Health Behavior Patterns and Associated Risk of Memory-Related Disorders Among Middle-Aged and Older Chinese Couples

Objectives: Studies on the interdependence of couples' health behaviors and subsequent cognitive outcomes remain limited. Methods: Longitudinal data from the China Health and Retirement Longitudinal Study (2011-2018) were used (N = 1869 heterosexual couples). Latent class analysis identified the dyadic pattern of health behaviors in 2011 (i.e., alcohol consumption, smoking, and physical inactivity). Stratified Cox models examined the association of latent classes with risk of developing memory-related disorders in 2013-2018. Results: Three classes were identified: class 1 (21.25%, only husband smoke, and both active), class 2 (47.55%, both inactive, neither drink nor smoke), and class 3 (31.20%, both drink and smoke, and both active). Couples' sedentary lifestyle was associated with an increased risk of memory-related disorders among both husbands and wives. Conclusion: Couples were moderately concordant in their physical activity but weakly in smoking and drinking. Couple-based interventions, especially promoting physical activity, may reduce cognitive aging among middle-aged and older Chinese couples.

Enrichment of dementia caregiving relationships through psychosocial interventions: A scoping review

Objectives

Enrichment, defined as "the process of endowing caregiving with meaning or pleasure for both the caregiver and care recipient" can support relationships between people living with dementia (PLWD) and their caregivers. This study aims to explore (1) the types of psychosocial interventions that may enrich relationships between dementia caregiving dyads, and (2) the components within these psychosocial interventions that may contribute to enrichment.

Methods

A scoping review was conducted based on the Joanna Briggs Institute framework. We operationalized and contextualized core elements from Cartwright and colleagues' enrichment model, which was also used to guide the review. Five electronic databases were searched. Psychosocial intervention components contributing to enrichment were identified and grouped within each core element.

Results

Thirty-four studies were included. Psychosocial interventions generating enrichment among dyads mainly involved supporting dyadic engagement in shared activities, carer education or training, or structural change to the environment around PLWD. Intervention components contributing to the enrichment of dyadic relationships were identified within "acquired symbolic meaning", "performing activity", and "fine tuning". Dyadic communication support and skill-building were common contributors to enrichment.

Conclusion

Our findings may inform the planning and development of interventions to enrich dyadic relationships in the context of dementia. In formal caregiving contexts, future interventions may consider dedicating space for relationships to build and grow through positive interactions. In informal caregiving contexts, existing relationships should be considered to better support dyads engage in positive interactions.

Sustaining Our Relationship: Dyadic Interactions Supported by Technology for People with Dementia and Their Informal Caregivers

Impaired memory function and challenges in communication affect the ability of people living with dementia to interact with family caregivers socially. The onset of dementia in a family member and the communication challenges that follow can lead to conflict, isolation and loss of closeness in the relationship. I-CARE is a tablet-based technology providing leisure activities specifically designed for people living with dementia to do in tandem with caregivers. The intention is that caregiving dyads engage with I-CARE together, using the activities contained in the system as the basis for positive social interactions. This paper reports on a mixed-methods feasibility study of I-CARE, evaluating the system's usability and assessing the impact on caregiving dyads. We also explored barriers and facilitators to independent use of the technology among community-dwelling people living with dementia and their family caregiver. Results suggest that I-CARE is a feasible tool to facilitate positive experiences in dementia caregiving dyads. Important relationship outcomes for the participating dyads were enrichment in social interactions, facilitated communication, having a shared activity and relationship sustenance. Successful uptake requires continuous proactive support tailored to the needs and preconditions of users over an extended time until they feel confident using the system independently.

Family Functioning and Multiple Sclerosis: Study Protocol of a Multicentric Italian Project

Multiple Sclerosis (MS) is a chronic inflammatory and neurodegenerative disease, which not only affects physical functioning, but is also associated with cognitive impairments and great psychological distress. The combination of those symptoms may have negative consequences on the family functioning of patients with MS, with detrimental effects on both marital relationships and parental bonding. Furthermore, the presence of individual characteristics and of an adequate social support may also contribute to the quality and endurance of family relationships. Particularly, high levels of alexithymia, a personality trait that affects the recognition of a person's own emotions, have been associated with reduced interpersonal communication skills and enhanced anxiety/depressive symptoms. Therefore, the main aim of the present study is to provide an in-depth evaluation of family functioning and related factors in patients with MS and their families. In order to reach this goal, the perceived quality of family functioning, dyadic relationships, and parental bonding will be first investigated. Secondly, the possible associations between the quality of family relationships and the presence of alexithymia, psychological distress, and perceived social support will be examined. Patients with MS and their families who will consent to take part in the study will be asked to provide sociodemographic and clinical information, and to complete a series of questionnaires, presented and uploaded on an online dedicated platform. The final sample will be made up of 300 families, consecutively recruited from the Italian medical centers involved in the project. The results of the present study will shed light on the family functioning of patients with MS, through a comprehensive assessment of the main factors that are associated with family dynamics. A holistic evaluation of those aspects can help clinicians and researchers understand family dynamics in MS population better.

Living With Cognitive Impairment in China: Exploring Dyadic Experiences Through a Person-Centered Care Lens

China has experienced a substantial increase in the number of older adults with dementia and milder forms of cognitive impairment. Being spouses of Persons with cognitive impairment (PWCI) and living with them for several decades does not necessarily mean that it is easier for them to provide person-centered care and maintain a valued and healthy relationship. The current study explored how elements of PCC, as operationalized by the Senses Framework, operate or fail to operate in the dyadic experiences of PWCI and their spousal care partners within the socio-cultural context of China. Our findings suggest that PWCI and their spouses experience the six senses through the person-centeredness in their daily interactions with each other. It also indicated successes and challenges to being person-centered early in the disease and identified their unmet needs as well as barriers and facilitators to improve their well-being.

Perception Accuracy of Affiliative Relationships in Elementary School Children and Young Adolescents

There has been a rapid growth of studies focused on selection and socialization processes of peer groups, mostly due to the development of stochastic actor-based models to analyze longitudinal social network data. One of the core assumptions of these models is that individuals have an accurate knowledge of the dyadic relationships within their network (i.e., who is and is not connected to whom). Recent cross-sectional findings suggest that elementary school children are very inaccurate in perceiving their classmates' dyadic relationships. These findings question the validity of stochastic actor-based models to study the developmental dynamics of children and carry implications for future research as well as for the interpretation of past findings. The goal of the present study was thus to further explore the adequacy of the accuracy assumption, analysing data from three longitudinal samples of different age groups (elementary school children and adolescents). Our results support the validity of stochastic actor-based models to study the network of adolescents and suggest that the violation of the accuracy assumption for elementary school children is not as severe as previously thought.

"We are a Team": Couple Identity and Memory Loss

Couplehood can be an important source of resilience in the face of memory loss, but couple identity has only recently been explored and has rarely been measured. This paper examines older spouses' descriptions of their couple identity and discusses salient themes. Data come from 19 couples from the Couples Life Story Project, a life review intervention where one partner has memory loss. Using baseline data, we analyzed how partners depicted their couple identity using a series of separate and overlapping circles. Almost half of the partners independently chose identical depictions of their relationships. An interpretative phenomenological approach revealed three major themes of couple identity: (1) doing things together and separately; (2) feelings, shared history, and closeness over time and; (3) essence of relationship. This study contributes to the small body of literature that focuses on couple identity and how partners mutually cope with aging-related challenges.

Two-Wave Dyadic Analysis of Marital Quality and Loneliness in Later Life: Results From the Irish Longitudinal Study on Ageing

This study examines dyadic reports of marital quality and loneliness over a two-year period among 932 older married couples resident in Ireland. Data from the first two waves of The Irish Longitudinal Study on Ageing (2009-2013) were analyzed to determine whether husbands' and wives' marital quality and loneliness at baseline predicted both spouses' loneliness 2 years later. Two-wave lagged models tested the cognitive perspective on loneliness, the induction hypothesis, and actor-partner interdependence. Results indicated that perceptions of negative marital quality at baseline were related with greater loneliness 2 years later, supporting the cognitive perspective. Further, both spouses' reports of loneliness at baseline were related with loneliness 2 years later, supporting the induction hypothesis. Partners' reports of marital quality were not related with future loneliness, failing to support actor-partner interdependence. I discuss the implications of these findings for theory, practice, and future research concerning intimate relationships and loneliness in later life.

A practical guide to the study of social relationships

Behavioral ecologists have devoted considerable effort to identifying the sources of variation in individual reproductive success. Much of this work has focused on the characteristics of individuals, such as their sex and rank. However, many animals live in stable social groups and the fitness of individuals depends at least in part on the outcome of their interactions with other group members. For example, in many primate species, high dominance rank enhances access to resources and reproductive success. The ability to acquire and maintain high rank often depends on the availability and effectiveness of coalitionary support. Allies may be cultivated and coalitions may be reinforced by affiliative interactions such as grooming, food sharing, and tolerance. These findings suggest that if we want to understand the selective pressures that shape the social behavior of primates, it will be profitable to broaden our focus from the characteristics of individuals to the properties of the relationships that they form with others. The goal of this paper is to discuss a set of methods that can be used to quantify the properties of social relationships.

Methods for the design and analysis of relationship and partner effects on sexual health

Sexual intercourse involves two people and many aspects of sexual health are influenced by, if not dependent on, interpersonal processes. Yet, the majority of sexual health research involves the study of individuals. The collection and analysis of dyadic data present additional complexities compared to the study of individuals. The aim of this article was to describe methods for the study of dyadic processes related to sexual health. One-sided designs, including the PLM, involve a single individual reporting on the characteristics of multiple romantic or sexual relationships and the associations of these factors with sexual health outcomes are then estimated. This approach has been used to study how relationship factors, such as if the relationship is serious or casual, are associated with engagement in HIV risk behaviors. Such data can be collected cross-sectionally, longitudinally or through the use of diaries. Two-sided designs, including the actor-partner interdependence model, are used when data are obtained from both members of the dyad. The goal of such approaches is to disentangle intra- and inter-personal effects on outcomes (e.g., the ages of an individual and his partner may influence sexual frequency). In distinguishable datasets, there is some variable that allows the analyst to differentiate between partners within dyads, such as HIV status in a serodiscordant couple. When analyzing data from these dyads, effects can be assigned to specific types of partners. In exchangeable dyadic datasets, no variable is present that distinguishes between couple members across all dyads. Extensions of these approaches are described.