On the role of personality in successful aging: A scoping review

BACKGROUND AND OBJECTIVES

This study aimed to critically examine current knowledge on the role of personality in successful aging, considering McAdams' (Hooker & McAdams, 2003; McAdams, 2015) three-level, six-foci model of personality. The aim was also to pinpoint knowledge gaps that research should address in the future.

RESEARCH DESIGN AND METHODS

We carried out a scoping review on the literature on successful aging and personality, following the five-step framework proposed by Arksey and O'Malley (2005) and further expanded by Levac et al. (2010).

RESULTS

Research into the role of personality in successful aging has grown significantly over the last 20 years. However, the increasing number of publications on the topic was primarily accounted for by studies focused on layer 1 and particularly layer 2 of McAdams' model of personality, with layer 3 being scarcely addressed. Research that included more than one layer of personality was rare.

DISCUSSION AND IMPLICATIONS

Our study pinpointed gaps that should be considered in future research in this area. These gaps were related to advancing towards agreed-upon definitions of successful aging and personality, broadening the scope of research on this topic, and integrating personality dimensions on research on successful aging.

Digital Gender Gap in the Second Half of Life is Declining: Changes in Gendered Internet Use Between 2014 and 2021 in Germany

OBJECTIVES

The main purpose of the study has been to examine changes in Internet use among men and women in three age groups (mid-life, early old age, and advanced old age) between 2014 and 2021. We tested two hypotheses: The complementary hypothesis posits that online activities reproduce gender differences in offline activities. The compensatory hypothesis posits that women are catching up over time in male-typed activities as Internet access approaches saturation for both genders.

METHODS

We used representative, longitudinal data from the German Ageing Survey (DEAS) collected in 2014, 2017, 2020, and 2021 (n=21,505, age rage 46-90 years). We ran logistic regressions on Internet access and Internet use for four differently gender-typed activities: social contact (female-typed), shopping (gender neutral), entertainment (male-typed), and banking (male-typed).

RESULTS

Between 2014 and 2021, women drew level with men in Internet access. Gender differences in all four forms of Internet use declined considerably between 2014 and 2021. Women overtook men in using the Internet for social contact. In older age groups, men held the lead regarding online banking. During the COVID-19 crisis, women caught up to men in Internet use, especially for entertainment.

DISCUSSION

Overall time trends support the complementary hypothesis. By contrast, the finding that women have been catching up in in some male-typed online activities during the COVID-19 pandemic, supports the compensatory hypothesis.

INTERNET USE AND LONELINESS: CURE OR CAUSE? LONGITUDINAL ANALYSIS OF OLDER ADULTS’ INTERNET USE

The internet provides an indispensable platform for social interaction, entertainment and everyday tasks. Especially older adults might benefit from staying engaged online to counteract loneliness. Yet, current research on how internet use effects loneliness still paints a contradictory picture. The current study investigates the longitudinal influence of social internet use forms as opposed to general internet use on loneliness across three years (2014-2017) separately in two age groups (pre-retirement: 40-64 years and post-retirement: 65-85 years), using data from the German Ageing Survey (DEAS). Structural equation modelling shows, that general web use predicts an increase in loneliness in both age-groups. However, contacting friends and family online seems to protect against loneliness over and above the effect of overall internet use, at least for the younger age-group. Therefore, the current study underlines the importance of investigating what exactly people do online instead of seeing the internet as a homogenous tool.

Toward a More Comprehensive Concept of Successful Aging: Disability and Care Needs

Rowe and Kahn’s model of Successful Aging 2.0 argues that changing environmental settings, societal policies, and individual life styles will lead to a significant extension of healthy life years. Recent epidemiological research, however, confirms the dilemma that the ongoing extension of life expectancy prolongs not only the years in good health but also those in poor health. We see it as a major limitation that Rowe and Kahn’s model is not able to cover the emerging linkage between increasing life expectation and aging with disability and care needs. Therefore, we suggest a set of propositions towards a more comprehensive model of successful aging which captures desirable living situations including for those who grow old with disabilities and care needs. We describe individual, environmental, and care related strategies and resources for autonomy and quality of life when facing disabilities and care needs in late life, putting emphasis on inter-individual differences and social inequality. We argue that expanding the traditional concept of successful aging to aging with disabilities and care needs serves not to undermine, but rather to anchor the concept in aging science and in public perception.

Regional resources buffer the impact of functional limitations on perceived autonomy in older adults with multiple illnesses

Retaining perceptions of autonomy is a key component of successful aging. Perceived autonomy refers to the capacity to make and enact self-directed decisions. These perceptions are often threatened in older adults with multiple illnesses, when functional limitations resulting from these illnesses impede the enactment of self-directed decisions. Regional resources (in Germany specifically at the level of administrative districts) might counteract these impediments of autonomy. Economically stronger districts can provide more-concrete support resources for older adults, buffering the negative effect of functional limitations on self-perceived autonomy. This study assessed participants aged over 65 with 2 or more chronic conditions. In total, N = 287 provided data (Mage = 73.3, SD = 5.07), and n = 97 were women. Gross domestic product (GDP) per capita was used as a proxy measure of administrative district wealth in Germany. Hierarchical multilevel regression analyses with cross-level interactions were conducted. Results suggest that the detrimental effect of functional limitations on perceived autonomy is less pronounced for participants residing in higher GDP districts. Conversely, for participants in lower GDP districts, the effect is exacerbated. This finding suggests that districts with greater financial resources might be better able to invest in supports that promote and facilitate autonomy and, thus, provide a buffer against threats to individual perceived autonomy.

Interactive effects of social support and social conflict on medication adherence in multimorbid older adults

With increasing age and multimorbidity, medication regimens become demanding, potentially resulting in suboptimal adherence. Social support has been discussed as a predictor of adherence, but previous findings are inconsistent. The study examines general social support, medication-specific social support, and social conflict as predictors of adherence at two points in time (6 months apart) to test the mobilization and social conflict hypotheses. A total of 309 community-dwelling multimorbid adults (65-85 years, mean age 73.27, 41.7% women; most frequent illnesses: hypertension, osteoarthritis and hyperlipidemia) were recruited from the population-representative German Ageing Survey. Only medication-specific support correlated with adherence. Controlling for baseline adherence, demographics, physical fitness, medication regimen, and attitude, Time 1 medication-specific support negatively predicted Time 2 adherence, and vice versa. The negative relation between earlier medication-specific support and later adherence was not due to mobilization (low adherence mobilizing support from others, which over time would support adherence). Social conflict moderated the medication-specific support to adherence relationship: the relationship became more negative, the more social conflict participants reported. Presence of social conflict should be considered when received social support is studied, because well-intended help might have the opposite effect, when it coincides with social conflict.

Loneliness in old age in Eastern and Western European societies: theoretical perspectives

Data from European countries participating in the Generations and Gender Surveys showed that mean loneliness scores of older adults are higher in Eastern than in Western European countries. Although co-residence is considered as one of the fundamental types of social integration, and although co-residence is more common in Eastern Europe, the mean loneliness scores of older co-resident adults in Eastern Europe are still very high. This article investigates mechanisms behind the puzzling between-country differences in social integration and loneliness. Firstly, the theoretical framework of loneliness is discussed starting from the individual's perspective using the deficit and the cognitive discrepancy approach and taking into account older adults' deprived living conditions. Secondly, mechanisms at the societal level are investigated: cultural norms, the demographical composition and differences in societal wealth and welfare. It is argued that an integrated theoretical model, as developed in this article, combining individual and societal level elements, is most relevant for understanding the puzzling reality around social integration and loneliness in country-comparative research. An illustration of the interplay of individual and societal factors in the emergence of loneliness is presented.

Contextual and individual predictors of physical activity: Interactions between environmental factors and health cognitions

OBJECTIVE

Although health behavior theories assume a role of the context in health behavior self-regulation, this role is often weakly specified and rarely examined. The two studies in this article test whether properties of the environment (districts) affect if and how health-related cognitions are translated into physical activity.

METHODS

Multilevel modeling was used to examine the assumed cross-level interactions. Study 1 is a large-scale survey representative of the German adult population (N = 6,201). Gross domestic product (GDP) on the level of administrative districts was used to indicate environmental opportunities and barriers. Study 2 examined cross-level interactions of proximal predictors of physical activity (intentions, action planning, and coping planning) in older adults with multiple illnesses (N = 309), a high-risk group for health deteriorations.

RESULTS

Study 1 showed that on the individual level, health attitudes (B = .11) and education (B = .71) were significantly associated with physical activity. GDP moderated the attitudes-behavior relation (B = .01), with higher attitude-behavior relations in districts with higher GDP. Study 2 finds that intention (B = .16), action planning (B = .17), and coping planning (B = .13) significantly predict activity. In addition, district-level GDP significantly moderated the relations between action planning and coping planning, but not intention, on physical activity.

CONCLUSIONS

Results suggest that the effects of health attitudes and planning on physical activity are moderated by environmental factors. Districts with higher GDP provide better contextual opportunities for the enactment of concrete if-then plans for physical activity. This has implications for both theory and health promotion.

[Autonomy despite multimorbidity in old age--the Berlin-based AMA research consortium]

The proportion of the population with multiple illnesses increases with age and growing numbers of people are now living to a very old age. Despite medical progress and improved living conditions, many old people have to deal with physical, psychological, and social impairments. It is a crucial challenge for health and social policy to support the elderly with health-related impairments in their desire to lead as independent a life as possible. Against this background the research consortium Autonomy Despite Multimorbidity in Old Age (AMA I) examined the extent to which the self-determined life style of multimorbid old and very old persons can be supported and maintained. In order to reflect the diversity of life worlds of the elderly, the study sample included participants who were not notably impaired in their everyday functioning, participants in need of nursing care and participants with cognitive impairments. Moreover, the sample comprised both older persons who were still living in their own homes and nursing home residents. The studies conducted within the AMA framework focused on the resources available to old persons living in different situations and on how these resources can be strengthened. This article presents findings from the first phase of funding of the AMA research consortium. In a second phase of funding (2011-2013, AMA II), sustainable practice-based interventions are being developed to mobilize resources which can help multimorbid older persons to maintain their autonomy and the practical viability of these interventions will be tested.

Research on Active Aging in Germany

The year 2012 is the European Year of Active Aging and Intergenerational Solidarity. On this occasion, the journal GeroPsych presents an overview of the contributions of gerontopsychology to active aging across Europe. Active aging comprises both individual processes and societal opportunity structures for health, participation and integration. The goal of interventions for active aging is to enhance the quality of life as people age. In the following, we will sketch the situation of gerontopsychological research on active aging in Germany. We firstly describe some important milestones in the history of gerontopsychology in Germany, secondly point to some research institutions and their contributions to active aging in Germany, and thirdly give some examples of research on active aging we are involved in ourselves.

Changes in functional health, changes in medication beliefs, and medication adherence

OBJECTIVE

Medication adherence often lies below recommendations although it is crucial for effective therapies, particularly in older adults with multiple illnesses. Medication beliefs are important factors for individual adherence, but little is known about their origin. We examine whether changes in functional health predict changes in medication beliefs, and whether such changes in beliefs predict subsequent medication adherence.

DESIGN

At three points in time over a 6-month period, 309 older adults (65-85 years) with multiple illnesses were assessed. Latent true change modeling was used to explore changes in functional health and medication beliefs. Adherence was regressed on changes in beliefs.

MAIN OUTCOME MEASURES

Medication beliefs were measured by the Beliefs About Medicines Questionnaire; medication adherence by the Reported Adherence to Medication Scale.

RESULTS

Functional health and medication beliefs changed over time. Increasing physical limitations predicted increases in specific necessity and specific concern beliefs, but not in general beliefs. Changes in specific necessity beliefs predicted intentional adherence lapses, changes in general overuse beliefs predicted unintentional adherence lapses.

CONCLUSIONS

Medication beliefs partly depend on health-related changes, and changes in beliefs affect individual adherence, suggesting to target such beliefs in interventions and to support older adults in interpreting health changes.

What do people include when they self-rate their health? Differential associations according to health status in community-dwelling older adults

AIMS

Self-rated health (SRH) is widely regarded a valid and reliable indicator of health status. The validity of self-rated health has been demonstrated in many studies, for example by predicting mortality over and above medical and epidemiological data. However, the meaning of SRH can differ between individuals, especially in elderly individuals with considerable individual differences in their physical health states. It is thus important to determine whether predictors of self-rated health vary according to physical health status in order to interpret self-rated health data.

METHODS

In a representative survey study, 1174 individuals over 65 years of age rated their health and filled in questionnaires on subjective well-being, control beliefs, depressive symptoms, and functional health. Structural equation modeling with latent moderated structural equations was used to determine whether health status (number of illnesses) moderated the association of self-rated health with these predictors.

RESULTS

Self-rated health was predicted by positive affect, depressive symptoms, control beliefs, and physical functioning. Moderated effects were found for positive affect and physical functioning, suggesting that there are stronger associations with positive affect in healthier individuals and stronger associations with physical functioning in less healthy individuals.

CONCLUSIONS

This implies that SRH has differential associations depending on health status, which should be taken into account in interpreting any research with SRH as predictor or criterion.

Maintaining autonomy despite multimorbidity: self-efficacy and the two faces of social support

Multimorbidity-the co-occurrence of multiple illnesses-is a frequent condition in older adults and poses serious threats to autonomy. In order to identify resources for autonomy despite multimorbidity, our longitudinal study tested main and interaction effects of personal and social resources (self-efficacy and social support) on maintaining autonomy. Three hundred and nine individuals (aged 65-85 years) with multiple illnesses completed measures of self-efficacy beliefs, received instrumental social support and perceptions of autonomy. Data were analyzed using structural equation modeling. Cross-sectionally, individuals with lower perceptions of autonomy received more support from their networks. Longitudinally, the relation of received support with autonomy was moderated by self-efficacy: Simple slopes analyses showed that social support compensated for lower levels of self-efficacy, whereas in individuals with higher self-efficacy the resources interfered. Receiving social support bolstered autonomy in lower self-efficacious individuals, but in highly self-efficacious individuals support threatened autonomy. This has implications for both theory and practice, as it suggests differential effects of social resources depending on personal resources.

[Theories on aging and health: what do aging and old age mean and what constitutes a good life in old age?]

The present paper starts by introducing different perspectives of the aging process and includes biological, psychological, and sociological theories in its scope. The article addresses the issue of when "old age" begins and why a distinction is made between the third and fourth age. With increasing age, it becomes more and more difficult to differentiate between health-related losses due to illnesses or to aging. However, this can be important with respect to health behavior and health care. Having the best possible health in old age is an important factor for a good life in old age. Over their whole lives, from childhood to old age, people can actively contribute to their health in old age. But health is not the sole criterion for a good life in old age. Having interests and aims are just as important as being integrated in a social network. In old age, people often differ greatly and this is why there is such variety in what people consider to constitute a good life for themselves in old age.

Giving and Taking —Differential Effects of Providing, Receiving and Anticipating Emotional Support on Quality of Life in Adults with Multiple Illnesses

Multimorbidity challenges quality of life (QoL) in old age. Anticipating and providing social support have been shown to promote QoL whereas receiving support often had detrimental effects. Little is known about which psychological processes explain these effects. This study examines the effects of receiving, anticipating and providing emotional support on QoL, with control beliefs and self-esteem as simultaneous mediators in an elderly multimorbid sample ( N = 1415). Anticipating and providing support positively predicted QoL, mediated through self-esteem and control beliefs. Received support negatively predicted QoL, without mediation. Self-esteem and control beliefs can help to explain the relation between QoL and support.

Socioeconomic status and health in the second half of life: findings from the German Ageing Survey

This study examined social inequalities in health in the second half of life. Data for empirical analyses came from the second wave of the German Ageing Survey (DEAS), an ongoing population-based, representative study of community dwelling persons living in Germany, aged 40–85 years (N = 2,787). Three different indicators for socioeconomic status (SES; education, income, financial assets as an indicator for wealth) and health (physical, functional and subjective health) were employed. It could be shown that SES was related to health in the second half of life: Less advantaged persons between 40 and 85 years of age had worse health than more advantaged persons. Age gradients varied between status indicators and health dimensions, but in general social inequalities in health were rather stable or increasing over age. The latter was observed for wealth-related absolute inequalities in physical and functional health. Only income-related differences in subjective health decreased at higher ages. The amount of social inequality in health as well as its development over age did not vary by gender and place of residence (East or West Germany). These results suggest that, in Germany, the influence of SES on health remains important throughout the second half of life.

Serious health events and their impact on changes in subjective health and life satisfaction: the role of age and a positive view on ageing

Various studies have pointed to the great importance of subjective health as an indicator for mortality in older age, while less is known about factors that contribute to changes of subjective (self-rated) health over time. Based on a nationwide longitudinal survey (German Ageing Survey, N = 1,286; initial age 40-85), two major findings emerged: first, the incidence of a serious health event caused greater changes in subjective health and life satisfaction in middle compared to older age. This was as expected because serious health events are less common in middle age and are correspondingly experienced more often as an "off-time event". Secondly, the study extended previous findings on the impact of a positive view of ageing on health by showing that this optimistic view positively affects subjective health and life satisfaction even in the face of a serious health event. Overall, the study indicates that a positive view on ageing is an important psychological resource in the case of a serious health event, both when it occurs on-time or off-time from a developmental perspective.

Longitudinal Findings on Aging-Related Cognitions, Control Beliefs, and Health in Later Life

We examined the influence of individual views of aging on health changes in later life. We hypothesized that aging-related cognitions affect health changes irrespective of control beliefs and that the impact of aging-related cognitions on health is higher than for the reverse direction of causality. We based our analyses on data from the longitudinal part of the German Aging Survey (N = 1,286; participants were 40-85 years of age at baseline). Because of the selectivity of the sample, we also computed the same analyses for the baseline sample (N = 4,034) with estimated Time 2 data for those individuals who dropped out. The results of structural equation modeling were concordant with our hypotheses, and therefore they corroborate previous findings on the importance of beliefs about aging.

Lassen sich auditive Verarbeitungs- und Wahrnehmungsstörungen (AVWS) bei Kindern mit Lese-Rechtschreib-Störungen nachweisen?

BACKGROUND

In this paper the dichotic tests and the CERA (Cortical Evoked Response Audiometry) of children with dyslexia had been examined, in order to find out if there are auditory processing and perception disorders.

PATIENTS AND METHODS

33 children with dyslexia had been compared with 28 children without problems of writing and reading. The mean age of the children was 9 years. All of the children had been examined by the following audiometric measurements: tympanometry, pure-tone-audiometry, speech-audiometry, dichotic Tests by Uttenweiler and Feldmann and the Cortical Evoked Response Audiometry (CERA) rated according to Esser.

RESULTS

The intelligence quotients were in the group of dyslexic children significantly lower. The Uttenweiler and Feldmann tests were in dyslexic children significantly lower in the control group as well. The late cortical responses ware normal or near normal in both groups.

CONCLUSION

Dichotic speech tests indicate central auditory processing and perception deficits in dyslexia. These tests are confounded, however, by attention and memory deficits. The CERA rated according to Esser does not point out to these auditory disorders in dyslexia.

Comparative ageing research: a flourishing field in need of theoretical cultivation

Comparative ageing research is a flourishing field, partly because of European funding in this area. Comparing different societies and cultures seems especially fruitful for the analysis of societal and cultural factors in development over the life course. From a nomothetic perspective, the aim of comparisons is the search for similarities and communalities in different societies and cultures; from an idiographic perspective, researchers are looking for societal and cultural specificity and distinctiveness. However, the potentials of comparative ageing research are not fully realized for the time being. In many cases, there is little theorizing as to whether there should be differences (or similarities) in ageing processes across countries, societies, or cultures. This paper discusses theoretical aims and ambitions of comparative ageing research in general. Comparative theories are sketched which could serve as a basis for comparative ageing research, and ageing theories are discussed which could be modified to be used in comparative research. The rationale of comparative ageing research is described and illustrated through empirical examples. Epistemological and methodological pitfalls (problems of conceptual, operational, functional, and measurement equivalence) are a substantial obstacle to comparative ageing research. Hence, merits and limitations of comparative designs and sampling procedures are considered.

Lebenssituationen älter werdender und alter Menschen in Deutschland

This contribution aims to convey a general overview of the living conditions of aging and old people in Germany. It introduces a series of contributions devoted to the topic "health in old age" and focuses on older people as a very heterogeneous group in society. Who exactly are these older people? We start by discussing the definition of "old age" as a stage of life and the distinction between a "third" and "fourth" age. This is followed by a presentation of some facts describing demographic change at the population level. The main body of the contribution looks at households and housing, family relations and social integration, income, life satisfaction and the health of older people. The two waves of the German Aging Survey, a representative study of persons in the second half of life undertaken in 1996 and 2000, provide the empirical base for the paper.

Establishing systems of care in Germany: a long and winding road

Since 1995/1996 a long-term care insurance (LTCI), which promised to develop new support structures, in particular for the group of potentially frail elderly people, has been implemented in Germany. It will be shown that this LTCI has undoubtedly improved the social situation of the persons in need of care, even if its scheme is only providing basic support with a ceiling in cash-benefits and benefits in-kind, and privileging home care by informal caregivers. But certain misdevelopments in the LTCI have shown that the present scheme requires further effort to cope with these negative effects and to elaborate new integrated models of care that bridge the still existent gap between medical and social support. This article points to long traditions of separating the social and medical dimensions in Germany which have also resulted in divided institutional arrangements. The current scheme of the LTCI, its organizational principles and its entitlements and benefits are outlined, which gives the opportunity to point out certain deficiencies, e.g., the still inappropriate provision for dementia care which is due to the dominant IADL-orientation of the medical assessment procedure and its implicit negligence of social care elements. The public debate about necessary improvements in benefits for the demented aged has already led to slight revisions of the LTCI, and will develop into a more comprehensive movement to path-bridging models of social and medical care in which the quality dimension will play a decisive role.

[Importance of family for quality of life of the elderly in a social and cultural comparison]

This paper explores the role of the family and its contribution to quality of life in old age under a comparative perspective, looking at different European welfare states (Norway, Germany, Spain and Israel). The literature demonstrates a consistent association between well-being and social networks in old age. Intergenerational family relations seem to be of special relevance in their contribution to health and well-being of older family members. Key features of intergenerational relationships include association, help, and support. However, in modern welfare states, certain tasks traditionally performed by families are covered by services. To assess the relative impact of families and the welfare state and to understand the interaction between them both a comparative perspective is needed analyzing diverse cultures and welfare regimes. Cultural and societal contexts are of central importance in exploring and understanding the complex association between family relations and the quality of life of the elderly. It is hypothesized that there is an interaction between family structure and welfare state transfers. This hypothesis states that the relationship between family structure and quality of life depends on the type of welfare state and welfare state transfers and services. Hence, the relationship between quality of life and family support should be strong only in those cases where welfare state transfers are low. The empirical results partly confirm the theoretical assumptions of welfare state regime dependence of the children's effect on the elder's quality of life. Three out of the four analyzed countries show results that strongly support the hypothesis of an intervening effect of welfare state systems on the connection between family and overall quality of life in old age. However, further analyses are needed. First, more sensitive indicators of parent-child relations have to be used. Second, needs and their intervening effects on the direct linkages between children and quality of life have to be taken into account in more complex analyses. Third, more elaborated indicators of "quality of life" should be used in future analyses.

Intergenerational solidarity and caregiving

In this paper the topic of caregiving and intergenerational solidarity will be explored in four parts. First, relevant aspects of caregiving will be pointed out. Second, general theoretical models will be used to analyse the problem of caregiving. Third, the German situation and especially the still rather new long-term care insurance will be described. Fourth and finally, the basic outline of a European research project (OASIS), which is devoted to the topic of intergenerational solidarity and the use of service systems, will be presented.

[Every day activities and daily mood of the elderly]

Using the diary method, the correlation between daily mood and everyday activities is analyzed. Positive and negative affect were used as indicator of daily mood. Duration of social activities and resting during the day were used as indicator of daily activities. A total of 55 elderly persons kept a activity and mood diary for at least 50 days. The data were analyzed interindividually (using regression analyses) and intraindividually (using time series analyses). While positive affect and duration of social activities correlate positively in both inter- and intraindividual perspective, there is a relationship between negative affect and duration of rest only in interindividual perspective. Theoretical and practical implications of the results are discussed.

[Interventional gerontology in German-speaking countries: a social and behavioral science assessment]

This work is aimed at reviewing 20 years of gerontological intervention research within the social and behavioral domain in German speaking countries. Only controlled studies based on adequate measurement instruments are considered. Literature analyses reveal that the issue of cognitive intervention research is well-covered, underlining clear positive training effects in intellectual performance and memory. Also, studies on the limits of mental capacity represent a highlight of German cognitive training research. Another bunch of studies underlines the potential of different intervention to enhance independence in day-to-day function, social activity, and subjective well-being. Positive effects in self-concept, personal control, and attribution style are as well reported. A general discussion of this body of work leads to suggestions for future research priorities.

Psychological effects of hearing aid use in older adults

Hearing impairment in older adults is a chronic condition with high prevalence that shows negative correlations with communication, social integration, well-being, and cognition. In the present study, a group of elderly individuals with mild to moderate hearing loss who received a hearing aid for the first time in their lives (aural rehabilitation group, n = 70) and two age-matched control groups (hearing-impaired control group without hearing aids, n = 42, approximately normal hearing control group, n = 28) were tested longitudinally over a 6-month period. Measures examined their performance in the domains of communication problems, social activities, satisfaction with social relationships, well-being, and cognition. Data analyses show that in older persons with mild to moderate hearing loss, hearing aid use has positive effects on self-perceived hearing handicap, but there is no effect of hearing aid use in domains like social activities, satisfaction with social relations, well-being, and cognitive functioning.

[Use of hearing aids by the elderly: correlation between intention and behavior]

Hearing in old age has negative consequences for elderly hearing impaired individuals. Most important in aural rehabilitation is the fitting of hearing aids. Problematic is the low use of hearing aids by elderly hearing impaired individuals. Therefore, in the present study predictors of hearing aid use will be analyzed. The theory of planned behavior was used in a sample of 54 men and women with presbyacusis (54-87 years old) for the prediction of hearing aid use. The analyses revealed that actual hearing aid use is influenced mainly by the intention to use hearing aids and by normative beliefs of the person. The intention to use hearing aids is influenced mainly by the attitude towards using hearing aids. Practical implications of the results are discussed: Aural rehabilitation possibly can be improved by changing attitudes toward hearing aid use and asking important members of the social network to participate actively in the aural rehabilitation process.

[Successful Aging and social relations: selection and compensation in social contact behavior]

The model of selective optimization with compensation (Baltes & Baltes 1989; 1990) offers a theoretical concept of successful aging, that aims at the adaptivity of older persons in the aging process. The present study proposes an empirical operationalization of the model within the domain of social contact behavior, and relates this to self-referent knowledge on daily activities. Older persons with multiple chronic diseases and those in generally good health are compared according to their self-referent knowledge on daily activities and social contact behavior. All participants in the study were socially integrated and well functioning. A total of 35 subjects (mean age = 74.4 years) kept a prestructured dairy about their social contacts for a period of six days. Knowledge on daily activities was assessed in a semi-structured interview. The interviews and diaries were content analyzed (inter-rater reliability estimated via Cohen's Kappa for the interview: M = 0.84; for the diaries: M = 0.93). Results show that the highly social integrated subjects with multiple chronic disease performed significantly better in selective and compensatory strategies than the subjects in good health. Selection was indicated by (a) less family contact and a smaller number of group encounters, (b) more emotional support exchange, and (c) more knowledge on maintenance of daily activities. Compensation was indicated by (d) more frequent use of the telephone and (e) greater knowledge of prosthetic resources. It is concluded that social integration and participation can be optimized through selective and compensatory strategies in the face of chronic diseases in old age.