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Pereira H, Silva P, Torre RD, dos Santos MR, Moutinho A, Solinho S, Proença C, Cabral J, Santos AJ. Men's Social Connectedness in Later Life: A Qualitative Study with Older Men. Geriatrics (Basel) 2024; 9:53. [PMID: 38667520 PMCID: PMC11050630 DOI: 10.3390/geriatrics9020053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
This qualitative study aimed to understand men's social connectedness in later life in Portugal focusing on their perceptions, obstacles, strategies, and impact on well-being. The sample included 104 older Portuguese men over 65 years of age (Mage = 70.76 years). The qualitative data were the direct transcriptions of the answers given by participants to the electronic interview using thematic analysis. Findings revealed six overarching themes encompassing 18 subcategories: definitions of social connectedness (social support, community identity, mental health promotion, use of community structures), difficulties/obstacles in maintaining social connectedness (ageism, lack of initiative, physical limitations, psychological traits, resources), strategies/actions or resources to establish social connections (use of technology, use of community groups, leisure and sport activities, church/religion), negative impact of difficulties in establishing relevant social connections (mental health, physical health, relationships), positive actions from being socially connected (positive prescriptions to promote social connectedness), and concerns from being socially disconnected (health risks). These findings indicate that the lack of social connectedness creates social vulnerability in later life, and social support is needed to ensure safer aging among older men.
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Affiliation(s)
- Henrique Pereira
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal; (P.S.); (R.D.T.); (M.R.d.S.); (A.M.); (S.S.); (C.P.); (A.J.S.)
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Patricia Silva
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal; (P.S.); (R.D.T.); (M.R.d.S.); (A.M.); (S.S.); (C.P.); (A.J.S.)
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Renata Della Torre
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal; (P.S.); (R.D.T.); (M.R.d.S.); (A.M.); (S.S.); (C.P.); (A.J.S.)
| | - Marta Rosário dos Santos
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal; (P.S.); (R.D.T.); (M.R.d.S.); (A.M.); (S.S.); (C.P.); (A.J.S.)
| | - Adriana Moutinho
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal; (P.S.); (R.D.T.); (M.R.d.S.); (A.M.); (S.S.); (C.P.); (A.J.S.)
| | - Sofia Solinho
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal; (P.S.); (R.D.T.); (M.R.d.S.); (A.M.); (S.S.); (C.P.); (A.J.S.)
| | - Constança Proença
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal; (P.S.); (R.D.T.); (M.R.d.S.); (A.M.); (S.S.); (C.P.); (A.J.S.)
| | | | - Ana Jorge Santos
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal; (P.S.); (R.D.T.); (M.R.d.S.); (A.M.); (S.S.); (C.P.); (A.J.S.)
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Stringfellow MK, Fields NL, Lee K, Anderson KA, Brokaw E. Healthy Aging and Older Adults with Autism: A Scoping Review. Gerontologist 2024:gnae026. [PMID: 38520290 DOI: 10.1093/geront/gnae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Autism Spectrum Disorder (ASD) is a lifelong diagnosis. While several studies have examined the effects of autism throughout childhood, few have considered older adulthood and the difference between the allistic (i.e., persons who are not autistic) population and autistic older adults. In literature regarding healthy aging, there is sparse evidence regarding the intersections of older adulthood and autism. The purpose of this scoping review was to examine the state of literature regarding autistic older adults and the domains of healthy aging, utilizing the framework conceived by Arksey and O'Malley (2005). RESEARCH DESIGN AND METHODS To identify the research question, we took the following steps: identify the relevant studies; select studies; chart the data; and collate, summarize, and report the results. The specific domains of healthy aging considered include physical health, mobility, mental health, cognition and memory, and social connectedness. RESULTS A total of 35 articles were selected for final review. Fifty-seven percent of these studies considered only one domain of healthy aging, 23% studied two domains, while 14% measured three domains and 6% assessed four domains. No study considered all five domains. Of the five domains considered for this scoping review, mental health and cognition and memory were the most represented domains in the studies. DISCUSSION AND IMPLICATIONS Overall, healthy aging among autistic older adults is largely understudied. More research is needed to better identify and tailor interventions and services for autistic older adults and their families to support healthy aging.
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Affiliation(s)
| | - Noelle L Fields
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Kathy Lee
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Keith A Anderson
- Department of Social Work, University of Mississippi, Oxford, Mississippi, USA
| | - Eva Brokaw
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
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Song Y, Wu F, Sharma S, Clendenen TV, India‐Aldana S, Afanasyeva Y, Gu Y, Koenig KL, Zeleniuch‐Jacquotte A, Chen Y. Mid-life adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and late-life subjective cognitive complaints in women. Alzheimers Dement 2024; 20:1076-1088. [PMID: 37861080 PMCID: PMC10917042 DOI: 10.1002/alz.13468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Evidence is limited on the role of mid-life Dietary Approaches to Stop Hypertension (DASH) diet in late-life subjective cognitive complaints (SCCs). METHODS We included 5116 women (mean age in 1985-1991: 46 years) from the New York University Women's Health Study. SCCs were assessed from 2018 to 2020 (mean age: 79 years) by a 6-item questionnaire. RESULTS Compared to women in the bottom quartile of the DASH scores, the odds ratio (OR) for having two or more SCCs was 0.83 (95% confidence interval: 0.70-0.99) for women in the top quartile of DASH scores at baseline (P for trend = 0.019). The association was similar with multiple imputation and inverse probability weighting to account for potential selection bias. The inverse association was stronger in women without a history of cancer (P for interaction = 0.003). DISCUSSION Greater adherence to the DASH diet in mid-life was associated with lower prevalence of late-life SCCs in women.
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Affiliation(s)
- Yixiao Song
- Division of EpidemiologyDepartment of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
- Department of EpidemiologyNYU School of Global Public HealthNew YorkNew YorkUSA
| | - Fen Wu
- Division of EpidemiologyDepartment of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Sneha Sharma
- NYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Tess V. Clendenen
- Division of EpidemiologyDepartment of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Sandra India‐Aldana
- Division of EpidemiologyDepartment of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Yelena Afanasyeva
- Division of EpidemiologyDepartment of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Yian Gu
- Department of NeurologyColumbia UniversityNew YorkNew YorkUSA
- Taub Institute for Research in Alzheimer's Disease and the Aging BrainColumbia UniversityNew YorkNew YorkUSA
| | - Karen L. Koenig
- Division of EpidemiologyDepartment of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Anne Zeleniuch‐Jacquotte
- Division of EpidemiologyDepartment of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Yu Chen
- Division of EpidemiologyDepartment of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
- Department of Environmental MedicineNYU Grossman School of MedicineNew YorkNew YorkUSA
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Bahl NKH, Øversveen E, Brodahl M, Nafstad HE, Blakar RM, Landheim AS, Tømmervik K. Multiple psychological senses of community and community influences on personal recovery processes from substance use problems in later life: a collaborative and deductive reflexive thematic analysis. Int J Qual Stud Health Well-being 2023; 18:2190200. [PMID: 36924073 PMCID: PMC10026775 DOI: 10.1080/17482631.2023.2190200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
PURPOSE There is a pressing need for substance use services to know more about how to promote recovery from substance use problems, particularly in later life. Psychological sense of community (PSOC) is an important recovery dimension. This study aims to clarify in what ways PSOC and communities influence later life recovery processes. METHOD A collaborative and deductive reflexive thematic approach was used to analyse 23 interviews with older adults in recovery from different substance use problems. RESULTS The findings suggest that PSOC and recovery in later life include multiple communities (relational, geographical, substance use-related, ideal and service-related) and affective states (PSOC and NPSOC). Older adults' recovery, moreover, can be described as personal and heterogenic (with respect to community relationships, individual needs, type of substance use problem, age of onset and meaningful activities). CONCLUSIONS The findings confirm age of onset, type of substance use problem and community memberships as essential to later life recovery. They also supplement prior evidence on community resources and challenges to later life recovery. Importantly, the new findings extend and nuance current understandings of later life recovery. Taken together, the article illustrates MPSOC as a useful concept, with central practical and theoretical implications for later life recovery.
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Affiliation(s)
- Nina Kavita Heggen Bahl
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Emil Øversveen
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Morten Brodahl
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Mental Health Division, Innlandet Hospital Trust, Brumunddal, Norway
| | | | | | - Anne Signe Landheim
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Innlandet University of Applied Sciences, Faculty of Social and Health Sciences, Section for Mental Health and Rehabilitation, Campus Elverum, Norway
| | - Kristin Tømmervik
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
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Tangchitnusorn K, Wongboonsin P. Migration Decisions in the Fourth Age: The Case of East Asian Retirees in Thailand. J Aging Soc Policy 2023:1-13. [PMID: 37830413 DOI: 10.1080/08959420.2023.2267398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/14/2023] [Indexed: 10/14/2023]
Abstract
Previous studies have not amply explored the next move of older adults currently spending their retirement abroad. This paper examined the future migration decisions of East Asian retirees in the last stage of life marked by frailty, dependency, and abjection (i.e. the fourth age). A survey of Chinese and Japanese retirees in Thailand (n = 204) was conducted during 2019-2021. Binary logistic regression analysis indicated that age, income, religion, residence, Thai spouse/partner, and property at origin were significantly associated with future migration decisions (p < .05). Future research and policymaking should enhance Thailand's capacity to facilitate fourth age living.
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Motamedi S, Amleshi RS, Javar BA, Shams P, Kohlmeier KA, Shabani M. Cannabis during pregnancy: A way to transfer an impairment to later life. Birth Defects Res 2023; 115:1327-1344. [PMID: 37318343 DOI: 10.1002/bdr2.2207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 05/11/2023] [Accepted: 05/20/2023] [Indexed: 06/16/2023]
Abstract
Epidemiological studies examining the influence of cannabis across the lifespan show that exposure to cannabis during gestation or during the perinatal period is associated with later-life mental health issues that manifest during childhood, adolescence, and adulthood. The risk of later-life negative outcomes following early exposure is particularly high in persons who have specific genetic variants, implying that cannabis usage interacts with genetics to heighten mental health risks. Prenatal and perinatal exposure to psychoactive components has been shown in animal research to be associated with long-term effects on neural systems relevant to psychiatric and substance use disorders. The long-term molecular, epigenetic, electrophysiological, and behavioral consequences of prenatal and perinatal exposure to cannabis are discussed in this article. Animal and human studies, as well as in vivo neuroimaging methods, are used to provide insights into the changes induced in the brain by cannabis. Here, based on the literature from both animal models and humans, it can be concluded that prenatal cannabis exposure alters the developmental route of several neuronal regions with correlated functional consequences evidenced as changes in social behavior and executive functions throughout life.
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Affiliation(s)
- Sina Motamedi
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Saboori Amleshi
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnoush Akbari Javar
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
- Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Parisa Shams
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
- Department of Anatomical Sciences, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kristi A Kohlmeier
- Department of Drug Design and Pharmacology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mohammad Shabani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
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Nilsen C, Agerholm J, Kelfve S, Wastesson JW, KÅreholt I, Nabe-Nielsen K, Meinow B. History of working conditions and the risk of old-age dependency: a nationwide Swedish register-based study. Scand J Public Health 2023:14034948231188999. [PMID: 37537973 DOI: 10.1177/14034948231188999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
AIMS There is substantial evidence that previous working conditions influence post-retirement health, yet little is known about previous working conditions' association with old-age dependency. We examined job strain, hazardous and physical demands across working life, in relation to the risk of entering old-age dependency of care. METHODS Individually linked nationwide Swedish registers were used to identify people aged 70+ who were not receiving long-term care (residential care or homecare) at baseline (January 2014). Register information on job titles between the years 1970 and 2010 was linked with a job exposure matrix of working conditions. Random effects growth curve models were used to calculate intra-individual trajectories of working conditions. Cox regression models with age as the timescale (adjusted for living situation, educational attainment, country of birth, and sex) were conducted to estimate hazard ratios for entering old-age dependency during the 24 months of follow-up (n = 931,819). RESULTS Having initial adverse working conditions followed by an accumulation throughout working life encompassed the highest risk of entering old-age dependency across the categories (job strain: HR 1.23, 95% CI 1.19-1.27; physical demands: HR 1.36, 95% CI 1.31-1.40, and hazardous work: HR 1.35, 95% CI 1.30-1.40). Initially high physical demands or hazardous work followed by a stable trajectory, or initially low-level physical demand or hazardous work followed by an accumulation throughout working life also encompassed a higher risk of dependency. CONCLUSIONS A history of adverse working conditions increased the risk of old-age dependency. Reducing the accumulation of adverse working conditions across the working life may contribute to postponing old-age dependency.
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Affiliation(s)
- Charlotta Nilsen
- Stress Research Institute, Stockholm University, Sweden
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Sweden
| | - Janne Agerholm
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
- Department of Global Public Health, Division of Social Medicine, Karolinska Institutet, Sweden
| | - Susanne Kelfve
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
- Department of Culture and Society, Division Ageing and Social Change & Division of Social Work, Linköping University, Sweden
| | - Jonas W Wastesson
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Ingemar KÅreholt
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Sweden
| | - Kirsten Nabe-Nielsen
- The National Research Center for the Working Environment, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Denmark
| | - Bettina Meinow
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
- Stockholm Gerontology Research Center, Sweden
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Alharbi TA, Owen AJ, Ryan J, Gasevic D, McNeil JJ, Woods RL, Nelson MR, Freak-Poli R. Socio-Demographic, Lifestyle, and Clinical Characteristics of Early and Later Weight Status in Older Adults: Secondary Analysis of the ASPREE Trial and ALSOP Sub-Study. Geriatrics (Basel) 2023; 8:71. [PMID: 37489319 PMCID: PMC10366913 DOI: 10.3390/geriatrics8040071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/10/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
OBJECTIVE To identify the socio-demographic, lifestyle, and clinical characteristics associated with self-reported weight status in early (age 18 years) and late (age ≥ 70 years) adulthood. METHODS The number of participants was 11,288, who were relatively healthy community-dwelling Australian adults aged ≥70 years (mean age 75.1 ± 4.2 years) in the Aspirin in Reducing Events in the Elderly (ASPREE) Longitudinal Study of Older Persons (ALSOP) sub-study. Self-reported weight at the study baseline (age ≥ 70 years) and recalled weight at age 18 years were collected. Height measured at baseline was used to calculate the BMI at both time points. Individuals were categorised into one of five 'lifetime' weight status groups: healthy weight (at both age 18 year and ≥70 years), overweight (at either or both times), non-obese (age 18 year) to obesity (age ≥70 years), obesity (age 18 years) to non-obese (age ≥ 70 years), and early and later life obesity (at age 18 years and ≥70 years). RESULTS Participants who experienced obesity in early and/or late adulthood were at a higher risk of adverse clinical characteristics. Obesity in late adulthood (regardless of early adulthood weight status) was associated with high proportions of hypertension, diabetes, and dyslipidaemia, whereas obesity in early adulthood (regardless of late adulthood weight status) was associated with lower cognitive scores (on all four measures). DISCUSSION/CONCLUSION Healthy or overweight weight status in early and later adulthood was associated with more favourable socioeconomic, lifestyle, and clinical measures. Obesity in early adulthood was associated with lower cognitive function in later adulthood, whereas obesity in later adulthood was associated with hypertension, diabetes, and dyslipidaemia.
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Affiliation(s)
- Tagrid A Alharbi
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
- Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
| | - John J McNeil
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
| | - Mark R Nelson
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS 7001, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd, Melbourne, VIC 3004, Australia
- School of Clinical Sciences at Monash Health, Monash University, 27-31 Wright Street, Melbourne, VIC 3004, Australia
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Alcaide M, Garcia OF, Queiroz P, Garcia F. Adjustment and maladjustment to later life: Evidence about early experiences in the family. Front Psychol 2023; 14:1059458. [PMID: 36935989 PMCID: PMC10017455 DOI: 10.3389/fpsyg.2023.1059458] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/09/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Previous parenting studies with European-American families have identified optimal parenting as being based on warmth combined with strictness (i.e., authoritative parenting). The present study analyzes, in adolescents and adults, their adjustment and maladjustment related to age and their early experiences in the family. Methods The sample consisted of 2,158 Spanish people (58.29% women): 624 adolescents, 630 young adults, 504 middle-aged adults, and 400 older adults. The families were classified into one of the four parental typologies (authoritative, indulgent, authoritarian, and neglectful) based on their scores in the two main dimensions (warmth and strictness). Child functioning was measured as components of adjustment (self-esteem, emotional self-concept, and empathy) and maladjustment (aggression and hostile sexism). Results Overall, only adolescents and adult children raised in indulgent families reported the highest self-esteem, emotional self-concept, and empathy, and the lowest aggression and hostile sexism. Authoritative parenting (warmth with strictness) was related to a lower emotional self-concept and greater aggression and hostile sexism than indulgent parenting (warmth without strictness). The worst scores corresponded to authoritarian and neglectful parenting. Discussion The present findings provide new evidence about early experiences in the family, even after parental socialization has ended. Interestingly, contrary to the main findings from classic studies with European-American families, only high parental warmth combined with low parental strictness (i.e., indulgent parenting) is always positive for greater adjustment and less maladjustment in all age groups.
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Affiliation(s)
- Marta Alcaide
- Department of Methodology of the Behavioural Sciences, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Oscar F. Garcia
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
- *Correspondence: Oscar F. Garcia,
| | - Pablo Queiroz
- Faculty of Health Sciences, Federal University of Rio Grande do Norte, Trairi, Brazil
| | - Fernando Garcia
- Department of Methodology of the Behavioural Sciences, Faculty of Psychology, University of Valencia, Valencia, Spain
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Alharbi TA, Ryan J, Freak-Poli R, Gasevic D, McNeil J, Woods RL, Britt C, Nelson MR, Owen AJ. Self-Reported Early and Later Life Weight and the Risk of All-Cause Mortality in Older Adults. J Nutr Health Aging 2023; 27:301-308. [PMID: 37170438 PMCID: PMC10353754 DOI: 10.1007/s12603-023-1907-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/25/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES The extent to which body weight in early adulthood is associated with late-life mortality risk is unclear. This study aimed to determine the association between body mass index (BMI) in early adulthood (at 18 years of age) and older age (70 years and over), and the risk of mortality in later life. DESIGN Secondary analysis of the ASPREE Longitudinal Study of Older Persons (ALSOP). SETTING, PARTICIPANTS Data were from 14,853 relatively healthy community-dwelling Australians aged ≥ 70 years when enrolled in the study. MEASUREMENTS Self-reported weight at age ≥ 70 years and recalled weight at age 18 years were collected at ALSOP study baseline. Height was measured with a stadiometer and was used for calculation of BMI at both timepoints. BMI at each timepoint was defined as: underweight, normal weight, overweight and obese. Individuals were categorised into one of five 'lifetime' BMI groups: normal weight (BMI between 18.5 and 24.9 at both times), overweight (25.0-29.9 at either or both times), obesity to non-obese (≥30.0 at age 18 and <30.0 ≥ 70 years), non-obese to obesity (<30.0 at age 18 and ≥30.0 at age ≥ 70 years), and early and later life obesity (≥30.0 at both times). RESULTS During a median 4.7 years follow-up, 715 deaths occurred. Obesity at 18 years, but not in older age (p=0.44), was significantly associated with the risk of mortality in later life, even after accounting for current health status (HR: 2.35, 95% CI: 1.53-3.58, p<0.001). Compared with participants with normal BMI at both time points, being obese at both time points was associated with increased mortality risk (HR=1.99, 95% CI: 1.04-3.81, p=0.03), and the risk was even greater for individuals who were obese at 18 years but were no longer obese in older age (HR=2.92, 95% CI: 1.65-5.16, p<0.001), in fully adjusted models. Participants who were normal weight at 18 years and were obese in later life, did not have an increased mortality risk (p=0.78). CONCLUSIONS Obesity in early adulthood, and obesity in both early and later life, were associated with increased mortality risk in later life. This highlights the importance of preventing obesity in early adulthood and maintaining a normal weight over an adult lifespan.
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Affiliation(s)
- T A Alharbi
- Dr Alice J. Owen, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St. Kilda Rd., Level 4, Melbourne VIC 3004, Australia, Tel: +61 3 9903 0416,
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Treagust N, Sidhom E, Lewis J, Denman C, Knutson O, Underwood BR. The epidemiology and clinical features of personality disorders in later life; a study of secondary care data. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5837. [PMID: 36317445 PMCID: PMC9828462 DOI: 10.1002/gps.5837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/21/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Personality disorders (PDs) are often conceptualised as impacting individuals throughout their life. However, there has been limited study of the disorders in those over the age of 65. We have used the psychiatric secondary care medical records of 21,971 individuals over the age of 65 from Cambridgeshire, UK, who received care between 2014 and 2021 to characterise older patients with a PD diagnosis. METHODS The data from all patients >65 with a diagnosis of personality disorder (PD) was extracted (n = 217) along with two comparison groups (n = 2170); patients <65 with a diagnosis of PD and patients >65 with a psychiatric diagnosis other than PD or dementia. RESULTS Compared to younger patients with PD, older patients were more likely to be male, married, suffering from a mixed PD and live in less deprived areas. Compared to patients >65 with diagnoses other than PD, older patients were more likely to be female, single or divorced and had a higher level of social deprivation. Our most striking finding was that older patients with PDs were more likely to experience polypharmacy. A mean of 18.48 different drugs had been prescribed over their lifetime, compared to 9.51 for patients >65 with other mental health diagnoses. CONCLUSION Here we present the largest ever description of this group of patients and provide insights that could inform clinical practice and future research.
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Affiliation(s)
- Natasha Treagust
- University of Cambridge School of Clinical MedicineCambridge Biomedical CampusCambridgeUK
| | - Emad Sidhom
- Department of Clinical NeurosciencesUniversity of CambridgeCambridge Biomedical CampusCambridgeUK,Windsor UnitFulbourn HospitalCambridgeshire and Peterborough NHS Foundation TrustCambridgeUK
| | - Jonathan Lewis
- Department of Clinical NeurosciencesUniversity of CambridgeCambridge Biomedical CampusCambridgeUK
| | - Chess Denman
- Department of Clinical NeurosciencesUniversity of CambridgeCambridge Biomedical CampusCambridgeUK
| | - Olivia Knutson
- University of Cambridge School of Clinical MedicineCambridge Biomedical CampusCambridgeUK
| | - Benjamin R. Underwood
- Windsor UnitFulbourn HospitalCambridgeshire and Peterborough NHS Foundation TrustCambridgeUK,Department of PsychiatryUniversity of CambridgeForvie SiteCambridgeUK
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12
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Hafford-Letchfield T, Hanna JR, Ellmers TJ, Rasmussen S, Cogan N, Gleeson H, Goodman J, Martin S, Walker P, Quaife M. Talking really does matter: Lay perspectives from older people on talking about suicide in later life. Front Psychol 2022; 13:1009503. [PMID: 36467190 PMCID: PMC9709258 DOI: 10.3389/fpsyg.2022.1009503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/06/2022] [Indexed: 09/19/2023] Open
Abstract
Background The cumulative body of research on suicidality in later life describes its unique and complex features in older people when compared with that in other population groups. Yet significant gaps exist in how research informs the further development of suitable interventions. The perspectives of older people are also limited in research findings. Aims Therefore, this exploratory study aimed to (1) identify potential barriers and enablers in discussing suicidal thoughts and their expression in later life from the perspectives of lay older people and (2) explore where opportunities might occur in approach, place, relationships, and language with older people to discuss suicidal thoughts and their expression. Method We conducted in-depth qualitative individual interviews with 15 people aged 70-89 years. This method helped explore older peoples' own lay perspectives on suicidal thoughts in later life and how these are expressed, and their understanding of where and how people might seek support. Results A total of three themes were generated from the dataset: (1) intergenerational and socio-cultural differences in suicide expression, (2) the normalization of suicidal thoughts in later life, and (3) the importance and difficulties of everyday discussion and opportunities to express suicidal thoughts. Conclusion Suicidal thoughts and their expression appear commonly and are normalized in later life yet remain taboo and hidden. The participants revealed how such thoughts and behaviors are typically expressed through colloquial or "off-hand" remarks and comments and the importance of authentic listening. The findings highlight the importance of more informal discussions around these topics and how care professionals, practitioners, and providers might frame opportunities for dialogue with people who may want to access support. Further engagement with community-informed participatory research methods in which older people provide their own perspectives and experiences is important in addressing these gaps. There is a need for co-designing in developing screening, assessment, and signposting outside of clinical settings that can be used in everyday caring relationships with people in later life.
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Affiliation(s)
- Trish Hafford-Letchfield
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Jeffrey R. Hanna
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Toby J. Ellmers
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Susan Rasmussen
- School of Psychological Sciences and Health, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Nicola Cogan
- School of Psychological Sciences and Health, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Helen Gleeson
- School of Mental Health and Social Work, School of Education, Middlesex University, London, United Kingdom
| | | | - Sophie Martin
- School of Psychological Sciences and Health, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Patrick Walker
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Matthew Quaife
- School of Mental Health and Social Work, School of Education, Middlesex University, London, United Kingdom
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13
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Pacini A, Vseteckova J, Haider S. The Effects of Mindfulness-Based Interventions on Couples in Later Life. A Mixed Methods Systematic Review. Clin Gerontol 2022; 46:315-329. [PMID: 35767429 DOI: 10.1080/07317115.2022.2093687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To review current quantitative and qualitative evidence on the physical and mental health outcomes and participant experiences following mindfulness-based interventions (MBIs) for couples over the age of 65. METHODS The search strategy used PubMed; Web of Science; PsycInfo; The Dementia Evidence Toolkit; NIH RePORTER; NIH Clinical Trials.gov and Scopus databases and followed the JBI framework. RESULTS Four studies were included, of these, three were described as patient-carer dyads. Overall, the studies suggested that standardized, eight-week mindfulness interventions may be feasible for older adult independent couples and caregiving dyads, including people with cognitive decline, but the available evidence should be considered with caution. CONCLUSIONS Further high-quality studies investigating specific older adult dyads with sensitive and appropriate outcome measures are needed. CLINICAL IMPLICATIONS Whilst older adult mindfulness groups delivered to couples are feasible, conclusions about the effects of mindfulness on older adult caregiving and/or romantic couples are impossible to establish.
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Affiliation(s)
- Adele Pacini
- Faculty of Arts and Social Sciences, The Open University and Clinical Psychologist in Later Life Mental Health Care, Gatehouse Charity, Milton 5 Keynes, UK
| | - Jitka Vseteckova
- Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
| | - Sharif Haider
- Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
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14
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Gewirtz-Meydan A, Ayalon L. Reasons people refrain from sex in later life. J Sex Marital Ther 2022; 49:189-207. [PMID: 35708188 DOI: 10.1080/0092623x.2022.2087811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There has been an increase in research on sexual activity in later life, yet far less is known about the actual perceptions and experiences of older adults who refrain from sexual activity. In the current study, a thematic analysis was conducted to identify patterns in semi-structured interviews with 47 older adults, aged 60-91. The analysis yielded seven themes that describe why older adults refrain from sex: 1) avoiding confronting sexual dysfunctions, 2) avoiding confronting the aging body, 3) avoiding performance anxiety, 4) being uninterested in sexual activity, 5) taking time to grieve the loss of a partner, 6) avoiding judgment, and 7) seeing sexuality as evolving and changing. Themes were organized according to the bio-psycho-social perspective and based on the axis of personal (self-focused) and interpersonal (partner-focused) motives. It is perfectly acceptable for people to refrain from sexual activity for their own reasons. However, if older adults want to remain sexually active, they should receive complete information about the many possibilities of treating different sexual problems in later life and about the many ways, beyond sexual penetration, one can enjoy sexual activity even in old age.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| | - Liat Ayalon
- School of Social Work, Bar-Ilan University, Ramat Gan, Israel
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15
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Hafford-Letchfield T, Hanna J, Grant E, Ryder-Davies L, Cogan N, Goodman J, Rasmussen S, Martin S. "It's a Living Experience": Bereavement by Suicide in Later Life. Int J Environ Res Public Health 2022; 19:ijerph19127217. [PMID: 35742466 PMCID: PMC9223552 DOI: 10.3390/ijerph19127217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022]
Abstract
Bereavement by suicide for people in later life is significantly under-researched. Research on ageing and suicide has yet to address the experiences of those bereaved by suicide and how such a devastating loss affects the ageing experience. Objectives: We explored the substantive issues involved in bereavement by suicide and its impact on later life. Methods: This was a co-produced qualitative study. Peer researchers with lived experience conducted in-depth interviews with twenty-four people aged 60-92 years. A phenomenological approach informed the data analysis. Main Findings: Themes described included (1) moral injury and trauma; (2) the rippling effect on wider family and networks; (3) transitions and adaptations of bereaved people and how their 'living experience' impacted on ageing. Conclusions: It is important to understand how individual experiences of suicide intersect with ageing and the significance of targeted assessment and intervention for those bereaved by suicide in ageing policies and support.
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Affiliation(s)
- Trish Hafford-Letchfield
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow G1 1XQ, UK; (J.H.); (E.G.); (L.R.-D.); (S.M.)
- Correspondence:
| | - Jeffrey Hanna
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow G1 1XQ, UK; (J.H.); (E.G.); (L.R.-D.); (S.M.)
| | - Evan Grant
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow G1 1XQ, UK; (J.H.); (E.G.); (L.R.-D.); (S.M.)
| | - Lesley Ryder-Davies
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow G1 1XQ, UK; (J.H.); (E.G.); (L.R.-D.); (S.M.)
| | - Nicola Cogan
- School of Psychological Sciences, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow G1 1XQ, UK; (N.C.); (S.R.)
| | | | - Susan Rasmussen
- School of Psychological Sciences, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow G1 1XQ, UK; (N.C.); (S.R.)
| | - Sophie Martin
- School of Social Work and Social Policy, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow G1 1XQ, UK; (J.H.); (E.G.); (L.R.-D.); (S.M.)
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16
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Beeris C, Niemeijer A, Machielse A. Count Your Life by Smiles and Tears: An Integrative Review on Resilience and Growing Older. Gerontol Geriatr Med 2022; 8:23337214221119050. [PMID: 36090316 PMCID: PMC9449508 DOI: 10.1177/23337214221119050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 11/15/2022] Open
Abstract
The concept of “resilience” is considered helpful in understanding how people
navigate adversities typical to later life. It is also a concept of growing
interest internationally in research and in social policy and (social) practice.
This article employs an integrative review methodology to explore current trends
in theoretical and empirical research on resilience. A total of 25 quantitative
and qualitative studies from 2011 to 2020 are included in this review. Findings
indicate how the reviewed studies typically define resilience from three
perspectives: resource-based, outcome-based, and process-based perspectives of
resilience. In the results of the same studies, the resource-based and
outcome-based perspectives are elaborated upon while detailed results from a
process-based perspective are lacking. Additionally, even though adversity is
recognized as a key element in conceptualizing resilience, it is scarcely
defined if defined at all in the reviewed studies. Further research is
recommended in this article to contribute to a realistic and encouraging
narrative on growing older in social policy and (social) practice.
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Affiliation(s)
- Chloe Beeris
- University of Humanistic Studies, Utrecht, The Netherlands
| | | | - Anja Machielse
- University of Humanistic Studies, Utrecht, The Netherlands
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17
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Maguire E, Mulryan N, Sheerin F, McCallion P, McCarron M. Autism spectrum disorder in older adults with intellectual disability: a scoping review. Ir J Psychol Med 2021;:1-14. [PMID: 34612183 DOI: 10.1017/ipm.2021.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Ireland has an ageing population of persons with intellectual disability (ID), autism spectrum disorder (ASD) and both (ID/ASD). Despite this, little is known about the prevalence of ASD and its effect on functional outcomes, psychiatric comorbidity or diagnostic issues in an older population with ID. This article reviews the literature on older adults with ID/ASD and identifies opportunities for future research in this population. METHOD The authors searched the Medline, Pubmed, Embase, CINAHL and PsychInfo databases using the search terms using key words: (older adults) AND (ID OR mental retardation OR learning disability) AND (autism OR ASD). After excluding articles for relevance, a scoping review was carried out on the results retrieved. RESULTS Of the 1227 articles retrieved from the literature on ID and autism/ASD in older adults, 85 articles were relevant to an adult population with ID/ASD. The data were collated and are presented covering domains of diagnosis, prevalence, psychiatric comorbidities and functional outcomes. CONCLUSIONS Despite increased prevalence in childhood ASD in the last 20 years, there is a lack of research regarding adults, especially older adults, with ASD, up to half of whom will have some level of ID. The existing literature suggests that older adults with ID/ASD may have reduced functional independence, increased psychiatric comorbidity and psychotropic prescribing and more behavioural presentations than the older population generally or those with ID only. There is a need for longitudinal data to be collected on this ageing population so that care and management needs can be met in the future.
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18
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Fristedt S, Carlsson G, Kylén M, Jonsson O, Granbom M. Changes in daily life and wellbeing in adults, 70 years and older, in the beginning of the COVID-19 pandemic. Scand J Occup Ther 2021; 29:511-521. [PMID: 34088255 DOI: 10.1080/11038128.2021.1933171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND In the beginning of the COVID-19 pandemic, Swedish authorities enforced specific recommendations on social distancing for adults 70 years and older (70+). Day-to-day life changed for 15% of the Swedish population. The aim of the study was to explore how adults 70+ experienced and managed changes in everyday life due to the COVID-19 pandemic and how those changes affected wellbeing at the beginning of the virus outbreak. METHODS Eleven women and six men, (mean age 76 years), living in ordinary housing, participated in remote semi-structured interviews in April 2020. The interviews were analysed with qualitative content analysis. FINDINGS The theme Suddenly at risk - '…but it could have been worse' included four categories My world closed down; Negotiations, adaptations and prioritizations to manage staying at home; Barriers and facilitators to sustain occupational participation; and Considerations of my own and other's health and wellbeing emerged from the data analysis. CONCLUSION Everyday life changes had implications for health and well-being. The participants questioned previous conceptions of meaning in relation to habitual activities, likely leading to consistent occupational changes. However, these long-term effects remain to be explored, and considered to enable older adult's health during the pandemic and beyond.
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Affiliation(s)
- Sofi Fristedt
- Department of Health Sciences, Lund University, Lund, Sweden.,School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Maya Kylén
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Oskar Jonsson
- Department of Health Sciences, Lund University, Lund, Sweden
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19
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Li D, Menotti T, Ding Y, Wells NM. Life Course Nature Exposure and Mental Health Outcomes: A Systematic Review and Future Directions. Int J Environ Res Public Health 2021; 18:ijerph18105146. [PMID: 34066287 PMCID: PMC8152056 DOI: 10.3390/ijerph18105146] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 12/18/2022]
Abstract
Recently, an emerging body of literature has examined the relationships between early life nature exposure and mental health in later life; however, no critical synthesis yet exists regarding the extent and strength of these relationships. This study presents the first systematic review of studies in this growing area. Following the PRISMA framework, we searched six databases (i.e., Scopus, Web of Science, MEDLINE, Embase, PsycINFO, and CINAHL); conducted identification, screening, eligibility, and inclusion analyses; and identified a final set of 29 articles. The review set comprises primarily longitudinal studies, with several cross-sectional studies using retrospective measures of childhood nature exposure. The majority of included studies were published between 2016 and 2020 and conducted in Europe and North America. Five domains of mental health outcomes are associated with early-life nature exposure: incidence of mental disorders, psychiatric symptoms and emotions, conduct problems in children, cognitive function, and subjective well-being. The evidence lends support to an overall beneficial role of early nature exposure on mental health, although inconsistencies are reported. Taken together, the evidence does not suggest that exposure at any given life stage is more saliently associated with mental health outcomes than at others. We discuss the validity concerns and methodological remedies and offer directions for future research.
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Affiliation(s)
- Dongying Li
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX 77843, USA; (T.M.); (Y.D.)
- Correspondence:
| | - Tess Menotti
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX 77843, USA; (T.M.); (Y.D.)
| | - Yizhen Ding
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX 77843, USA; (T.M.); (Y.D.)
| | - Nancy M. Wells
- Department of Design and Environmental Analysis, College of Human Ecology, Cornell University, Ithaca, NY 14853, USA;
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20
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O’Neal CW, Wickrama K(K. The Contribution of Stressful Marital Interactions to Loneliness and Health across Mid-life and Later Adulthood. J Fam Issues 2021; 42:553-570. [PMID: 34504384 PMCID: PMC8425179 DOI: 10.1177/0192513x20921927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although past research has noted longitudinal, and sometimes bi-directional, associations between marital interactions, loneliness, and physical health, previous work has not identified long-term associations and differential associations over life-course stages (i.e., mid-life and later adulthood). Utilizing a life-course stress process perspective and a sample of 250 couples in enduring marriages over 17 years (2001-2017), a structural equation model within a dyadic framework assessed the unique influences of stressful marital interactions on loneliness and physical health and the variation in bi-directional influences of loneliness and physical health over time. Marital interactions were relatively stable across life stages, yet marital interactions appear to influence loneliness and physical health. Notable distinctions were evident across life stages (from mid-life to later adulthood and then within later adulthood). Findings are discussed with an emphasis on the implications for health promotion and prevention programs targeting couples' quality of life in later years.
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Affiliation(s)
- Catherine Walker O’Neal
- Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA
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21
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Briones S, Meijering L. Using Everyday Technology Independently When Living with Forgetfulness: Experiences of Older Adults in Barcelona. Gerontol Geriatr Med 2021; 7:2333721421993754. [PMID: 33623810 PMCID: PMC7876746 DOI: 10.1177/2333721421993754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 12/06/2020] [Accepted: 01/11/2021] [Indexed: 11/16/2022] Open
Abstract
Older adults living with forgetfulness encounter difficulties when
engaging with changing and dynamic everyday technology (ET). The
capability to use ET is important for independence in later life and
is affected by the contextual and individual characteristics of older
adults. Using the capability approach as a theoretical lens, this
phenomenological study aims to explore the experiences of older adults
living with forgetfulness, in order to identify contextual and
individual factors that facilitate the use of ET in everyday life. A
qualitative methodology was used to interview 16 community-dwelling
older adults participating in memory and technology workshops at local
community centres in Barcelona. Findings show that motivation and
openness to learning played a facilitating role in our participants’
use of ET. The presence of social support in the form of “technology
experts” and community centres offering learning opportunities were
also enhancing factors that encourage independence when engaging with
ET. In conclusion, our study demonstrates the importance of expanding
intergenerational ET learning opportunities, through the creation of
age-friendly spaces.
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Affiliation(s)
- Samuel Briones
- University of Groningen, The Netherlands.,Utrecht University, The Netherlands
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22
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Sun N, Hua CL, Qiu X, Brown JS. Urban and Rural Differences in Trajectories of Depressive Symptoms in Later Life in the United States. J Appl Gerontol 2020; 41:148-157. [PMID: 33234026 DOI: 10.1177/0733464820972527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This research has two primary goals: to examine the relationship between urban residence and trajectories of depressive symptoms and to investigate whether this relationship differs by social isolation and loneliness. METHOD Data are from 2006, 2008, 2010, 2012, 2014, and 2016 waves of the Health and Retirement Study (HRS), a nationally representative sample of U.S. adults aged 51+ (n = 3,346 females and 2,441 males). We conduct latent growth curve analysis to predict both baseline and trajectories of depression based on urban or rural residency. RESULTS Residing in urban or rural areas is neither significantly associated with baseline nor the development of late-life depressive symptoms. For females, the relationship between urban residence and baseline depressive symptoms is explained by socioeconomic factors. DISCUSSION Findings of this study serve to better understand how social and geographic contexts shape long-term well-being of older adults.
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Affiliation(s)
- Na Sun
- Miami University, Oxford, OH, USA
| | | | - Xiao Qiu
- Miami University, Oxford, OH, USA
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23
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Thoma MV, Höltge J, Eising CM, Pfluger V, Rohner SL. Resilience and Stress in Later Life: A Network Analysis Approach Depicting Complex Interactions of Resilience Resources and Stress-Related Risk Factors in Older Adults. Front Behav Neurosci 2020; 14:580969. [PMID: 33281572 PMCID: PMC7705246 DOI: 10.3389/fnbeh.2020.580969] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/23/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Emerging systemic approaches on resilience propose that a person's or group's adaptability to significant stress relies on a network of interdependent resources. However, little knowledge exists on systemic resilience in older survivors of early-life adversity (ELA) and how ELA affects their resource network in later life. OBJECTIVE This study investigated how ELA may be linked to the interplay of resources and stress-related risk factors in later life. RESEARCH DESIGN AND METHODS Data from N = 235 older adults (M age = 70.43 years; 46.40% female) were assessed. Half the participants were affected by ELA through compulsory social measures and placements in childhood, and/or adolescence ("risk group"). The other half were age-matched, non-affected participants ("control group"). Using psychometric instruments, a set of resilience-supporting resources in later life and current stress indices were assessed. Regularized partial correlation networks examined the interplay of resources in both groups, whilst also considering the impact of stress. RESULTS Both groups demonstrated only positive resource interrelations. Although the control group showed more possible resource connections, the groups did not significantly differ in the overall strength of connections. While group-specific resource interrelations were identified, self-esteem was observed to be the most important resource for the network interconnectedness of both groups. The risk group network showed a higher vulnerability to current stress. DISCUSSION AND IMPLICATIONS Network analysis is a useful approach in the examination of the complex interrelationships between resilience resources and stress-related risk factors in older adulthood.
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Affiliation(s)
- Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Ageing”, University of Zurich, Zurich, Switzerland
| | - Jan Höltge
- Resilience Research Centre, Dalhousie University, Halifax, NS, Canada
| | - Carla M. Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Ageing”, University of Zurich, Zurich, Switzerland
| | - Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Ageing”, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Ageing”, University of Zurich, Zurich, Switzerland
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Abstract
Objectives: This study examined the association between food insecurity status and healthcare access, utilization, and quality among adults aged 55 years and older. Methods: Data collected between 2011 and 2016 for the California Health Interview Survey were used. The sample included 72,212 individuals who were divided into three groups: food secure (FS), low food security (L-FS), and very low food security (VL-FS). Results: Logistic regression analyses controlled for demographics. Food insecurity was associated with decreased access to and quality of care and increased utilization. Specifically, VL-FS was more likely to delay care than FS. Additionally, VL-FS and L-FS had greater odds of visiting an emergency room than FS. Furthermore, VL-FS and L-FS were more likely to have a doctor who did not always explain aspects of care carefully compared to FS. Discussion: These findings suggest a need for increased screening for food insecurity in healthcare settings.
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Affiliation(s)
- Emily A Janio
- Division of General Internal Medicine and Primary Care, 8788University of California, Irvine, CA, USA
| | - Dara H Sorkin
- Division of General Internal Medicine and Primary Care, 8788University of California, Irvine, CA, USA
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25
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Abstract
This study aimed to investigate whether (1) depression is associated with cognitive decline in Korean older adults and (2) the relationship between depression and cognitive function varies by gender. Using Korean Longitudinal Study of Aging data of 2006 to 2014, we studied 1787 adults aged 65 years or older who had normal cognitive function at baseline. This study examined the effects of depression on cognitive decline by using an interaction term of baseline depression and time, and compared relationships by gender. Among male participants, K-MMSE (Korean-Mini-Mental Status Examination) scores decreased with age, at an annual rate of approximately 0.465 points. Baseline depression was found to accelerate the decline in cognitive function, by approximately 0.184 points per year. Among female participants, K-MMSE scores decreased with age, at an annual rate of approximately 0.585 points. Baseline depression was not related to the decline in cognitive function. These results suggest the need for community-based programs to increase awareness of mental health problems need to be developed to encourage the use of health services to prevent or delay cognitive decline in older Korean males.
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Affiliation(s)
- Jongnam Hwang
- Wonkwang University, Iksan City, Jeollabuk-do, Republic of Korea
| | - Seongju Kim
- Konyang University Hospital, Daejeon City, South Korea
| | - Sujin Kim
- Korea Institute for Health and Social Affairs, Sejong City, South Korea
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26
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Abstract
Objectives: Little research has investigated the prospective association between subjective-aging-perception and depressive symptoms in Chinese older adults. The aim of this study is to evaluate the differential associations of feeling old with depressive symptoms among urban and rural community-dwelling Chinese older adults using panel data drawn from two waves of nationally representative surveys.Method: We conducted secondary data analysis and utilized the data of 5,685 urban and 5,612 rural community-dwelling older adults aged 60 years and above who participated in both the 2006 and the 2010 Sample Survey on the Aged Population in Urban/Rural China (SSAPUR). A single-item measure of subjective age was used to distinguish between feeling old and feeling not old.Results: Ordinary least regression analyses indicated that the longitudinal effect of subjective age on depressive symptoms existed only in the urban sample (p<.001) but not in the rural sample and that feeling not old was related to less depressive symptoms in the urban sample, after controlling for baseline measures of depressive symptoms and sociodemographic and health factors.Conclusion: This study provides new longitudinal evidence of the impact of subjective age on depression among Chinese older individuals. The findings provide useful information for depression interventions among urban older Chinese individuals.
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Affiliation(s)
- Kun Liang
- Department of Social Work, East China University of Science and Technology, Shanghai, China
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27
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Liddle J, Pitcher N, Montague K, Hanratty B, Standing H, Scharf T. Connecting at Local Level: Exploring Opportunities for Future Design of Technology to Support Social Connections in Age-Friendly Communities. Int J Environ Res Public Health 2020; 17:ijerph17155544. [PMID: 32751898 PMCID: PMC7432362 DOI: 10.3390/ijerph17155544] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/28/2020] [Indexed: 11/16/2022]
Abstract
Social connectedness in later life is an important dimension of an age-friendly community, with associated implications for individual health and wellbeing. In contrast with prior efforts focusing on connections at a distance or online communities where the digital technology is the interface, we explore the design opportunities and role of technology for connectedness within a geographically local community context. We present findings from interviews with 22 older adults and a linked ideation workshop. Our analysis identified shared concerns and negative perceptions around local relationships, connections and characteristics of the geographical area. However, local connectedness through technology was largely absent from day-to-day life and even perceived as contributing to disconnection. By uncovering how older adults use and perceive technology in their social lives and combining these findings with their ideas for improving local connections, we highlight the need for thoughtful consideration of the role of technology in optimising social connections within communities. Our research highlights a need for design work to understand the specifics of the local context and reduce emphasis on technology as the interface between people. We introduce an amended definition-'underpinned by a commitment to respect and social inclusion, an age-friendly community is engaged in a strategic and ongoing process to facilitate active ageing by optimising the community's physical, social and digital environments and its supporting infrastructure'-to conceptualise our approach. We conclude by suggesting areas for future work in developing digitally connected age-friendly communities.
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Affiliation(s)
- Jennifer Liddle
- Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (B.H.); (T.S.)
- Open Lab, Newcastle Helix, Newcastle University, Newcastle upon Tyne NE4 5TG, UK;
- Correspondence:
| | - Nicole Pitcher
- Assistance Publique – Hôpitaux de Paris, 75004 Paris, France;
| | - Kyle Montague
- Open Lab, Newcastle Helix, Newcastle University, Newcastle upon Tyne NE4 5TG, UK;
| | - Barbara Hanratty
- Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (B.H.); (T.S.)
| | - Holly Standing
- Department of Nursing, Midwifery and Health, Coach Lane Campus East, Northumbria University, Newcastle upon Tyne NE7 7XA, UK;
| | - Thomas Scharf
- Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (B.H.); (T.S.)
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28
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Nettleton S, Martin D, Buse C, Prior L. Materializing architecture for social care: Brick walls and compromises in design for later life. Br J Sociol 2020; 71:153-167. [PMID: 31855288 PMCID: PMC6973086 DOI: 10.1111/1468-4446.12722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 09/16/2019] [Accepted: 11/14/2019] [Indexed: 06/10/2023]
Abstract
This article reports on an ethnography of architectural projects for later life social care in the UK. Informed by recent debates in material studies and "materialities of care" we offer an analysis of a care home project that is sensitive to architectural materials that are not normally associated with care and well-being. Although the care home design project we focus on in this article was never built, we found that design discussions relating to a curved brick wall and bricks more generally were significant to its architectural "making". The curved wall and the bricks were used by the architects to encode quality and values of care into their design. This was explicit in the design narrative that was core to a successful tender submitted by a consortium comprising architects, developers, contractors, and a care provider to a local authority who commissioned the care home. However, as the project developed, initial consensus for the design features fractured. Using a materialized analysis, we document the tussles generated by the curved wall and the bricks and argue that mundane building materials can be important to, and yet marginalized within, the relations inherent to an "architectural care assemblage." During the design process we saw how decisions about materials are contentious and they act as a catalyst of negotiations that compromise "materialities of care."
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Affiliation(s)
| | - Daryl Martin
- Department of SociologyUniversity of YorkYorkUnited Kingdom
| | - Christina Buse
- Department of SociologyUniversity of YorkYorkUnited Kingdom
| | - Lindsay Prior
- Department of SociologyQueens University BelfastBelfastUnited Kingdom
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29
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Musselwhite C, Scott T. Developing A Model of Mobility Capital for An Ageing Population. Int J Environ Res Public Health 2019; 16:E3327. [PMID: 31509961 DOI: 10.3390/ijerph16183327] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/29/2019] [Accepted: 09/08/2019] [Indexed: 11/16/2022]
Abstract
Driving a car meets older people’s needs, providing utility (getting from A to B), psychosocial (providing identity and roles and feelings of independence and normality) and aesthetic (mobility for its own sake) mobilities. Giving up driving is related to poorer health and wellbeing. This paper addresses how older people cope when they give up driving, using Bourdieu’s theory of capital as a way of categorising different barriers and enablers to managing without a car in a hypermobile society. Older people are most likely to mention barriers and enablers to mobility relating to infrastructure capital (technology, services, roads, pavements, finance and economics), followed by social capital (friends, family, neighbourhood and community). Cultural capital (norms, expectations, rules, laws) and individual capital (skills, abilities, resilience, adaptation and desire and willingness to change) are less important but still significantly contribute to older people’s mobility. Implications for policy and practice suggest that provision for older people beyond the car must explore capital across all four of the domains.
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Stončikaitė I. Revisiting Happiness and Well-Being in Later Life from Interdisciplinary Age-Studies Perspectives. Behav Sci (Basel) 2019; 9:bs9090094. [PMID: 31484406 PMCID: PMC6770928 DOI: 10.3390/bs9090094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/27/2019] [Accepted: 08/30/2019] [Indexed: 12/31/2022] Open
Abstract
Important demographic shifts and the so-called ‘longevity revolution’ have generated profound transformations in social interpretations of old age, an increased interest in age studies and new ideas on how to age well. The majority of current successful ageing models, however, represent rather a prevailing construct in Western societies. Physical and psychosocial well-being and the ability to adjust to the ideals of successful ageing are often seen as an integral part of a good quality in life. Those who do not or cannot follow these lines are often regarded as morally irresponsible and seem to be doomed to have a lonely, unhealthy and unhappy later life. This paper questions the current discourses of successful ageing in terms of healthy and happy living and calls for a reconsideration of more global, integrated and holistic understandings of the process of growing old.
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31
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Finney N, Marshall A. Is migration in later life good for wellbeing? A longitudinal study of ageing and selectivity of internal migration. Area (Oxf) 2018; 50:492-500. [PMID: 30555170 PMCID: PMC6282955 DOI: 10.1111/area.12428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 06/09/2023]
Abstract
Migration scholarship has recently paid attention to lifecourse and non-economic effects of moving house. Yet consideration of the effects of internal migration in later life has been relatively neglected despite their implications for social and spatial inequalities. Thus we address two questions: how trajectories of wellbeing in later life vary for movers and non-movers, and how the event of moving affects wellbeing. In both cases we distinguish between "voluntary" and "involuntary" movers. We use 10 years (2002-2012) of the English Longitudinal Study of Ageing (ELSA) to analyse trends in wellbeing for age cohorts and to examine how wellbeing changes through the event of moving. The Control, Autonomy, Selfrealisation and Pleasure (CASP-19) measure of wellbeing is used. We find that, after controls for demographic and socio-economic characteristics, involuntary movers have lower levels of wellbeing than stayers or voluntary movers; and involuntary movers experience a stabilisation in the decline in wellbeing following migration which is not seen for voluntary movers. So, migration in later life is good for wellbeing, maintaining advantageous wellbeing trajectories for voluntary movers and improving wellbeing trajectories for involuntary movers. These findings imply a rich potential of ELSA and similar longitudinal datasets for examining residential mobility; the need for ageing inequalities studies to take more account of residential mobility; the need for internal migration scholarship to pay greater attention to reason for move; and for policy to consider the potentially beneficial effects of residential mobility in later life, particularly for those in adverse circumstances.
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Affiliation(s)
- Nissa Finney
- School of Geography and Sustainable DevelopmentUniversity of St AndrewsSt AndrewsFifeUK
| | - Alan Marshall
- School of Social and Political ScienceUniversity of EdinburghEdinburghUK
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32
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Maniragaba F, Kwagala B, Bizimungu E, Wandera SO, Ntozi J. Predictors of quality of life of older persons in rural Uganda: A cross sectional study. AAS Open Res 2018; 1:22. [PMID: 32259022 PMCID: PMC7118782 DOI: 10.12688/aasopenres.12874.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 01/22/2023] Open
Abstract
Background: Little is known about the quality of life of older persons (OPs) in Uganda in particular, and Africa in general. This study examined factors associated with quality of life of older persons in rural Uganda. Method: We performed a cross-sectional survey of 912 older persons from the four regions of Uganda. Data were analyzed at univariate, bivariate and multivariate level where ordinal logistic regression was applied. Results: Older persons in northern (OR=0.39; CI=0.224-0.711) and western (OR=0.33; CI=0.185-0.594) regions had poor quality of life relative to those in central region. Those who were HIV positive had poor quality of life (OR=0.45; CI=0.220-0.928) compared to those who were HIV negative. In contrast, living in permanent houses predicted good quality of life (OR=2.04; CI=1.391-3.002). Older persons whose household assets were controlled by their spouses were associated with good quality of life (OR=2.06;CI=1.032-4.107) relative to those whose assets were controlled by their children. Conclusion: Interventions mitigating the HIV and AIDS related Quality of life should target older persons. The government of Uganda should consider improving housing conditions for older persons in rural areas.
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Affiliation(s)
- Fred Maniragaba
- Department of Population Studies, Makerere University, Kampala, 7062, Uganda
| | - Betty Kwagala
- Department of Population Studies, Makerere University, Kampala, 7062, Uganda
| | | | | | - James Ntozi
- Department of Population Studies, Makerere University, Kampala, 7062, Uganda
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33
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Paulson D, Shah M, Herring D, Scott R, Herrera M, Brush D, Bassett R. The relationship between moderate alcohol consumption, depressive symptomatology, and C-reactive protein: the Health and Retirement Study. Int J Geriatr Psychiatry 2018; 33:316-324. [PMID: 28612359 DOI: 10.1002/gps.4746] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 05/02/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Moderate alcohol use has been broadly associated with health benefits among older adults, including improved mood. Aims of this study were to evaluate the relationship of moderate alcohol use and depressive symptomatology over a period of eight years, and to examine inflammation, indicated by C-reactive protein (CRP), as one mechanism by which this relationship functions. METHODS The study included 3177 community-dwelling participants over the age of 65 in 2008 drawn from the Health and Retirement Study. Data from the 2006, 2008, 2012, and 2014 waves were used. Alcohol use was measured via self-report and was dichotomized as abstinent (0 drinks per week) and moderate (1-14 drinks per week). Inflammation was measured using CRP, which was collected using an enzyme-linked immunosorbent assay and provided in units of μg/mL. Control variables included gender, age, body mass index (BMI), and medical burden. RESULTS A latent growth curve model with full information maximum likelihood was used, with results revealing that moderate drinkers endorsed fewer depressive symptoms at baseline and a steeper rate of change over time. Abstinent respondents' depressive symptomatology was characterized by a more linear change rate. Further, moderate drinkers had lower CRP levels suggesting that inflammation partially mediates the relationship between moderate alcohol use and depressive symptomatology. CONCLUSIONS Moderate alcohol use predicts fewer depressive symptoms among older adults. This relationship is partially moderated by CRP and is eroded by the passage of time. Future research should identify additional mechanisms relating alcohol to positive health outcomes and less depressive symptomatology. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Daniel Paulson
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Mona Shah
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Danielle Herring
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Rosanna Scott
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Manuel Herrera
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - David Brush
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Rachel Bassett
- Department of Psychology, University of Central Florida, Orlando, FL, USA
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34
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Nazroo J. Class and Health Inequality in Later Life: Patterns, Mechanisms and Implications for Policy. Int J Environ Res Public Health 2017; 14:E1533. [PMID: 29292775 DOI: 10.3390/ijerph14121533] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 12/03/2017] [Accepted: 12/04/2017] [Indexed: 12/22/2022]
Abstract
The growth of the post-retirement population, which has occurred as a result of rapid growth in life expectancy coupled with the ageing of the baby boomer cohort, has led to significant concern. This concern, however, typically neglects the heterogeneity of later life experiences and how these are patterned by inequalities that reflect how process of social stratification continue to operate into later life. This paper draws on a programme of work, based on analysis of the English Longitudinal Study of Ageing, to empirically examine questions of inequality in later life. It begins by illustrating the patterning of health inequality. It then investigates the importance of later life contexts and events in shaping inequality through and after the retirement process. In doing so it examines the extent to which later life continues to reflect stable social structures that shape inequalities and, consequently, health and wellbeing in later life. The paper then illustrates how the effects of socioeconomic position on health in later life can be theorised as a product of class processes, borrowing in part from Bourdieu. Other dimensions of inequality, such as gender, ethnicity, area and sexuality, are not discussed here. The paper concludes with a discussion of the need for a close focus on inequalities in later life in research, policy and practice.
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35
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Brown PJ, Badreddine D, Roose SP, Rutherford B, Ayonayon HN, Yaffe K, Simonsick EM, Goodpaster B. Muscle fatigability and depressive symptoms in later life. Int J Geriatr Psychiatry 2017; 32:e166-e172. [PMID: 28198046 DOI: 10.1002/gps.4678] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/11/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Fatigability is the degree to which performance decreases during a specific activity of a given intensity and duration. Depression is known to heighten subjective fatigue, but whether its association with physical fatigability is unknown. Further, whether fatigability is a precursor or risk factor for the development of subsequent depressive symptoms is also unclear. METHODS Data are from the Health Aging and Body Composition Study with fatigability assessed using isokinetic dynamometry of the knee extensors at year 3, and depressive symptoms ascertained longitudinally using the Center for Epidemiologic Studies Depression (CES-D) scale. The relationship between fatigability and depressive symptoms was evaluated using linear and Cox regression models. RESULTS There was a significant cross-sectional association between fatigability and depressive symptomatology (β = -0.06, p = 0.02), after adjusting for demographic variables, medical comorbidities, cognition, gait speed, and physical activity levels. Greater fatigability was associated with greater adjusted scores on the 10-item CES-D (F2, 1695 = 38.65, p < 0.001), with individuals with greater fatigability on average reporting an adjusted CES-D score 0.5 point greater than those individuals with higher levels of resistance to fatigability (mean of 70% or better; p < 0.001). Fatigability however was not associated with the development of depression at follow-up (p = 0.828). CONCLUSIONS This study found an association between skeletal muscle fatigability and higher depressive symptoms in older adults, but no longitudinal association was identified. These findings suggest that age-related changes in energy capacity may affect the phenomenology of late life depression. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Patrick J Brown
- Division of Geriatric Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
| | | | - Steven P Roose
- Division of Geriatric Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
| | - Bret Rutherford
- Division of Geriatric Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
| | - Hilsa N Ayonayon
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Kristine Yaffe
- Neurology, Psychiatry, Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Eleanor M Simonsick
- Intramural Research Program, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Bret Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital and Sanford Burnham Presbys Medical Discovery Institute, Orlando, FL, USA
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- Translational Research Institute for Metabolism and Diabetes, Florida Hospital and Sanford Burnham Presbys Medical Discovery Institute, Orlando, FL, USA
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36
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Abstract
OBJECTIVES Although work-related psychosocial stress and type 2 diabetes mellitus (T2DM) have been investigated, the association between lifelong work stress and T2DM in later life remains unclear. This study examined whether high work stress increased the risk of T2DM risk in later life, accounting also for other sources of stress outside work, such as burden from household chores. METHODS From the population-based prospective study SNAC-K, 2719 diabetes-free participants aged ≥60 years were identified and followed up for 6 years. T2DM was ascertained by glycated haemoglobin level, self-report, hypoglycaemic medication use and clinical records. Levels of job control and demands over the whole working life were assessed by a validated matrix. Household chores load was assessed by hours spent on such chores. Multivariate logistic regression models were used to estimate the association between job strain and T2DM. RESULTS During the 6-year follow-up, 154 incident cases of T2DM were identified. High job strain was associated with T2DM occurrence amongst the 60-year-old cohort (OR = 3.14, 95% CI: 1.27-7.77), and only amongst women (OR = 6.18, 95% CI: 1.22-31.26), but not in men. When taking into account household chores load, a more pronounced risk of T2DM was associated with high job strain in combination with heavy household chores load in women aged 60 years at baseline (OR = 9.45, 95% CI: 1.17-76.53). CONCLUSION Work-related psychosocial stress may increase the risk of T2DM only amongst women in their early 60s. The risk can be amplified by high household chores load.
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Affiliation(s)
- K-Y Pan
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - W Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - F Mangialasche
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - L Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - H-X Wang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden.,Stress Research Institute, Stockholm University, Stockholm, Sweden
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37
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Abstract
BACKGROUND Many people ageing with intellectual disabilities (ID) age in place in group homes. Participation is a central concept in support and service to people with ID, but age is often a determining factor for participation among this group. Choice and control are dimensions of participation. AIM The aim of this article is to explore how choice and control in the everyday life of people ageing with ID is expressed and performed in the group home's semi-private spaces. MATERIAL AND METHODS Participant observations and interviews with residents and staff were conducted in four different group homes in Sweden that had older residents. RESULTS Four categories were found that can be understood as aspects of choice and control in the group home's semi-private spaces in the everyday life of people ageing with ID. These categories included aspects such as space and object, time and routines, privacy, and a person-centred approach. CONCLUSION AND SIGNIFICANCE People ageing with ID are vulnerable when it comes to maintaining choice and control in various situations in the home's semi-private spaces. It is argued that occupational therapists should include this occupational arena in their evaluations and interventions for people ageing with ID.
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Affiliation(s)
- Ida Kåhlin
- a National Institute for the Study of Ageing and Later Life (NISAL), Department of Social and Welfare Studies , Linköping University , Norrköping , Sweden
| | - Anette Kjellberg
- b Faculty of Health Sciences, Department of Social and Welfare Studies , Linköping University , Norrköping , Sweden
| | - Jan-Erik Hagberg
- a National Institute for the Study of Ageing and Later Life (NISAL), Department of Social and Welfare Studies , Linköping University , Norrköping , Sweden
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Abstract
This study is the first to examine the experiences and needs of an international sample of current, English-speaking, lesbian, transgender-identified (trans-lesbian) adults around a number of later life and end-of-life perceptions, preparations, and concerns. I analyzed a subset (n = 276) of the cross-sectional data collected from the online Trans MetLife Survey on Later-Life Preparedness and Perceptions in Transgender-Identified Individuals (N = 1,963). I assessed perceptions and fears around aging, preparation for later life, and end-of-life as well as numerous demographic and psycho-social variables. Despite the overall feeling that they have aged successfully, the respondent trans-lesbian population harbors significant fears about later life. I found that this population, while better-prepared than the overall respondent trans-identified population, is still ill-prepared for the major legalities and events that occur in the later to end-of-life time periods.
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Affiliation(s)
- Tarynn M Witten
- a Center for the Study of Biological Complexity , Virginia Commonwealth University , Richmond , Virginia , USA
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39
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Abstract
This article explores mutual caregiving between older spouses aging with physical disabilities. Nine older couples, where both partners had lived long lives with physical disabilities, were interviewed as dyads about mutual caregiving. The couples not only had access to different kinds and degrees of formal support but also provided mutual care to each other in a variety of ways. Interview coding using grounded theory led to two overarching categories from which motivation for mutual caregiving could be understood. These categories were Mutual care as freedom and Mutual care as imperative. The results extend understanding about how older couples with disabilities attached meaning to their mutual caregiving, and why mutual care was sometimes preferable, despite the availability of other sources of help and despite practical difficulties of providing this help. These findings suggest that health care professionals need to be sensitive to the dynamics of the couple relationship and carefully explore the couple's preferences for how formal support can best be provided in ways that honor and sustain the integrity of the couple relationship.
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40
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Abstract
BACKGROUND Elderly suicide is a public health problem worldwide, and the risk factors are multidimensional. Chronic mental health problems, personality traits, stressful life events, comorbid medical conditions, social isolation, unemployment, and poverty are associated with higher risk for suicide in later life. There was a relative paucity of data on the neurobiological markers of elderly suicide. OBJECTIVE This study examines the conjoint roles of cerebrovascular risk factors (CVRFs) and other established biopsychosocial risk factors in older adults who had made a recent suicide attempt. DESIGN A cross-sectional, case-controlled study. SETTING A tertiary care setting in a public sector and a community setting. SUBJECTS AND METHODS Cases (N=77) were nondemented Chinese adults aged ≥65 years, enrolled in a regional psychogeriatric service following a suicide attempt; comparison subjects (N=99) were community-dwelling nondemented older adults with no lifetime history of suicide. Measures of sociodemographic profile, life events, suicidal behavior, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I psychopathology, personality traits, functional status, physical health, CVRFs, and executive cognitive functions were administered. RESULTS WEIGHTED SUM OF CVRF SCORE WAS SIGNIFICANTLY HIGHER IN OLDER WOMEN WHO HAD MADE A RECENT SUICIDE ATTEMPT (MEAN: 10.56; standard deviation [SD]: 5.46) than comparison subjects (mean: 7.24; SD: 4.04) (t=3.52, P=0.001; df=99). Logistic regression showed that CVRF score (Exp[B]: 1.289, P=0.033), DSM-IV depressive disorders (current) (Exp[B]: 348, P<0.001), number of life events in the past 12 weeks (Exp[B]: 10.4; P<0.001), and being married (Exp[B]: 12.2, P<0.048) significantly increased odds for suicide attempt status in older women (Nagelkerke R (2): 0.844). Association of CVRF score and suicide attempt status was not observed in older men for whom number of life events in the past 12 weeks (Exp[B]: 9.164; P<0.001), higher neuroticism (Exp[B]: 1.028; P=0.048), and impaired performance on a Modified Card Sorting Test (Exp[B]: 0.646; P=0.032) significantly increased odds for suicide attempt status in a logistic regression model (Nagelkerke R (2): 0.611). CONCLUSION Risk factors for cerebrovascular diseases may be associated with higher risk for attempted suicide in older women, but not in older men. Older men and women have distinct risk factor profiles that may inform targeted intervention and prevention strategies.
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Affiliation(s)
- Sau Man Sandra Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Fung Kum Helen Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Chiu Wa Linda Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Sau Man Corine Wong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
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41
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Abstract
There is growing literature on LGBT persons in the second half of life, with a disproportionate focus on the experiences of older gay men and lesbians. Notwithstanding the need for much additional research with larger and more diverse samples, much has been learned about this unique population. A partial demographic portrait of gay men and lesbians in the second half of life is offered, along with research describing their health behaviors and conditions, concerns about aging, and social support needs and experiences. Gender and age-cohort differences are noted as are the costs and consequences of a lifetime of stigma and discrimination and the potential for further study in this and related fields.
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Affiliation(s)
- Brian de Vries
- Gerontology Program, San Francisco State University , San Francisco, California
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42
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Clarke LH, Korotchenko A, Bundon A. 'The calendar is just about up': older adults with multiple chronic conditions reflect on death and dying. Ageing Soc 2012; 32:1399-417. [PMID: 24976657 DOI: 10.1017/S0144686X11001061] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Drawing on data from in-depth interviews with 35 men and women aged 73-91, this article examines the ways in which older adults with multiple chronic conditions talk about and prepare for death and dying. While the focus of the original study did not include questions concerning the end-of-life, the majority of our participants made unprompted remarks regarding their own and others' mortality. The participants discussed the prevalence of death in their lives as it related to the passing of significant others, as well as their own eventual demise. Additionally, the men and women expressed hopes and fears about their impending death, in particular with respect to prolonged pain and suffering, institutionalisation, and a loss of mental acuity and independence. Many of our participants also described their end-of-life plans, which included making funeral arrangements, obtaining living wills, and planning their suicides. They further reported a number of barriers to their planning for death, including a lack of willingness on the part of family members to discuss their wishes as well as a scarcity of institutional resources and support. We discuss our findings in relation to the extant research concerning older adults' experiences of death and dying, as well as Glaser and Strauss' (1971) theory of status passage and Marshall's (1986) conceptualisation of authorship and the legitimation of death.
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43
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Abstract
Techniques of possession research among older people tend to accentuate their prizing of things and their use of special dispositions to achieve the protection or 'safe passage' of things as they transfer to a new owner. Such efforts on behalf of possessions may also be undertaken to perpetuate the self. To study the care of things and self in a wider context, we examined older people's repertoire of disposition strategies during episodes of household relocation and downsizing. We analysed the narratives of persons in 75 households in the Midwestern United States of America. People indeed told stories about the safe passage of cherished possessions - their initiative to place things, appreciation by new owners, and attempts to project the values or memory of the giver. Such accounts of special placements, however, dotted rather than dominated recollections of the move. More commonly, large quantities of items were passed via non-specific offers of possessions to others who may volunteer to take them. This allowed people to nonetheless express satisfaction that their possessions had found appreciative owners. Even though our interviews did not disclose extensive attempts at self-transmission, whole-house downsizing may affirm the self in another way: as conscientious about the care of things. Such affirmation of the present self as accomplished and responsible can be seen as a positive adaptation to the narrowing life world.
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44
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Mohlman J, Bryant C, Lenze EJ, Stanley MA, Gum A, Flint A, Beekman ATF, Wetherell JL, Thorp SR, Craske MG. Improving recognition of late life anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: observations and recommendations of the Advisory Committee to the Lifespan Disorders Work Group. Int J Geriatr Psychiatry 2012; 27:549-56. [PMID: 21773996 PMCID: PMC4048716 DOI: 10.1002/gps.2752] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 05/04/2011] [Accepted: 05/11/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Recognition of the significance of anxiety disorders in older adults is growing. The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a timely opportunity to consider potential improvements to diagnostic criteria for psychiatric disorders for use with older people. The authors of this paper comprise the Advisory Committee to the DSM5 Lifespan Disorders Work Group, the purpose of which was to generate informative responses from individuals with clinical and research expertise in the field of late-life anxiety disorders. METHODS This paper reviews the unique features of anxiety in later life and synthesizes the work of the Advisory Committee. RESULTS Suggestions are offered for refining our understanding of the effects of aging on anxiety and other disorders (e.g., mood disorders) and changes to the DSM5 criteria and text that could facilitate more accurate recognition and diagnosis of anxiety disorders in older adults. Several of the recommendations are not limited to the study of anxiety but rather are applicable across the broader field of geriatric mental health. CONCLUSIONS DSM5 should provide guidelines for the thorough assessment of avoidance, excessiveness, and comorbid conditions (e.g., depression, medical illness, cognitive impairment) in anxious older adults.
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Affiliation(s)
- Jan Mohlman
- Rutgers, tState University of New Jersey, USA.
| | | | | | - Melinda A. Stanley
- VA HSR&D Houston Center of Excellence, Michael E. DeBakey VA Medical Center
,VA South Central Mental Illness Research, Education and Clinical Center, Baylor College of Medicine
| | | | - Alastair Flint
- University Health Network & University of Toronto, Toronto General Research Institute & Toronto Rehab Research Institute
| | | | | | - Steven R. Thorp
- Center of Excellence in Stress and Mental Health, VA San Diego Healthcare System, University of California, San Diego
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45
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Abstract
Unipolar major depression is among the leading contributors to the global burden of illness-related disability, and is predicted to be the greatest contributor to illness burden by 2030. It is a matter of public health significance to identify people at high risk for depression and/or already mildly symptomatic, and to discover ways of implementing timely and rational risk reduction strategies to preempt major depression. In this article, the published literature is reviewed to summarize what is known about depression prevention in older adults, and, ultimately, to inform future research.
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Affiliation(s)
- Fawzi Hindi
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213, USA
| | - Mary Amanda Dew
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, School of Medicine, 3811 O’Hara Street, Suite 502, Iroquois Building, Pittsburgh, PA 15213, USA
| | - Steven M. Albert
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, A211 Crabtree Hall, Pittsburgh, PA 15261, USA
| | - Francis E. Lotrich
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, School of Medicine, 3811 O’Hara Street, TDH 1408, Pittsburgh, PA 15213, USA
| | - Charles F. Reynolds
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, A211 Crabtree Hall, Pittsburgh, PA 15261, USA,Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, School of Medicine, 3811 O’Hara Street, 758 Bellefield Towers, Pittsburgh, PA 15213, USA,Corresponding author. Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, School of Medicine, 3811 O’Hara Street, 758 Bellefield Towers, Pittsburgh, PA 15213.
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46
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Abstract
The early (intrauterine and neonatal) life environment plays an important role in programming the susceptibility in later life to chronic degenerative diseases, such as obesity, cardiovascular diseases, diabetes mellitus, cancer and osteoporosis. Among other hormones, leptin plays a major role in the regulation of the overall metabolism and has multiple neuroendocrine (adeno- and neuro-hypophysis axes and the hypothalamus-pituitary-adrenal axis) and immune functions. The hormone exerts its actions beginning in the early life time period, regulating the intrauterine and early extrauterine life growth and development, as well as the adaptation to extrauterine life, neonatal thermogenesis and response to stress. Recent findings also support a role of leptin in the process of fetal bone remodeling and brain development. Therefore, it is of interest to explore the physiology of leptin in early life, as well as those factors that may perturb the balance of the hormone with pathological consequences in terms of confining an increased risk for disease in later life. This review aims to summarize reported findings concerning the role of leptin in early life, as well as the association of fetal, maternal and placental factors with leptin levels, while attempting to speculate mechanisms through which these factors may influence the risk for developing chronic diseases in later life.
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Affiliation(s)
- Delia-Marina Alexe
- Epidemiology and Preventive Medicine, Department of Hygiene and Epidemiology, Athens University School of Medicine, Goudi, 11527, Athens, Greece
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