Showing papers in "Journals of Gerontology Series B-psychological Sciences and Social Sciences in 2007"
TL;DR: Positive effects of caregiving on physical health are most likely to be found in psychologically distressed caregivers facing dementia-related stressors.
Abstract: Effects of caregiving on physical health have received less theoretical and empirical attention than effects on psychological health. This meta-analysis integrates results from 176 studies on correlates of caregiver physical health. Caregiver depressive symptoms had stronger associations with physical health than did objective stressors. Higher levels of care recipient behavior problems were more consistently related to poor caregiver health than were care receiver impairment and intensity of caregiving. Higher age, lower socioeconomic status, and lower levels of informal support were related to poorer health. Predictors of physical health are not identical to predictors of psychological health. Associations of caregiving stressors with health were stronger among older samples, dementia caregivers, and men. In sum, negative effects of caregiving on physical health are most likely to be found in psychologically distressed caregivers facing dementia-related stressors.
980 citations
TL;DR: The findings suggest that the health disadvantages found previously among grandparent caregivers arise from grandparents' prior characteristics, not as a consequence of providing care, and health declines appear to be the exception rather than the rule.
Abstract: Objectives. The purpose of this study was to examine the effects of caring for grandchildren on health behaviors and mental and physical health among older adults. Methods. Using a sample of 12,872 grandparents aged 50 through 80 from the Health and Retirement Study, we examined the relationship between stability and change in various types of grandchild care and subsequent health, controlling for covariates and earlier health. Results. We found no evidence to suggest that caring for grandchildren has dramatic and widespread negative effects on grandparents’ health and health behavior. We found limited evidence that grandmothers caring for grandchildren in skipped-generation households are more likely to experience negative changes in health behavior, depression, and selfrated health. We also found some evidence of benefits to grandmothers who babysit. Discussion. Our findings suggest that the health disadvantages found previously among grandparent caregivers arise from grandparents’ prior characteristics, not as a consequence of providing care. Health declines as a consequence of grandchild care appear to be the exception rather than the rule. These findings are important given continuing reliance on grandparents for day care and increasing reliance on grandparents for custodial care. However, the findings should be tempered by the recognition that for a minority of grandparents, coresidential grandchild care may compromise health.
395 citations
TL;DR: Results indicated that training produces immediate improvements across all subtests of the Useful Field of View test, particularly for older adults with initial speed of processing deficits.
Abstract: We combined data from six studies, all using the same speed of processing training program, to examine the mechanisms of training gain and the impact of training on cognitive and everyday abilities of older adults. Results indicated that training produces immediate improvements across all subtests of the Useful Field of View test, particularly for older adults with initial speed of processing deficits. Age and education had little to no impact on training gain. Participants maintained benefits of training for at least 2 years, which translated to improvements in everyday abilities, including efficient performance of instrumental activities of daily living and safer driving performance.
374 citations
TL;DR: Although the oldest-old individuals were overrepresented in the friend-focused-supported and restricted types, age did not moderate the association of types with well-being and a holistic consideration of structure, function, and quality of social networks in old age offers unique insights.
Abstract: Theories of social relations suggest that individuals' personal networks reflect multiple aspects of relationships, and that different constellations are more or less supportive of well-being. Using data from the Berlin Aging Study (N = 516; age, M = 85 years), we derived network types that reflect information about structure, function, and quality, and we examined their association with well-being. A cluster analysis revealed six network types: diverse-supported, family focused, friend focused-supported, friend focused-unsupported, restricted-nonfriends-unsatisfied, and restricted-nonfamily-unsupported. Well-being was predicted differentially by the six types. Although the oldest-old individuals (85 years of age or older) were overrepresented in the friend-focused-supported and restricted types, age did not moderate the association of types with well-being. A holistic consideration of structure, function, and quality of social networks in old age offers unique insights.
366 citations
TL;DR: Age-related changes in social relations varied across the different dimensions, and significant interpersonal differences existed in these trajectories, highlighting the dynamic nature of social relationships in late life.
Abstract: Objectives. This research aimed to chart age-related changes in 11 dimensions of social relations during later life. We also examined interpersonal differences in intra-individual changes. Methods. We used hierarchical linear modeling with data from a nationwide survey of 1,103 elders who were interviewed up to four times over a 10-year period. Results. Age-related changes in social relations varied across the different dimensions, and significant interpersonal differences existed in these trajectories. Emotional support was relatively stable with advancing age, whereas other types of received support (i.e., tangible and informational) increased with age and levels of provided support declined. Furthermore, the findings revealed declines in contact with friends, support satisfaction, and anticipated support. These changes were not uniform throughout the sample, as indicated by significant random effects with respect to the intercepts and slopes in virtually each model. Gender and socioeconomic status accounted for some of this variation. Discussion. These findings highlight the dynamic nature of social relationships in late life. In addition, the findings both provide evidence of older adults managing their social ties to meet the challenges of aging and suggest the importance of the interplay between giving and receiving support.
278 citations
TL;DR: In this article, the authors discuss the emergence of capacity assessment as a distinct field of study and recommend studies of a wide range of capacity constructs, focusing on clinical markers of diminished capacity, methods to improve clinical assessment, and intersections of law and clinical practice.
Abstract: The convergence of the aging of our society, the increase in blended families, and an enormous intergenerational transfer of wealth has greatly expanded the incidence and importance of capacity assessment of older adults. In this article we discuss the emergence of capacity assessment as a distinct field of study. We review research efforts in two domains: medical decision-making capacity and financial capacity. Existing research in these two areas provides a first pass at many key questions related to capacity assessment, but additional studies that replicate, extend, and improve on this research are urgently needed. An agenda for future is detailed that recommends studies of a wide range of capacity constructs, focusing on clinical markers of diminished capacity, methods to improve clinical assessment, and the many intersections of law and clinical practice.
266 citations
TL;DR: The results of structural equation modeling corroborate previous findings on the importance of beliefs about aging and suggest that aging-related cognitions affect health changes irrespective of control beliefs.
Abstract: We examined the influence of individual views of aging on health changes in later life. We hypothesized that aging-related cognitions affect health changes irrespective of control beliefs and that the impact of aging-related cognitions on health is higher than for the reverse direction of causality. We based our analyses on data from the longitudinal part of the German Aging Survey (N = 1,286; participants were 40-85 years of age at baseline). Because of the selectivity of the sample, we also computed the same analyses for the baseline sample (N = 4,034) with estimated Time 2 data for those individuals who dropped out. The results of structural equation modeling were concordant with our hypotheses, and therefore they corroborate previous findings on the importance of beliefs about aging.
253 citations
TL;DR: Novel platforms, including collaborative training, videotapes and audiotapes, and online and CD-ROM-based training are discussed, as well as approaches that combine multiple training modalities and that embed memory enhancement within cognitively stimulating activities of everyday life, such as Experience Corps.
Abstract: This article reviews both traditional and novel approaches for training and maintaining memory abilities in older adults. Despite variations in training methods and participant samples, growing evidence suggests that healthy, nondemented elders can improve and maintain their memory skills. However, traditional approaches have not been as successful in demonstrating transfer of training, and there are constraints on widescale dissemination of trainer-led, group-based formats. We discuss novel platforms, including collaborative training, videotapes and audiotapes, and online and CD-ROM-based training. We also consider approaches that combine multiple training modalities and that embed memory enhancement within cognitively stimulating activities of everyday life, such as Experience Corps. These newer approaches may enhance the accessibility, affordability, and applicability of memory training and cognitive stimulation programs.
241 citations
TL;DR: The way in which a person experiences retirement from the labor force is not influenced solely by factors that diminish the Older worker's amount of choice but also relates to the older worker's social environment.
Abstract: Objectives. This study examined perceptions of involuntary retirement. We investigated the extent to which differences in how retirement is perceived stem from differences in (a) restrictive circumstances, (b) the older worker’s preferences for retirement, (c) timing, and (d) social embeddedness. Methods. Using multiactor panel data from 778 Dutch older workers who experienced the transition into retirement, we estimated an ordered logistic model to explain perceptions of involuntary retirement. Results. This study showed that the way in which a person experiences retirement from the labor force is not influenced solely by factors that diminish the older worker’s amount of choice (health and organizational constraints) but also relates to the older worker’s social environment (social timing and social network influences). Discussion. The way he or she frames the retirement transition in social relationships within the family and at work affects the older worker’s subjective experience of retirement.
219 citations
TL;DR: Research showed that older adults were more problem focused than young adults in their approach to solving instrumental problems, whereas older adults selected more avoidant-denial strategies than young adult when solving interpersonal problems.
Abstract: Using the Everyday Problem Solving Inventory of Cornelius and Caspi, we examined differences in problem-solving strategy endorsement and effectiveness in two domains of everyday functioning (instrumental or interpersonal, and a mixture of the two domains) and for four strategies (avoidance-denial, passive dependence, planful problem solving, and cognitive analysis). Consistent with past research, our research showed that older adults were more problem focused than young adults in their approach to solving instrumental problems, whereas older adults selected more avoidant-denial strategies than young adults when solving interpersonal problems. Overall, older adults were also more effective than young adults when solving everyday problems, in particular for interpersonal problems.
219 citations
TL;DR: Findings from multilevel models suggest that age and control beliefs play an important role in a person's reactivity to interpersonal, network, and work stressors.
Abstract: We examined age and control belief differences in physical and emotional reactivity to daily stressors in four domains: interpersonal, work, network, and home. We combined data from the National Study of Daily Experiences and the Midlife in the United States survey, resulting in 1,031 participants who reported on 7,229 days. Findings from multilevel models suggest that age and control beliefs play an important role in a person's reactivity to interpersonal, network, and work stressors. Specifically, older age and lower perceived constraints were each related to lower emotional and physical reactivity to interpersonal stressors. High mastery buffered the physical effects of work stressors for younger and older adults, and high mastery was important for middle-aged adults' emotional reactivity to network stressors. High constraint was associated with the strongest physical reactivity to network stressors for younger and older adults.
TL;DR: The findings indicated that older African Americans and Caribbean Blacks reported higher levels of religious participation, religious coping, and spirituality than older Whites.
Abstract: Objectives. The purpose of this study was to examine similarities and differences in religious involvement among three groups of older adults-African Americans, Caribbean Blacks, and non-Hispanic Whites. Methods. We used data from the National Survey of American Life, a nationally representative household study of African Americans and Caribbean Blacks with a national sample of non-Hispanic Whites who reside in areas (census tracks and block groups) at least 10% African American. We examined demographic correlates of 16 measures of organizational, nonorganizational, subjective religiosity, as well as religious coping and spirituality. Results. The findings indicated that older African Americans and Caribbean Blacks reported higher levels of religious participation, religious coping, and spirituality than older Whites. We observed few significant differences between older African Americans and older Caribbean Blacks. Gender, age, marital status, income, education, marital status, and region all exhibited significant influences on religious participation and spirituality. Discussion. Racial groups within the older population present distinctive profiles of religious participation and spirituality. The demographic correlates of religious involvement and spirituality are consistent across a variety of diverse dimensions and measures.
TL;DR: Although better emotion recognition performance was significantly correlated with more eye looking in younger adults, the same was not true in older adults, and this was discussed in terms of brain changes with age.
Abstract: Research suggests that a person's emotion recognition declines with advancing years. We examined whether or not this age-related decline was attributable to a tendency to overlook emotion information in the eyes. In Experiment 1, younger adults were significantly better than older adults at inferring emotions from full faces and eyes, though not from mouths. Using an eye tracker in Experiment 2, we found young adults, in comparison with older adults, to have superior emotion recognition performance and to look proportionately more to eyes than mouths. However, although better emotion recognition performance was significantly correlated with more eye looking in younger adults, the same was not true in older adults. We discuss these results in terms of brain changes with age.
TL;DR: The data suggest that the three constructs exist simultaneously but in varying combinations, confirming that in cross-cultural contexts family cohesion predominates, albeit with low degrees of conflict and ambivalence.
Abstract: Objectives. The purpose of this study was to test empirically two major conceptualizations of parent–child relations in later adulthood—intergenerational solidarity–conflict and ambivalence paradigms—and their predictive validity on elders’ quality of life using comparative cross-national data. Methods. Data were from a sample of 2,064 elders (aged 75 and older) from the five-country OASIS study (Old Age and Autonomy: The Role of Service Systems and Intergenerational Family Solidarity; Norway, England, Germany, Spain, and Israel). Multivariate and block-recursive regression models estimated the predictivity of the two conceptualizations of family dynamics on quality of life controlling for country, personal characteristics, and activity of daily living functioning. Results. Descriptive analyses indicated that family solidarity, especially the affective/cognitive component (called Solidarity A), was high in all five countries, whereas conflict and ambivalence were low. When I entered all three constructs into the regression Solidarity A, reciprocal intergenerational support and ambivalence predicted quality of life. Controlling for activity of daily living functioning, socioeconomics status, and country, intergenerational relations had only a weak explanatory power, and personal resources explained most of the variance. Discussion. The data suggest that the three constructs exist simultaneously but in varying combinations, confirming that in cross-cultural contexts family cohesion predominates, albeit with low degrees of conflict and ambivalence. The solidarity construct evidenced relatively robust measurement. More work is required to enhance the ambivalence measurement.
TL;DR: The findings suggest the need for researchers to capture the heterogeneity of caregiver resilience when examining the longitudinal implications of informal long-term care and delivering clinical interventions.
Abstract: Longitudinal studies have documented how dementia caregivers adapt to their role. Less is known about how resilience (defined as lower or higher perceived burden in the face of frequent care demands) affects key dementia caregiving outcomes. The present study utilized data from 1,979 dementia caregivers over a 3-year period to ascertain whether resilience influences transitions from dementia caregiving, such as institutionalization, care recipient death, or loss to follow-up. Multinomial logistic regression models revealed that high baseline resilience (low burden, high care demands) was associated with less frequent institutionalization and loss to follow-up as well as more frequent care recipient mortality. The findings suggest the need for researchers to capture the heterogeneity of caregiver resilience when examining the longitudinal implications of informal long-term care and delivering clinical interventions.
TL;DR: Intention to undertake SBT was much more closely related to all elements of coping appraisal than to threat appraisal, including the belief that it has multiple benefits and is associated with a positive social identity, and the feeling that family, friends, and doctors would approve of taking part.
Abstract: Many older people refuse to participate in programs of strength and balance training (SBT), limiting their effectiveness for falls prevention. To persuade older people to take up SBT, we need to know whether their intention to undertake SBT is motivated by the perceived threat of falling or the perceived suitability and benefits of SBT. A survey of 558 people aged 60 to 95 years assessed intention to undertake SBT, as well as measures of threat appraisal (concern about falling, perceived risk, and consequences of falling) and coping appraisal (perceived benefits and appropriateness for them of undertaking SBT). Intention to undertake SBT was much more closely related to all elements of coping appraisal than to threat appraisal. The elements of coping appraisal included the belief that it has multiple benefits and is associated with a positive social identity, and the feeling that family, friends, and doctors would approve of taking part.
TL;DR: The findings reveal that the mortality advantage for Hispanics is concentrated at lower levels of socioeconomic status, with little or no advantage at higher levels.
Abstract: Objectives. This study examined socioeconomic differentials in mortality among Hispanics in the United States, focusing on the older ages. We address previous research suggesting that social disparities in health are smaller for Hispanics than for non-Hispanic Whites and examine whether these differentials in survival are related to the mortality advantage that characterizes the older Hispanic population (i.e., the Hispanic paradox). Methods. We used Poisson regression models based on data from the 1989 to 1994 waves of the National Health Interview Survey, with linked mortality through 1997, to estimate death rates for Hispanics and non-Hispanic Whites by age, gender, and socioeconomic status. Results. Deaths rates varied significantly (p < .05) by education and income for Whites and Hispanic subgroups defined by nativity (U.S. born and foreign born) and nationality (Mexican, Puerto Rican, and other Hispanic). However, with the exception of Puerto Ricans, the effects of education were significantly smaller for Hispanics than for Whites. The ethnic differences in mortality patterns by income were not statistically significant. Discussion. The findings reveal that the mortality advantage for Hispanics is concentrated at lower levels of socioeconomic status, with little or no advantage at higher levels. We propose several mechanisms related to immigration and assimilation patterns that may underlie these patterns of mortality.
TL;DR: Recent hospitalizations, personal beliefs, and recent experience with the painful death of a loved one all influence end-of-life preparations, and it is found that education, gender, marital status, and religious affiliation affect end- of-life planning.
Abstract: Objectives. End-of-life planning among healthy older adults may protect them from unwanted medical treatments in later life, in the event that they become incapable of making health care decisions for themselves. We explore two formal and one informal components of end-of-life planning (living will, durable power of attorney for health care, and discussions) and assess whether one’s health and health care encounters, personal beliefs, and experience with others’ deaths affect these practices. Methods. Using two waves of data (1992‐1993 and 2004) from the Wisconsin Longitudinal Study, we estimated binary and multinomial logistic regression models to predict end-of-life preparations among a sample of communitydwelling persons aged 64‐65 (N ¼ 3,838). Results. Recent hospitalizations, personal beliefs (Death Avoidance and the belief that doctors should control health care decisions), and recent experience with the painful death of a loved one all influence end-of-life preparations. Consistent with past studies, we also found that education, gender, marital status, and religious affiliation affect end-of-life planning. Discussion. Health care providers may encourage end-of-life preparations by assuaging patients’ death anxiety and fostering decision-making autonomy. Initiating discussions about recent deaths of loved ones may be an effective way to trigger patients’ own end-of-life preparations.
TL;DR: It is shown that apparent neighborhood-level socioeconomic effects on depressive symptoms among urban-dwelling older adults are largely if not entirely compositional in nature, and residential stability in the urban neighborhood may not be emotionally beneficial to its aged residents.
Abstract: Objective This study seeks to determine whether depressive symptoms among older persons systematically vary across urban neighborhoods such that experiencing more symptoms is associated with low socioeconomic status (SES), high concentrations of ethnic minorities, low residential stability and low proportion aged 65 years and older. Methods Survey data are from the Study of Assets and Health Dynamics Among the Oldest Old (AHEAD), a 1993 U.S. national probability sample of noninstitutionalized persons born in 1923 or earlier (i.e. people aged 70 or older). Neighborhood data are from the 1990 Census at the tract level. Hierarchical linear regression is used to estimate multilevel models. Result The average number of depressive symptoms varies across Census tracts independent of individual-level characteristics. Symptoms are not significantly associated with neighborhood SES, ethnic composition, or age structure when individual-level characteristics are controlled statistically. However, net of individual-level characteristics, symptoms are positively associated with neighborhood residential stability, pointing to a complex meaning of residential stability for the older population. Discussion This study shows that apparent neighborhood-level socioeconomic effects on depressive symptoms among urban-dwelling older adults are largely if not entirely compositional in nature. Further, residential stability in the urban neighborhood may not be emotionally beneficial to its aged residents.
TL;DR: In this article, the authors examined participants' perceptions of their usefulness to friends and family, measured at a baseline interview, as a predictor of subsequent increases in self-reported mobility disability, the onset of difficulty in performing activities of daily living, or mortality occurrence over a 7-year follow-up period.
Abstract: We examined feelings of usefulness to others as a predictor of disability and mortality risk in a sample of older adults (aged 70–79 years) from the MacArthur Study of Successful Aging. We examined participants’ perceptions of their usefulness to friends and family, measured at a baseline interview, as a predictor of subsequent increases in self-reported mobility disability, the onset of difficulty in performing activities of daily living, or mortality occurrence over a 7-year follow-up period. Compared with older adults who frequently felt useful to others, those who never or rarely felt useful were more likely to experience an increase in disability or to die over the 7-year period, even when we accounted for a number of demographic, health status, behavioral, and psychosocial factors. This suggests that feelings of usefulness may shape health trajectories in older adults.
TL;DR: To examine how emotional content affects the amount of visual detail remembered, young and older adults study neutral, negative, and positive objects and showed enhanced specific recognition for negative (not positive) objects.
Abstract: To examine how emotional content affects the amount of visual detail remembered, we had young and older adults study neutral, negative, and positive objects. At retrieval, they distinguished same (identical) from similar (same verbal label, different visual details) and new (nonstudied) objects. A same response to a same item indicated memory for visual details (specific recognition), whereas a same or similar response to a same or similar item signified memory for the general sort of object (general recognition). Both age groups showed enhanced specific recognition for negative (not positive) objects. Young adults' general recognition advantage also was restricted to negative objects, whereas older adults showed enhanced general recognition for positive and negative objects. Negative (not positive) content enhanced the visual specificity of memory in both ages, but positive content conferred a general memory advantage only for older adults.
TL;DR: This article considers two nontraditional approaches for developing interventions to improve cognition in older adults that involves the activation of automatic processes through the formation of implementation intentions that enhance the probability that a desired action will be completed.
Abstract: This article considers two nontraditional approaches for developing interventions to improve cognition in older adults. Neither of these approaches relies on traditional explicit training of specific abilities in the laboratory. The first technique involves the activation of automatic processes through the formation of implementation intentions that enhance the probability that a desired action will be completed, such as remembering to take medications. The second involves experimentally studying the role of active social and cognitive engagement in improving cognition. We then consider methodological issues associated with the use of these novel techniques.
TL;DR: To varying degrees depending on the measure used, higher resident well-being was associated with facility size, facility acceptance of payment from Florida's low income program, and resident perceptions of adequate privacy, and the most consistent findings concerned internal social relationships.
Abstract: Objectives. We examined how organizational characteristics, transition experiences, and social relationships impact three subjective measures of well-being among assisted living residents: life satisfaction, quality of life, and perception that assisted living feels like home. Methods. Data were from 384 assisted living residents interviewed for the Florida Study of Assisted Living. Using ordinary least squares and logistic regression we estimated associations between resident well-being and organizational characteristics, transition experiences, and social relationships, controlling for gender, age, education, and physical functioning. Results. To varying degrees depending on the measure used, higher resident well-being was associated with facility size, facility acceptance of payment from Florida’s low income program, and resident perceptions of adequate privacy. Non-kin room sharing reduced life satisfaction, whereas food quality positively affected all measures of well-being. The most consistent findings concerned internal social relationships. Residents with high scores on internal social relationship measures reported more positive well-being across all measures than residents with low scores on the same measures. Discussion. Individuals have the capacity to form new support networks following a move to assisted living, and relationships formed become more salient to their well-being than the continuation of past relationships or the physical characteristics of the immediate surroundings.
TL;DR: Compared with their continually married counterparts, people who experienced spousal loss reported greater likelihood of pursuing volunteer roles, not immediately but a few years after the death of their spouse, highlighting the compensatory function of volunteer participation that helps to offset the negative impact of widowhood on well-being in later life.
Abstract: Objectives. Volunteering is an important component of social life but may be interrupted by life events. This research investigated how widowhood influences subsequent volunteer participation as well as the potential moderating effect volunteer participation may have in coping with the death of a spouse. Methods. Analysis of three waves (1986‐1994) of longitudinal data from the Americans’ Changing Lives study tested (a) the effect of widowhood on volunteer participation, (b) the influence of the timing since becoming widowed on volunteering and personal well-being, and (c) the interaction effects of volunteering and widowhood on personal wellbeing. A cross-sectional time-series design is used to test relationships with people aged 50 years and older at baseline. Results. Compared with their continually married counterparts, people who experienced spousal loss reported greater likelihood of pursuing volunteer roles, not immediately but a few years after the death of their spouse. Volunteer roles adopted after spousal loss protected against depressive symptoms, and increases in volunteer hours enhanced self-efficacy. Discussion. These patterns highlight the compensatory function of volunteer participation that helps to offset the negative impact of widowhood on well-being in later life.
TL;DR: The intriguing evidence of gender differences in the correlates of mental health within the context of traditional Asian society is discussed and further research on social components of gender Differences in mental health across diverse cultures is suggested.
Abstract: Objectives. This study examined the differential impact of social roles and socioeconomic resources on the mental health of Korean men and women aged 65 years or older. Methods. The study sample was a weighted population of 930 people (905 survey samples) aged 65 years or older who had responded to the health behavior survey of the 2001 Korean National Health and Nutrition Examination Survey. Results. We observed striking gender differences in the correlates of poor mental health. Living alone was significantly associated with depressive symptoms and suicidal ideation in men but not in women. Living in a multigenerational family without a spouse and having a lower household income were significantly associated with poor mental health in both men and women. Discussion. We discuss the intriguing evidence of gender differences in the correlates of mental health within the context of traditional Asian society and suggest further research on social components of gender differences in mental health across diverse cultures.
TL;DR: Results provided modest but important evidence supportive of increasing state investment in HCBS, however, within-state allocation of HCBS resources requires further research and careful consideration about fairness for individual seniors and their families.
Abstract: Previous research has shown that families play critical roles in the care of frail elderly members as direct care providers and decision makers (Freedman, 1996). However, less is known about how long-term care (LTC) policy contexts affect seniors' LTC service use. In particular, states vary greatly in their public support for home- and community-based services (HCBS), a range of services, such as personal care, adult day care, nutrition, and transportation services, provided in noninstitutional settings that are intended to help disabled older persons live in the community (Muramatsu & Campbell, 2002). This article examines how states' commitment to HCBS affects the risk of nursing home admission among older Americans and how family caregiving resources moderate such effects.
TL;DR: Differences in personality in the earliest stages of dementia of the Alzheimer type (DAT) relative to healthy aging, and the power of personality in discriminating healthy aging from early-stage DAT are examined.
Abstract: This study examined differences in personality in the earliest stages of dementia of the Alzheimer type (DAT) relative to healthy aging, and the power of personality in discriminating healthy aging from early-stage DAT. Four groups of participants (middle-aged controls, older controls, persons with very mild DAT, and persons with mild DAT) and their families were administered Costa and McCrae's NEO Five-Factor Inventory. On the basis of both self-report and informant report, there was an increase in neuroticism and a decrease in conscientiousness in persons with very mild DAT relative to healthy individuals without it, and in persons with mild DAT relative to those with very mild DAT. Moreover, informant reports of neuroticism and conscientiousness capture substantial unique variance in discriminating healthy aging and very mild DAT, above and beyond standard neuropsychological tests. Discussion focuses on the importance of personality traits as a noncognitive indicator of early-stage DAT.
TL;DR: Given the continued erosion in employer-sponsored retiree health benefits and defined benefit pension plans, boomers will likely remain at work longer than members of the previous generation.
Abstract: Objectives. Recent changes in retirement trends and patterns have raised questions about the likely retirement behavior of baby boomers, the large cohort born between 1946 and 1964. This study examined recent changes in retirement expectations and the factors that drove them. Methods. Using data from the Health and Retirement Study, the analysis compared self-reported probabilities of working full time past ages 62 and 65 among workers aged 51 to 56 in 1992 and 2004. The study modeled retirement expectations for both generations and used the estimated regression coefficients to identify the forces that accounted for generational differences. Results. Between 1992 and 2004, the mean self-reported probability of working full time past age 65 among workers aged 51 to 56 increased from 27% to 33%. Lower rates of retiree health insurance offers from employers, higher levels of educational attainment, and lower rates of defined benefit pension coverage accounted for most of the growth. Discussion. Given the continued erosion in employer-sponsored retiree health benefits and defined benefit pension plans, boomers will likely remain at work longer than members of the previous generation. Lengthier careers will likely promote economic growth, increase government revenue, and improve individual financial security at older ages.
TL;DR: It is found that a higher neuroticism level was associated with lower functioning on the IADLs and the physical self-maintenance scale and worse HRQOL on the Social Functioning and Role Emotional subscales of the SF-36.
Abstract: Both lower education and the personality trait of neuroticism have been associated with lower health-related quality of life (HRQOL) among older adults, but little is known about the role of other personality traits in HRQOL. We examined the associations of all Five-Factor Model personality traits and education, above and beyond physician-rated medical burden, with different aspects of HRQOL in a sample of 442 primary care patients 65 years of age or older who completed the NEO Five-Factor Inventory. We used the Medical Outcomes Survey Short Form-36 (SF-36), instrumental activities of daily living (IADLs), and the physical self-maintenance scale to assess different aspects of HRQOL. Even after statistically adjusting for age, gender, the presence of major depressive disorder, and physician-rated medical morbidity, we found that a higher neuroticism level was associated with lower functioning on the IADLs and the physical self-maintenance scale and worse HRQOL on the Social Functioning and Role Emotional subscales of the SF-36. Higher conscientiousness level was associated with better HRQOL on the SF-36 Role Physical scale and better IADL function. Higher education level was associated with better HRQOL on all measures except emotional role impairment. In exploratory moderation analyses, a higher openness level diminished the effect of medical burden on IADL impairment. Preliminary population-attributable risk comparisons suggest that--on a strictly population basis--the impairment conferred by a neuroticism level that is 1 SD above the mean may be equivalent to or greater than that of major depressive disorder. Future research aimed at understanding how personality traits are linked with HRQOL and functioning in later life may enhance the identification of at-risk older adults and inform the development of interventions.
TL;DR: The findings showed that middle-aged and older adults fell into four clusters: helpers, home maintainers, worker/volunteers, and super helpers, which provides a foundation for future research into how experts can employ productive activity clusters to understand better well-being across the life course.
Abstract: Objectives. This study investigated the latent structure of productive activity among middle-aged and older adults. Whereas most researchers have examined forms of productive activity as discrete behaviors, our approach captured the reality that many persons engage in more than one activity and commit varying degrees of time to these activities. Methods. We took the data for this study from the Americans’ Changing Lives survey. The activities examined include formal volunteer work, informal help to others, unpaid domestic work, caregiving, and paid work. We describe the complex clusters of activities and time commitment to those activities using latent class cluster analysis. Results. Our results demonstrated that a four-cluster model fit the data well. Specifically, the findings showed that middle-aged and older adults fell into four clusters: helpers, home maintainers, worker/volunteers, and super helpers. We also show how individual characteristics (e.g., age, gender, race) are associated with the likelihood of being in one of these four groups. Discussion. This measurement strategy provides a foundation for future research into how experts can employ productive activity clusters to understand better well-being across the life course. This is important because our results show that many activities do not occur independently but rather are linked in patterned ways.