The Relationship between Physical Health and Psychological Well-Being among Oldest-Old Adults

Healthy aging among centenarians and near-centenarians: Findings from the Georgia Centenarian Study

The Georgia Centenarian Study is one of the earliest comprehensive studies on centenarians. Based on the Georgia model of adaptation, the primary purpose of this study was to assess the health and well-being of our oldest population, with a focus on several primary adaptation areas: genetics and family longevity, environmental support, individual characteristics, cognitive and behavioral skills, health behaviors, and physical and mental health, including overall life satisfaction. The results of the three Georgia Centenarian sub-studies indicate that genetic and environmental variables play an important role in determining different levels of healthy aging, but they also highlight relevant mediating and moderating effects in a network of interrelating adaptation components.

Multiple Roads to Success: A Latent Class Analysis on Successful Ageing Among Hong Kong Near-Centenarians and Centenarians (NCC)

Notwithstanding the oldest-old cohort being the fastest-growing population in most ageing societies, characterizing successful ageing in adults of advanced age, such as nonagenarians and centenarians, remains challenging. This study investigated the successful ageing subphenotypes using the data from Hong Kong Centenarian Study 2. Between April 2021 and September 2022, 146 family caregivers of community-dwelling older adults aged 95 or above were interviewed by phone. Latent class analysis identified three classes-Overall Frail (46.6%) with poor mobility, cognitive and functional health, Nonambulant (37.0%) but good functional health, and Robust (16.4%) with overall good health-from 11 indicators based on caregivers' reports. Although we found a low prevalence of fulfillment of all indicators of successful ageing, our findings will help care professionals appreciate the heterogeneity underlying partial successful ageing in this vulnerable cohort for segmented and targeted healthy longevity interventions.

Understanding women's suffering and psychological well-being: exploring biopsychosocial factors in mothers of children with ADHD - a case study

Overview

Parents play a dynamic part in child development. Mothers have a great responsibility towards the upbringing child. Previous research has demonstrated that parenting stress levels are high among Parents of children with attention deficit hyperactivity disorder (ADHD).

Aim

Parenting stress affects the psychological well-being of the mother. It is necessary to identify the factors that affect psychological well-being based on Biopsychosocial factors, including biological, psychological, and social factors.

Methodology

An in-depth case study was conducted with the mother of a 7-year-old child diagnosed with attention deficit hyperactivity disorder.

Results

The mother lacks self-efficacy and low perceived social support in. Equipping themselves and building up the knowledge on handling the child and training the child with the developmental disorder increase parenting self-efficacy. Support from family, partner, and society will help them strengthen themselves and may have high psychological support.

Income loss and subsequent poor psychological well-being among the Chinese population during the early COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has had major ramifications for health and the economy at both the individual and collective levels. This study examined exogenous negative changes in household income and their implications on psychological well-being (PWB) among the Chinese population during the COVID-19 pandemic.

METHODS

Data were drawn from the early China COVID-19 Survey, a cross-sectional anonymous online survey administered to the general population in China. Self-reported PWB was measured using a 5-point Likert scale with five questions related to the participants' recent psychological state. Hierarchical multiple linear regression was employed to examine whether income loss during the COVID-19 pandemic was associated with poor psychological health.

RESULTS

This study included 8,428 adults, of which 90% had suffered from a moderate or severe loss of household income due to the early COVID-19 pandemic. Those who had experienced moderate or severe loss of income scored significantly lower on psychological well-being than those who did not experience income loss (19.96 or 18.07 vs. 21.46; P < 0.001); after controlling for confounders, income loss was negatively associated with PWB scores (moderate income loss: B = - 0.603, P < 0.001; severe income loss: B = - 1.261, P < 0.001). An interaction effect existed between the degree of income loss and pre-pandemic income groups. Specifically, participants in the middle-income group who had suffered severe income loss scored the lowest on PWB (B = - 1.529, P < 0.001). There was also a main effect on income loss, such that participants with varying degrees of income loss differed across five dimensions, including anhedonia, sleep problems, irritability or anger, difficulty with concentration, and repeated disturbing dreams related to COVID-19.

CONCLUSIONS

Income loss during the pandemic has had detrimental consequences on psychological well-being, and the magnitude of the impact of income loss on psychological well-being varied according to previous income levels. Future policy efforts should be directed toward improving the psychological well-being of the economically vulnerable and helping them recover from lost income in the shortest time possible.

Information communication technology accessibility and mental health for older adults during the coronavirus disease in South Korea

Introduction

As society ages and the digital economy continues to develop, accessibility to information and communication technology (ICT) has emerged as a critical factor influencing the mental health of older adults. Particularly, in the aftermath of the COVID-19 pandemic, the need for non-face-to-face communication has significantly increased older adults' reliance on ICT for accessibility. This transition from a self-motivated engagement to a more socially passive mode of interaction highlights the importance of creating a digitally inclusive aging society.

Methods

This empirical study used pooled cross-sectional data from the Digital Gap Survey conducted in South Korea in 2018 and 2020. It aimed to analyze the association between ICT accessibility and the mental health of older adults during the COVID-19 pandemic.

Results

A significant positive relationship was found between ICT and mental health among older adults in South Korea. However, this positive association weakened during the COVID-19 period. Furthermore, the analysis revealed heterogeneity among older adults by age, sex, and place of residence, with older females in their 70s living in rural areas experiencing the greatest weakening.

Discussion

These results highlight the need for tailored interventions and support mechanisms for specific demographic groups of older adults. We recommend that the South Korean government implement various policies to facilitate the post-COVID-19 digital landscape. These include initiatives such as ICT-related education programs, development of user-friendly e-government systems, and creation of social media platforms designed to accommodate the needs and preferences of older adults.

Identify travel and health factors influencing well-being of the older adults-a case study in China

Objective

With the increase in aging populations worldwide, the travel well-being of the elders has gained attention. The objective of this study is to examine the nonlinear relationships between the well-being of the older people in China and factors associated with travel and health.

Method

Based on the data collected in China, combined embedded feature selection and decision tree built by Gini index were utilized to screen for influential factors and to determine the importance of the features selected. Tamhane's T2 was used to study the differences in the important factors among older people with different levels of travel well-being.

Results

This study found that the travel well-being of older adults depends mainly on accessibility to public places, such as schools and medical facilities, and the availability of bus services. Out of expectation, the most important influential factor of travel well-being of older people is the distance from home to high school. This is related to the traditional Chinese concept of education. In addition, it was found that the body mass index is more important than self-perceived health as an influence factor of travel well-being of the elders in China. Social skills are important factors too.

Conclusion

This study investigated various health-related and travel-related factors and their impacts on the travel well-being of older adults Chinese with the overall goal to improve the quality of life of the elders in China. The findings may provide a theoretical basis for the implementation of various transportation management and urban planning and design -related policies to improve the travel well-being of older adults in China.

The association between gut-health promoting diet and depression: A mediation analysis

BACKGROUND

Recent research has highlighted the relevance of a gut-health promoting diet as a possible treatment and prevention for depression. A dietary pattern with consumption of fermented food and high consumption of dietary fiber can promote gut health, physical health, and might even improve mental health. This study aimed to investigate the interrelationship among diet, physical health, and depression.

METHODS

This study used a nationally representative sample (N = 16,572) from the National Health and Nutrition Examination Survey (2011-2018). Dietary information was collected by dietary recall interviews. Depression was assessed by the 9-item Patient Health Questionnaire. Subjective physical health was indicated by self-reported Body Mass Index (BMI). Objective physical health was indicated by BMI measured by trained health technicians. Path analysis was used to test the association between diet and depression, and the mediating roles of self-reported BMI and BMI measured by technicians.

RESULTS

Consumption of probiotic foods and higher intake of fiber were significantly associated with lower levels of depressive symptoms. Both subjective and objective physical health significantly mediated the relationship between variables of diet and mild depressive symptoms. Subjective physical health also significantly mediated the relationship between high intake of dietary fiber and lower likelihood of reporting severe depressive symptoms.

CONCLUSION

Despite being cross-sectional in nature, this study presented evidence that gut-health promoting diets may reduce depressive symptoms through improving physical health. These findings provide preliminary support to diet programs for preventing depression and diet programs as an alternative or supplementary treatment of depression.

Infidelity in the Adolescence Stage: The Roles of Negative Affect, Hostility, and Psychological Well-Being

BACKGROUND

Infidelity is a relational process common in all types of romantic relationships and has been established as one of the main causes of relationship breakdown. However, little is known about this type of transgression in adolescent romantic relationships, although it manifests as a fairly frequent behavior involving different motivations. Even less is known about the emotional impact of infidelity on the offending person and its association with hostile behavior and psychological well-being.

METHODS

Through an experimental study (N = 301 Spanish adolescents (190 female and 111 male; M_age = 15.59, SD = 0.69; range from 15 to 17), we sought to analyze the effect of manipulating two types of motivations for infidelity (sexual vs. emotional dissatisfaction) on negative affect, hostility, and psychological well-being.

RESULTS

The main results revealed that committing infidelity motivated by hypothetical sexual (vs. emotional) dissatisfaction was indirectly related to lower psychological well-being through its effects on increased negative affect and hostility.

CONCLUSIONS

Last but not least, we discuss these findings, highlighting the possible implications of infidelity for the psychosocial and psychosexual development of adolescents.

Predictors and Moderators of Quality of Life in Male Users of Anti-Aging Products

For most individuals, changes occurring during the aging process may cause dissatisfaction and concerns regarding body image, with implications on quality of life (QoL). The aim of this study was to assess the contribution of sociodemographic and psychological variables and the type of anti-aging products/treatments on men's QoL, as well as to evaluate the moderating role of aging perceptions in the relationship between psychological morbidity and QoL. This study used a cross-sectional design and included a sample of 111 male participants who used anti-aging cosmetic products/aesthetic treatments. Participants were assessed on body image, self-esteem, psychological morbidity, aging perceptions, traits of perfectionism, and QoL. Results suggested that psychological morbidity and perceptions of the aging process as chronic negatively contributed to QoL, and emotional representations of aging moderated the relationship between psychological morbidity and QoL. According to the findings, psychological intervention programs to improve QoL should focus on men with higher levels of psychological morbidity and more negative emotional responses to the aging process.

Staying connected in old age: associations between bonding social capital, loneliness and well-being and the value of digital media

OBJECTIVES

We examined associations between age, bonding social capital (BSC), loneliness and psychological, social and emotional well-being in old age. As in theory digital media can support both preservation of and access to someone's social capital, we also explored associations between the use of WhatsApp, social network sites (SNS) and Internet applications and respectively BSC and loneliness.

METHOD

In this cross-sectional study a sample of 349 older adults (range = 70y-93y; Mean(SD)=74.8y(4.9y); 59.6% male) filled out a questionnaire including the bonding social capital subscale of the personal social capital scale for elderly (PSCSE), validated scales measuring social, emotional, and psychological well-being and loneliness, the SNS intensity scale and items measuring frequencies of Whatsapp use and use of various Internet functions. Also relevant demographic and other covariates were included.

RESULTS

Regression analyses including relevant covariates confirmed our hypotheses, finding negative associations between BSC and both age and loneliness, and positive associations between BSC and psychological, social and emotional well-being. WhatsApp and Internet use were both found positively associated with BSC, whilst a negative association between WhatsApp use and loneliness was found. SNS use was not associated with BSC nor with loneliness.

CONCLUSION

Our findings indicate BSC as an important factor in positive aging and illustrate a widening gap between the need for socio-emotional resources versus their availability. With regard to digital media, we conclude that its value in old age should be sought in providing access to one's bonding social capital rather than adding to it by expanding the number of social relations.

The Role of Sports in the Subjective Psychological Well-Being of Hungarian Adult Population in Three Waves of the COVID-19 Pandemic

(1) Background: In this study, sport and subjective psychological well-being is investigated in three waves of the COVID-19 pandemic. (2) Methods: We have conducted three different representative sample surveys (n = 3600 altogether) on the Hungarian adult population and investigated the sample's subjective psychological well-being with the WHO-5 Well-Being Index, as well as changes in their subjective well-being through the different waves of the pandemic. Sporting habits and socio-economic variables were also surveyed, and OLS regression models were created focused on the WHO-5 measures. (3) Results: The subjective psychological well-being of the Hungarian adult population decreased significantly, but in the second and third wave of pandemic restrictions, an increase in subjective psychological well-being has been measured. The relationships between the time spent on doing sports and subjective psychological well-being were significant in each pandemic waves. The highest subjective psychological well-being and its highest increase were reported by those who could increase their time spent on doing sports as well. (4) Conclusions: The relationships between the sports activities, physical health, size of settlement, changes in income and subjective psychological well-being of the Hungarian adult population were significant in all three waves of the COVID-19 pandemic.

Subjective well-being predicts Covid-19 risk in the elderly: a case-control study

BACKGROUND

Covid-19 is a serious public health concern. Previous studies have shown that although there are concerns about the subjective well-being (SWB) of older people in the Covid period, the link between SWB and the risk of Covid-19 is still unclear. This study aimed to investigate the predictive effect of SWB on the Covid-19 risk in the elderly as well as the determinants of SWB.

METHODS

This case-control study was performed in the elderly over 60 years of age. The case group consisted of all hospitalized patients with COVID-19 and the control group from the same population with no history of COVID-19 matched by age, sex, and place of residence. Data collection tools included a demographic questionnaire and SWB scale of Keyes and Magyarmo to measure emotional, psychological and social well-being. All data were analyzed via SPSS and STATA software. Multiple binary logistic regression was run to predict the probability of Covid-19 risk on the values of total SWB and its three subscales and multiple linear regression to identify SWB determinants.

RESULTS

The results showed that increasing one unit in total SWB reduces the risk of Covid-19 by 4% (OR = 0.969, CI = 0.947-0.991, p = 0.006). Emotional well-being with 0.823 had the highest odds ratio for predicting Covid-19 risk, followed by social well-being with an odds ratio of 0.981. Increasing age and education, better economic status, marriage against celibacy, lack of comorbidity, and a better understanding of own health were associated with greater SWB.

DISCUSSION

This study provides evidence for the protective effect of SWB on Covid-19 risk. To promote SWB, we need to focus on the elderly with higher financial worries and comorbidities, as well as those with less education, health perception and SWB. Therefore, it will be important for the elderly to determine strategies to improve SWB during the epidemic.

Social Isolation and Loneliness among Near-Centenarians and Centenarians: Results from the Fordham Centenarian Study

Social isolation and loneliness have been recognized as problems older people face due to their adverse effects on health and mortality, but very few researchers have analyzed their co-occurrence, which might be particularly prevalent and critical among the very old. In this study, we investigated the prevalence of combinations of social isolation and loneliness among near-centenarians and centenarians. We used data collected from 94 individuals aged 95–107 from the Fordham Centenarian Study. We built a four-group typology and explored associations with individual characteristics in various domains (demographic, socioeconomics, social, health, care, and psychological) with multinomial logistic regression models. Considering their combinations, the most prevalent groups were “isolated and lonely” and “neither isolated nor lonely” (29.8% and 28.7%, respectively). The “lonely but not isolated” (20.2%) and “isolated but not lonely” (21.3%) groups were also notably large. The likelihood of belonging to each group varied according to various individual characteristics, such as education, health, and personality. Social isolation and loneliness are distinct phenomena among centenarians. The consideration of their varied combination can help better assess life conditions at very old ages. Taking into account the differences between groups can facilitate the design of tailored interventions to improve the lives of near-centenarians and centenarians.

Disability Assessment in Geriatric Psychiatry and Social Welfare Measures in Geropsychiatry in India

BACKGROUND

Rising population of elder people and associated rise in health problems, frailty and disabilities have significant socioeconomic and health care implications. Mental health related disability contributes significantly in the global disability statistics and is an important health and quality of life indicator. Assessment of disabilities in elderly is essential part of routine evaluation, further it also helps the clinicians in identifying current functional status and choosing and monitoring therapeutic interventions and need for social welfare schemes.

METHODS

In order to understand the process of disability assessment in geriatric psychiatry and to gather information about social welfare schemes a literature review in Google Scholar and PubMed electronic database, and website of various ministries under Government of India was done, using developed key search terms for articles published up to February 2021. The identified eligible articles were reviewed for ideas and concepts, which were then integrated and categorized under broader themes. Finally, the broad categories were discussed briefly based on the above framework.

RESULTS

Review findings are summarized under the following headings: concept of ageing and disability, assessment of disability, process of certification, and social welfare schemes.

CONCLUSIONS

The process of disability assessment comprises of comprehensive clinical evaluation, use of standardized rating instruments and disability certification wherever warranted or asked for. It is now being acknowledged worldwide by provisions of various social welfare benefits, that living with disability and increased care needs should be an integral part of definition of successful ageing.

Testing a holistic conceptual framework for early childhood teacher well-being

Using a holistic conceptualization of teacher well-being in concert with the Job Demands and Resources (JD-R) framework, our interdisciplinary study examined associations among various job demands and resources and whole teacher well-being (i.e., professional, psychological, and physical well-being) in early care and education settings. First, we investigated direct associations of job demands and resources with teachers' professional well-being. Second, we tested two models of potential mediation for the relationship of job demands and resources to well-being using structural equation modeling techniques: (a) that psychological and physical well-being mediate the relationship between demands, resources, and professional well-being; and (b) that professional well-being mediates the relationship between demands, resources, and psychological and physical well-being. Although our sample of early childhood teachers (n = 262) reported high levels of professional well-being (i.e., work commitment, self-efficacy), a substantial number of them experienced challenges in both psychological (e.g., perceived stress, depressive symptoms) and physical (e.g., ergonomic pain) well-being. As expected, teachers' work-related stressors and work resources (positive work climate, quality of the physical environment) were directly associated with teachers' professional well-being. Contrary to our expectations, however, instrumental resources (i.e, wages, health insurance) did not predict any aspects of teachers' professional well-being. Our data only supported the first of the two tested mediation hypotheses (i.e., that psychological and physical well-being mediated the associations between working conditions and professional well-being), but with one caveat: physical well-being preceded psychological well-being in mediating the associations. These results advance our understanding of the challenges present in the early childhood workforce and have implications for policies and programs to improve teacher working conditions and well-being.

The development of Need-Threat Internal Resiliency Theory in COVID-19 crisis utilizing deductive axiomatic approach

Resiliency for older people represents the capacity to return to equilibrium when difficulties arise and was found as integral predictor of their health status. This study aims to develop a theory that attempts to explain the older adults' resiliency perspectives during crisis and how it has affected their well-being and quality of life as population group. Deductive theory generation using axiomatic approach was adopted resulting to five axioms that served as basis for the generation of three propositions such as: (1) An older person's health needs have tendencies to develop into a health threat, (2) when the threat is perceived, older persons developed a sense of internal control and adaptation to the changes it creates known as internal resiliency, and (3) internal resiliency can influence the quality of life in old age. The evolved theory suggests that in times of crisis (e.g., COVID-19 pandemic), health needs develop into a health threat that compels older persons to develop internal resiliency in order to preserve their integrity, wellbeing and quality of life. This study widens the nursing perspectives in addressing older persons' resiliency by the unique condition at which older clients are placed affecting both the pathological nature of the illness as well as the preventive interventions which the society is forced to implement.

Psychometric Properties of Flourishing Scales From a Comprehensive Well-Being Assessment

In this article, we develop a measure of complete well-being. The framework is derived from the theoretical model of human flourishing understood as a state in which all aspects of a human life are favorable. The approach extends beyond psychological well-being and reflects the World Health Organization definition of health that not only considers the health of body and mind but also embraces the wholeness of the person. The Well-Being Assessment (WBA) is a comprehensive instrument designed to assess holistic well-being in six domains: emotional health, physical health, meaning and purpose, character strengths, social connectedness, and financial security. Although each of these domains is distinct, all of them are nearly universally desired, and all but financial security constitute ends in themselves. Data were collected from a representative sample of working adults. A sample of 276 employees participated in the pilot, 2,370 participated in the first wave and 1,209 in the second wave of the survey. The WBA showed a good fitting (40 items, six factors), satisfactory reliability, test-retest correlation, and convergent/discriminant validity in relation to stability over time and relevant health measures, as well as a good fit to the data that were invariant over time, gender, age, education, and marital status. The instrument can be of use for scientists, practitioners, clinicians, public health officials, and patients. Adoption of more holistic measures of well-being that go beyond psychological well-being may help to shift the focus from health deficiencies to health and well-being promotion.

The Association Between Chronic Disease and Psychological Distress: An Australian Twin Study

There is a commonly observed association between chronic disease and psychological distress, but many potential factors could confound this association. This study investigated the association using a powerful twin study design that can control for unmeasured confounders that are shared between twins, including genetic and environmental factors. We used twin-paired cross-sectional data from the Adult Health and Lifestyle Questionnaire collected by Twins Research Australia from 2014 to 2017. Linear regression models fitted using maximum likelihood estimations (MLE) were used to test the association between self-reported chronic disease status and psychological distress, measured by the Kessler Psychological Distress Scale (K6). When comparing between twin pairs, having any chronic disease was associated with a 1.29 increase in K6 (95% CI: 0.91, 1.66; p < .001). When comparing twins within a pair, having any chronic disease was associated with a 0.36 increase in K6 (95% CI: 0.002, 0.71; p = .049). This within-pair estimate is of most interest as comparing twins within a pair naturally controls for shared factors such as genes, age and shared lived experiences. Whereas the between-pair estimate does not. The weaker effect found within pairs tells us that genetic and environmental factors shared between twins confounds the relationship between chronic disease and psychological distress. This suggests that associations found in unrelated samples may show exaggerated estimates.

Associations Between Religious/Spiritual Practices and Well-Being in Indian Elderly Rural Women

Religion and spirituality (R/S) are embedded in all aspects of life in India, a predominantly rural economy. The aim of this mixed methods study was to assess the associations between a culturally tailored intervention and preexisting religious/spiritual (R/S) practices with indicators of well-being and factors which contribute to happiness among elderly rural women from Haryana state, India. The study consisted of three groups: field experimental group (FEG; n = 24); practitioners of preexisting R/S practices for at least 6 weeks Satsang (SG, n = 54), Brahma Kumaris (BKG, n = 54), and Radha Soami (RSG, n = 30), and non-practitioners of R/S practices (n = 64). All groups completed self-report measures of overall happiness and life satisfaction, global health, quality of life, and health status and physical health. Results revealed that FEG participants improved significantly on physical health, body balancing, and self-care; no changes were observed on the other well-being measures following the intervention. Practitioners of preexisting R/S practices were found significantly different from the non-practitioners on some indicators of health, quality of life, and well-being. Qualitative measures pointed to the importance of R/S and family and interpersonal relationships among elderly rural women.

Bonding personal social capital as an ingredient for positive aging and mental well-being. A study among a sample of Dutch elderly

OBJECTIVES

The current study aims to add to the limited empirical research of possible benefits of personal social capital for the well-being of elderly. A validated personal social capital scale, measuring both bonding and bridging social capital in a general population, was adjusted to fit the characteristics of the social environment of elderly, to explore the association between social capital and well-being of elderly, as well as the mediating role of loneliness.

METHOD

A sample of 328 Dutch adults, varying in age from 65 to 90 years (Mean = 72.07; SD = 4.90) filled out an online questionnaire including the adapted personal social capital scale for elderly (PSCSE), as well as validated scales measuring social, emotional, and psychological well-being and loneliness. Relevant other (demographic) variables were included for testing construct and criterion validity.

RESULTS

CFA analysis revealed the subdimensions bonding and bridging social capital with reliability scores of respectively α = .88 and α = .87, and α = .89 for the total scale. Regression analyses confirmed construct and criterion validity. Subsequently, significant positive associations between bonding social capital and respectively social, emotional and psychological well-being were found. These associations were mediated by loneliness. Bridging social capital was only found to be significantly associated with social well-being, not mediated by loneliness.

CONCLUSION

Our findings have enhanced our understanding of the association between social capital and mental well-being of elderly and indicate that bonding personal social capital in particular may be considered an ingredient for positive aging.

Psychometric Properties of the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) in the Iranian Older Adults

PURPOSE

Mental wellbeing is considered as an important and effective factor in older adults' psychological health. Due to lack of a standard instrument for the assessment of mental wellbeing in Iranian older adults, the present study was performed to examine validity and reliability of the Persian version of the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS-P) for use among Iranian older adults.

PATIENTS AND METHODS

The study sample included 304 older adults aged 60 and over, admitted to the Shohada Educational Hospital affiliated to the Tabriz University of Medical Sciences, North West of Iran. The participants were recruited through the convenience sampling method in May to September 2017.

RESULTS

The mean and standard deviation of the mental wellbeing score were 50.30 and 8.82, respectively. Exploratory factor analysis (EFA) results demonstrated a one-factor solution with 13 items which was verified by the confirmatory factor analysis (CFA). The estimated internal consistency measure of Cronbach's alpha (0.93) and two weeks' time test-retest reliability index (0.84) met the prerequisite criteria.

CONCLUSION

According to the results, the WEMWBS-P with 13 items has acceptable validity and reliability to assess the mental wellbeing of Iranian and other Persian-speaking older adults.

Emotional Well-Being and Cognitive Function Have Robust Relationship With Physical Frailty in Institutionalized Older Women

Introduction

Frailty associated to core dimensions of psychological well-being (PwB) has appeared as a possible new frailty phenotype named psychological frailty, implying a parallel to physical frailty (PF). Very little is known about the associations between mental well-being, especially emotional, mood, and self-perception dimensions, and the frailty syndrome in institutionalized older populations. The present study aims to examine the interlink between the PF phenotype and the core dimensions of PwB in Portuguese institution-dwelling older women.

Methods

Cross-sectional data were collected. A total of 358 older women, aged 75 years or more, were recruited from four nursing homes within the city of Coimbra and asked to complete a sociodemographic and a general health assessment survey. The main PwB dimensions were assessed in all participants: (i) global cognitive status was assessed using The Montreal Cognitive Assessment (MoCA) Neuropsychology Test, (ii) self-perception was screened using the General Self-Efficacy Scale (GSES) and Global Self-Esteem Scale, (iii) CES-D of depression and Perceived Stress Scale (PSS) were used to screen mood states, and (iv) subjective happiness, satisfaction with life, and attitudes to aging psychometric rating scales were used to screen for emotional well-being. The syndrome of PF was assessed using Fried’s PF phenotype that includes weight loss, weakness, slowness, exhaustion, and low physical activity (PA) level assessments.

Results

Frail older women had a poor score in all PwB outcomes, except for global self-esteem and satisfaction with life. A hierarchical regression model analysis showed that global cognitive status and emotional well-being of subjective happiness and attitude to aging showed a significant negative relationship with PF in both unadjusted and adjusted models (explaining 34 and 40% of variance, respectively).

Conclusion

Emotional well-being and global cognitive performance are strongly associated with PF. Implementing active lifestyle interventions to improve positive psychological outcomes using geriatric assessments could assist in the older institutionalized patients’ physical and mental health care.

The Double-Burden Effect: Does the Combination of Informal Care and Work Cause Adverse Health Outcomes Among Females in China?

Objective: This study investigates the impact of informal care and work stress on women's health and further disentangles this effect through intensity and channel analysis. Method: This research uses the 2000-2015 China Health and Nutrition Survey and employs the propensity score matching model with fixed effects. Results: The care and work burden significantly increases the probability of women suffering from chronic diseases, being underweight or overweight, and self-reporting poor health by 0.63%, 1.69%, and 2.35%, respectively. This double-burden effect is exacerbated as the care and work hours increase. Women who care for more than 20 hr and work for more than 50 hr per week experience the most serious health decline. We further find that the double burden leads to health deterioration through channels of reduced exercise and increased psychological stress. Discussion: This study provides a reliable decision-making basis for policy makers to formulate strategies for informal caregivers in China.

Identifying the Factors Related to Depressive Symptoms Amongst Community-Dwelling Older Adults with Mild Cognitive Impairment

High-level depressive symptoms have been reported in individuals with mild cognitive impairment (MCI), resulting in increased risk of progression to dementia. However, studies investigating the correlates of depressive symptoms among this population are scarce. This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, poor perceived positive social interaction, small social network, low level of physical activity, poor functional status, subjective memory complaint, and poor health perception were correlated with depressive symptoms. The findings highlight that depressive symptoms are sufficient to warrant evaluation and management in older adults with MCI. Addressing social isolation, assisting this vulnerable group in functional and physical activities, and cultivating a positive perception towards cognitive and physical health are highly prioritized treatment targets among individuals with MCI.

Poor emotional well-being is associated with rapid progression in amyotrophic lateral sclerosis

The study aimed to determine the impact of emotional well-being on disease aggressiveness and survival in amyotrophic lateral sclerosis (ALS). In 224 patients with ALS (without significant cognitive deficits) the revised ALS Functional Rating Scale (physical function), the ALS Assessment Questionnaire (ALSAQ-40) for health-related Quality of Life and survival data were collected. Data analysis comprised logistic regression, Kaplan-Meier curves analyses and Cox regression model. Most patients reported to be worried about how the disease will affect them in the future and 67% reported to feel depressed. Patients with good emotional well-being were characterized by better physical function (higher ALSFRS-R) and lower disease aggressiveness. The association between high emotional well-being and lower disease aggressiveness was confirmed in the univariate analysis and also after adjustment for known predictors of disease progression. In the Kaplan-Meier survival curve analysis the overall 1-year, 2-year and 3-year mortality did not significantly differ between patients with poor and good emotional well-being. Our study demonstrates an association between emotional well-being and disease progression. Knowing that subjective well-being is neither a necessary nor a sufficient cause of health, longitudinal studies are necessary to explore when well-being does and does not influence disease progress and survival in ALS.

Characterizing the disability experience among adults living with HIV: a structural equation model using the HIV disability questionnaire (HDQ) within the HIV, health and rehabilitation survey

BACKGROUND

People aging with HIV can experience a variety of health challenges associated with HIV and multimorbidity, referred to as 'disability'. Our aim was to characterize the disability experience and examine relationships between dimensions of disability among adults living with HIV.

METHODS

We performed a structural equation modeling analysis with data from the Canadian web-based HIV, Health and Rehabilitation Survey. We measured disability using the HIV Disability Questionnaire (HDQ), a patient-reported outcome (69 items) that measures presence, severity and episodic features of disability across six domains: 1) physical symptoms, 2) cognitive symptoms, 3) mental-emotional health symptoms, 4) difficulties carrying out day-to-day activities, 5) uncertainty and worrying about the future, and 6) challenges to social inclusion. We used HDQ severity domain scores to represent disability dimensions and developed a structural model to assess relationships between disability dimensions using path analysis. We determined overall model fit with a Root Mean Square Error of Approximation (RMSEA) of < 0.05. We classified path coefficients of ≥ 0.2-0.5 as a medium (moderate) effect and > 0.5 a large (strong) effect. We used Mplus software for the analysis.

RESULTS

Of the 941 respondents, most (79%) were men, taking combination antiretroviral medications (90%) and living with two or more simultaneous health conditions (72%). Highest HDQ presence and severity scores were in the uncertainty domain. The measurement model had good overall fit (RMSEA= 0.04). Results from the structural model identified physical symptoms as a strong direct predictor of having difficulties carrying out day-to-day activities (standardized path coefficient: 0.54; p < 0.001) and moderate predictor of having mental-emotional health symptoms (0.24; p < 0.001) and uncertainty (0.36; p < 0.001). Uncertainty was a strong direct predictor of having mental-emotional health symptoms (0.53; p < 0.001) and moderate direct predictor of having challenges to social inclusion (0.38; p < 0.001). The relationship from physical and cognitive symptoms to challenges to social inclusion was mediated by uncertainty, mental-emotional health symptoms, and difficulties carrying out day-to-day activities (total indirect effect from physical: 0.22; from cognitive: 0.18; p < 0.001).

CONCLUSIONS

Uncertainty is a principal dimension of disability experienced by adults with HIV. Findings provide a foundation for clinicians and researchers to conceptualize disability and identifying areas to target interventions.

Disease progression impacts health-related quality of life in amyotrophic lateral sclerosis

OBJECTIVES

To determine the impact of disease progression on health-related quality of life in amyotrophic lateral sclerosis (ALS).

METHODS

A total of 161 patients with ALS were enrolled. Assessments included the revised ALS Functional Rating Scale and the ALS Assessment Questionnaire (ALSAQ-40). Data analysis comprised linear regression and multivariate analyses.

RESULTS

ALSFRS-R score (β = 0.75, p < 0.001), depression (β = 0.08, p < 0.001), pain (β = 0.07, p < 0.001), hopelessness (β = 0.07, p = 0.001), and progression rate (β = 0.02, p = 0.02) explained 76% of the ALSAQ-40 summary index variance. Progression rate alone explained 7% of the ALSAQ-40 summary index variance. The subdomains of emotional well-being, followed by ADL, and finally communication and eating were most strongly influenced by progression rate.

CONCLUSION

Our study demonstrates the importance of physical health for emotional well-being. In particular, slower disease progression is associated with higher levels of emotional well-being in ALS.

Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults

Background

Relationships among sexual activity, problems and concerns, and well-being among older adults have not been fully explored.

Aim

To investigate associations among sexual activity, problems and concerns, and experienced well-being in a representative sample of older adults.

Methods

In this cross-sectional analysis from the English Longitudinal Study of Ageing, sexual behavior, problems, and concerns were assessed via a self-completed questionnaire. Covariates included age, partnership status, socioeconomic status, smoking status, alcohol intake, limiting long-standing illness, and depressive symptoms. Data were analyzed using 1-way independent analysis of variance.

Main Outcome Measure

Enjoyment of life was assessed with the pleasure subscale of the CASP-19 (Control, Autonomy, Self-realization, and Pleasure), a validated measure of quality of life specific to older age.

Results

Data on sexual activity and enjoyment of life were available for a total of 3,045 men and 3,834 women (mean age 64.4 years in men and 65.3 years in women). Men and women who reported any sexual activity in the past year had significantly higher mean enjoyment of life scores compared with those who were not sexually active (men, 9.75 vs 9.44 [P < .001]; women, 9.86 vs 9.67 [P = .003]). Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life. Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101). Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.

Conclusion

This is among the first studies to show that well-being is higher among older adults when they are sexually active. Preferences regarding the expression of sexual activity differed between the sexes. Further longitudinal research is needed to confirm a causal association between sexual activity and well-being.

Smith L, Yang L, Veronese N, et al. Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults. Sex Med 2019;7:11–18.

The Impact of Road Construction on Subjective Well-Being in Communities in Madre de Dios, Peru

The interoceanic highway (IOH) in Madre de Dios, Peru has driven dramatic change in the Peruvian Amazon basin. We conducted a mixed methods study to examine the impact of these changes on the subjective well-being (SWB) of four communities on the IOH. Themes that emerged qualitatively included changing health threats, environmental degradation, and the impact of increased migration. To achieve a higher level of SWB, respondents emphasized the need for higher incomes, opportunities to learn new skills, and a better education for their children. Potential threats to SWB included marital problems and poorer health. Quantitative analyses suggested that social support and a sense of security impacted reported SWB scores based on life satisfaction, and the impact of income on life satisfaction was mediated by food security. Although long-term residents felt that specific determinants of SWB had both increased (food variety, transport and access to work) and decreased (access to natural resources and hunting), the majority reported that their lives had improved overall. Health had been affected by the IOH in both negative ways (increased dengue and road accidents) and positive ways (improved access to health services). Our results suggest that the rapidly-changing communities near the IOH link well-being to health, income, community, and the environment.

Successful aging among Chinese near-centenarians and centenarians in Hong Kong: a multidimensional and interdisciplinary approach

OBJECTIVES

This study applied a multidimensional model on a continuum to examine successful aging (SA) and investigated whether SA is associated with biomedical and psychosocial-demographic factors among Hong Kong Chinese near-centenarians and centenarians.

METHOD

A cross-sectional data analysis was performed on a geographically representative sample of 120 near-centenarians and centenarians with an age range of 95-108 years. We developed an integrated and cumulative Successful Aging Index (SAI) based on participants' performance in four dimensions: (1) physical and functional health (PF), (2) psychological well-being and cognition (PC), (3) social engagement and family support (SF), (4) economic resources and financial security (EF). To examine the criterion validity of SAI, we conducted a multiple binary logistic regression with interviewer-rated health. A multiple regression model was ran to investigate the independent biomedical and psychosocial-demographic correlates of SAI.

RESULTS

Results show that only 5.8% of participants attained SA in all four dimensions. PF had the least achievers, whereas the proportion was the highest in PC. SAI was significantly associated with interviewer-rated health and a high level of high-density lipoprotein cholesterol. Living with family or friends, high level of optimism, fewer diseases, and barriers to social activities were independent predictors of SAI score.

CONCLUSION

In the light of the lack of consensus on the constituents and assessment of SA especially among very old adults, our findings add to the extant literature by underscoring the importance of the multidimensional nature and the utility of an integrated and cumulative-based assessment of SA at the extreme of longevity.

Depression Moderates the Frailty-Subjective Health Link among Chinese Near Centenarians and Centenarians

OBJECTIVE

Very old adults may be physically frail, but they do not necessarily experience poor subjective health. The authors hypothesized that the relationship between frailty and subjective health is moderated by depression for very old people.

METHODS

In a cross-sectional study, a survey administered was by a face-to-face interview to 129 community-dwelling older adults aged 95-108. Measurements included the five-item FRAIL scale, the Geriatric Depression Scale Short-Form (GDS), and a subjective health rating. Hierarchical multiple regressions were conducted to test the moderation effects, adjusting for age, gender, living arrangement, perceived socioeconomic status, and cognition.

RESULTS

The interaction effect between frailty and depression was significant. Inspection of the simple slopes revealed that those who were more depressed had a more negative frailty-subjective health relationship. There was no significant moderation effect for a withdrawal-apathy-vigor dimension of the GDS.

CONCLUSION

Our findings suggest a protective psychological mechanism may enable very old adults to maintain an optimistic view of their health despite their increasing physical and functional limitations.

The Moderating Role of Autonomous Motivation on the Relationship between Subjective Well-Being and Physical Health

The purpose of this study was to investigate the moderator effects of autonomous motivation on the relationship between subjective well-being and physical health. Using a cluster sampling approach 486 students (403 female and 83 male students) were included in this study. Subjective well-being, physical health and autonomous motivation were determined by self-report measures. Data were analysed using hierarchical regression analysis and analysis of variance. The results show that high self-determination moderates the relationship between high subjective well-being and physical health. Accordingly, the best physical health was reported by participants who had high level of subjective well-being and whose behaviours were self-determined. Additional analyses have shown that the moderating effect of self-determination is based on the moderational impact of autonomous motives and not the controlling ones. Additionally, whether autonomous motivation moderates the relationship between components of subjective well-being and physical health was also tested. The findings have shown that autonomous motives moderate relationship between physical health and one component of well-being, positive affect. Consequently, a good physical health was found among participants with high positive affect and behaviours regulated by high degree of autonomous motives. Conclusion which can be drawn from these findings is that if an individual behaves autonomously then it can contribute to positive mind-body influences and support their own health.

Successful aging and subjective well-being among oldest-old adults

PURPOSE OF THE STUDY

This research integrates successful aging and developmental adaptation models to empirically define the direct and indirect effects of 2 distal (i.e., education and past life experiences) and 5 proximal influences (i.e., physical functioning, cognitive functioning, physical health impairment, social resources, and perceived economic status) on subjective well-being. The proximal influences involved predictors outlined in most extant models of successful aging (e.g., Rowe & Kahn, 1998 [Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon Books.]). Our model extends such models by including distal impact as well as interactions between distal and proximal impacts.

DESIGN AND METHODS

Data were obtained from 234 centenarians and 72 octogenarians in the Georgia Centenarian Study. Structural equation modeling was conducted with Mplus 6.1.

RESULTS

Results showed significant direct effects of physical health impairment and social resources on positive aspects of subjective well-being among oldest-old adults. We also found significant indirect effects of cognitive functioning and education on positive affect among oldest-old adults. Social resources mediated the relationship between cognitive functioning and positive affect; and cognitive functioning and social resources mediated the relationship between education and positive affect. In addition, physical health impairment mediated the relationship between cognitive functioning and positive affect; and cognitive functioning and physical health impairment mediated the relationship between education and positive affect.

IMPLICATIONS

Integrating 2 different models (i.e., successful aging and developmental adaptation) provided a comprehensive view of adaptation from a developmental perspective.

Psychological well-being and metacognition in the fourth age: an explorative study in an Italian oldest old sample

OBJECTIVES

The research largely aimed at exploring the impact of marital status, cognitive efficiency, gender, physical health and sociocultural context on self-rated emotional competence, depression, memory and cognitive measures.

METHOD

Ninety-four healthy adults aged 75-99 were recruited in the Sardinian province of Ogliastra, where a collectivistic culture prevails, and in northern Italy, which in turn is characterized by the prevalence of individualistic cultural traits. Participants were administered self-referent metacognitive efficiency, subjective wellness and depression measures.

RESULTS

Sardinian elders self-rated lower levels of depression and cognitive failures and had greater levels of emotional competence.

CONCLUSIONS

Perceived psychological well-being, metacognitive efficiency and depression seem to be affected by sociocultural context.

Health conditions in regions of Eastern and Western Europe

OBJECTIVES

We report health conditions in the regions of the European Union (EU) from both objective and subjective perspectives and verify whether drawing conclusions regarding the health conditions in different countries without considering the countries' sub-national variability may lead to inaccurate results.

METHODS

To depict health conditions in the EU regions, two classification methods are used: (1) hierarchical clustering with Ward's method and squared Euclidean distance and (2) k-mean clustering. To illustrate the intra-country variability of health conditions, the coefficients of variation are computed.

RESULTS

Health conditions are considerably better in the western regions of the EU. Objective and subjective health measures do not always coincide. Extensive within-country differences in health conditions exist.

CONCLUSIONS

The EU is clearly split into the EU-15 and Central and Eastern European countries; however, this division is observed with respect to objective health conditions only. Inclusion of self-perceived health status in the analysis measures considerably changes this picture.

Relationships between dimensions of disability experienced by adults living with HIV: a structural equation model analysis

As individuals age with HIV it is increasingly important to consider the health-related consequences of HIV and multiple morbidities, known as disability. We assessed relationships between four dimensions of disability among adults living with HIV. We conducted a structural equation modeling analysis using data from 913 participants in the Ontario HIV Treatment Network Cohort Study to determine relationships between four latent variables of disability in the Episodic Disability Framework: physical symptoms and impairments, mental health symptoms and impairments, difficulties with day-to-day activities, and challenges to social inclusion. Results indicated that physical symptoms and impairments, mental health symptoms and impairments and difficulties with day-to-day activities directly or indirectly predicted challenges to social inclusion for adults living with HIV. Challenges to social inclusion were directly predicted by mental health symptoms and indirectly by physical health symptoms via (mediated by) having difficulties carrying out day-to-day activities and mental health symptoms and impairments. These findings provide a basis for conceptualizing disability experienced by people living with HIV.

The older they are, the less successful they become? Findings from the georgia centenarian study

This study examined whether oldest-old adults are successful agers. Three hundred and six octogenarians and centenarians of Phase III of the Georgia Centenarian Study participated in this study. A first model examined Rowe and Kahn's successful aging model (Rowe and Khan (1997 and 1998)) including the probability of disease, physical or cognitive capacity, and engagement with life. All three components were applied to assess how many oldest-old adults satisfied all three criteria. The result showed about 15% of octogenarians (15.1%), and none of centenarians satisfied all three components of successful aging. Consequently, a second alternative model focused on psychosocial aspects including three different components: subjective health, perceived economic status, and happiness. Different from Rowe and Kahn's successful aging model, a total of 62.3% of octogenarians and 47.5% of centenarians satisfied all three components of the alternative model of successful aging. The results suggest that additional criteria of successful aging should be considered thereby expanding the concepts and multidimensional aspects of successful aging among oldest-old adults.

Multidimensional predictors of fatigue among octogenarians and centenarians

BACKGROUND

Fatigue is a common and frequently observed complaint among older adults. However, knowledge about the nature and correlates of fatigue in old age is very limited.

OBJECTIVE

This study examined the relationship of functional indicators, psychological and situational factors and fatigue for 210 octogenarians and centenarians from the Georgia Centenarian Study.

METHODS

Three indicators of functional capacity (self-rated health, instrumental activities of daily living, physical activities of daily living), two indicators of psychological well-being (positive and negative affect), two indicators of situational factors (social network and social support), and a multidimensional fatigue scale were used. Blocked multiple regression analyses were computed to examine significant factors related to fatigue. In addition, multi-group analysis in structural equation modeling was used to investigate residential differences (i.e., long-term care facilities vs. private homes) in the relationship between significant factors and fatigue.

RESULTS

Blocked multiple regression analyses indicated that two indicators of functional capacity, self-rated health and instrumental activities of daily living, both positive and negative affect, and social support were significant predictors of fatigue among oldest-old adults. The multiple group analysis in structural equation modeling revealed a significant difference among oldest-old adults based on residential status.

CONCLUSION

The results suggest that we should not consider fatigue as merely an unpleasant physical symptom, but rather adopt a perspective that different factors such as psychosocial aspects can influence fatigue in advanced later life.