Education and Psychosocial Functioning Among Older Adults: 4-Year Change in Sense of Control and Hopelessness

Effects of Mind-Body Qigong Exercise on Overall Health, Fatigue/Sleep, and Cognition in Older Chinese Immigrants in the US: An Intervention Study with Control

Background

Culturally relevant exercises may help improve health and address disparities faced by older immigrants due to language and cultural barriers. Few studies have focused on such exercise interventions among older Chinese immigrants at US daycare centers.

Methods

We conducted a 10-week nonrandomized controlled trial in older Chinese immigrants in Philadelphia, US. The intervention group practiced Chinese Qigong (Baduanjin) 5 days a week guided by trained research assistants and video instructions. The control group maintained their usual daily activities. We collected self-report assessments on overall health, sleep, and fatigue and implemented two computerized cognitive tests measuring psychomotor vigilance task (PVT) and memory twice, preintervention and postintervention. Repeated measures general linear model (GLM) and paired samples t-tests were used for data analyses.

Results

Eighty-eight older adults (Qigong, n = 53; control, n = 35) with an average age of 78.13 (SD = 5.05) were included. Groups showed no significant differences at baseline evaluation. After the 10-week exercise, the intervention group showed significant improvements in overall health (p=0.032), fatigue (p < 0.001), and cognitive functions including memory (p=0.01), response speed (p=0.002), and response time (p=0.012) on the PVT, as well as marginally significant benefits in sleep (p=0.058). Between-group comparisons identified significant group-by-time interactions in health (p=0.024), sleep (p=0.004), fatigue (p=0.004), and memory (p=0.004).

Conclusion

We revealed significant positive effects of Qigong in older Chinese immigrants across multiple health domains. Findings highlight the potential of a culturally relevant exercise in addressing health disparities.

Validation of the Spanish version of the Perceived Control Scale: Perceived Constraints on Personal Control and Perceived Mastery

OBJECTIVES

Perceived control is a relevant variable for understanding middle and older adults' mental health. The Perceived Control Scale has two dimensions, Perceived Constraints on Personal Control and Perceived Mastery, and is a widely used instrument for assessing perceived control in adults. The aim of this study was to analyze the psychometric properties of the Spanish version of the Perceived Control Scale with data from two different studies.

METHOD

In Study 1, 348 older adults between 60 and 92 years old were assessed through face-to-face assessments. In Study 2, 334 adults between 40 and 90 years completed an online survey. Perceived control, self-perceptions of aging, and anxiety and depressive symptomatology were assessed. An exploratory (Study 1) and confirmatory (Study 2) factor analysis of the Perceived Control Scale were performed, and reliability and its relationship with the other assessed variables were evaluated.

RESULTS

Results from parallel, exploratory, and confirmatory factor analyses suggested that the Spanish version of the Perceived Control Scale has a bidimensional structure: Perceived Constraints on Personal Control and Perceived Mastery. Good internal consistency was found for the scale in both samples. The results revealed negative and significant associations with negative self-perceptions of aging, and anxiety and depressive symptomatology.

CONCLUSION

The Spanish version of the Perceived Control Scale shows good psychometric properties which endorse its use with middle-aged and older adults assessed either face-to-face or through online surveys.

Identifying the impact of social isolation and loneliness on psychological well-being among the elderly in old-age homes of India: the mediating role of gender, marital status, and education

BACKGROUND

Social isolation and loneliness can be detrimental to the overall functioning of the older adults. The study examines the impact of social isolation and loneliness on the psychological well-being of older adults residing in various old-age homes in India and investigates the mediating role of gender, marital status, and education level in the way social isolation and loneliness affect psychological well-being.

METHODS

Data has been collected from 320 individuals aged sixty years or above. Data were collected using standardized measures like Lubben Social Network Scale- 6, revised UCLA Loneliness Scale, and shortened version of psychological well-being scale by Ryff & Keyes (1995). Multivariate and mediation analysis were performed to understand the associations of social isolation and loneliness with psychological well-being.

RESULTS

A statistically significant MANOVA effect was obtained for social isolation (F = 3.836, p < .01), and loneliness (F = 3.782, p < .01). Gender and education as independent factors were significantly associated with the psychological well-being of individuals. However, both gender and education did not mediate the impact of social isolation and loneliness on the psychological well-being of older adults. Further, marital status had a partial mediating effect on the relationship between social isolation, loneliness, and psychological well-being.

CONCLUSIONS

The findings of the study can be incorporated into measures aiming at alleviation of feelings of social isolation and loneliness among the elderly. Further, the findings can be used to design various intervention strategies aimed at the reduction of social isolation and loneliness among older adults and the restoration of their psychological well-being.

Age Specificity of Effects of Health Problems on Drinking Reduction: A Lifespan Developmental Analysis

Older adult drinking poses a growing public health concern, especially given the ongoing aging of the United States population. As part of a larger lifespan developmental project contrasting predictors of drinking reductions across different periods of adulthood, we tested age differences in effects of health problems on drinking declines across young adulthood, midlife, and older adulthood. We predicted these effects to be developmentally specific to midlife and older adulthood. We also tested moderation by alcohol use disorder (AUD) symptomatology and by indices of sociodemographic disadvantage (sex and race/ethnicity). Analyses used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), leveraging NESARC's vast age range (18-90 + ; N = 43,093) and two waves of longitudinal data. Multiple-group cross-lag models tested differences across age groups in cross-lag paths between health problems and alcohol consumption. As hypothesized, health problem effects on drinking reductions were developmentally specific to midlife and older adulthood. However, models testing moderation by AUD symptomatology showed that these adaptive effects of health problems on drinking reductions did not extend to those with one or more AUD symptoms. Little evidence was found for moderation by sex or race/ethnicity. Findings support the notion of health concerns as a pathway to drinking reduction that increases in importance across the adult lifespan. However, given the moderation by AUD symptoms, findings also highlight a need to understand barriers to health-related pathways to drinking reduction among relatively severe midlife and older adult drinkers. These findings hold implications for lifespan developmental tailoring of clinical, public health, and policy interventions.

Coping Styles and Cognitive Function in Older Non-Hispanic Black and White Adults

OBJECTIVES

Coping styles refer to cognitive and behavioral patterns used to manage the demands of stressors, and effective coping represents a psychological resource. Some studies have linked coping styles to executive functioning, but less is known about coping styles and their associations with cognition across social groups known to differ in stress exposure and dementia risk. This study aimed to characterize associations between coping styles and cognitive functioning across non-Hispanic Black and non-Hispanic White older adults.

METHODS

Participants were drawn from the Michigan Cognitive Aging Project (N = 453; age mean (SD) = 63.6 (3.2); 53% non-Hispanic Black). Problem-focused and emotion-focused coping were measured using the Coping Orientation to Problems Experienced Inventory. Global cognition was a composite of 5 cognitive domain scores derived from comprehensive neuropsychological tests. Cross-sectional associations between coping styles and cognition were examined using race-stratified regressions controlling for demographic and health covariates.

RESULTS

Black older adults reported more emotion-focused coping than White older adults, but there were no race differences in problem-focused coping. Among Black older adults, less problem-focused coping and more emotion-focused coping were each associated with worse cognition. Among White older adults, emotion-focused coping was marginally linked to cognition.

DISCUSSION

Greater emotion-focused coping among Black older adults may reflect greater exposure to stressors that are uncontrollable. Patterns of racial differences in coping-cognition links are in line with the social vulnerabilities hypothesis. Coping style may be a particularly important psychosocial resource for cognitive health among Black older adults that could be incorporated into culturally relevant interventions.

Effects of reminiscence therapy on psychological outcome among older adults without obvious cognitive impairment: A systematic review and meta-analysis

Introduction

Reminiscence therapy has been a high-benefit and low-cost measure of psychosocial intervention for older adults in recent years. It has attracted much attention in the intervention study of older adults without obvious cognitive impairment. This study aimed to evaluate the effects of reminiscence therapy on psychosocial outcomes among older adults without obvious cognitive impairment and analyze the divergences of different intervention programs (form, duration, and setting) on outcomes.

Methods

We searched the commonly used databases and used RevMan 5.4 in the meta-analysis (PROSPERO-ID: CRD42022315237). All eligible trials used the Cochrane Risk of Bias Tool and the Effective Public Health Practice Project quality assessment tool to identify the quality and determine the bias risk grade.

Results

Twenty-seven studies were included, involving 1,755 older adults. Meta-analysis showed that reminiscence therapy has a significant effect on both depression and life satisfaction. Group reminiscence played a significant role in improving life satisfaction. Depression symptoms were not affected by the intervention duration (P = 0.06), while life satisfaction was significantly improved after more than 8 weeks of intervention (P < 0.00001). Intervention settings drove differences in depressive symptoms (P = 0.02), and the effect size of the community was larger.

Conclusion

Reminiscence therapy can significantly reduce depressive symptoms and improve life satisfaction. There are different effects of reminiscence therapy in different intervention schemes on psychological outcomes among older adults. More well-designed trials with large sample sizes and long-term follow-ups are necessary to confirm and expand the present results.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=315237, identifier: CRD42022315237.

Educational quality may be a closer correlate of cardiometabolic health than educational attainment

Educational quality may be a closer correlate of physical health than more commonly used measures of educational attainment (e.g., years in school). We examined whether a widely-used performance-based measure of educational quality is more closely associated with cardiometabolic health than educational attainment (highest level of education completed), and whether perceived control (smaller sample only), executive functioning (both samples), and health literacy (smaller sample only) link educational quality to cardiometabolic health. In two samples (N = 98 and N = 586) collected from different regions of the US, educational quality was associated with cardiometabolic health above and beyond educational attainment, other demographic factors (age, ethnoracial category, sex), and fluid intelligence. Counter to expectations, neither perceived control, executive function, nor health literacy significantly mediated the association between educational quality and cardiometabolic health. Findings add to the growing literature suggesting that current operationalizations of the construct of education likely underestimate the association between education and multiple forms of health. To the extent that educational programs may have been overlooked based on the apparent size of associations with outcomes, such actions may have been premature.

Genes Related to Education Predict Frailty Among Older Adults in the United States

OBJECTIVE

This article expands on research that links education and frailty among older adults by considering the role of genes associated with education.

METHOD

Data come from a sample of 7,064 non-Hispanic, white adults participating in the 2004-2012 waves of the Health and Retirement Study. Frailty was measured with two indices: (a) The Frailty Index which corresponds to a deficit accumulation model; and (b) The Paulson-Lichtenberg Frailty Index which corresponds to the biological syndrome/phenotype model. Genes associated with education were quantified using an additive polygenic score. Associations between the polygenic score and frailty indices were tested using a series of multilevel models, controlling for multiple observations for participants across waves.

RESULTS

Results showed a strong and negative association between genes for education and frailty symptoms in later life. This association exists above and beyond years of completed education and we demonstrate that this association becomes weaker as older adults approach their 80s.

DISCUSSION

The results contribute to the education-health literature by highlighting new and important pathways through which education might be linked to successful aging.

"What Doesn't Kill You, Makes You Stronger": Psychosocial Resources and the Mental Health of Black Older Adults

A robust body of research has shown that Black Americans are less likely than Whites to have psychiatric disorders despite the social and economic disadvantage and systemic racism that they face. This mental health paradox has been demonstrated across all ages of the life course, including older adulthood. One of the prevailing explanations for the lower prevalence of psychiatric disorders among Blacks pertains to the influence of psychosocial resources on mental health. Psychosocial resources can directly or indirectly support mental health through physiological and psychological pathways. They can also mitigate the adverse effects of social stressors of discrimination and other stressors on psychological distress and mental illness. Black older adults may particularly benefit from psychosocial resources because they have had a lifetime of experiencing and overcoming adversity. Although this cycle of stress adaptation can wear away at the physical body, it may facilitate mental health resilience. In this chapter, we review research on the relationship between psychosocial resources and mental health. The chapter begins with a brief review of the Black-White mental health paradox and the mechanisms through which psychosocial resources operate to influence mental health. We then review research on intrapersonal, interpersonal, and community-level psychosocial resources that are particularly salient for Black Americans. Throughout the chapter we highlight research specifically focused on Black older adults and discuss the cultural relevance of each resource to their mental health and psychological functioning.

Hopelessness Among Middle-Aged and Older Blacks: The Negative Impact of Discrimination and Protecting Power of Social and Religious Resources

Background and Objectives

Hopelessness—a state of despair characterized by a negative outlook towards the future and a belief in insurmountable challenges—is a risk factor for major depression, cardiovascular disease, and all-cause mortality among older adults. It is also an understudied consequence of discrimination. Older blacks disproportionately report experiencing discrimination and, as a result, may be at greater risk of feeling hopeless. However, social and religious resources may protect against the adverse effects of discrimination. The current study examines whether social support, social engagement, religious attendance, and religiosity buffer the effects of self-reported everyday discrimination on hopelessness among a nationally representative sample of blacks.

Research Design and Methods

Using data from the 2010/2012 psychosocial assessment of the Health and Retirement Study, we regressed hopelessness on everyday discrimination, stratifying by 2 age groups, ages 51–64, representing middle-age (n = 1,302), and age 65 and older, representing old age (n = 887). Interaction terms tested whether each resource moderated the discrimination–hopelessness relationship controlling for depressive symptoms, socioeconomic status, and demographic characteristics.

Results

Greater reports of everyday discrimination were associated with higher levels of hopelessness for middle-aged and older blacks. For middle-aged blacks, the resources did not moderate the discrimination–hopelessness relationship; rather, higher levels of support (b = −0.294, p < .01), religiosity (b = −0.297, p < .001), religious attendance (b = −0.218, p < .05) were independently and inversely associated with hopelessness. For older blacks, higher levels of religiosity moderated the discrimination–hopelessness relationship (b = −0.208, p < .05) and higher levels of support (b = −0.304, p < .05) and social engagement (b = −0.236, p < .05) were independently and inversely associated with hopelessness.

Discussion and Implications

Findings suggest that self-reported everyday discrimination increases hopelessness among middle-aged and older blacks but social and religious resources may counterbalance its effects, in age-specific ways, to protect against hopelessness. Religiosity may be especially important for older blacks as a buffer against the negative consequences of discrimination on hopelessness.

Racial/Ethnic Disparities in Self-Rated Health and Sense of Control for Older Adults Receiving Publicly Funded Home- and Community-Based Services

Objectives: This study examines racial/ethnic differences in self-rated health (SRH) and sense of control among older adults receiving publicly funded home- and community-based services (HCBS) and tests the mediating role of functional, emotional, and financial stressors. Methods: Data are from 2015 National Core Indicators—Aging and Disability Survey collected from face-to-face interviews with 1936 older adults aged 65 years or older receiving HCBS in Minnesota. Path analysis based on logistic regression was used. Results: Racial/ethnic minority HCBS users had lower SRH and sense of control than white participants, with Asian participants reporting the lowest scores. Whereas functional impairment was a common explanatory factor for the racial/ethnic differences, negative mood and financial strain were mediators for Asian and Hispanic/Latino participants, respectively. Discussion: Racial/ethnic disparities in well-being exist among older HCBS users, with different mediators at play. Customized services are needed to meet diverse needs of older adults of different racial/ethnic groups.

Self-perceptions of aging mediate the longitudinal relationship of hopelessness and depressive symptoms

OBJECTIVES

The purpose of the current study was to examine the hypothesis that the prospective relationship between hopelessness and depressive symptoms is mediated by self-perceptions of aging.

METHODS

Data from 3 waves of the US Health and Retirement Study (2008, 2012, and 2014) were used (N = 4606; age M = 65.3, 55.5% female). In mediation analyses, hopelessness in 2008 was the independent variable, self-perceptions of aging in 2012 were the mediator, and depressive symptoms in 2014 were the outcome variable.

RESULTS

After controlling for covariates, hopelessness in 2008 was an independent predictor of self-perceptions of aging in 2012 (β = -.10, P < .001), and self-perceptions of aging in 2012 was an independent predictor of depressive symptoms in 2014 (β = -.41, P < .001). Hopelessness in 2008 showed both direct (β = .09, P < .001) and indirect (β = .03, P < .001) effects on depressive symptoms in 2014, indicating partial mediation by change in self-perceptions of aging.

CONCLUSIONS

As hypothesized, change in self-perceptions of aging partially mediated the relationship of hopelessness with depressive symptoms 6 years later. Findings are consistent with a conceptualization of hopelessness as broad negative expectations about the future that may contribute to negative self-perceptions of aging and subsequent changes in depressive symptoms. Reducing hopelessness, increasing hope, and improving self-perceptions of aging have potential to reduce and prevent depressive symptoms for older adults. Future research should examine the mechanisms of these interrelationships and other aging outcomes.

Sociodemographic Factors Associated With Changes in Successful Aging in Spain: A Follow-Up Study

OBJECTIVE

Successful aging (SA) refers to maintaining well-being in old age. Several definitions or models of SA exist (biomedical, psychosocial, and mixed). We examined the longitudinal association between various SA models and sociodemographic factors, and analyzed the patterns of change within these models.

METHOD

This was a nationally representative follow-up in Spain including 3,625 individuals aged ≥50 years. Some 1,970 individuals were interviewed after 3 years. Linear regression models were used to analyze the survey data.

RESULTS

Age, sex, and occupation predicted SA in the biomedical model, while marital status, educational level, and urbanicity predicted SA in the psychosocial model. The remaining models included different sets of these predictors as significant. In the psychosocial model, individuals tended to improve over time but this was not the case in the biomedical model.

CONCLUSION

The biomedical and psychosocial components of SA need to be addressed specifically to achieve the best aging trajectories.