Go/No-go Task (GNG) and Letter Comparison Task (LCT) as cognitive measures. Results: Higher psychosocial functioning was predicted by increased approach-based coping, being aged 65-69, 70-74, and over 75 years relative to being 60-64, and being in medium to excellent relative to poor health, while lower psychosocial functioning was predicted by increased avoidance based coping strategies and having average relative to low income. Psychosocial functioning was not seen to strongly predict cognitive functioning. However, being aged 75 years and older relative to being aged 60-64 predicted decreased accuracy on no-go trials and slower cognitive speed, and lower LCT accuracy was predicted by more avoidance-based coping and being in a religion other than Christianity or Catholicism (e.g., being spiritual). Conclusions: The results identified age, income, and health status as psychosocial function predictors among North American older adults, and increased age, religion, and use of avoidance-based coping strategies as predictors for decreased cognitive performance. The results shed light on future public health strategies to promote the psychosocial and cognitive health of older adults.

A Mixed Methods Effectiveness Study of a Peer Support Intervention for Older Adults During the COVID-19 Pandemic: Results of a Randomized Clinical Trial

OBJECTIVE

Low-income white older adults and those of color are at greater risk for depression but less likely to receive care. We evaluated the impact of a one-to-one peer support intervention compared to active control delivered by nonpeers for this population.

DESIGN

Mixed methods, single-blind randomized controlled trial.

SETTING

Community-based social service and aging organizations and geriatric primary care.

PARTICIPANTS

Low-income white older adults and those of color 50+ with depression.

INTERVENTIONS

Peer Enhanced Depression Care and nonpeer, social interaction control.

MEASUREMENTS

Primary outcome was depression (PHQ-9). Data were collected at baseline, postinterventions, 3, 6, 9, and 12 months. Poststudy interviews were conducted with both groups.

RESULTS

Among 149 randomized participants, the mean age was 70, 84% were women, 52% Black and 41% White. Both groups experienced an average decrease of 3.7 (SE: 0.55, 95% CI: [-4.77, -2.63]) points in depression from baseline to postintervention and 2.56 (SE: 0.71, 95% CI: [-3.95, -1.17]) points from baseline to 12 months. Effect sizes at postintervention (Cohen's d = 0.81) and at 12-months (Cohen's d = 0.52) indicate large and medium effects, respectively. Both groups experienced decreases in loneliness and increases in adaptive coping and self-efficacy. Qualitative findings suggest the intervention group learned coping skills and experienced behavior change, whereas control group described a general positive experience.

CONCLUSIONS

Peer support intervention was not superior to social interactions delivered by nonpeers. Divergent quantitative and qualitative results suggest the need for additional effectiveness trials of peer support interventions outside of pandemic conditions. Trial Registration ClinicalTrials.gov Identifier: NCT04319094.

Physical activity, sedentary behaviour and well-being: experiences of people with knee and hip osteoarthritis

Living with knee and hip osteoarthritis (OA) means living with pain and difficulty in movement. Given the beneficial effects of physical activity (PA) and reduction of sedentary behaviour (SB), these behaviours need to be understood in the context of individuals' daily lives and sense of well-being. Twelve individuals (age: 43-79 years; 67% female) with knee and/or hip OA purposively selected (e.g., age, OA duration, OA severity) participated in semi-structured interviews. Data was analysed using inductive thematic analysis. PA and SB were narrated as multifaceted experiences with two overarching themes, PA negotiations (valuing mobility, the burden of osteoarthritis, keep going, the feel-good factor), SB negotiations (the joy of sitting, a lot is too bad, the osteoarthritis confines), and two overlapping themes (the life context, finding a balance). Physical and psychological aspects of PA and SB experiences were interwoven. Participants valued mobility and were proactively trying to preserve it by keeping active. A constant negotiation among the OA burden, the need to enjoy life and life circumstances was underlying PA behaviour. Prescription and encouragement of a physically active lifestyle in this population should be linked to mobility-related personal values and sense of well-being, while addressing concerns around OA-safety and normalizing PA trade-offs.

Perceived stress moderates emotion regulation success in real-world contexts: an ecologically-valid multilevel investigation

BACKGROUND

Emotion regulation plays a crucial role in well-being in everyday life. Effective emotion regulation depends upon adaptively matching a given strategy to a given situation. Recent research has begun to explore these interactions in the context of daily reports of perceived stress, affect, and emotion regulation strategy usage. To further understand these differences in strategy efficacy in an ecologically valid context, we examined responses to real world stressors in a young adult sample.

METHODS

We surveyed a range of emotion regulation strategies, including two forms of cognitive reappraisal (i.e., reinterpretation, which involves cognitively reframing one's emotional responses, and psychological distancing, which involves adopting an objective, impartial perspective). Participants reported strategy usage, momentary perceived stress, and affect in response to multiple ecological momentary assessments over a period of 7 days.

RESULTS

Analyses of links between strategy usage and affect revealed that rumination was significantly negatively associated with more positive affect ratings. Further, a significant interaction between momentary perceived stress and reinterpretation usage was observed on affect, such that reinterpretation was more adaptive during situations perceived as less stressful.

CONCLUSION

These results provide further insight into the importance of situational context in determining the effectiveness of particular emotion regulation strategies.

Association between residential environment and emotional wellbeing among older adults in China: the mediating effect of health lifestyle

Introduction

The association between the residential environment and emotional wellbeing (EWB) in older adults has received extensive attention from gerontologists, especially during the COVID-19 pandemic; however, the mediating mechanism of how residential environment affects emotional wellbeing has not been fully explored. This study examined the effects of the residential environment on EWB and the mediating role of health lifestyle.

Methods

This study analyzed the survey data of 493 rural and 515 urban older adults from 2021 Chinese General Social Survey. General linear regression and structural equation models were used to examine the effects of residential environment and health lifestyle.

Results

Urban participants exhibited clear advantages in EWB, residential environment, and physical activity. Residential environment significantly affected the EWB of older adults, and health lifestyle played a mediating role in this relationship. The residential environment and health lifestyle did not significantly affect EWB in rural participants.

Discussion

This study revealed differences in the effects of health lifestyles and residential environments on EWB among older adults in rural and urban settings in China. This study provided empirical evidence of mental health disparities between older rural and urban Chinese residents.

The role of positive psychological wellbeing in walking speed differences among married and unmarried English older adults

Objectives: Walking speed has been identified as an important indicator of functional independence and survival among older adults, with marital status being related to walking speed differences. We explored explanatory factors, with a focus on positive psychological wellbeing, in walking speed differences between married and non-married individuals in later life. Methods: We used wave 8 (2016/17) cross-sectional data from adults aged 60-79 years who participated in the English Longitudinal Study of Ageing (n = 3,743). An Oaxaca-Blinder decomposition was used to compute walking speed differences between married and unmarried individuals, and the portion of those differences that could be explained by characteristic differences in those groups, particularly wellbeing. Results: Overall, married individuals had walking speeds that were 0.073 m/s (95% confidence interval: 0.055-0.092 m/s) faster than their unmarried counterparts. This was primarily driven by differences between the married and separated/divorced group, and the widowed group. Included covariates explained roughly 89% of the overall walking speed difference. Positive psychological wellbeing consistently explained a significant portion of walking speed differences, ranging between 7% to 18% across comparisons. Conclusion: Although wealth has been previously found to partially explain walking speed differences by marital status, we found that positive psychological wellbeing also demonstrated pertinence to these differences.

The impact of gardening on well-being, mental health, and quality of life: an umbrella review and meta-analysis

BACKGROUND

Gardening and horticultural therapy (HT) has been widely recognised as a multicomponent approach that has affected a broad range of health and well-being outcomes. The aim of this umbrella review and meta-analysis was to compare the findings of previous reviews on the impact of multiple gardening interventions and gardening attributes on different well-being constructs.

METHODS

Electronic databases including PubMed, Web of Science, Science Direct, the Cochrane Library, and Google Scholar were searched from inception to December 2022. Interventional and observational reviews were eligible for inclusion in this umbrella review. Outcome measures included mental well-being, health status and quality of life. The key exposure variables were gardening and horticultural therapy. Narrative synthesis was used to evaluate the overall impact of gardening and HT on study outcomes. For a subsample of studies with available quantitative data, a random effect meta-analysis was conducted.

RESULTS

This umbrella review included 40 studies (10 interventional studies, 2 observational studies, and 28 mixed interventional and observational studies). The reviewed studies reported an overall positive impact of gardening activities on several measures of mental well-being, quality of life, and health status. Meta-analysis showed a significant and positive effect of gardening and HT activities on well-being (effect size (ES) 0.55, 95% confidence interval (CI) 0.23, 0.87, p < 0.001).

CONCLUSIONS

Evidence from observational and interventional studies supports a positive role for gardening and HT activities on well-being and general health. Interventional studies with horticultural-based therapies were effective in improving well-being and quality of life both in the general population and vulnerable subgroups. The high degree of heterogeneity in the included studies cautions against any direct clinical implications of the study findings.

The combination of physical activity with fruit and vegetable intake associated with life satisfaction among middle-aged and older adults: a 16-year population-based cohort study

BACKGROUND

Life satisfaction (LS) is part of a positive psychological feeling that protects individuals from a physical decline in old age. A healthy lifestyle, including physical activity (PA) and a healthy diet, such as the intake of fruits and vegetables (F&V), can lead to a better experience of LS in older adults. However, the association between PA and F&V intake habits when occurring together in older adults is still unclear for LS. The study aimed to investigate the combined association of PA and F&V intake on LS among a cohort of older Taiwanese adults.

METHODS

Five waves of population-based data gathered by the Taiwan Longitudinal Survey on Aging between 1999 and 2015 were analyzed. The year 1999 was set as the baseline, and the number of respondents was 4,440. The independent variables included the frequency, duration, and intensity of PA and the frequency of F&V intake. LS was assessed by using the Life Satisfaction Index. We performed generalized estimating equations (GEE) analysis with adjustment for covariates of health behaviors and health indicators.

RESULTS

After adjusting for confounders, model 1 showed that moderate and high-PA levels significantly correlated with LS (odds ratio [OR] = 1.41, 95% CI = 1.12-1.79) and OR = 1.74, 95% CI = 1.50-2.02). Moreover, high-F&V intake significantly correlated with LS (OR = 2.07, 95% CI = 1.69-2.53). Regarding the combined association shown in model 2, compared with both the low PA and F&V intake group, there were significantly higher LS in the both-high-group (OR = 4.69, 95% CI = 3.49-6.31), only-high-F&V intake (OR = 2.87, 95% CI = 2.14-3.85), only-high-PA (OR = 2.48, 95% CI = 1.74-3.52).

CONCLUSIONS

Our findings show the significant combined association of PA and F&V intake on LS among older adults. In addition, older adults who engaged in higher frequency, duration, and intensity of daily PA combined more than seven times a week of F&V intake had significantly higher LS than those who only engaged in low PA or only intake less F&V. Adopting multiple healthy behaviors in daily life is a safe and effective approach to promote LS among older adults.

Representations of older people in Turkish prime-time TV series and Netflix original Turkish series: A comparative content analysis

In this study, older characters that appeared in all the episodes of the first seasons of eight most popular Turkish TV series on prime-time televisions in Turkey and those appeared in all the episodes of the first seasons of eight "original" Turkish series on Netflix were submitted to a comparative quantitative and qualitative content analysis. In this sense, the aim of this study was to reveal what kind of old age is promised to viewers by such media environments as TV and Netflix. Findings revealed that, when compared to the Turkish population, older people were significantly underrepresented in prime-time series and that, in other words, they were symbolically eliminated and exposed to age discrimination. Another finding is that older people were portrayed more fairly on Netflix than TV. Although older individuals were inadequately represented on Netflix as well, the difference between the two platforms was not statistically significant. On the other hand, while older women are significantly less represented than older men on both platforms, the study found no significant difference in gender representation between Netflix and prime-time TV. The findings also indicated that no older character, when evaluated qualitatively, was represented as the major character on either platforms and that, especially when it comes to having a profession, older people, specifically older women, were portrayed more negatively on both platforms, which means that older women faced a double jeopardy.

Happy people live longer because they are healthy people

OBJECTIVES

Higher levels of happiness are associated with longer life expectancy. Our study assessed the extent to which various factors explain the protective effect of happiness on all-cause mortality risk, and whether the association differs between older men and women.

METHODS

Using data from the Singapore Longitudinal Aging Studies (N = 6073) of community-dwelling older adults aged ≥ 55 years, we analyzed the association of baseline Likert score of happiness (1 = very sad to 5 = very happy) and mortality from mean 11.7 years of follow up. Cox regression models were used to assess the extent to which confounding risk factors attenuated the hazard ratio of association in the whole sample and sex-stratified analyses.

RESULTS

Happiness was significantly associated with lower mortality (p < .001) adjusted for age, sex and ethnicity: HR = 0.85 per integer score and HR = 0.57 for fairly-or-very happy versus fairly-or-very sad. The HR estimate (0.90 per integer score) was modestly attenuated (33.3%) in models that included socio-demographic and support, lifestyle or physical health and functioning factor, but remained statistically significant. The HR estimate (0.94 per integer score) was substantially attenuated (60%) and was insignificant in the model that included psychological health and functioning. Including all co-varying factors in the model resulted in statistically insignificant HR estimate (1.04 per integer score). Similar results were obtained for HR estimates for fairly-to-very happy versus fairly-to- very sad).

DISCUSSION

Much of the association between happiness and increased life expectancy could be explained by socio-demographic, lifestyle, health and functioning factors, and especially psychological health and functioning factors.

Change in patient-centered outcomes of psychological well-being, sleep, and suicidality following treatment with intravenous ketamine for late-life treatment-resistant depression

OBJECTIVE

To examine whether psychological well-being, sleep, and suicidality improved with treatment with intravenous (IV) ketamine for late-life treatment-resistant depression (TRD).

METHODS

This is an analysis of secondary outcomes in an open-label late-life TRD study examining the safety, tolerability, and feasibility of IV ketamine infusions. In the acute phase, participants (N = 25) aged 60 years or older received twice-a-week IV ketamine for 4 weeks. Then, participants with Montgomery-Asberg Depression Rating Scale (MADRS) total score <10 or ≥ 30% reduction from baseline proceeded to the continuation phase, an additional four weeks of once-a-week IV ketamine. The secondary outcomes analyzed here are based on the National Institute of Health Toolbox Psychological Well-Being subscales for Positive Affect and General Life Satisfaction, the Pittsburgh Sleep Quality Index, and the Scale for Suicidal Ideation.

RESULTS

Psychological well-being, sleep, and suicidality improved during the acute phase and those improvements were sustained during the continuation phase. Greater improvements in measures of psychological well-being and sleep were seen in participants who had greater improvements in MADRS scores and moved onto the continuation phase. All but one of the few participants with high suicidality at baseline improved; there were no cases of treatment-emergent suicidality.

CONCLUSIONS

Psychological well-being, sleep, and suicidality improved in participants with late-life TRD who received IV ketamine for 8 weeks. A future larger and longer controlled trial is needed to confirm and extend these findings.

REGISTRATION

ClinicalTrials.gov identifier: NCT04504175.

Changes in Daily Occupations Patterns, Optimism, and Positive Affect During COVID-19 Lockdown

Background. The COVID-19 outbreak caused an initial 2-week lockdown throughout Israel. Purpose. To identify (1) changes in time-usage patterns of daily occupations during the first COVID-19 lockdown, by gender and employment status, and (2) correlations among optimism, positive affect, and daily occupations during the lockdown. Method. In a voluntary, anonymous, retrospective, online cross-sectional survey, 481 participants completed the Life Orientation Test, Positive Affect Questionnaire, and Occupational Questionnaire. Findings. During lockdown, participants spent more time in recreation, rest, and sleep regardless of their employment status, and more women than men lost their employment. Both before and during lockdown, women spent significantly higher percentage of time performing everyday tasks but reported less rest and sleep than men. Recreation was associated with positive affect. Conclusion. The COVID-19 pandemic created a temporary occupational disruption. Although people devoted their time differently, the lockdown forced people to find ways to continue engaging in their occupations.

Friendly Residential Environments and Subjective Well-Being in Older People with and without Help Needs

Previous studies have shown that friendly environments are associated with well-being and higher quality of life in older people. This study aimed to investigate the relationship between friendly environments and subjective well-being by segmenting the population according to the need for help in performing activities of daily living (ADLs) in a representative sample of people over 55 years of age in the Basque Country (Spain) (n = 2760). To determine the predictive power of friendliness on subjective well-being, two separate linear regression models were obtained according to the need for help in ADLs. The results obtained show a greater explanatory power of the model in the case of people who required help. However, in the case of people who do not need help, subjective health had a greater weight in the predictions. This paper's findings support the greater importance of the characteristics of the physical and social environment, as people's functional status worsens, with friendliness being an explanatory factor for people's well-being as they age and their dependency increases.

Firefighter Well-Being Defined and Operationalized at the Organizational and Worker Level: A Qualitative Study

OBJECTIVE

The aim of the study is to define and explore organizational- and worker-level factors of firefighter well-being.

METHODS

Qualitative data were collected using interviews and focus group sessions among 17 career firefighters across 4 fire departments. Interviews were recorded and transcribed, and a general inductive approach was used to code similar concepts into themes.

RESULTS

Firefighters defined well-being as being content with oneself and being able to balance ones' emotional, mental, and physical health. Themes contributing to firefighter well-being include the nature of the job, the influence of others, and physical health. Subthemes mapping to themes include dealing with trauma, compartmentalizing work and home life, coworkers and station culture, the role of superiors on attitudes and practices, being a reliable firefighter, and lack of sleep.

CONCLUSIONS

Career firefighters describe well-being as a holistic approach to balancing emotional, mental, and physical health.

Two Routes to Status, One Route to Health: Trait Dominance and Prestige Differentially Associate with Self-reported Stress and Health in Two US University Populations

Objective

Social status has been extensively linked to stress and health outcomes. However, two routes by which status can be earned - dominance and prestige - may not uniformly relate to lower stress and better health because of inherent behavioral and stress-exposure differences in these two routes.

Methods

In one exploratory and two preregistered studies, participants (total N = 978) self-reported their trait dominance and prestige and self-reported several stress and health outcomes.

Results

The meta-effects evident across the three studies indicate that higher trait dominance was associated with worse outcomes - higher stress, poorer physical and mental health, poorer behavioral health, poorer life satisfaction, higher negative affect (range of absolute values of non-zero correlations, |r| = [0.074, 0.315], ps < 0.021) - and higher trait prestige was associated with better outcomes - lower stress, better physical and mental health, better behavioral health, better life satisfaction, higher positive and lower negative mood (|r| = [0.134, 0.478], ps < 0.001). These effects remained evident (with few exceptions) after controlling for socioeconomic status, other status-relevant traits, or self-enhancing motives; associations with behavior relevant to the COVID19 pandemic generally were not robust.

Conclusions

This work indicates that evolved traits related to the preferred route by which status is earned likely impact self-reported stress and health outcomes. Future research is necessary to examine physiological and other objective indicators of stress and health in more diverse populations.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40750-022-00199-3.

Cognitive, psychological and social factors associated with older adults' mobility: a scoping review of self-report and performance-based measures

Although many factors have been associated with mobility among older adults, there is paucity of research that explores the complexity of factors that influence mobility. This review aims to synthesise the available evidence for factors comprising the cognitive, psychological, and social mobility determinants and their associations with mobility self-reported and performance-based outcomes in older adults (60 years). We followed Arksey and O'Malley's five stages of a scoping review and searched PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and Sociological Abstract databases. Reviewers in pairs independently conducted title, abstract, full-text screening and data extraction. We reported associations by analyses rather than articles because articles reported multiple associations for factors and several mobility outcomes. Associations were categorised as significantly positive, negative, or not significant. We included 183 peer-reviewed articles published in 27 countries, most of which were cross-sectional studies and conducted among community-dwelling older adults. The 183 articles reported 630 analyses, of which 381 (60.5%) were significantly associated with mobility outcomes in the expected direction. For example, older adults with higher cognitive functioning such as better executive functioning had better mobility outcomes (e.g., faster gait speed), and those with poor psychological outcomes, such as depressive symptoms, or social outcomes such as reduced social network, had poorer mobility outcomes (e.g., slower gait speed) compared to their counterparts. Studies exploring the association between cognitive factors, personality (a psychological factor) and self-reported mobility outcomes (e.g., walking for transportation or driving), and social factors and performance-based mobility outcomes in older adults are limited. Understanding the additive relationships between cognitive, psychological, and social factors highlights the complexity of older adults' mobility across different forms of mobility, including independence, use of assistive devices, transportation, and driving.

Antimicrobial Dressing versus Standard Dressing in Obese Women Undergoing Cesarean Delivery: A Randomized Controlled Trial

OBJECTIVE

This study aimed to evaluate the effect of a novel antimicrobial dressing on patient satisfaction and health-related quality of life (HRQoL) following a cesarean delivery.

STUDY DESIGN

This was an open-label, single-center, two-arm randomized controlled trial. This study was done at the tertiary center, maternal unit, Galveston, TX. Pregnant women with body mass indices ≥35 kg/m2 were screened for eligibility. Women were randomized to ReliaTect Post-Op Dressing (RELIATECT) or standard wound dressing (STANDARD). Primary outcome was patient satisfaction and HRQoL using validated questionnaires. Secondary outcomes were provider satisfaction, surgical site infection (SSI) rates, and wound complications.

RESULTS

In total, 160 women were randomized. Population characteristics were not significant among groups. RELIATECT dressing group had an overall higher score of satisfaction and HRQoL compared with STANDARD group. Women in the RELIATECT group reported less incision odor and incisional pain. Compared with the STANDARD group, most women in RELIATECT dressing group reported better daily activities, self-esteem, personal hygiene, body image, and sleep. Providers reported that the RELIATECT dressing allowed better assessment of the surgical incision site, allowed patients to shower early, and did observe less wound dressing leakage. No differences were found in other secondary end points.

CONCLUSION

Postcesarean RELIATECT dressing for wound care in pregnant women with obesity had better patient and provider satisfaction as well as better HRQoL scores. Further, level 1 evidence is needed to assess its impact on SSI rates and wound complication, as this trial was not powered to accomplish this goal.

KEY POINTS

· This study was conducted to evaluate RELIATECT on patient satisfaction and HRQoL following a cesarean.. · Post-cesarean RELIATECT dressing for wound care had better HRQoL and patient and provider satisfaction scores.. · This is the first randomized controlled trial evaluating RELIATECT dressing in obese pregnant women undergoing cesarean section..

Factors Affecting Workplace Well-Being: Building Construction Projects

This study explores the factors affecting workplace well-being in building construction projects. The objectives of this study are (1) to investigate the critical factors for workplace well-being in building construction projects, (2) to compare the critical factors between large enterprises (LEs) and small-medium enterprises (SMEs), and (3) to compare the critical factors between high-rise building construction projects and non-high-rise building construction projects. Data from 21 semi-structured interviews with construction industry professionals in Malaysia and a systematic literature review were used to develop a potential list of factors. Then, the factors were used to create a survey that was distributed to industry professionals. Data from 205 valid responses were analyzed using mean score ranking, normalization, the Kruskal–Wallis test, and overlap analysis. Fourteen critical factors were determined, including salary package, working hours, project progress, planning of the project, workers’ welfare, relationship between top management and employees, timeline of salary payment, working environment, employee work monitoring, communication between workers, insurance for construction worker, general safety and health monitoring, collaboration between top management and employee, and project leadership. This study contributes to the body of knowledge by identifying the critical factors for improving workplace well-being. The study findings allow researchers and practitioners to develop strategies to promote workplace well-being in building construction projects.

Association between Happiness and Economic Status among Older Adults in Two Myanmar Regions

Few studies have examined whether objective or subjective economic status (ES) has a greater association with the happiness of older adults, despite concerns regarding the growing economic cost of morbidity and their functional dependence in developing countries with aging populations. Thus, this study examined whether objective/subjective ES was associated with happiness in older adults in two Myanmar regions. A multistage random sampling procedure and face-to-face interviews were conducted in the urban and rural areas of Myanmar. The happiness of 1200 participants aged >60 years was evaluated using a single happiness score ranging from 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective ES, was calculated from 17 household asset items, such as radio, washing machines, and television. Subjective ES was assessed by asking “Which of the following best describes your current financial situation in light of general economic conditions?” Responses ranged from “very difficult” to “very comfortable”. Both low objective and subjective ES were negatively associated with happiness, after adjusting for confounding variables and stratification by region (urban and rural areas). Although objective and subjective ES had similar associations with happiness in urban areas, subjective ES had a stronger association in rural areas.

Auditing the ‘Social’ of Quantum Technologies: A Scoping Review

Various phrases such as “social implications”, social impact” and “ethical, legal and social implications” are used to indicate the impact of a given scientific or technological advancements on the ‘social’. The impact on the ‘social’ is one focus of science and technology governance discussions. Many terms and phrases can be used to audit the engagement of a given technology (such as quantum technologies) with the ‘social’. Marginalized groups are particularly impacted by the ‘social’. Equity, Diversity, and, Inclusion (EDI) and similar phrases are part of discussing the ‘social’. EDI frameworks and phrases are employed as policy concepts to decrease the research, education, and general workplace problems members of marginalized groups such as women, Indigenous peoples, visible/racialized minorities, disabled people, and LGBTQ2S+ encounter at universities and other workplaces. How quantum technologies-focused discussions engage with the ‘social’ can impact EDI activities, and quantum technologies-focused discussions can be impacted in turn by EDI activities. The objective of this study was to map the engagement with the ‘social’ in the quantum technologies-focused academic literature. A scoping review coupled with a manifest coding approach was used to answer three research questions: (1) Which terms, phrases, and measures that can be seen to cover aspects of the ‘social’ are present in the quantum technologies-focused academic literature? (2) To what extent are EDI frameworks and phrases present in the quantum technologies-focused academic literature? (3) Which marginalized groups visible in EDI discourses are covered in the quantum technologies-focused academic literature? Using the academic databases SCOPUS, EBSCO-HOST, Web of Science, Compendex, Inspec Archive, and Knovel, 362,728 English language abstracts were obtained for the manifest coding using 62 Quantum-related technical phrases and 1062 English language abstracts were obtained using 17 non-technical Quantum-related phrases. Within the 362,728 abstracts of the 200 terms and phrases (which did not have to contain the term “social”) used to answer the research questions, 87 were not mentioned in any abstracts, 47 were mentioned in less than 10, 30 were mentioned in between 10 and 100, and 29 were mentioned in over 100 abstracts. Within the 1062 abstracts, 164 terms and phrases were not mentioned at all, 19 were mentioned in over 10, 8 were mentioned in between 10 and 100 (all false positive), and one was mentioned in over 100 abstracts (false positive). The term “social” or phrases containing “social” appeared in only 867 of the 362,728 abstracts and only 10 of the 1062 abstracts. EDI frameworks and phrases were not present in the 362,728 abstracts and 1062 abstracts, and many marginalized groups engaged with in EDI discussions were not present in the 362,728 and 1062 abstracts either. The results reveal vast opportunities to engage with the ‘social’ of quantum technologies in many different ways, including through EDI frameworks and concepts and by engaging with marginalized groups covered under EDI.

COVID-19 pandemic stresses and relationships in college students

OBJECTIVE

The goal of this study was to understand how intergenerational intimacy and individuation associate with COVID-19 pandemic-related stresses and changes to relationship qualities, and consequentially, with substance use indicators, happiness, and life satisfaction.

BACKGROUND

Intergenerational family systems theory suggests that dysfunctional relationship patterns in one's family of origin contribute to greater stress, and consequentially, to poorer health outcomes. We examined how these patterns emerge for young adults during a pandemic.

METHOD

A sample (N = 501) of young adults at a large university in Texas completed an online questionnaire about health and happiness.

RESULTS

More intergenerational intimacy was associated with more positive COVID-19 pandemic-related changes in relationship quality with family and friends, and with more happiness and life satisfaction. More intergenerational individuation was associated with less COVID-19 pandemic-related stress, fewer coping motives for alcohol use, and with more happiness and life satisfaction. Less COVID-19 pandemic-related stress and more positive COVID-19 pandemic-related changes in relationship qualities with family and friends were associated with more positive outcomes.

CONCLUSION

More positive intergenerational relationships are associated with more positive outcomes in regards to COVID-19 pandemic-related stress and relationship changes.

IMPLICATIONS

Promoting positive intergenerational relational qualities between young adults and their parents can buffer against pandemic-related consequences in health and happiness. Family health practitioners should promote these intergenerational qualities in families, which in turn should increase positive psychosocial and health outcomes in the context of a pandemic.

Quality of Life and Burden of Disease in Italian Patients with Transfusion-Dependent Beta-Thalassemia

Lifespan treatment in transfusion-dependent β-thalassemia (TDT) is expected to impact quality of life. This study aimed at evaluating health-related quality of life (HRQoL), well-being, and the burden of TDT on Italian patients. Patients (≥14 years) were invited to complete a cross-sectional, online volunteer survey. HRQoL was measured by the 36-item short-form health survey (SF-36) and wellbeing was measured by the Italian version of the Psychological General-Well-Being-Index (PGWBI). A total of 105/167 completed questionnaires were analyzed (46% males; median age 44, (IQR = 11)). Patients reported lower HRQoL compared with the general population in all SF-36 domains (except for emotional well-being (p = 0.7024) and role limitations due to emotional problems (p = 0.1389)). PGWBI domains general health and vitality and the total PGWBI score were all significantly lower (p = 0.0001) compared with the general population. On average, patients spent 16.62 h/month engaged in care activities that were additional to the time required for completing transfusions. Of the 16.62 h/month, 11.7 h/month were required for therapy management and 4.92 h/month for family management. This study found lower HRQoL and well-being in physical and psychological domains compared with the general population. Further, patients were found to have a high perceived burden of disease.

Transcendent Experiences Among Pilgrims to Lourdes: A Qualitative Investigation

Millions of pilgrims visit Lourdes each year, often seeking revitalisation rather than miraculous cures. We sought to understand the phenomenon of transcendent experiences. We spoke with 67 pilgrims including assisted pilgrims, young volunteers and medical staff. About two in five reported a transcendent experience: some felt they had communicated or had close contact with a divine presence, while others reported a powerful experience of something intangible and otherworldly. Transcendent experiences are an important feature of pilgrimage to Lourdes and the place offers the faithful a means of connecting with the divine, with nature and with the self.

Navigating the Pathway to Care in Adults With Cerebral Palsy

As individuals with cerebral palsy (CP) age, they face unique challenges which complicate their ability to access and receive appropriate health care. These problems exist at the level of the health care system, the clinician, and the individual. At the system level, there is an inadequate number of professionals who are informed of and interested in the care of adults with CP. Pediatric clinicians prefer treating children, and adult caregivers are not knowledgeable about and may feel less competent about CP. Pediatric care does not translate well to the adult population, and information about best practices for adults is just starting to develop. Differences in the physiologic development of individuals with CP render well-established clinical protocols for risk screening of chronic diseases less effective. Moreover, lack of supportive resources decreases a caregiver's sense of self-efficacy in treating this population. The patient's ability to navigate these barriers is complicated by the high prevalence of comorbid cognitive impairment and mental health issues including anxiety, depression, and other psychiatric disorders; a bidirectional relationship between challenges in navigating care/needs and comorbid mental health conditions appears likely. Many patients have additional barriers related to social determinants of health, such as access to transportation, accessible health care facilities, and other personal and environmental factors that may impede health maintenance and wellness. Increasing and disseminating knowledge, harnessing the power of new technologies such as telemedicine, and addressing mental health issues are some of the methods that are available to help adults with CP navigate this road.

Trait positive affect buffers the association between experimental sleep disruption and inflammation

BACKGROUND

Sleep disturbances and insufficient sleep are highly prevalent. Both clinical sleep disorders and multiple forms of experimental sleep loss predict heightened inflammation. As such, it is necessary to investigate potential protective factors. Given that trait positive affect (PA) is associated with reduced inflammation, and buffers the proinflammatory effects of stress, it is possible that high trait positive affect might protect individuals from an inflammatory response to sleep disruption. The present study tested this hypothesis in an experimental sleep disruption paradigm with assessment of cellular inflammation.

METHODS

Data were drawn from good sleeping adults (n = 79) who participated in a randomized, within-subjects crossover experiment comparing the effects of two nights of sleep disruption versus two nights of uninterrupted sleep. Stimulated monocytic production of intracellular proinflammatory cytokines tumor necrosis factor (TNF) and interleukin-6 (IL-6) were assayed using flow cytometric methods and indexed as the percentage of monocytes expressing TNF, IL-6, or co-expressing both. Hypotheses were evaluated using linear mixed effects models.

RESULTS

Controlling for negative affect, body mass index, age, and sex, PA significantly moderated the associations between sleep condition and stimulated monocyte production of IL-6 (b = -1.03, t = -2.02, p = .048) and its co-expression with TNF (b = -0.93, t = -2.00, p = .049), such that inflammatory responses were blunted among those high in PA with increases principally among those low in PA. The effect on TNF was similar in terms of effect size, but marginally significant.

CONCLUSIONS

Activation of cellular inflammation in response to sleep disruption is buffered by PA independent of negative affect. Interventions that promote PA might protect persons from the inflammatory activation following sleep loss, with the potential to mitigate the adverse health consequences of sleep disturbance.

Subjective Well-Being, Depression, and Delays in Care Among Older Adults: Dual-Eligible Versus Medicare-Only Beneficiaries

We aimed to (a) determine the role of subjective well-being and depression in care delays among Medicare beneficiaries and (b) examine whether subjective well-being and depression play a differential role among Medicare-only and dual-eligible beneficiaries. A nationally representative sample of 1,696 older adults participated in the study. Roughly, 22% of participants reported often or sometimes experiencing care delays, with more delays among dual eligibles. We found that higher levels of subjective well-being were significantly related to less frequent care delays. In contrast, higher levels of depression were significantly related to more frequent care delays. Moreover, as depression increased, the predicted probability of delays increased to a greater extent among dual eligibles than Medicare-only beneficiaries. These findings signify the importance of identifying and implementing strategies to enhance subjective well-being and reduce depression in older adults, particularly dual eligibles, to improve access to timely care.

Life Satisfaction, Positive Affect, and Sleep Impairment in Masters Athletes: Modulation by Age, Sex, and Exercise Type

Introduction

The masters athlete has been proposed as a model of successful aging. Research studies investigating psychological outlook in older athletes have primarily addressed negative affects including depression, anxiety, and stress. The impact of lifelong exercise on positive affect and life satisfaction as well as sleep impairment that could impact on these psychological states is largely unknown.

Methods

A series of questionnaires (general life satisfaction, positive affect, and sleep-related impairment) were administered to 240 masters athletes participating in the World Masters Athletics Championships. Total raw scores were converted into T scores for comparison with the general population. Meaningful difference was defined by the PROMIS^® as one-half standard deviation from the centering sample.

Results

Meaningful differences were observed for improved general life satisfaction and reduced sleep impairment for all masters athletes. Positive affect did not reach the meaningful difference threshold. No significant sex differences were found for any of the questionnaires (all p > 0.05). Similarly, no significant differences were found between endurance, sprint, and strength/power sports for general life satisfaction (p = 0.18), positive affect (p = 0.46), and sleep impairment (p = 0.77). In general, life satisfaction increased with age (r = 0.15, p = 0.02), and sleep impairment trended towards reduction with age (r = −0.13, p = 0.05). Positive affect demonstrated no correlation with age (r = 0.09, p = 0.18).

Conclusion

This study demonstrates that the lifestyles of masters athletes contribute to improved general life satisfaction and reduced sleep impairment but not improved positive affect. The beneficial effects were observed irrespective of age, gender, and sporting types.

The Role of Psychological and Social Well-being on Physical Function Trajectories in Older Adults

BACKGROUND

Psychological and social well-being are emerging as major determinants in preserving health in old age. We aimed to explore the association between these factors and the rate of decline in physical function over time in older adults.

METHODS

Data were gathered from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). The study population consisted of 1,153 non-demented, community-dwelling men and women free from multimorbidity or impairments in basic or instrumental activities of daily living at baseline. They were followed over 12 years to capture the rate of decline in physical function, which was measured by combining data on walking speed, balance, and chair stands. The association between baseline psychological and social well-being and decline in physical function was estimated through linear mixed models, after multiple adjustments including personality and depressive symptoms.

RESULTS

Higher levels of psychological (β = .007; p = .037) and social (β = .008; p = .043) well-being were significantly associated with a decreased rate of decline in physical function over the follow-up. There was a significant three-way interaction between psychological well-being*time*sex (female vs male) (β = .015; p = .047), showing that a slower decline in physical function was observed only among women and not in men. The association was strongest for individuals with high levels of both psychological and social well-being (β = .012; p = .019).

CONCLUSION

High levels of psychological and social well-being may slow down the age-related decline in physical function, which confirms the complexity of older adults' health, but also points towards new preventative strategies.

Measurement Equivalence of the Subjective Well-Being Scale Among Racially/Ethnically Diverse Older Adults

OBJECTIVES

The present study examined differences by race/ethnicity in the measurement equivalence of the Subjective Well-Being Scale (SWBS) among older adults in the United States.

METHOD

Drawn from the National Health and Aging Trends Study (NHATS), adults aged 65 years and older from three racial/ethnic groups (n = 1,200) were selected for the analyses from a total of 8,245: 400 non-Hispanic Whites, 400 African Americans, and 400 Hispanics/Latinos. We tested measurement equivalence of the SWBS that is categorized into three domains: positive and negative affect (four items), self-realization (four items), and self-efficacy and resilience (three items). Multiple-group confirmatory factor analyses were conducted to test measurement invariance.

RESULTS

After adjusting for age, gender, and education, the underlying construct of the SWBS was noninvariant across three racial/ethnic elderly groups.

DISCUSSION

Findings suggest that the comparison of latent means (especially for positive and negative affect and self-realization) across racial/ethnic groups is highly questionable. The SWBS should be used with extreme caution when it is applied to diverse racial/ethnic elderly groups for comparison purposes. Implications are discussed in cultural and methodological contexts.

Effects of participatory art-based painting workshops in geriatric inpatients: results of a non-randomized open label trial

BACKGROUND

Art-based activities like painting workshops demonstrated health benefits in older individuals living in home care facilities. Few studies examined the effects of painting workshops in geriatric inpatients.

AIM

The study aims to examine whether the participation in painting workshops performed in patients admitted to a geriatric acute care ward reduced the number of medications taken daily, use of psychoactive medications, the length of stay and inhospital mortality.

METHODS

Based on a non-randomized open label trial, 79 inpatients who participated in painting workshops and 79 control inpatients were recruited in the geriatric acute care ward of the Jewish general hospital (Montreal, Quebec, Canada). Four outcomes were used: the number of medications taken daily and use of psychoactive medications the day of discharge to geriatric acute care ward, the length of hospital stay and inhospital mortality.

RESULTS

The participation in Painting workshops were associated with a lower number of medications taken daily at discharge (Coefficient of regression β =  - 1.35 with P = 0.001) and lower inhospital mortality (odd ratio (OR) = 0.09 with P = 0.031). No significant association was reported with use of psychoactive medications and length of stay.

CONCLUSION

The participation in painting workshops reduced the number of medications taken daily and incident inhospital mortality in geriatric inpatients admitted to a geriatric acute care ward, suggested a positive effect on health condition of this participatory art-based activity.

Psychometric validation of the Persian version of the Emotional Style Questionnaire

Emotions play a central role in scientific models of decision-making, human development, interpersonal processes, psychopathology, and well-being. The Emotional Style Questionnaire (ESQ) is a novel and multifaceted psychometric scale that assesses the dimensions of individual's emotional styles. The present study evaluated the validity and factor structure of the Persian ESQ. The original version of the ESQ was translated and back-translated into Persian, followed by a pilot study. A sample of university students and staff participated in a survey (n = 822) which included the ESQ, Overall Anxiety Severity and Impairment Scale (OASIS), World Health Organization Quality of Life Brief Version (WHOQOL-BREF), Difficulties in Emotion Regulation Scale (DERS), and Positive and Negative Affect Schedule (PANAS). Results showed that the Persian ESQ had very good internal consistency (Cronbach's alpha coefficient: 0.84; Composite reliability = 0.89) and adequate test-retest reliability after four weeks (intraclass coefficient, r = .71 with 95% CI [.63, .77]). The confirmatory factor analysis model fitted the data well (χ2/df = 2.86, CFI = .970, SRMR = .046, PCLOSE = .85 > .05, RMSEA = .048, 90% CI [.043, .053]). Also, measurement invariance indicated the ESQ had acceptable construct validity among different groups. As for criterion-related validity, the ESQ positively correlated with scores on the WHOQOL-BREF (r = .76) and PANAS-positive affect (r = .62), and negatively correlated with the scores on the OASIS (r = -.68), DERS (r = -.39), and PANAS-negative affect (r = -72). The findings provide evidence that the ESQ is a reliable and valid instrument for assessing healthy emotionality among Persian speaking individuals. The Persian ESQ can be used in psychological intervention and clinical research in Iran and other Persian-speaking countries.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-020-01205-1.

Using hypnoanalysis and guided imagery to identify and manage emotional aspects of multiple sclerosis

BACKGROUND

To date, no studies have used hypnosis to examine and manage the potential emotional causes of multiple sclerosis (MS) in the scientific field; therefore, we decided to compare the effectiveness of hypnoanalysis and guided imagery for determining and manage these emotional causes.

METHODS

Fifteen participants with severe MS were included and assigned into 2 groups: hypnoanalysis and guided imagery. In the hypnoanalysis group, the participants underwent 10 hypnotic sessions to understand events related to the cause of the disease, which were restructured (the events were modified by adding the psychological resources that each involved person needed); in addition, other techniques were used to investigate the causes and solutions according to the participants' unconscious. The guided imagery group received 10 group sessions of body relaxation and guided imagery, which were recorded for practice at home. Outcome measures, namely, disability (the Expanded Disability Status Scale, EDSS), quality of life (QoL, measured with the SF-36) and number of relapses, were evaluated 4 months previous the intervention, at baseline, post-intervention, and 3 months later.

RESULTS

Hypnoanalysis revealed that stressful events and psychoemotional maladaptive patterns acted as causal, detonating, or aggravating factors of disease, and psychoemotional changes were the most frequent and varied solutions. No changes were observed in disability between the two groups. The guided imagery group showed an improvement in 2 subscales of QoL when compared with the hypnoanalysis group (which disappeared at the follow-up); this difference is probably due to the increased number of sessions and probably due to psychoemotional maladaptive patterns being more frequently mentioned than difficult circumstances in life and/or unsolved past events. However, the techniques used in hypnoanalysis were effective in understanding the potential emotional causes of MS, which showed high intra- and inter-participant consistency.

CONCLUSIONS

The daily use of guided imagery overcame the restructuring of negative past events to improve QoL in patients with MS.

TRIAL REGISTRATION

ACTRN12618002024224 (retrospectively registered).

Multi-cultural perspectives on group singing among diverse older adults

Group choir singing has been shown to have health benefits for older adults. However, because most studies have included predominantly white participants, it is unknown whether findings generalize to older adults from more diverse backgrounds. This multi-site qualitative study assessed perceived benefits of group singing for socioeconomically and racially/ethnically diverse older adults. We interviewed 31 choir participants, 6 music professionals and 6 administrators involved in a large, cluster-randomized trial. We used content analysis to identify themes. Psychosocial engagement was most commonly reported, with six components: emotional well-being, self-esteem, self-confidence, social connection and support, decreased loneliness, and cultural identity and multi-cultural appreciation. A few reported cognitive and physical benefits. They also suggest that group singing among ethnically diverse older adults can have multiple psychosocial benefits and enhance a sense of cultural identity and appreciation of other cultures. These findings can help in selecting structured outcome measures for choir interventions.

Correlates of Life Satisfaction Among Middle-Aged and Older Black Adults

BACKGROUND

This study examines satisfaction across life domains (condition of the home, city of residence, daily life/leisure, family life, current financial situation, total household income, health, and life as a whole) among Black adults. The study also explores the association between satisfaction in each life domain and sociodemographic, personality, and mental/physical health measures.

METHODS

A community-dwelling sample of Black adults (n = 93, age range = 55-80) residing in the Tampa, FL area, completed a life satisfaction scale and measures of sociodemographic factors, personality, and mental/physical health between October 2014 and June 2016.

RESULTS

Better life satisfaction was observed in the oldest-old (80+) compared with the middle-aged (55-64; p < .05). Less education, less financial strain, lower depressive symptoms, and better self-rated physical health were associated with higher satisfaction although the pattern of results varied by domain.

CONCLUSIONS

Our findings suggest that the evaluation of life satisfaction domains may be a useful approach for identifying specific individual needs, which may inform age-friendly community initiatives.

Effects of "Thursdays at the Museum" at the Montreal Museum of Fine Arts on the mental and physical health of older community dwellers: the art-health randomized clinical trial protocol

Background

Recently, we demonstrated that the Montreal Museum of Fine Arts’ (MMFA) participatory art-based activity, known as “Thursdays at the Museum,” improved the well-being, quality of life, and physical health (i.e., frailty) of older community dwellers by using a pre-post intervention, single arm, prospective and longitudinal experimental design. The present randomized clinical trial (RCT), known as the Art-Health RCT (A-Health RCT), aims to compare changes in well-being, quality of life, frailty, and physiological measures in older community dwellers who participate in “Thursdays at the Museum” (intervention group) and in their counterparts who do not participate in this art-based activity (control group).

Methods/design

The current unicenter, randomized, clinical, controlled, comparative trial recruits 150 older community dwellers to two parallel arms (75 participants in the intervention group and 75 participants in the control group). The intervention is a 3-month cycle of weekly “Thursdays at the Museum,” which are structured 2-h-long art-based workshops performed in a group setting at the MMFA. The control group is composed of participants who do not take part in art-based activities, receive their usual health and/or social services, and commit to report any other activity practiced during the same time. Assessments of the primary outcome (well-being) and the secondary outcomes (quality of life, frailty, and physiological measures including heart rate, daily step count, sleep duration, and its phases) are performed on six occasions: at baseline, at the beginning of the second and third months, at the end of the third month, as well as 6 and 12 months after the last workshop. Statistical analyses are performed with the intention to treat and per protocol. Comparisons of changes in outcome measures between intervention and control groups use repeated measures tests.

Discussion

Art-based activities carried out at museums have been receiving increased interest from researchers and policy-makers because of their benefits to mental and physical health. There are few robust studies, such as RCTs, that focus on older community dwellers or assess the efficacy of these participatory museum activities. The A-Health RCT study provides an opportunity to confirm the benefits of a participatory art-based museum activity on the elderly population and to show the key role played by museums in public health promotion.

Trial registration

NCT03679715; Title: A-Health RCT: Effects of Participatory Art-Based Activity on Health of Older Community Dwellers; First posted date: September 20, 2018; prospectively registered.

Difficulties with health self-management by older adults: The role of well-being

The purpose of this study was to investigate the association between three aspects of well-being (positive and negative affect, self-realization, and self-efficacy and resilience) and disease self-management or difficulties in managing care. Logistic regression models were used to analyze data from a sample of community-dwelling Medicare beneficiaries 65-years or older who participated in the National Health and Aging Trends Study and responded to well-being and engagement in health care questions (n = 1663). All three aspects of well-being were significantly associated with reduced difficulties in care management for both the participants and their family and friends who assist them. Self-efficacy and resilience had the strongest association; older adults with higher levels of self-efficacy and resilience were more likely to handle care by self. Our findings highlight the importance of incorporating strategies to enhance well-being of older adults to reduce the difficulties of managing activities necessary to stay healthy.

Emotional health outcomes are influenced by sexual minority identity and HIV serostatus

For people living with HIV (PLWH) and sexual minorities (SM), the intersection of identities can compound experiences like stigma and discrimination resulting in poor emotional health. We investigated the separate and interactive associations of HIV serostatus and sexual identity with emotional health. Our dataset included 371 participants. Emotional health was assessed by the NIH Toolbox emotion battery which yields negative affect, social satisfaction, and psychological well-being. Regressions were conducted for each composite, with HIV serostatus, sexual identity, and their interaction as independent variables along with covariates. The HIV serostatus x SM identity interaction was statistically significant in the regression of Negative Affect (p = .01): heterosexuals living with HIV had worse Negative Affect compared to heterosexual HIV-persons (p = .01). The interaction terms were for social satisfaction and psychological well-being were not significant. However, among PLWH, sexual minorities reported better Social Satisfaction (p = .03) and marginally better psychological well-being (p = .07) compared to heterosexuals.

An outcome-wide analysis of bidirectional associations between changes in meaningfulness of life and health, emotional, behavioural, and social factors

The sense that one is living a meaningful life is associated with positive health outcomes, but less is known about the role of changes in sense of meaning. This outcome-wide analysis investigated bidirectional associations between changes in ratings of doing worthwhile things in life and 32 factors in 6 domains of human function in 5,694 men and women (M = 66.65 years) from the English Longitudinal Study of Ageing. Participants rated the extent they felt that the things they did in life were worthwhile in 2012 and 2014. Analyses were adjusted for age, gender, education and social class, and were weighted for non-response. We found that health (e.g. few chronic diseases, no chronic pain), emotional wellbeing (e.g. few depressive symptoms, good sleep), greater physical activity, social factors (e.g. close relationships, friends, organizational membership, volunteering, cultural engagement), and economic factors (wealth, income), at baseline were associated with 2 year increases in worthwhile ratings. Conversely, increases in worthwhile ratings over 2 years were related to more favourable health, emotional, behavioural, and social changes between 2012 and 2016 independently of baseline levels. These bidirectional relationships highlight the importance of maintaining worthwhile activities at older ages.

Association of Positive Affect with Cognitive Health and Decline for Elder Mexican Americans

The goal of this study was to investigate the linkages of positive affect (PA) with cognitive health and its decline among elder Mexican Americans. We conducted secondary analysis of longitudinal data from the Sacramento Area Latino Study on Aging (SALSA). We used the structural equation modeling framework to achieve three specific aims: (1) identify a valid measure of PA, (2) describe within-person trajectories of PA and cognitive health, and (3) test the inter-relations of these two processes over time. Results showed that, on average, PA and cognitive ability (including verbal memory) decreased over time. Yet, there was significant variability in these patterns of change. Bivariate latent growth curve models showed significant correlations of baseline levels and rates of change of PA and cognitive ability even after controlling for age, education, sex, bilingualism, and depression. Results support the hypothesis that increases and decreases in PA tend to be related to increases and decreases in cognitive health at old age among Mexican Americans.

Animal-Assisted Intervention Improves Pain Perception in Polymedicated Geriatric Patients with Chronic Joint Pain: A Clinical Trial

Chronic joint pain is associated to an increase in the consumption of medication and decrease in life quality in elderly people, which requires developing non-pharmacological treatments. The aim of this study was to evaluate the effectivity of a group intervention, based on animal-assisted therapy and applied to elderly people with chronic joint pain and polymedication, regarding the decrease of chronic pain, use of analgesics and improvement of life quality. A randomized controlled trial, two arms and open-label was conducted in a Primary Health Center. Twelve weekly sessions of kinesitherapy; in the EG, these exercises were performed with the additional assistance of the therapy dog. A total of 52 participants (22 Control Group (CG), 30 EG), average age 77.50 (±7.3), women 90.4%. A significant reduction on post-intervention values of pain β = −0.67(−1.27, −0.08), p = 0.03 and pain induced insomnia β = −0.53(−1.01, −0.05), p = 0.03 was found in EG for increasing baseline values. Animal-assisted therapy leads to an additional reduction in the perception of pain and pain induced insomnia in individuals with higher baseline severity. The presence of the dog improves the attachment to intervention and the satisfaction of the participants.

Impact of home- and center- based physical training program on cardio-metabolic health and IGF-1 level in elderly women

Background

Data in the literature concerning the effects of physical activity on lipid and IGF-1levels are controversial in postmenopausal women. The aim of the present study was to determine the combined effects of a 12 weeks home-based walking program aiming to achieve 10,000 steps daily and a center- based aerobic exercise training on functional capacity, some important cardio-metabolic parameters, IGF-1 level and psychological items among elderly female patients. Sixty female patients (67.4 ± 5 years) with moderate to high cardiovascular risk were randomly assigned either to an exercise training program for 12 weeks or to the control group.

Results

Our organized training program resulted in a significantly improved daily physical activity (4232 [IQR: 3162–7219] to 8455 [IQR: 6757–11,488]; p < 0.001 ft-steps), functional capacity (MET) (8.17 ± 1.57 to 8.87 ± 1.76) (p = 0.002), metabolic status including total cholesterol (5.17 ± 1.13 to 4.77 ± 1.12 mmol/l), LDL cholesterol (3.37 ± 1.05 to 2.81 ± 0.98 mmol/l), triglyceride (1.68 ± 0.71 to 1.28 ± 0.71 mmol/l) and HgbA1c (6.24 ± 0.67 to 6.06 ± 0.58 mmol/l), as well as IGF-1 (59.68 ± 27.37 to 66.79 ± 22.74 ng/ml) levels (p < 0.05) in the training group. From psychological tests only physical functionality improved significantly (p = 0.03) in the training group. The training group significantly differed from the control group in four parameters including MET (p = 0.003), LDL-cholesterol (p = 0.046), triglyceride (p = 0.001) and IGF-1 levels (p < 0.001) after the intervention.

Conclusion

The applied home-, and- center based training program effectively increased the daily physical activity of the elderly female patients and improved several cardio-metabolic parameters. Further investigations are needed on larger patient population to establish our findings and examine how these positive changes may decrease CV events and mortality.

Association Between Subjective Well-being and Living Longer Without Disability or Illness

IMPORTANCE

Subjective well-being is associated with reduced mortality, but it is not clear whether additional time is spent in good health or with chronic disease and disability.

OBJECTIVE

To evaluate the associations between affective well-being, total life expectancy, and life expectancy free of disability and chronic disease.

DESIGN, SETTING, AND PARTICIPANTS

This survey study used data on 9761 participants from the English Longitudinal Study of Ageing who were followed up for a maximum of 10 years (mean [SD] follow-up, 6 [3.7] years). Discrete-time multistate life table models were used to estimate total life expectancy and life expectancy free of disability or chronic disease. Data were collected between March 2002 and March 2013 and analyzed from December 2018 to April 2019. Analyses were adjusted for wealth and cohabiting status.

MAIN OUTCOMES AND MEASURES

The main outcome was life expectancy free of disability and chronic disease. Affective well-being was assessed at baseline as a combination of enjoyment of life and the lack of significant depressive symptoms. Disability was measured in terms of impaired activities of daily living and instrumental activities of daily living, and chronic disease as the occurrence of 6 serious illnesses.

RESULTS

Data were analyzed from 9761 participants (5297 [54%] female; mean [SD] age at baseline, 64 [9.9] years). High affective well-being was associated with longer life expectancy and with longer disability-free and chronic disease-free life expectancies. For example, a woman aged 50 years who reported high affective well-being could expect to live 6 years longer than a woman of similar age with low well-being; 31.4 of her remaining years (95% CI, 30.5-31.9 years) would be likely to be free of disability, compared with 20.8 years (95% CI, 20.1-22.1 years) for a woman with low affective well-being. A man aged 50 years with high affective well-being could expect to live 20.8 years (95% CI, 18.7-22.4 years) without chronic disease, compared with 11.4 years (95% CI, 8.5-14.6 years) for a man reporting low well-being. Similar patterns were observed at the ages of 60, 70, and 80 years.

CONCLUSIONS AND RELEVANCE

This study suggests that people who report high levels of subjective well-being live longer and also healthier lives than those with lower well-being. These findings add weight to endeavors to promote the subjective well-being of older people.

Resilience and well-being after traumatic brain injury

Purpose: This study examined the extent to which resilience is associated with well-being outcomes after traumatic brain injury, and whether those relationships are independent of global personality traits, such as affectivity.Materials and methods: Sixty-seven adults with complicated-mild to severe traumatic brain injury participated. Measures included the Connor-Davidson Resilience Scale, Modified Cumulative Illness Rating Scale, Disability Rating Scale, SF-12 Health Survey, Satisfaction with Life Scale, and Community Integration Measure.Results: Objective physical health and disability showed modest relation to resilience, indicating that adverse health conditions and disability decreased with increasing resilience. The three measures of subjective well-being showed modest-to-strong positive relation to resilience. These correlations between resilience and well-being generally remained significant after accounting for negative and positive affectivity. Results also suggest that the influence of resilience on well-being has a threshold effect: a greater influence on outcome among people with low or inadequate resilience than among people with average or high resilience.Conclusion: The experience of brain injury does not diminish the positive influence resilience may have on long-term well-being. Resilience may function as a buffer to trauma even in the challenging context of cognitive insult. Routine assessment of resilience might be beneficial to the rehabilitation team.Implications for rehabilitationResilience is positively associated with subjective and objective well-being among adults with moderate-to-severe traumatic brain injury, and it appears to function among adults with traumatic brain injury similarly to adults without cognitive disabilities.Resilience overlaps with overarching trait personality constructs such as affectivity; yet, it has unique characteristics and unique value in understanding well-being.The adverse effects of low resilience show stronger influence on well-being than do the positive effects of high resilience.Routine assessment of resilience might be beneficial to the rehabilitation team in understanding patients and their families, especially in discharge planning, where beliefs about personal capabilities to rebound from adversity shape likely future behavior.

The modifying effect of positive emotion on the relationship between cognitive impairment and disability among older Mexican Americans: a cohort study

OBJECTIVE

To determine if positive emotion modifies the relationship between cognitive impairment and activities of daily living disability status over 10 years in Mexican American adults aged 75 years and older.

METHODS

A retrospective cohort design using data from the Hispanic established populations for the epidemiologic studies of the elderly. About 2674 participants aged 75 years and older were included and followed over 10 years. Cognition was measured using the mini-mental state examination, positive emotion was measured using four questions from the Center for Epidemiologic Studies Depression Scale, and disability was measured using seven activities of daily living items. A series of generalized estimating equations models were used, with the initial analysis including those with disability at baseline and subsequent analyses excluding disability at baseline.

RESULTS

Positive emotion and cognitive impairment consistently decreased and increased risk for activities of daily living disability, respectively. Positive emotion was a significant modifier in the cross-sectional analysis, and was not a statistically significant modifier in the longitudinal or predictive series analysis.

CONCLUSIONS

Positive emotion and cognitive impairment differentially affect the risk of developing activities of daily living disability. Further research is needed to explore the interaction of positive emotion and cognitive impairment, and to identify appropriate interventions that address the specific cognitive and emotional needs of older Mexican Americans. Implications for rehabilitation Promoting emotional well-being may be protective against incident disability for older adults. Cognitive impairment significantly predicts incident disability in activities of daily living and should be considered an early indicator of impending disability for older adults.

Correlates and Predictors of Mobility Limitation in Community-Dwelling Hispanic Older Adults in the United States: A Systematic Review

This article presents a systematic review of the literature on correlates/predictors of mobility limitation among community-dwelling U.S. Hispanic older adults. A search of scientific databases (PubMed, CINAHL, and PsycINFO) was conducted. After abstract and full text review, 20 epidemiologic studies that met all eligibility criteria were included. The theoretical framework of mobility was used to categorize factors related to mobility limitation. The majority of the studies reviewed (n = 17) examined some aspect of physical factors in relation to mobility limitation. Several factors emerged as important influences on mobility outcomes: diabetes mellitus, stroke, obesity, arthritis, and depression. None examined the influence of built environment. This review suggests that multilevel factors can impact both mobility limitations and disability among U.S. Hispanic older adults. However, the study findings were inconsistent, with some studies showing significant relationships or effects and others demonstrating no associations or mixed findings.

Becoming frail: a major turning point in patients' life course

BACKGROUND

The frailty concept requires that practices should be adapted to meet the challenge of dependence. The GP is in the front line of management of frail elderly patients.

OBJECTIVES

To explore the perception of elderly persons of the term and concept of frailty and to understand their perception of the risk of loss of independence.

METHODS

Two qualitative studies by individual interviews in the homes of elderly persons identified as potentially frail by their GP, or diagnosed as frail and at risk of loss of independence. The sampling was theoretical. The analysis was carried out using an inductive approach following the phases of thematic analysis. The researchers used triangulation and collection was concluded when theoretical saturation had been reached.

RESULTS

The concept of frailty was seen as forming an integral part of physiological ageing and appeared to be irreversible. The term of frailty had a negative connotation. The physical, cognitive and psychological components of frailty were present in the participants' discourse. Nutritional and sensory components were less present. Frailty due to inappropriate medication was not cited. Seven risk factors for loss of independence were identified: social isolation, poor physical health, poor mental health, loss of mobility, unsuitable living conditions, unsuitable environment, and low resources.

CONCLUSIONS

Becoming frail is a major turning point in patients' life course. Coordinated multiprofessional management that takes account of patients' perceptions could help in negotiating a feasible care plan adapted to the patient's needs.