bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship Between Big Five Personality Traits and Driving Styles in Older Adults
Authors: Tian Junyan , Raika Anabella , Stavrinos Despina , Ross Lesley
Published: December 2020

Older adults’ psychosocial factors, including personality, are correlated with driving performance and driving cessation. However, the relationship between personality and driving styles has been examined only among young and middle-aged drivers. This study examined the relationships of personality factors and self-reported driving styles among 72 healthy older drivers aged 65-85 (M=72.29, SD=5.36) using the Multidimensional Driving Style Inventory (MDSI) scale to measure reckless and careless, anxious, angry and hostile, and patient and careful driving styles. Personality was accessed with the Big Five Personality questionnaire. Correlational results indicated that less conscientiousness was significantly correlated with increased reckless and careless and less patient and careful driving styles; and lower agreeableness was significantly correlated with greater angry and hostile and less patient and careful driving styles. Being a man was associated with greater reckless and careless and angry and hostile driving styles. Age was not associated with driving styles. Accordingly, three regressions were tested. After controlling for gender, only lower conscientiousness was associated with greater reckless and careless driving style (β=-.007, p=.03). Men had a higher risk of reckless and careless (β=.342, p<.01) and angry and hostile (β=.392, p<.01) driving styles. Our results highlight the relationship between personality traits and self-reported driving styles among older adults, and how gender may influence some of these relationships. Future research should further investigate the associations between gender and personality traits and older adults’ driving mobility and safety.
Personality Traits and Emotional Support Exchanges Among Oldest-Old Parents and Older-Adult Children in Korea
Authors: Lee Kyuho
Published: December 2020

Previous studies show that personality traits are predictors of individuals’ exchanges (i.e., giving, perceiving, and evoking) in social support in general relationships. Less attention has been paid, however, to the roles of personality traits in parent-child relation, especially in the very old parent-child dyads. Focusing on personality’s effects on the perception of received support, this study examines 1) whether personality traits are associated with a perception of received emotional support, 2) which personality traits work as a predictor of support perception, and 3) whether the similarity between parent and children exist in the patterns of personality-support relationships among Korean very old parent-child dyads. A total of 105 dyads of very old parents, 81 to 97 years old (M = 87.9, SD = 2.8), and their older-adult children, 65 to 72 years old (M = 65.9, SD = 1.2), participated in the study. The results of the actor-partner interdependence model reveal that less neurotic and more agreeable parents perceived more emotional support from children(actor-effects); parents with more agreeable children perceived more support from children(partner-effect). There was no actor- and partner effects of personality traits on the emotional support children perceived. Our findings show that children, as compared to their parents, are maybe less affected by parents’ personality traits reflected by parents’ interaction behaviors. We further provide explanations of each path from the personality traits to emotional support.
Personality, Depression, Social Functioning, and Suicidal Behavior in Depressed Older Adult Inpatients
Authors: Yenko Ira , Ho Jennifer , Geramian Helene , Mak Wing Jin , Park Hyunyoung Ellen , Aronov Avner , Francois Dimitry , Zweig Richard
Published: December 2020

Older adults are at higher risk for completed suicide. However, research in late-life suicide for high-risk populations remains a neglected topic, with some researchers suggesting that our knowledge of risk factors and risk conferral remains incomplete and insufficient in their predictive ability. Personality processes, in the context of interpersonal problems, have been associated with suicidal behavior, depression, and social functioning, but have rarely been evaluated in samples of older adults during periods of highest risk. This study examined factors underlying the relationship between personality processes, depression, social role functioning, and suicidal behavior in older adult inpatients. It also examined the examined the additive effect of personality processes, social adjustment, and depression on suicidal behavior. Depressed middle aged and older adult inpatients (N=52; Age M= 66.88, SD= 8.76) completed self-report measures of personality pathology (IIP-PD-25), depression (GDS-30), social functioning (SAS-SR), and recent suicidal behavior (SIB). Our research found that while interpersonal pathology was positively associated with depression (GDS-30, ß = .37, p = .006) and social functioning (SAS-SR, ß = .384, p = .003), it was not associated with suicidal behavior. The combined model of social functioning and depression displayed a trend toward significance, but neither variable was robust enough to emerge as an independent predictor of suicidal behavior. However, bivariate analyses found moderate effect sizes between depression or social functioning and suicidal behavior. Risk for suicidal behavior likely involves dynamic, complex, and interrelated relationships with clinical implications regarding assessment within this population.
Opioid Literacy in an Immigrant Group in Rural Area: Use of Social Determinant of Health Framework
Authors: Lee Hee Yun , Choi Eun Young , Song Jieun , Gajos Jamie , Luo Yan
Published: December 2020

Opioid overdose risk is particularly high in immigrant communities partly due to limited English proficiency (Guarino et al., 2015). Previous studies reported that social determinants of health (SDH) have been associated with risk for opioid overdose (Dasgupta et al., 2018). The current study examines the association between SDH and literacy of opioid overdose risk among the immigrant population living in a rural area. Specifically, we examine the association in various age groups including young adults (aged 20 to 34), middle-aged (aged 35 to 49), and older adults (ages 50 to 75). Data were drawn from a sample of Korean American immigrants residing in rural Alabama (N=225). The participants administered the Brief Opioid Knowledge (BOOK) Questionnaire (Dunn et al., 2016). Multiple regression analyses were conducted for three age groups to identify predictors of opioid literacy. Overall, older adults had lower levels of opioid literacy relative to their younger counterparts. Among young adults, low English proficiency, more chronic conditions, and greater depressive symptoms were significant predictors of limited opioid literacy. For the middle-aged adults, lower levels of health literacy and more pain symptoms were associated with limited opioid literacy. Among older adults, women, those with higher English proficiency, and lower health literacy had lower levels of opioid literacy. The findings demonstrated a greater vulnerability of older immigrants to limited opioid literacy. Different predictors based on SDH of limited opioid literacy across age groups have implications for tailored health promotion strategies to reduce opioid overdose risk.
Do Control Beliefs Moderate the Relationship Between Function and Physical Activity?
Authors: Teas Elizabeth , Friedman Elliot
Published: December 2020

Most older adults get far less than recommended levels of physical activity (PA), and interventions to improve PA have limited effectiveness. Barriers to PA include reduced physical function (PF) and diminished feelings of control, but their interactive influences on PA in older adults are unclear. Using two methodologies, the current study determined whether control beliefs modify the relationship between PF and PA. Data were from the second wave of the Midlife in the United States (MIDUS) study; the sample was constrained to participants with PA greater than 0 (n= 955, mean age= 54.27). PF (grip strength, gait speed, and chair stands) was measured during a clinic visit. Participants were asked about routine PA, from which a Metabolic Equivalent of Task score was calculated, and the extent to which they believed they have control over their life (0-7 scale). In linear regression models, including interactions between control beliefs and PF variables, gait speed and control were associated with PA; none of the interaction terms were significant. The second model used a person-centered approach to explore the potential of non-linear relationships and differences in groups of people by creating typologies. The group with low control and slow gait speed had significantly lower PA than the other three groups. Results suggest nuanced associations among PA, PF, and control beliefs where feelings of control may compensate for slow gait speed in particular. They also support the use of person-centered approaches to identify non-linear associations between modifiable protective factors and key outcomes in aging research.
Problem Drinking Predicts Functional Health and Mortality Risk 10 Years Later in the MIDUS Study
Authors: Miller Sara , Almeida David , Maggs Jennifer
Published: December 2020

The current study examined whether problem drinking in older adulthood is associated with greater longitudinal risk of functional impairment and mortality through 2016. Problem drinking consists of patterns of alcohol use resulting in symptoms of alcohol dependence or health and social consequences. Participants were adults (n=2654, 56.1% female) from Wave 2 (mean age=55, range=30-84) and Wave 3 (mean age=64, range=39-93) of the Survey of Midlife Development in the United States (MIDUS) Study. Participants reported problem drinking behaviors (e.g., alcohol related role interference) and any disability in basic and instrumental activities of daily living (ADL, iADL). Mortality data was acquired from the 2016 MIDUS Mortality dataset. Results indicated that 20.7% of the sample reported at least one problem drinking behavior in the past year. Multiple linear regression analyses revealed that the sum of problematic drinking behaviors at Wave 2 predicted 10-year longitudinal change in impairments in ADL’s (b=0.05, p<0.01) and iADL’s (b=0.05, p<0.01) after controlling for age, education, gender, and previous ADL/iADL. Logistic regression results revealed that for every additional alcohol use problem reported at MIDUS 2, the odds of mortality increased by 1.74 (b=0.55, p<0.01), beyond controls for age and number of chronic conditions. The findings that problem drinking has a unique positive association with impaired functioning and mortality risk during older adulthood supports public health efforts to encourage reduced consumption, increased medical screening, and expanded treatment options.
The Stress-Buffering Effect of Daily Physical Activity on Negative and Positive Affect
Authors: Lee Sun Ah , Joo Susanna , Lee Kayeon , Chai Hye Won , Jun Hey Jung , Almeida David
Published: December 2020

Previous studies show that physical activity is beneficial for emotional well-being. This study extends prior research by examining whether engagement in physical activity moderates the association between daily stressor severity and daily emotional well-being. We used data from the second wave of the National Study of Daily Experiences, a sub-project of the Midlife in the United States (MIDUS) study. Respondents (N = 1,851; ages 33 to84) reported their daily experiences across eight consecutive days. Multilevel models explored concurrent and lagged interaction effects between daily stressor severity and physical activity on negative and positive affect and whether these associations differed by age. Physical activity was measured by engagement in vigorous physical activity for at least 30 minutes. Results showed significant interactions between stressor severity and physical activity on same-day negative and positive affect. Specifically, stressor severity was associated with smaller elevation in daily negative affect on physically active days (b = 0.08, p < 0.001) compared to non-active days (b = 0.11, p < 0.001). Reductions in daily positive affect were greater on physically inactive days (b = -0.11, p < 0.001) compared to active days (b = -0.08, p < 0.001). These associations did not differ by age, but additional findings revealed that stressor severity was associated with greater elevation in negative affect among younger respondents (b = 0.12, p < 0.001) than older adults (b = 0.10, p < 0.001). These results highlight the importance of engagement in physical activity for emotional well-being under stressful situations in daily context.
Rethinking Social Relationships: The Differential Investment of Resources Model of Social Development
Authors: Fiori Katherine , Windsor Tim , Huxhold Oliver
Published: December 2020

The empirical evidence concerned with the centrality of social relations to individual functioning across adulthood continues to accumulate. Theoretical development about age-related changes in social relationships, however, has lagged behind. In particular, existing theories either do not account for the influence of the developmental context, or are difficult to examine empirically because they do not posit specific testable mechanisms. We present a new conceptual model that we believe effectively incorporates much of the existing empirical work. The Differential Investment of Resources (DIRe) model has five distinct features. First, the model distinguishes between different types of ‘social ties’ by defining two crucial dimensions - closeness and kinship. Second, the investment of time and energy is defined as the core mechanism that explains the formation and maintenance of social ties. Third, individual characteristics, categorized as capacities, motivations, and skills, determine the amount, direction, and efficacy of the time and energy invested. Fourth, the model incorporates the developmental context: (a) in its effect on the social opportunity structure; (b) in its effect on time and energy; and (c) in its effect on the individual. Additionally, the social opportunity structure itself is determined by the individual’s existing social network ties (i.e., social capital). Finally, the model describes how different types of ties, in turn, affect individual characteristics via social functions (social exchanges, social evaluations, and social influences). The proposed model will not only stimulate a healthy new debate in the field, but will also provide a theoretical basis for future research and hypothesis-testing.
Social Networks and Depression Over Time: The Mediating Role of Social Support and Social Isolation
Authors: Visaria Abhijit , Sung Pildoo , Chan Angelique W M
Published: December 2020

It is well established that a strong social network is an important factor for successful ageing, specifically for promoting and maintaining psychological wellbeing at older ages. Strong social networks are a source of social support especially at a time of need, and can also help older adults remain connected, active, and engaged in group activities. In this study, we seek to better understand the underlying pathways in the relationship between social networks and depressive symptoms, specifically comparing the extent to which the relationship is mediated by the receipt of material/monetary support, relative to perceived social isolation. We use data from the Panel on Health and Aging of Singaporean Elderly, a nationally-representative study of older Singapore citizens and permanent residents aged 60 years and older in 2009 (N=4990), with two follow-up surveys in 2011 (N=3103) and 2015 (N=1572). We conduct cross-lagged mediation analysis, and control for a number of potential confounders including cognitive function, chronic physical ailments, socioeconomic status, and demographic variables such as age, sex, marital status, and family size. Our preliminary analysis shows that a reciprocal relationship between social networks and depressive symptoms is mediated to a larger extent by social isolation compared to weaker social support.
The Effects of Employment on Depression and Life Satisfaction Among Old-Aged Using the DD Method Combined With PSM
Authors: Song Si Young , Jun Hey Jung , Lee Sun Ah
Published: December 2020

The purpose of this study is to explore the effect of employment on depression and life satisfaction among old-aged. Using 12th (2017) wave and 13th (2018) wave of Korean Welfare Panel Study (KoWePS), three stages of analyses were conducted. First, through propensity score matching (PSM) method, sample with similar propensity scores was matched between the group that did not work in 12th wave but worked in 13th wave (experimental group, N=180), and the group that did not work in 12th and 13th wave (comparative group, N=180). Second, the matched sample was used to conduct multiple regression analysis with the group dummy variable (experimental group, comparative group) as an independent variable, and depression and life satisfaction as the dependent variables. Third, combined model of propensity score matching (PSM) and double difference (DD) method was conducted to more appropriately derive the net effect of employment. The results of multiple regression after propensity matching showed that employment had a positive effect on reducing depression (B= -1.70, p< .01) and increasing life satisfaction (B= .12, p< .01) in old-aged. Furthermore, in combined model of PSM and DD, life satisfaction was improved when employed compared to non-employed (B= .15, p< .05). The results of this study are meaningful in that the meaning of employment in old-aged is more clearly derived by solving selection bias and endogenous problems. Also, this study may provide reference for establishing welfare policies related to employment among old-aged.
E-Mail-Related Problem-Solving Behaviors Across Age Groups: An Analysis of Log File Data
Authors: Yamashita Taka , Saal Leah , Millar Roberto , Sahoo Shalini , Cummins Phyllis
Published: December 2020

Email is one of the most common and useful online communication tools. However, older adults tend to have difficulties fully taking advantage of email. Organizing the information in the email software environment and sending a message to selected recipients are examples of common email-related problem-solving. To date, little data are available to understand the email-related problem-solving behaviors of older adults. Nationally representative survey data and log-file data of the U.S. adults (n = 1,341) are derived from the 2012 Program for International Assessment of Adult Competencies (PIAAC), which provides computer-based assessment data on problem-solving skills. The PIAAC respondents used the computer device and solved the problems in the simulated email environment. Descriptive summary showed that those 55 years and older took longer (169 seconds), referred to the help menu (15%) and used the cancel button (26%) more often than younger age groups (e.g., age 25-34; 103 seconds, 3% and 17%, respectively) in one of the tasks. Additionally, binary logistic regression showed that taking longer time (odds-ratio = 0.99, p < 0.05) and using the help menu (odds-ratio = 0.85, p < 0.05) were associated with the incorrect answer to the email problem-solving, although the findings varied across different types of problems. These unique findings from the combination of survey and log-file data analyses suggested that some older adults may benefit from the training for common email-related problems rather than teaching themselves. Detailed descriptions of computer-based assessment log file data and other results are also evaluated in this study.
Age Difference in Social Discounting: Generous Level Also Makes a Difference
Authors: Lin Hongmei , Zhang Xin
Published: December 2020

Social discounting refers to the phenomenon that individuals’ generous behaviors decline as the social distance increases. But little is known how age could influence social discounting. The present study aimed at a more comprehensive understanding of age-related differences in social discounting. Moreover, as previous studies suggested that older adults are more loss aversion, we would also test whether framing (gain vs loss) could influence social discounting between two age groups. A mixed-model factorial design of 2 (age group: younger vs. older adults) × 2 (framing: gain vs. loss) × 2 (generous level: low vs. high) × 8 (social distance) was conducted, with a total of 78 younger adults and 82 older adults. A significant social distance × age interaction was found, which replicated previous studies suggesting that older adults are more generous toward socially distant others. Interestingly, a significant age × framing × generous interaction was also found, such that in low generous condition, older adults tend to be more generous than younger adults under both gain and loss framing, while such age difference disappeared in high generous condition. These findings indicate that generous level has a positive impact on people social discounting, inducing younger adults to get more generous. Contrary to our expectation, the framing of gain and loss seems not to wave individuals’ social discounting. It seems that people think more seriously about the amount of allocation rather than framing.
Social Support From Kin and Mortality Risk Among Older Adults in a Historical Aging Population
Authors: Jennings Julia
Published: December 2020

Family are often sources of social, instrumental, and financial support for older adults. However, in many types of survey and archival data, details on the provision of support are lacking. This study examines the association between kin availability and cause-specific mortality among adults over age 60 using multiple longitudinal linked data sources from North Orkney, Scotland, 1851-1911. This study explores the relationships between cause of death and kin availability, as certain ailments may be amenable to interventions related to social support in this period while others may not. This approach will aid in interpreting the effects of social support that may be transmitted through kin networks. Reconstructed individual life courses (N=4,946) and genealogies, in combination with data on the proximity non-coresident kin, are used to examine kin availability and propinquity over the life course. Cause of death is available from death records and has been coded into the ICD. Orkney provides an interesting case study as longitudinal information is available on mortality and kin availability during a time of population aging. Kin availability is associated with longevity in this sample, while cause-specific analysis allows us to evaluate the role of social support in promoting longevity net of this association.
Engagement in Advance Care Planning: The Association With Cognitive Impairment and Care Preferences
Authors: Lee Hyo Jung , Kim Giyeon
Published: December 2020

Although there has been growing evidence that Advance care planning (ACP) benefits people with cognitive impairment nearing death, our understanding about this issue is still limited. This study examines whether cognitive impairment is associated with ACP engagement and end-of-life care preferences among older adults in the U.S. Using data from the 2012 National Health and Trends Study (n=1798, aged 65 to 101), we identified four levels of ACP engagement: None (28%), Informal ACP conversation only (12%), Formal ACP only (14%), and Both informal and formal ACP (46%). Older adults with None showed the highest prevalence of having cognitive impairment (17%), followed by those with Formal ACP only (15%) and the other two (6%, 6%). The results of Multinomial Logistic Regression showed that, compared to those without, respondents with cognitive impairment had 143% increased relative risk of having None (RR = 2.43, CI: 1.58-3.73) and 81% increased relative risk of completing Formal ACP only (RR = 1.81, CI: 1.11-2.95) relative to completing Both informal and formal ACP. In addition, respondents with None were more likely to prefer to receive all treatments available nearing death than those with any ACP engagement. Achieving high quality care at the end of life can be more challenging for older adults with cognitive impairment and their family caregivers due to the limited capacity. Although encouraged, informal ACP conversation with loved ones does not necessarily occur before the formal ACP, especially, for those with cognitive impairment. Therefore, they may merit more attention such as early ACP engagement.
The Psychosocial and Spiritual Components of a Good Death
Authors: Maynard Quentin , Csikai Ellen
Published: December 2020

Advances in medical care led to more older adults living longer, with at least one chronic illness. Correspondingly, the disease trajectory and dying process may be prolonged, providing more time to plan for a ‘good death.’ A ‘good death’ is typically described in the literature according to medical and biological aspects, with limited explicit discussion of psychosocial and spiritual elements. The purpose of this study was to explore older adults’ perceptions of psychosocial and spiritual factors that contribute to a death they would consider ‘good’. Using descriptive qualitative research methods, 12 community-dwelling older adults in central Alabama participated in two in-depth interviews. The findings suggested a range of physical, psychological, social, and spiritual components contributed to the conception of a ‘good death’ and were often interrelated. For example, the medical treatment desired at end of life was influenced by the perceived effects on the participants’ family/social network. Reflecting on previous experiences with death, along with motivations and values, guided what participants believed could help achieve their ‘good death.’ Most realized that preparation would allow for control over their experiences at end of life. The study findings emphasized the need to consider the holistic nature of advanced planning for the end of life according to what older adults and their families perceive as important to a ‘good death’. Efforts by professionals to maximize quality of life throughout serious illness and near the end of life are essential and can be accomplished through understanding what a ‘good death’ means to older adults.
Successful Aging: A Comprehensive Outcome Using Latent Profile Analysis
Authors: Longley Kasey , Grzywacz Joseph
Published: December 2020

Understanding “successful aging” is a primary goal of gerontology and adult development researchers that has been motivated by rapid the increases in life expectancy over the last 100 years. Successful aging, as it is understood by Rowe and Kahn, is conceptualized multidimensionally in terms of limited disease and disability, high physical, mental and cognitive functioning, and active engagement with life. “Success” in all three domains reflects the idealized manifestation of “successful aging.” Nevertheless, research on successful aging typically focuses on only one or two aspects of the model – most commonly physical disease or disability. The overall goal of this research is to advance understanding and subsequent attempts to promote holistic successful aging. Specifically, using key metrics from each domain of successful aging from the Midlife Development in the United States (MIDUS), this study characterizes distinct profiles of successful aging, and it describes the distribution of these profiles in the adult population. Results indicate 3 profiles. These are labeled as Successfully Aged, Somewhat Successfully Aged, and Least Successfully Aged. Approximately 82.1% of the population (mean age=50.5) is classified as Successfully Aged, whereas the remainder are classified in the Somewhat Successfully Aged (12.2%), and Least Successfully Aged (5.6%), respectively. As expected, those who were classified as Successfully Aged had the highest cognitive scores, sense of well-being, and self-rated health; and had the lowest number of age-related physical disabilities (i.e. cancer, stroke, osteoporosis, etc.) and mental health conditions (depression, anxiety disorder, and panic disorder). This outcome can be applied to multiple predictors.
Evaluating the Association Between Single Item Literacy Screener and Health Outcomes in Patients With Lung Cancer
Authors: Nguyen Julie , McNaughton Caitlyn , Sautter Jessica
Published: December 2020

Health literacy is becoming increasingly important in areas such as cancer care, where treatments are relatively difficult to navigate. This study aims to describe the how health literacy is associated with healthcare outcomes and health system usage among patients with lung cancer. Data include retrospective medical record data from 456 patients with lung cancer; half were age 70 and older. Patients were coded as having adequate or limited health literacy based on their response to their Single Item Literacy Screener (SILS). Data were collected from a 12 month period following diagnosis for each patient. One-third of patients had limited health literacy; this was significantly more common among adults age 70 and older. Patients with limited health literacy were more likely to have newly diagnosed lung cancers of stage 3B or higher (59.18% vs. 42.76%, p = 0.0011) compared to those with adequate health literacy. Patients with limited health literacy had higher median levels of depression based on the PHQ-9 questionnaire (4.0 vs. 3.0, p = 0.0082) and a higher median number of emergency department visits (1 vs. 0, p = 0.0156) and unplanned hospitalizations (1 vs. 0, p = 0.0044). Furthermore, patients with limited health literacy were more likely to have an emergency department visit or unplanned hospitalization sooner (p < 0.0001). These data illustrate a lower quality of life and a higher dependency on healthcare services for patients with limited health literacy. Assessment and interventions may be necessary to ensure access to quality healthcare.
Is Pain Time Pattern Predictive of Future Time Perspective in Older Chronic Pain Patients?
Authors: Fennell Gillian , Yip Abby Pui Wang , Reid M Cary , Enguidanos Susan , Zelinski Elizabeth , Loeckenhoff Corinna
Published: December 2020

Chronic pain patients constitute 65% of those ages 65 and older in the US. Many affected older adults are challenged to manage physical and psychological consequences tied to the intensity, interference, and temporal pattern of their pain. However, little quantitative research highlights the psychological impact of constant versus intermittent or ever-present-yet-variable pain, even though temporal pain pattern may have meaningful predictive power for wellbeing and future time perspective (FTP). A positive and expansive view of the future is particularly adaptive for this population because it is positively associated with treatment adherence. In this study, we analyzed secondary data to determine whether pain temporal pattern and pain duration are associated with differences in participant scores on Carstensen & Lang’s Future Time Perspective scale. All participants (N=142) were 45 years old and older with non-cancer chronic pain lasting three months or more. There was no significant association between pain time pattern and FTP (p=.35). Additionally, controlling for pain duration, average FTP scores did not vary significantly as a function of time pattern (p=.07). Our analyses demonstrated no significant relationship between pain time pattern and FTP and no significant moderating effect of pain duration. However, in contrast to the previous literature, FTP was not significantly associated with age and negatively (rather than positively) associated with subjective health (r=-.08, p=.35; r=-.24, p<.01), thus raising concerns about the generalizability of these findings. Implications for understanding time perceptions in older pain patients are discussed.
The Effect of Neighborhood Experiences on Positive Mental Health Among Community-Dwelling Older Adults
Authors: Gan Daniel R Y , Cheng Grand H-L , Ng Tze Pin , Fung John Chye , Cho Im Sik
Published: December 2020

Given reduced life spaces, the neighborhood often functions as a social venue for older adults. Yet how these everyday social spaces affect older adults’ psychosocial wellbeing remains largely unknown. Drawing on the GRP-CARE Survey data, this paper examined the relation between neighborhood experiences and positive mental health. Participants were 601 community-dwelling Singaporeans aged 50+ who lived in public housing neighborhoods. Neighborhood experiences were measured using the four-factorial, 16-item OpenX scale (Gan, Fung, Cho, 2019); positive mental health was measured using a six-factorial, 19-item scale (Vaingankar et al., 2011). Both scales have good psychometric properties and had been validated. Path analysis between relevant factors of both scales was conducted using Stata, within a theorized model of causation from neighborhood environment to social factors to psychosocial health. Age, education, ethnicity and sex were controlled for. Multiple linear regression analysis showed a strong, positive association between neighborhood experiences and mental health (p=0.000) even after controlling for personal traits (operationalized as depressive symptoms, GDS) in addition to sociodemographic variables. Path analysis showed that two distinct neighborhood health processes mediated this association. These were (1) the potential for a sense of community in the neighborhood improved emotional support, and (2) having better neighborly friendships improved interpersonal skills. These neighborhood health processes provide us with new lenses to understand older adults’ everyday experiences of their neighborhoods. Community-based interventions to improve older adults’ psychosocial wellbeing may be developed to facilitate these processes. Spatial and programmatic implications will be discussed in relation to age-friendly cities and communities (AFCC).
The Intersectionality of Person, Space, and Time for Understanding Aging in Place
Authors: Ramadhani Widya , Harris Maurita , Rogers Wendy
Published: December 2020

Aging in place is interpreted differently across times and disciplines in the literature. Multiple interpretations of aging in place can lead to differences in expectations and goals when planning products, services, and technologies for older adults. We conducted a historical review across databases in the fields of anthropology, architecture, gerontol-ogy, medicine, psychology, and sociology to explore the evolution of ‘aging in place’ term across time and disciplines. We included articles that used the terminology “aging in place” or “ageing in place” in titles, abstracts, keywords, or subject. From the aging in place definition excerpts collected, we identified the preliminary themes and grouped them into three main themes: people, space, and time. Although the narrative of aging in place is highly related to living spaces, the cause and influencing factors are tied beyond the space. Person and time-related factors that are related to the aging experience im-pact the way aging in place is defined. When designing products, services, and technolo-gies to support successful aging in place, designers, researchers, policymakers, and care-givers should be aware that aging in place is at the intersection of personal, spatial, and temporal elements of older adults’ lives. Based on the multiple perspectives of disci-plines, we concluded that aging in place is beyond the matter of location, but also takes into account the person’s capacity and the changes over the person’s lifespan. Founda-tional understanding of the multiple factors that influence aging in place is critical to support older adults to have a healthy and optimal aging experience.
The Impact of Changing the CMS Nursing Home Compare 5-Star Ratings on the Use of Antipsychotics
Authors: Fashaw Shekinah , Shireman Theresa , McCreedy Ellen , Ogarek Jessica
Published: December 2020

Due to their potential to increase falls and death in people with dementia, antipsychotic medications (APMs) have been the subject of several federal efforts to reduce their use in nursing homes (NHs). In 2015, the Centers for Medicare & Medicaid Services added inappropriate APM use to their NH 5-star quality ratings. We examined the impact of this policy decision on NH residents with dementia by race/ethnicity. Using a quasi-experimental study design and Minimum Data Set (MDS) 3.0 assessments, we examined long-stay NH residents with dementia. We examined changes in APM use quarterly (2013-2016) using interrupted time series analyses, stratified by race/ethnicity. There were about 1 million NH residents per quarter. Baseline use of APMs among persons with dementia was 29.1% for Whites, 29.2% for Blacks, and 33.7% for Hispanics. All three races experienced significant declines in APM use prior to the addition of AP use into the quality rating (p<0.001). During the first quarter of rating system changes, there were significant declines in APM use for all three races: Blacks, 0.48%; Hispanics, 1.0%; Whites, 0.49%. Subsequent rates of decrease in APM use did not differ from the baseline rate of decline (p> 0.5). The policy change did result in a one-time, significant drop in APM use, but did not alter the rate of decline already in place, presumably stemming from the National Partnership instituted in 2012. Hispanics started with the highest rate of APM use and experienced the greatest decreases over time and with the new star rating measure.
A Study on Community Formation Patterns Based on the Usage of Benches by Seniors
Authors: Lee Yunjeong , Nishino Akiko , Matsuda Yuji , Otsuki Toshio , Nishide Kazuhiko
Published: December 2020

In Japan, the rate of aging exceeds 27%, and the decline of communities has been an issue. Therefore, in this study we take the T housing complex as an example where the rate of aging is more than 40% and aim to understand the usage pattern of benches. An observational research was conducted for 19 days to examine the usage of a total of 23 benches, 17 existing ones and 6 newly installed ones, in the T housing complex. This investigation led to the findings. An average of 417 people used the benches in a day. Research determined that there are four different types of bench utilization, and they each present different ways of building relationships with other people. Bench use behavior was broken into four different categories. Sitting on a bench alone (without building relationships with others) was classified as “single use”. Sitting on a bench with another person but not engaging in any relationship-building behavior was classified as “sharing”. Sitting on a bench and exhibiting relationship-building behavior with others (such as through talking) was classified as “chatting”. Sitting with companions in groups of 3 or more people and exhibiting relationship-building behavior was classified as “group use”. Our findings provide evidence that a bench can be a device to foster the formation of diverse communities.
Barriers to Disaster Preparation When Older Adults Are Taking Care of Older Adults
Authors: Chen Zhirui , Cong Zhen
Published: December 2020

This study examined the association between age and barriers for disaster preparation in the U.S., including the moderating effect of caring for an elderly person. Using a sample of 1147 individuals from the 2017 FEMA National Household Survey, we tested age as the key predictor, which had four groups: 18-44 (young age), 45-64 (middle age), 65-74 (young-old), and 75+ (old-old). Binomial logistic regression was conducted to investigate how age and the responsibility to take care of an older adult affected the likelihood of having preparation barriers, controlling for respondents’ gender, education, race, home ownership, disability, and responsibility to take care of an older adult. The results showed that compared with other age groups, young-old were significantly less likely to have barriers for disaster preparation. In addition, taking care of an older adult increased the likelihood of having preparation barriers. Interestingly, relative to the young-old, caring for an older adult presented additional challenges for other age groups to have barriers for preparation. Our findings directed attention to age patterns in barriers for disaster preparation and heterogeneity among older adults, and also highlighted that caring for older adults could exacerbate barriers for disaster preparation. The life course perspective informed the discussion of results, which emphasized on life-span development and linked lives.
Perceived Neighborhood Environmental Factors Related to Sarcopenia in Urban-Dwelling Older Adults
Authors: Seo Yuri , Kim Miji , Shim Hayoung , Jung Heeeun , Lee Seoyoon Jane , Won Chang Won
Published: December 2020

Sarcopenia is common among older individuals and has adverse health outcomes. However, little is known about its association with neighborhood environmental factors. We explored the relationship between sarcopenia and neighborhood environmental factors among community-dwelling older adults aged 70–84 years in urban areas in the Korean Frailty and Aging Cohort Study. There were 1,776 participants in this cross-sectional study (mean age 75.9±3.8 years, 54.1% women). Sarcopenia was defined using the Asian Working Group for Sarcopenia guidelines. The neighborhood environmental factors were assessed using the 17-item Environmental Module of the International Physical Activity Questionnaire (IPAQ-E). The prevalence of sarcopenia was 22.5%. In the multivariate analysis adjusted for potential confounders, compared to the 5th quintile of the IPAQ-E score, the odds ratio (OR and 95% confidence interval [CI]) for sarcopenia in the 1st, 2nd, 3rd and 4th quintile were 2.14 (1.41-3.26), 1.70 (1.11-2.61), 1.76 (1.16-2.68) and 1.62 (1.07-2.47), respectively. Sarcopenia was associated with environmental factors including access to destinations (β = -0.015) and neighborhood safety (β = -0.008) (all p<0.05). Furthermore, no access to public transportation (OR 2.05, 95% CI 1.20-3.50), poor access to recreational facilities (OR 1.40, 95% CI 1.02-1.92), no presence of destination (OR 1.53, 95% CI 1.07-2.21), hill hazard (OR 1.34, 95% CI 1.02-1.77), and lack of safety from traffic (OR 1.35, 95% CI 1.02-1.79) was associated with an increased risk of sarcopenia. Our study suggests that neighborhood environmental characteristics are associated with sarcopenia and better neighborhood environmental strategies can help prevent sarcopenia among older adults.
A Longitudinal Study of Retirement Transition and Advance Directive Completion
Authors: Koss Catheryn
Published: December 2020

Advance directives (AD) help to ensure patients’ wishes are honored and contribute to improved end-of-life care. According to normative life course theory, retirement is a significant role change that signals a transition into the third age and its socially prescribed activities. To the extent that ACP is viewed as something to do when one reaches a more advanced stage in life, retirement may spark recognition that planning for incapacity and the end of life is now personally relevant and appropriate. This study tested whether transitioning from work to retirement prompted AD completion. The sample included Health and Retirement Study participants 65 and older who, in 2012, had no ADs and were not completely retired (N = 919). Retirement was operationalized as both a categorical status and as a multistep process. Three waves of data were analyzed using multinomial logistic regression to test associations between retirement transition and advance directive completion. By 2014, 21% had completed ADs and another 17% completed them by 2016. Those who completely retired between 2012 and 2014 were almost twice as likely to complete ADs between 2014 and 2016. Graduated increase in level of retirement between 2012 and 2014 was associated with higher odds of new AD possession in 2016, but did not reach statistical significance at p < .05. These results suggest the period following retirement may be an optimal time to encourage patients and clients who have not already done so to complete advance directives.
Linking Work-Life Occupational Exposures With Distress and Mortality Before and After Retirement
Authors: Laditka Sarah , Laditka James , Arif Ahmed
Published: December 2020

Mental health problems have surpassed musculoskeletal injuries as causes of work disability. Workers in certain occupations may have high risks for mental health problems and premature death even after retirement. People in high risk occupations for many years may be particularly vulnerable, along with groups with higher health risks such as rural residents. Little research examines their occupation-related risks. No research has examined how occupational exposures affect mental health in retirement. We studied these life course risks using the nationally representative Panel Study of Income Dynamics, following participants 36 years beginning 1981, with annual measures of occupation and distress (n=16,994; 129,880 occupation measures; 415 deaths). We estimated hazards of developing distress in occupations hypothesized to have high and low distress risks, adjusted for factors associated with occupational choice and mental health including age, education, income, race/ethnicity, sex, childhood and midlife health, and family trauma. Compared to low risk occupations, working in high risk occupations was associated with 20% elevated odds of distress (adjusted odds ratio, OR 1.20, 95% confidence interval, CI 1.13 1.28) and 55% elevated risk of death (hazard ratio 1.55, CI 1.11-2.16). Each additional year in a high risk occupation increased the odds by 5%. Rural residents had the highest occupation-related distress risk (adjusted OR 3.05, CI 2.39-3.97). At ages 70+ each additional past exposure year was associated with 2% higher distress risk (p<0.05), and 4.6% higher mortality (p<0.05). Workers in certain occupations have high risks of psychological distress and death, even after retirement.
A Short Screening Measure of Contextual Vulnerability for Financial Exploitation
Authors: Campbell Rebecca , Lichtenberg Peter
Published: December 2020

Financial exploitation (FE) among older adults is an expensive personal and societal problem. Many professionals who work with older adults need fast and reliable measures to detect FE, including: APS workers, financial professionals, and healthcare providers. Very few standardized measures exist to assess an older adult’s risk for FE, and fewer still that do not require extensive training to administer. Lichtenberg et al. (in press) presented the Financial Exploitation Vulnerability Scale (FEVS), which assesses the context (i.e. financial, social, and psychological) in which an older adult is making a financial decision. This 17-item scale differentiates between older adults who’ve experienced FE and those who have not. It has excellent psychometric properties and clinical utility to detect FE beyond demographic and neuropsychological variables. We utilized exploratory factor analysis to examine the factor structure of the FEVS and reduce the number of items. Participant data (n=243) were drawn from two samples: a community-based sample and a group of individuals who were seeking financial coaching services following a financial scam or theft. Examination of the eigenvalues yielded a unidimensional scale. An iterative process was used to remove items that did not load on the single factor or with low corrected item total correlations. The final scale contained nine items and retained its ability to detect financial exploitation (AUC=0.778) and good internal consistency (a=0.845). This short form scale (FEVS-SF) is a brief, standardized screening measure to assess contextual vulnerability for FE that is accessible to professionals who work with older adults.