Showing papers in "Research on Aging in 1998"
TL;DR: In this article, education's positive effects extend beyond jobs and earnings, and they propose that education can improve health because it increases effective agency, and that education's benefits extend beyond job and earnings.
Abstract: The concept of human capital implies that education improves health because it increases effective agency. We propose that education's positive effects extend beyond jobs and earnings. Through educ...
480 citations
TL;DR: The importance of participation in voluntary formal associations for enhancing health is supported by four kinds of evidence as discussed by the authors, including seven prospective studies of social relations and mortality, which show the independent effect of formal social participation, net of informal ties.
Abstract: The importance of participation in voluntary formal associations for enhancing health is supported by four kinds of evidence. (1) Seven prospective studies of social relations and mortality show the independent effect of formal social participation, net of informal ties. (2) Conceptual analysis demonstrates that voluntary formal associations constitute a separate class of social causation. (3) Our factor analysis of data from a sample of 629 nonmetropolitan elderly identified two types of formal social participation: "instrumental," as in associations that are community oriented, and "expressive," as in those that exist for the benefit of the members. (4) Regression analysis showed that the instrumental participation factor is linked, net of controls, to the perceived health of both men and women, whereas the expressive factor predicts for women only.
158 citations
TL;DR: In this article, the authors examined the relationship between the demands of providing care to a spouse with dementia and caregiver health behaviors, specifically exercise, sleep patterns, weight maintenance, smoking, and alcohol consumption.
Abstract: This study examines the relationship between the demands of providing care to a spouse with dementia and caregiver health behaviors, specifically exercise, sleep patterns, weight maintenance, smoking, and alcohol consumption. Structural equation modeling was used to test a model predicting health behavior change from personal and environmental characteristics, perceived stress, social support, and depressive symptoms in a sample of 233 spouse caregivers of dementia patients and to examine gender differences in these relationships. Results support the hypothesis that caregiving negatively influences health behaviors. Among both women and men, health behavior change is directly influenced by depressive symptoms and objective burden. In addition, depressive symptoms mediate the effects of self-efficacy and objective burden on health behavior change. These results support the notion that health behavior change may represent one mechanism by which caregiving stress leads to adverse health outcomes.
97 citations
TL;DR: In this paper, the authors test hypotheses about why widowhood should be more difficult psychologically for men than women, and find that widowhood does have a stronger effect on depression for men, partly because of the intervening effects of health and time since widowhood.
Abstract: Hypotheses predicting why widowhood should be more difficult psychologically for men than women are tested on a sample of 746 older persons. Widowhood does have a stronger effect on depression for men, partly because of the intervening effects of health and time since widowhood. However, much of the gender difference remains unexplained. Possible causes, including the fact that widowhood is a more usual component of the life cycle for women, are discussed.
97 citations
TL;DR: In this paper, the purpose of the study was to measure positive affect (PA) and negative affect (NA), and the factors that might influence these in the very elderly were investigated.
Abstract: The purpose of the study was to measure positive affect (PA) and negative affect (NA), and the factors that might influence these in the very elderly. The study involved 105 people, 90 years and ol ...
75 citations
TL;DR: While the numbers of AIDS cases have grown dramatically for all age groups, the proportion of cases for persons age 50 and older (at diagnosis) has remained a fairly stable 10% of the total case load, resulting in more than 60,000 cases in 1997.
Abstract: This article explores the stability and changes in national trends related to AIDS rates, transmission routes, and risk factors from the mid-1980s to 1997. The authors show that while the numbers of AIDS cases have grown dramatically for all age groups, the proportion of cases for persons age 50 and older (at diagnosis) has remained a fairly stable 10% of the total case load, resulting in more than 60,000 cases in 1997. Contrary to popular belief, the most prevalent transmission route for middle-aged and older people has always been through sexual contact. While middle-aged and older people may be at reduced risk compared to younger age groups, these data also reveal a disturbing trend. People age 50 and older continue to be less knowledgeable about AIDS risks, perceive themselves to be at lower risk, and, for those with known AIDS-related risks, have made fewer behavioral accommodations to avoid such risksas compared to younger people. With recent data indicating a faster rise in new AIDScases among the ...
65 citations
TL;DR: The experience of mature women in the HIV/AIDS epidemic is explored, especially in terms of their vulnerability to infection and lack of AIDS-related knowledge, as well as the suggestion to employ a life-course perspective when developing education, intervention, and treatment programs forwomen.
Abstract: This article explores the experience of mature women in the HIV/AIDS epidemic,especially in terms of their vulnerability to infection and lack of AIDS-relatedknowledge. Demographic trends illustrate the increase of AIDS diagnoses amongmidlife women and women of color. The proportion of adolescent and adult femalecases among women age 50 and older has been 9% to 10% since 1989. However, theproportion of those mature women who are age 65 and older when diagnosed hasdeclined from 36% in 1989 to 20% in 1997. Lack of accurate knowledge amongwomen in older cohorts is shown with data from the 1994 National Health InterviewSurvey. Increased age is related to not having accurate information, including knowledge necessary to protect oneself from high-risk behavior such as the effectivenessof condoms or that someone with AIDS can look well and healthy. Finally, researchrecommendations are made along with the suggestion to employ a life-courseperspective when developing education, intervention, and treatment programs...
57 citations
TL;DR: The authors conducted interviews with 63 HIV-infected late middle-age and older adults (i.e., age 50 or older) and found a variety of themes that reflect the themes of the epidemic.
Abstract: Semistructured interviews were conducted with 63 HIV-infected late middle-age andolder adults (i.e., age 50 or older). An analysis of the narrative material revealed avariety of themes that reflect...
53 citations
TL;DR: In this paper, a participant-observation study examines communication and the construction of identities as they contribute to or impede the preservation of self in an Alzheimer's special care unit (SCU).
Abstract: This participant-observation study examines communication and the construction of identities as they contribute to or impede the preservation of self in an Alzheimer's special care unit (SCU). A so...
52 citations
TL;DR: The authors consider a variety of educational strategies that can address both primary prevention (risk reduction) and secondary prevention (prompt identification and treatment) with regard to older adults in order to design and implement effective HIV/AIDS education programs for older adults.
Abstract: This article discusses the need for targeting adults age 50 and older for HIV/AIDS prevention education. First, the authors consider a variety of educational strategies that can address both primar...
52 citations
TL;DR: In this paper, the authors examined whether social support and self-esteem buffered the impact of two types of stressful life events on depressive symptomatology in a prospective investigation of 728 full-time working men and women 58 to 64 years of age.
Abstract: The authors examined whether social support (measured as having a partner or spouse, satisfaction with partner or spouse relationships at Time 1 and at Time 2, and frequency of visits with close friends and relatives) and self-esteem buffered the impact of two types of stressful life events on depressive symptomatology in a prospective investigation of 728 full-time working men and women 58 to 64 years of age at recruitment in a metropolitan North Carolina area. Hierarchical regression analyses revealed that the impact of stressful events involving social networks was buffered by satisfying relationships at Time 1 and self-esteem. Satisfying relations at Time 1 also lessened the impact of work stressors on depressive symptoms.
TL;DR: Using data from the National Crime Victimization Survey for 1992 through 1994, it was found that older victims, particularly women, were more likely to sustain injuries as the result of a violent attack and morelikely to require medical care for these injuries.
Abstract: Using data from the National Crime Victimization Survey for 1992 through 1994, this article presents an accounting of robbery and assault victimizations against older Americans and how they differ ...
TL;DR: Using data obtained from interviews with the familial caregivers of persons with Alzheimer's disease, as well as the research findings of others, this article examined one dimension of caregiving, and found that caregiving a...
Abstract: Using data obtained from interviews with the familial caregivers of persons with Alzheimer's disease, as well as the research findings of others, this article examines one dimension of caregiving a...
TL;DR: This paper examined the association between educational attainment and grandparenting attitudes and behaviors, using a sample of 884 grandparents from two different studies of rural families, and found that educational attainment was positively associated with grandparent attitudes and behaviours.
Abstract: This study examines the association between educational attainment and grandparenting attitudes and behaviors. The sample of 884 grandparents comes from tworelated studies of rural families, the Io...
TL;DR: Current knowledge about HIV/AIDS in aging minority populations, particularly as they relate to sociodemographic, cultural, and health status factors, is discussed.
Abstract: This article focuses on emerging issues associated with HIV/AIDS in aging minoritypopulations. Based on a review of the literature as well as available national surveillance data, this article disc...
TL;DR: Factors that underlie older injectors' and other substance abusers' risk for HIV are explored and issues related to treatment of older HIV-positive injecting drug users are explored.
Abstract: Despite substantial progress in slowing the epidemic among substance-abusing populations, new cases of HIV increasingly can be attributed directly to injecting drug use through contaminated needles or indirectly through sexual transmission. While many studies examine factors related to drug use practices and AIDS among young and middle-aged substance abusers, few studies have considered how HIV is contracted or experienced among older addicts. This article reviews what is known about HIV and older substance abusers with special emphasis on the age-related factors that shape the experience of AIDS for this population. Next, drawing on findings from the Partners in Community Health Project, the analysis explores factors that underlie older injectors' and other substance abusers' risk for HIV. Next, issues related to treatment of older HIV-positive injecting drug users are explored. Finally, priorities for future research are identified.
TL;DR: In this article, the authors explore the allocation and nature of educational experiences throughout adult life, and they are especially concerned with the opportunities and barriers associated with the pursuit of education in the 21st century.
Abstract: This article explores the allocation and nature of educational experiences throughoutadult life. The authors are especially concerned with the opportunities and barriersassociated with the pursuit ...
TL;DR: This paper examined the social construction of identity by older dementia patients in the memory clinic through the use of accounts about memory loss, including cognitive accounts, experiential accounts, ability and attention, emotional accounts, and comparative accounts.
Abstract: This article examines the social construction of identity by older dementia patients in the memory clinic through the use of accounts about memory loss. The data are verbatim transcriptions of neuropsychological examinations between seventeen older dementia patients and four clinicians conducted at the Memory and Alzheimer's Clinic at the University of California, San Francisco. Using an interactional sociolinguistic framework, this article analyzes five kinds of accounts that discursively construct the identities of these older dementia patients: (1) cognitive accounts, (2) experiential accounts, (3) accounts of ability and attention, (4) emotional accounts, and (5) comparative accounts. This research has implications for improving the quality of life of older dementia patients to the extent that caregivers and family members can help dementia sufferers to construct and maintain a sense of their own identity.
TL;DR: A review of the growing research dealing with informal caregivers to people with HIV infection or AIDS, focusing particularly on the intersection of this work with research on aging, is presented in this paper.
Abstract: This article reviews the growing research dealing with informal caregivers to peoplewith HIV infection or AIDS, focusing particularly on the intersection of this workwith research on aging. It contrasts AIDS caregiving with what is known aboutcaregiving in general, which is often associated with caring for a frail older person.This comparison points to a scholarly literature in which aging, gender, generationaldifferences, and life-course issues have been a central concern. In addition, using datafrom the UCSF Care Study, this article presents some results from analyses concernedspecifically with the interpretation of age-related effects and caregiving. It emphasizesthe diversity among AIDS caregivers, who may be friends, partners, or familyrelatives, and the diversity of their experiences with caregiving, loss, and aging. Italso outlines important methodological and conceptual links between a life-courseperspective on aging and AIDS caregiving and suggests how each scholarly concernmay inform the other.
TL;DR: While a substantially larger proportion of older adults died within 90 days of diagnosis, the overall trend of an increasing age-associated gap in survival remained when these were excluded from the analysis.
Abstract: Older people with HIV infection die faster than younger counterparts, but it is notknown whether age-associated survival is changing over time. The authors used theCenters for Disease Control data set of adult cases of AIDS reported from January 1,1981, to December 31, 1994, to study age-associated differences in survival by yearof diagnosis. A total of 433,354 adults with AIDS were reported during this interval.Of these, 10.3% were younger than age 50. In 1983-1984, median survival for olderand younger people was 153 versus 274 days, respectively. By 1991-1992, mediansurvival had improved for both groups-396 and 731 days, respectively. However,the relative and absolute gap in survival grew. While a substantially larger proportionof older adults died within 90 days of diagnosis, the overall trend of an increasingage-associated gap in survival remained when these were excluded from the analysis.Older and younger people with AIDS have achieved prolonged survival, but theage-associated gap in survival has grown.
TL;DR: This special issue is based on the papers presented at a seminar to review current work on incontinence technology and it is gratifying to note that several of the projects described are the fruit of collaborations born at the earlier seminars.
Abstract: Urinary incontinence is surprisingly common, a ecting around 6 per cent of women and 2 per cent of men, and more than half of nursing home residents in the western world. A hidden and taboo problem, it causes much embarrassment, inconvenience, restriction of activities, and – in extreme cases – depression and social isolation. But it can often be cured, or at least alleviated and managed to minimize its impact on the quality of life of su erers and their carers, family, and friends. And technology has a major part to play. In 1997 the rst attempt of the Medical Engineering Division of the IMechE to organize a seminar to review current work on incontinence technology was stymied by the dearth of research activity on the subject: there was insu cient to ll even a one-day programme. In response, the Division changed tack and set out to stimulate fresh thinking by means of an innovative seminar programme entitled: Incontinence: the Engineering Challenge. A brave band of incontinent people agreed to tell their stories, interspersed by presentations in which equally brave scientists and engineers who had never worked on incontinence – and were therefore unfettered by over-familiarity with existing approaches – suggested solutions, drawing on their considerable experience in biomaterials, textiles technology, space science and engineering design. Meanwhile, an audience of academics, industrialists and healthcare professionals hungry for inspiration listened and took careful note. The approach was so successful that it was repeated in 1999. Finally, by 2001 there was su cient research going on to ful l the original plan to hold a seminar reporting on current activity and recent progress. This special issue is based on the papers presented at that seminar and it is gratifying to note that several of the projects described are the fruit of collaborations born at the earlier seminars. The arrangement of the papers follows the seminar programme. Mandy Fader opens with a critical review of the performance of existing incontinence products in which she highlights the strengths and limitations of the di erent approaches and suggests where research e ort should be focused in striving for improvements. Absorbent pads account for more than half of current expenditure on incontinence products, and the next four papers deal with advances in absorption technology, from progress in understanding the fundamental physics of uid/ bre wetting (David Lukas et al.), through the use of uid mechanics and imaging technology to model the spread of uid in absorbent structures (Ian Eames et al. and Mark Landeryou et al.), to a review of past, present and currently developing production line technology for pad manufacture (ColinWhite). The next block of four papers report on innovative e orts to overcome the limitations of existing (non-absorbent) incontinence devices or devise new ones. In the rst, Nicola Morris et al. report progress in understanding the mechanisms by which urethral catheters encrust and block, raising hopes for new products that will resist encrustation. The remaining three papers describe new designs: a urine collection device in which a uid sensor and small pump are used to transfer urine from a discrete bodyworn collection device to a convenient storage location (Eleanor Tinnion et al.); a supra-pubic port – an opening in the lower abdomen through which the bladder can be accessed for drainage and wash out (Roger Feneley et al.); and a logging device that enables care sta to discover the regular times at which their patients wet themselves so that they can take them to the toilet before incontinence events occur (Geo Cusick et al.). The nal two papers deal with implants. Jenny Southgate et al. report on their work to tissue engineer new bladders, while Loe van Veggel describes the development of a new polydimethylsiloxane bulking agent to support the bladder neck of women with stress urinary incontinence. The list of disciplines represented by the authors – and the seminar delegates who assembled to hear their original presentations – is impressively rich, revealing the breadth of wisdom now being brought to bear on this long-neglected problem. Equally impressive is the enthusiasm that characterised the seminar and comes through in the papers. There is every reason to expect i
TL;DR: Most of the research on elderly victimization has focused primarily on the Federal Bureau of Investigation's (FBI)'s major index crimes of murder, rape, and robbery; however, this restricted approa...
Abstract: Most of the research on elderly victimization has focused primarily on the Federal Bureau of Investigation's (FBI)'s major index crimes of murder, rape, and robbery; however, this restricted approa...
TL;DR: Unit-level data describing dementia care attributes in 390 units in 123 Minnesota nursing facilities were used in a two-stage analytic procedure to derive a typology of unit clusters that offers a potentially useful way of classifying dementia care in nursing homes.
Abstract: Unit-level data describing dementia care attributes in 390 units in 123 Minnesota nursing facilities were used in a two-stage analytic procedure (1) to derive a typology of unit clusters and (2) to describe similarities and differences across unit clusters in terms of dementia care attributes and other unit characteristics not used to derive the typology. Nursing units were classified with combinations of environmental, programmatic, and staff attributes into six unit clusters. Most special care units (SCUs) were in a single unit cluster (dementia units) with the most dementia care attributes and serving mostly residents with dementia. Two unit clusters (small custodial units and rehabilitation units) were composed exclusively of non-SCUs, whereas remaining unit clusters (conventional units, large undifferentiated units, and heavy care units) consisted predominantly of non-SCUs with roughly equal proportions of residents with and without dementia. The typology offers a potentially useful way of classifyin...
TL;DR: The authors fail to find consistent evidence that for-profit nursing homes provide poorer quality care to mentally ill residents using measures of structure, process, and outcome; they did find, however, that nursing homes may modify their approach to caring for these residents.
Abstract: This article examines whether a relationship exists between ownership status (for-profit and not-for-profit) of nursing homes and the quality of care for residents who are mentally ill. Rather than...
TL;DR: In this paper, the authors examined the use of informal and formal assistance with personal and instrumental activities of daily living and the amount received by a randomly selected sample of urban older persons.
Abstract: This research examines the use of informal and formal assistance with personal and instrumental activities of daily living and the amount received by a randomly selected sample of urban older persons. A modified version of the Andersen behavioral model is used to organize explanatory factors that include the elderly's attitudes toward service use and filial expectations. Findings underscore the important influence of attitudes on assistance use in contrast to self-designated race, which had no influence either independently or in interaction with attitudinal variables. Elderly persons more likely to receive assistance were women of older age with lower incomes, who expressed more concerns about using services and were more physically disabled. Those receiving larger amounts of help had fewer concerns about using formal services and lived with their primary caregivers.
TL;DR: Age differences in HIV health care needs, use patterns to shed light on distinctive aspects of health services needs and use by older individuals with HIV, and patterns in use of inpatient services are examined.
Abstract: This article brings together information on age differences in HIV health care needsand use patterns to shed light on distinctive aspects of health services needs and useby older individuals with H...
TL;DR: African American caregivers were found to be significantly less likely to provide all care alone without the help of secondary helpers.
Abstract: In this study, Black and White family caregivers are compared in terms of the division of labor among primary caregivers and secondary helpers. Three patterns of the division of labor were distinguished: (1) the primary caregiver as exclusive provider of care, (2) supplemental care (at least some care tasks are shared among at least two providers), and (3) specialization (different tasks are carried out by different providers). Employing both matching (by care recipients' diagnosis and number of functional impairments) and statistical controls of relevant confounders (income, employment, gender, type of residency, etc.), African American caregivers were found to be significantly less likely to provide all care alone without the help of secondary helpers.
TL;DR: In this article, the authors trace how a variety of new programs have come about; reviews previous steps to expand and diversify older adult education, particularly in the United States and Canada; looks at levels of participation, learner objectives, institutional responses and rationales; and questions the underlying ideological commitments of government, aging organization, postsecondary educational institutions, and private sector groups to meet the needs and wants of today's retirement-age persons.
Abstract: Opportunities for senior adults the world over to participate in formal and informal educational programs have increased dramatically during the past 30 years. At the forefront of innovations in programs for older learners are those that invite members to share in teaching, governance, curriculum development, and future planning. This article traces how a variety of new programs have come about; reviews previous steps to expand and diversify older adult education, particularly in the Unites States and Canada; looks at levels of participation, learner objectives, institutional responses and rationales; and questions the underlying ideological commitments of government, aging organization, postsecondary educational institutions, and private sector groups to meet the needs and wants of today's retirement-age persons. A brief look in the "distant mirror" of China's universities for older people helps crystallize the current situation in the United States.
TL;DR: In this paper, the idea of seeing the life course as narratively constructed is developed, and then that approach is used to explore how elders construct meaning about the life-course in th...
Abstract: In this article, first the idea of seeing the life course as narratively constructed is developed, and then that approach is used to explore how elders construct meaning about the life course in th...
TL;DR: HIV/AIDS's emerging impact and consequences for families and societies around the globe is described, with a primary focus on middle-aged and older members, and three contrasting nation/state settings are explored.
Abstract: The effects of HIV/AIDS on different societies spanning the globe are only beginning to be described. This article describes HIV/AIDS’s emerging impact and consequences for families and societies around the globe, with a primary focus on middle-aged and older members. It first provides the current data on the evolving international profile of the HIV/AIDS epidemic. Then, using primary sources and published data, it explores three contrasting nation/state settings (Uganda, Thailand, and India) to describe the cultural, social structural, and family consequences of HIV/AIDS. Findings include identification of emerging and potential strains on core cultural practices related to social integration at the community and family levels, as well as shifts in normative role relationships between multiple generations. Direct and indirect challenges to core moral and ethical issues beyond those simply related to infectious disease prevention and treatment are also identified. Finally, this article draws on these explorations to formulate several key priorities for future research and practice related to HIV/AIDS among older adults.