bluuebunny/crossref_metadata_2025 huggingface dataset:
Technology Based Cognitive Behavioral Therapy On Psychological Distress: Exploring Health, Pain, And Activity
Authors: Shah Avani , Morthland Martin , Scogin Forrest
Published: December 2021

This randomized controlled trial investigates two technologically based self-administered cognitive behavioral depression treatments (CBT) on psychological distress in older adults. Health may change the ability to participate in types of activities, thereby impacting mental well-being and treatment response. The aims of this research are 1) to understand the impact of technologically based cognitive behavioral treatment on psychological distress 2) explore how health, pain, and activity engagement may affect treatment response. Fifty one participants recruited were randomized to one of 3 groups: audio-based cognitive behavioral therapy, computer-based cognitive-behavioral therapy, and control group. The combined treatment groups are compared to the control group. Health was examined in multiple ways; the Vulnerable Elders Scale-13 score ; (Saliba et al., 2001); and a reported chronic pain condition. For overall psychological distress, improvement on the Brief Symptom Inventory General Severity Index (GSI; Derogatis & Spencer, 1983) scores from baseline to post-treatment indicated treatment response. The California Older Person’s Pleasant Events Scale (COPPES; Rider, Gallagher-Thompson, & Thompson, 2004) measured activity engagement. While controlling for the Time 1 GSI score, an ANOVA revealed a significant difference in psychological distress between the CBT treatment group and control group F(1, 43) =4.22, p=.046. A linear regression analysis with the VES-13 score and GSI baseline score as predictors and the GSI posttreatment score as the dependent variable, found that health did not significantly predict psychological distress outcomes. Observation of the descriptives and these analyses suggest that CBT can impact psychological distress, potentially even with variations in health and pain.
Management and Analysis of Large Qualitative Data Sets: Lessons Learned From Daily Journals for a Behavioral RCT
Authors: Musil Carol , Jeanblanc Alexandra
Published: December 2021

As part of a national RCT of a resourcefulness skills training intervention, 342 grandmother caregivers, completed daily online journals for 4 weeks, reporting “challenges or difficulties you faced today with your grandchildren or other family members and how you handled them.” In this paper, we describe the challenges and benefits of using an entirely online design for the distribution and collection of daily journals. We used NVIVO-12 Plus to perform directed content analysis to assess intervention enactment fidelity and compare content between intervention (trained in and prompted to discuss skills) and control groups. Over 92%(n=317) of participants completed daily journals. There was variation in reporting of skill use between groups: 36% of controls spontaneously used the skill “seek professional help” whereas only 4% of the control group reported the skill “change from usual reaction”. With careful management, qualitative data from large samples can be obtained and effectively analyzed for fidelity.
Multimorbidity Trajectory Classes as Predicted by Race, Ethnicity, and Social Relationship Quality
Authors: Newsom Jason , O'Neill AnneMarie , Denning Emily , Quiñones Ana , Botoseneanu Anda , Allore Heather , Nagel Corey , Dorr David
Published: December 2021

Growth mixture modeling was used to classify multimorbidity (≥2 chronic conditions) trajectories over a 10-year period (2006-2016) in the Health and Retirement Study (N = 7,151, mean age = 68.6 years). Race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White) and social relationship quality (positive social support and negative social exchanges, such as criticisms) were then used to predict trajectory class membership, controlling for age, sex, education, and wealth. We identified three trajectory classes: initial low levels and rapid accumulation of multimorbidity (increasing: 12.6%), initial high levels and gradual accumulation of multimorbidity (high: 19.5%), and initial low levels and gradual accumulation of multimorbidity (low: 67.9%). Blacks were more than twice as likely to be in the increasing (OR = 2.04, CI[1.29,3.21]) and high (OR = 2.28 CI[1.58,3.206]) multimorbidity groups compared with Whites, but there were no significant differences between Hispanics and Whites for either trajectory class (OR = .84 CI[.47,1.51]and OR = .74 CI[.41,1.34], respectively). Increments in perceived support were associated with significantly lower risk of membership in the increasing (OR = .59, CI[.46,.78]) and high classes (OR = .54 CI[.42,.69]), and increments in negative exchanges were associated with significantly higher risk of membership in the increasing (OR = 1.64 CI[1.19,2.25]) and high classes (OR = 2.22 CI[1.64,3.00]). These results provide important new information for understanding health disparities and the role of social relationships associated with multimorbidity in middle and later life that may aid in identifying those most at risk and suggesting possible interventions for mitigating that risk.
Perspectives on Aging Well Among Older Black Women in the US
Authors: Coats Jacquelyn
Published: December 2021

Despite changes in the demography of older Black women who are living longer, there is limited research on how older Black women conceptualize and understand successful and healthy aging. The objective of this presentation is to interrogate the meaning and cultural aspects of aging among older Black women, gaining insight into how gender and race operate and intersect to shape experiences and perceptions of aging. Using an intersectionality framework, this qualitative study was conducted with three older Black women. The women ranged in age from 58-65 years old, each residing in an US urban city (Detroit, St. Louis, Atlanta). Data were collected between October and November 2020, using a semi-structured, open-ended interview protocol to encourage participants to provide in-depth descriptions of how they conceptualized aging. Interviews were between 2 – 2.5 hours, conducted via videoconferencing, and audio-recorded for transcription. Participants discussed: the life experiences that have shaped their ability to age well; what it means to age well, and factors that might hinder someone from aging well. Transcripts were coded using a constructivist grounded theory approach. Results revealed six themes Black women in later life identify: aging well, aging as a mindset, independence and freedom, authenticity, personal control and preparation, and aging role models. This extends the knowledge base on how older Black women view aging and factors that enhance or diminish their ability to age well. Results from this study can be used to enhance the development of public health and social work interventions with older Black women.
The Interactive Effects of Education and Social Support on Blood Pressure in African Americans
Authors: Byrd DeAnnah , Jiang Yanping , Zilioli Samuele , Thorpe Roland , Lichtenberg Peter , Whitfield Keith
Published: December 2021

This study examined whether the effects of received and provided social support on blood pressure (BP) would differ by education. Data from 602 African American adults (48-95 years) enrolled in the Baltimore Study of Black Aging—Patterns of Cognitive Aging were analyzed using multiple linear regression. We found no main effects of received and provided social support on BP. However, a significant moderation effect was observed for systolic BP, such that greater received social support was positively associated with higher systolic BP among individuals with low levels of education, adjusting for age, sex, chronic health conditions, and depressive symptoms. The findings demonstrate that social support and education have joint effects on blood pressure, which highlights the importance of considering psychosocial determinants of adverse cardiovascular health outcomes that disproportionately affect African Americans.
Physical Function Transitions and Healthcare Utilization Among Older Mexican Americans.
Authors: Givan Amy , Chou Lin-Na , Kuo Yong-Fang , Snih Soham Al
Published: December 2021

The aim of this study was to examine the relationship between 2-year physical function transitions and one-year healthcare utilization among Mexican American Medicare beneficiaries. The sample consisted of 429 Mexican Americans ≥75 years old from the Hispanic Established Population for the Epidemiologic Study of the Elderly linked with Medicare claims data from the Centers for Medicare and Medicaid Services. Short Physical Performance Battery (SPPB) from Wave 5 (2004/05) to Wave 6 was used to create physical function transition groups. The outcomes were physician visits (<6, 6-12, >12 visits), number of emergency room visits, and number of acute hospitalizations one-year after physical function transitions. Multinomial logistic regression and Generalized Estimating Equation with negative binomial distribution were used to estimate the odds ratio of healthcare utilization as a function of physical function transition groups, controlling for socio-demographics and comorbidities. Participants who improved or remained moderate-high physical function had lower odds ratio (OR) of being hospitalized (0.40, 95% Confidence Interval [CI]=(0.18, 0.90)) or visiting the emergency room (OR=0.52, 95% CI=0.32-0.84) one-year later compared to participants who remained in the low physical function group. No difference in physician visits across physical function transition groups was found. This study showed healthcare utilization differed by physical function transition groups among Mexican American Medicare beneficiaries. Physical function improvement or maintenance of moderate-high physical function should be targeted in older Mexican Americans, a population at great risk of developing disability, to reduce or delay dependency and healthcare burden.
Human Capital and Employment Outcomes Among Foreign Educated and US Nurses Working in Long Term Care
Authors: Thompson Roy , Silva Susan , Corazzini Kirsten , Konrad Thomas , Cary Michael , McConnell Eleanor
Published: December 2021

Employing Foreign Educated Nurses (FENs) helps address Registered Nurse (RN) shortages in long-term care (LTC) in the United States (US). However, examination of factors explaining differences in their employment outcomes relative to US Educated Nurses (USENs) is limited. This study uses 2018 National Sample Survey of Registered Nurses data to compare income, work hours, job satisfaction, and human capital, defined as personal characteristics (knowledge, work experience) and behaviors (job mobility), of FENS and USENs working full-time in LTC. A human capital score, consisting of highest nursing education, skill certifications, state licensures, years of experience, multi-state employment history, and multi-lingual status was constructed. Covariates included nurse demographics, direct care role, and ability to practice to full scope. Covariate-adjusted group differences in employment outcomes and human capital were compared using ANCOVA and logistic regression. Mediation analyses explored whether human capital explained FEN vs USEN differences. FENs earned higher hourly wages (p=0.0169), worked fewer hours annually (p=0.0163), and reported greater human capital (p<.0001) compared to USENs. FENs and USENs, however, had similar annual salaries (p=0.3101) and job satisfaction (p=0.1674). Human capital mediated FEN vs USEN effects on hourly wages but not annual work hours. FENs’ higher levels of human capital partially account for FEN vs USEN differences in hourly wages. Application of the human capital concept advanced our ability to examine differences in employment outcomes and highlight aspects of the value that FENs contribute to LTC settings.
Dementia Specialization Among Adult Day Services Centers: National Study of Long-Term Care Providers
Authors: Lendon Jessica , Sengupta Manisha , Melekin Amanuel
Published: December 2021

Adult day services centers (ADSC) are a source of community-based care for persons with Alzheimer’s disease/other dementias. This study compares dementia specialized ADSCs (DSADSC) and their participants to other ADSCs that do not specialize in dementia care using the 2016-2018 National Study of Long-term Care Providers. DSADSCs account for 10% of all ADSCs and serve 15% of all ADSC participants with dementia. About half of DSADSC participants have dementia, compared to 30% in other ADSCs. A higher percentage of DSADSCs, compared to other ADSCs, were in the Midwest, were nonprofit, had a social model, and employed nursing aides. Fewer DSADSCs, compared to other ADSCs, provided nursing, mental health, and transportation services. More DSADSC participants were 75 years of age or older and needed assistance with eating and toileting. Findings may help identify how ADSCs, particularly, DSADSCs, meet the unique care needs of older adults with dementia.
Technologies and the Effects On Social Engagement In Long-Term Care Facilities During COVID-19: A Scoping Review
Authors: Wood Timothy , Freeman Shannon , Koopmans Alanna
Published: December 2021

During the COVID-19 pandemic, the sense of loneliness and social isolation felt by older adults in long-term care facilities has been exacerbated. Although there has been an increase in the number of digital solutions to mitigate social isolation during COVID-19, facilities in northern British Columbia do not have sufficient information regarding the technologies to support social connectedness. To support evidence-based policy decisions, a scoping review was conducted to identify existing virtual technology solutions, apps, and platforms that promote social connectedness among older adults residing in long-term care. A combination of keywords and subject headings were used to identify relevant literature within PubMed, CINAHL EBSCO, PsychINFO EBSCO, Embase OVIDSP, and Web of Science ISI databases. DistillerSR was used to screen and summarize the article selection process. Twenty-three articles were identified for full-text analysis. A variety of technologies are described which can be used to mitigate the impacts of social isolation felt by long-term care residents. However, many of these digital solutions require stable highspeed internet. This remains a challenge for facilities in northern areas as many have limited access to reliable internet. Metrics used to evaluate social engagement in the context of long-term care are also outlined. This research provides the preliminary groundwork necessary to better inform policy decisions about which technologies are available and, of these, which are effective at enhancing social connectedness for older adults in long-term care.
What is known about Cycling Without Age: A Scoping Literature Review
Authors: Kaufman Nicole , Zecevic Aleksandra , Christensen Suna , Victoria Cotnam
Published: December 2021

The Cycling Without Age (CWA) program provides residents of long-term care homes with a bike ride experience, as a volunteer pedals them around the community in a specially designed trishaw. There is limited evidence of the program's effectiveness on older adults, pilots, and communities. The purpose of this literature review is to scope and summarize contemporary CWA discourses to generate future research questions that will provide evidence for future implementation of CWA. Data collection and analysis followed Arksey and O'Malley's 2005 framework. A systematic search was conducted in PubMed, OMNI, and Ebscohost databases. A grey literature search strategy incorporated: grey literature databases, customized Google searches, targeted websites, consultation with expert librarians, and a social media analysis on Twitter, Facebook and LinkedIn. Content analysis was used to identify the key themes. A total of 165 sources (2 peer-reviewed, 103 grey literature, 60 social media) were included in the final analysis. The three main themes were (a) meaning from being on a bike, (2) impacts of CWA, and (3) formation of relationships. Findings suggest that the CWA program brought valuable meaning to the participants' lives, significantly improved their happiness, and was associated with the formation of new and diverse intergenerational relationships. A large amount of anecdotal evidence, social media chatter, and global adoption of CWA indicate its importance and potential to satisfy the need of older adults to engage with society. Future research on the physical and mental health benefits of CWA is required to support further implementation of the program.
Age Differences in Positive Event Appraisals during COVID-19: Evidence from a Daily Diary Study
Authors: Klaiber Patrick , Ong Lydia , DeLongis Anita , Sin Nancy
Published: December 2021

Multiple studies suggest that community-dwelling older adults are psychologically resilient in the face of the COVID-19 pandemic. Notably, during the initial weeks of the COVID-19 outbreak, older age was associated with engaging in more daily positive events (Klaiber et al., 2021, Journal of Gerontology: Psychological Sciences). We followed up on these findings by exploring age differences in positive event appraisals during the COVID-19 pandemic. During the 7-day diary study conducted between March and August 2020, 1036 participants (mean age = 45.95, SD = 16.04, range = 18-91) reported their positive events in nightly surveys. If at least one positive event occurred, participants rated their appraisals of the event on the following dimensions: importance, calmness, happiness, gratitude, personal responsibility, and control. Older adults (60 years+) rated their positive events to be more personally important and felt more calm and happy during these events, compared to younger (18-39 years) and middle-aged adults (40-59 years). Furthermore, older adults felt more grateful during positive events compared to younger but not middle-aged adults. There were no age differences in feelings of control or personal responsibility for positive events. These findings highlight the importance of daily positive events for older adults during a time of major stress. In line with theories on adult development, daily positive event processes in older adults are characterized by valuing positive and meaningful social connections, as well as a greater degree of positive event-specific emotions such as feeling calm, happy, and grateful.
Gender Differences in the Relationship Between Coping Style and Attitudes Towards Palliative Care
Authors: Engel Ilana , Watts Amber , Baker Tamara , Sinclair Christian
Published: December 2021

Palliative care (PC) is becoming more widely available and its benefits, including improved quality of life for patients, have been demonstrated. Studies on patient-level barriers to PC access focus on knowledge and misperceptions. This study aimed to explore, among a community sample, whether more approach-focused coping styles may be associated with more positive attitudes towards PC and whether more avoidant coping styles are associated with more negative attitudes towards PC. Two linear regression analyses (an approach model and an avoidance model) were conducted to determine predictors of attitudes towards PC, controlling for potential confounds. The sample consisted of 87 community-dwelling adults ages 65+ (mean age=72.72 (5.88); 56.32% = women; 86.21% = White). In both models, more knowledge of PC was associated with more positive attitudes towards PC (β = .71, p<.01). Coping by engaging more social support was significantly associated with more positive attitudes towards PC (β = .54, p<.05). Results demonstrated a significant interaction (β = -1.24, p<.01) such that women who endorsed high levels of disengaged coping reported more favorable attitudes towards PC than men who endorsed high levels of disengaged coping. Results indicate the need for a tailored approach to PC education for patients and families. Men who often cope with a stressor via distraction, self-blame, denial, or giving up may be less receptive to acceptance of PC. Future research on educational interventions tailored for individuals with distinct coping styles may be beneficial, particularly for men who frequently rely on disengaged coping styles.
Institutional Effects on Early Palliative Care among Mexican-Heritage Elders
Authors: Miller Susan , Apesoa-Varano Ester Carolina
Published: December 2021

This paper addresses Mexican-heritage older people’s experiences with early palliative care (EPC). EPC is the early provision of medical, social and spiritual reports to relieve suffering. Empirically, Mexican-heritage older people are known to have less access to EPC and, when they access it, to receive care of lower quality. However, little work has explored how Mexican-heritage older people think about and access such care. The paper addresses this gap. Methods are longitudinal: 36 Mexican-heritage people ranging in age from 55 to 90 years completed longitudinal semi-structured qualitative interviews, for a total of 69 interviews. Results explore how respondents’ participation in social institutions may mediate the effects of larger social structural constraints on their health and access to care.
Caregivers’ perception about their participation in a community-based exercise intervention - Body & Brain Project
Authors: Ribeiro Oscar , Marques Pedro , Barros Duarte , Silva Paula , Carvalho Joana , Borges-Machado Flávia
Published: December 2021

Evidence is scarce on caregivers’ perception regarding their participation in exercise interventions targeting individuals with neurocognitive disorder (NCD). This study aims to investigate the views of family caregivers of people with NCD about taking part in a community-based physical exercise intervention with their care-recipients. Twenty caregivers (N Male: 13; 66.5 ± 14.39 years old; age range: 36-88) answered to a semi-structured interview conducted by telephone about their perception on participating or not as class members of a 6-month multicomponent training intervention. Transcribed data from the interview were analyzed through thematic analysis. Main themes regard their perceived key-role in the care recipients’ participation, which included knowing their limitations, making them feel accompanied and motivated, and the possibility of providing comfort and tranquility throughout the intervention. Caregivers also mentioned the possibility of fulfilling own needs for physical activity and being engaged in new experiences. Disturbing the care recipients’ involvement and performance, the opportunity for respite during the sessions’ time, and being enrolled in the program only in specific moments or by telephone were also mentioned. Findings highlight the inclusive perspective of caregivers to take part of exercise programs designed for people with NCD, not only due to their decisive role on care-recipients engagement but also due to the associated (in-/)direct personal benefits. This data may be useful for planning and prescribing future community-based exercise interventions for NCD caregiving dyads. Trial registration: ClinicalTrials.gov - NCT04095962. Supported by FCT: “Body and Brain” (POCI-01-0145-FEDER-031808), CIAFEL (FCT/UIDB/00617/2020), and Ph.D. Grants (SFRH/BD/136635/2018) to FM (2020.05911.BD) to DB.
Creation And Pilot Testing Of The Confidence To Engage In Physical Therapy In Older Adults (CEPT) Measure
Authors: Bamonti Patricia , Harris Rebekah , Moye Jennifer , Bean Jonathan
Published: December 2021

The measurement of self-efficacy is important in physical therapy (PT) settings where patients face barriers and adoption of new behavior is critical for recovery. However, existing measures of exercise self-efficacy do not account for the internal (i.e., fatigue) and external (i.e., scheduling) barriers to self-efficacy observed in older adults. We developed a self-report measure assessing an individual’s confidence to engage in PT despite barriers. Qualitative ratings from patients (N = 75; age M =78.26 ± 11.2; 80% white; 20% African American) enrolled in PT at a Veterans Affairs Medical Center (VAMC) and their physical therapist were used to create a 21-item pool for the Confidence to Engage in Physical Therapy in Older Adults (CEPT). We next evaluated item characteristics and scale reliability and validity of the CEPT in a new sample of patients (N = 19; age M = 81.11± 8.93; 88.8% white, 11.1% African American) enrolled in an outpatient PT program who also received the Geriatric Depression Scale-15 (GDS-15), and the Activities-specific Balance (ABC) Scale. Response choice ranged from 0% (not confident at all) to 100% (highly confident) with higher scores indicating greater self-efficacy. Item analyses indicated adequate response variability across items (M = 55.9 ± 24.80, range 10-85). The scale demonstrated evidence of internal consistency reliability (Cronbach’s alpha) = 0.98. Construct validity was demonstrated by positive association between CEPT and the ABC (r = .74, p < .001) and negative association with GDS-15 (r = -.64, p < .01). The CEPT requires further evaluation with larger sample sizes.
Perceived Exertion in Physical Activity Measurement Across the Lifecourse: Results from SWAN
Authors: Ylitalo Kelly , Karvonen-Gutierrez Carrie , Sternfeld Barbara , Gabriel Kelley Pettee
Published: December 2021

Physical activity (PA) guidelines recommend 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity PA, in addition to muscle strengthening activities, each week. Many questionnaires ascertain PA frequency, duration, and intensity to benchmark achievement of PA recommendations. However, most scoring algorithms utilize absolute intensity estimates when exertion may be influenced by age or other sociodemographic or health characteristics. This study compared PA estimates with and without adjustments for perceived exertion and determined if that difference was associated with individual characteristics. Women (n=2,711) from the longitudinal Study of Women’s Health Across the Nation who completed ≥3 Kaiser Physical Activity Surveys (KPAS) across 8 biennial visits were included (baseline age: 46.4±2.7 years). KPAS responses were converted to metabolic equivalent of a task (METs) using the Compendium of Physical Activities to estimate absolute and perceived intensity-adjusted MET values. Latent class growth modeling identified subgroups of participants following similar patterns of change in the difference between absolute intensity-based and perceived intensity-adjusted estimates across time. Four major trajectory classes emerged with patterns reflecting: (1) lessening high-intensity exercise (2.2%); (2) increasingly high-intensity exercise (3.1%); (3) consistently moderate-intensity exercise (92.0%); and (4) consistently low-intensity exercise (2.8%). Consistently low-intensity exercisers, for whom absolute intensity-based estimates exceeded perceived intensity-adjusted estimates, were more likely to be Japanese or Chinese (p<0.001) and have lower BMI (p=0.05). However, for most participants, absolute intensity-based estimates approximated perceived intensity-adjusted estimates over time, suggesting that traditional PA scoring techniques may provide sufficient estimates for PA in longitudinal cohort studies of mid-life and older adult women.
Assisted Living Administrators' Views of Palliative Care
Authors: Abken Elise , Perkins Molly , Bender Alexis
Published: December 2021

As many older adults with progressive chronic conditions choose to age-in-place in assisted living (AL) communities, external healthcare workers (e.g., those who provide palliative care) increasingly support AL staff in caring for residents with complex health needs. Palliative care is a branch of healthcare dedicated to preserving quality of life by attending to the physical, mental, and spiritual needs of individuals with chronic, life-threatening diseases and is well suited to manage AL residents’ progressive medical conditions. However, AL residents and their care partners often face barriers to accessing palliative care. Using data from a larger 5-year NIA-funded study, we examined AL administrator knowledge and use of palliative care in seven AL communities around the Atlanta metropolitan area that were racially, ethnically, and socioeconomically diverse. Findings from thematic analysis of semi-structured interviews with 16 administrators indicated that 15 of 16 administrators were familiar with palliative care. A minority of administrators clearly distinguished palliative care from hospice services and conceptualized it as a “bridge” to hospice services. Administrators emphasized how palliative care assists communities in caring for health concerns in-house rather than having to send residents to the hospital. Despite their positive view of palliative care, administrators described infrequent use of palliative services in their communities. Findings show that although none of the AL communities integrate palliative care with their service offerings, AL administrators see value in palliative care for their residents. We provide recommendations for improving palliative care access and quality of life for AL residents at end of life.
Older Portuguese And Mexican Adults And Sexual Well-Being? A Cross-Cultural Qualitative Study
Authors: von Humboldt Sofia , Mendoza-Ruvalcaba Neyda Ma , Ribeiro-Gonçalves José Alberto , Low Gail , Leal Isabel
Published: December 2021

Objectives: Sexual well-being (SWB) refers to the subjective emotional and cognitive evaluation of the quality of the individual's sexuality, it plays a relevant role in quality of life and health promotion on old age and has cross-cultural implications. The aim of this study is to analyse comparatively the perspectives of older adults on their SWB in Portugal and Mexico. Methods: Data were collected from 86 Portuguese and 80 Mexican community-dwelling participants aged 65 years and older, using a semi-structured interview protocol. Older adults were inquired about their perceptions on what contributes to their sexual well-being. Socio-demographic data were also enquired. Content analysis was used to identify key themes. Results: Outcomes indicated eight themes: eroticism, supportive relationship, positive self-concept, health and self-care, romance, active life, tenderness and care, and no pain and no pregnancy restrictions, for both samples. Eroticism was the most frequent theme reported by Portuguese participants (31.4%) and health and self-care were the most frequent theme reported by Mexican participants (26.5%). Conclusions: The empirical results of this study indicated that SWB is strongly influenced by socio-cultural and psychosocial values. This cross-cultural comparison between Portugal and Mexico contributes to understand this concept in old age with different perspectives and place a scenario for future culture-adapted interventions and comprehensive policies. Keywords: Mexican, older adults; Portuguese; qualitative study; sexual well-being
Proactive Coping and Mindfulness are Associated with Less Stress in Older Adults
Authors: Graham Lyndsey , Neupert Shevaun
Published: December 2021

We examined the consequences of both chronic and life-event stressors for older adults, as well as antecedent strategies, such as proactive coping and mindfulness, that may mitigate stress. Given the potential negative outcomes associated with stress in older adulthood, exploring strategies to reduce or mitigate the negative impact of stress may be useful in promoting well-being in adulthood. Proactive coping involves an accumulation of resources that leads to reduced or avoided stressors in the future (Aspinwall & Taylor, 1997). Mindfulness calls an individual’s attention to the present moment, or may be characterized as an open, accepting attitude (Brown & Ryan, 2003). Using data from the Mindfulness and Anticipatory Coping Everyday study (English et al., 2019; Neupert & Bellingtier, 2017), 296 older adults in the United States, aged 60-90 years (M = 64.67, SD = 4.36), participated in relevant online survey measures. Results from multiple regression analyses suggested that people high in both chronic stress and life event stress had worse health, and that people high in proactive coping and mindfulness reported less stress. Study results underscore the impact of stress on health outcomes, and provide support for the use of antecedent strategies to address negative impacts of stress.
Mismatch Between Physical Health and Job Demands among Older Workers by Full Retirement Age
Authors: Andrasfay Theresa
Published: December 2021

Gradual increases to the Social Security full retirement age (FRA) from 65 to 67 were justified by improvements in the health of the older population and a general shift toward less physically demanding jobs. These two trends have been studied independently, but it is important to consider the agreement of these two factors—job demands and health—to understand whether those expected to work longer to receive full benefits have compatible health and job characteristics to do so. Using data from the 1992-2018 waves of the Health and Retirement Study, I observe 19,383 working individuals with FRA ranging from 65-67 while they are approaching retirement (ages 51-60). I compare the prevalence of person-work mismatch—defined by the co-occurrence of physical health conditions and self-reported physical job demands—by FRA. I find that individuals with an older FRA are less likely to be employed in physically demanding jobs while having arthritis. However, they are more likely to be employed in physically demanding jobs while having pain or fair/poor self-assessed health and are more likely to be employed in jobs requiring frequent stooping, kneeling, or crouching while simultaneously having difficulty with these activities. The co-occurrence of physically demanding work while having multiple mobility limitations has remained stable across the FRA cohorts. These findings indicate that older workers expected to work longer to receive full benefits have not experienced substantial improvements in the compatibility between their physical health and job demands that would facilitate working longer, and by some measures compatibility has declined.
Retirement, happiness, and health in Japan
Authors: Okamoto Shohei , Kobayashi Erika
Published: December 2021

While health effects of retirement have been well studied so far, previous findings remain inconclusive, and mechanisms underlying the linkage between retirement and health are unclear. This can be driven by regional or cohort heterogeneity as well as methodological differences, such as outcome measures and identification strategies; thus, much evidence needs to be accumulated. Utilising a national household survey conducted every year in 2004-2019 in Japan (the Japan Household Panel Survey), we evaluate the effects of retirement among Japanese adults aged 50-75 on their happiness and health in addition to other outcomes that could attribute to happiness or health changes (e.g. health behaviours, time use for some activities, and the expenses by item). As outcomes are not measured every year, we analyse 4,340-7,902 person-year observations by 756-1,389 individuals with the necessary information from 2009. To deal with the potential endogeneity of retirement, we adopt an instrumental variable approach utilising changes in retirement policy and public pension eligible age. Consequently, instruments seem valid only for men, and we find that retirement increases male retirees’ happiness and decreases psychological stress while effects on other health measures are not observed. Although their satisfaction with their income decline, perhaps because of the loss of their wage income, they tend to increase the proportion of expenses for cultural and recreational activities. Enhancement in personal life quality by more leisure activities and stress reduction from work, rather than improvements in health behaviours and physical health, may be key to understanding health benefits in retirement.
The Social Relations and Economic Preparation for Retirement of One-Person Households
Authors: Sung Heayoung
Published: December 2021

Objectives: The purpose of this study is to find out the effect of middle-aged one-person households on social relations and economic preparation for retirement. In addition, even within one-person households, I attempted to determine the difference according to whether the cause of the households’ composition was separation after marriage or a one-person household without a spouse due to being unmarried, bereavement, or divorce. Methods: As a result of the analysis using the data of the 2019 Korean Social Survey of the National Statistical Office, single-person households had weaker economic conditions, social relations, and economic preparation for retirement when compared to multi-person households. One-person households lacked a social network to receive help when they face difficulties compared to multi-person households, but there was no effect on group activities or the satisfaction with human relationships. However, households with no spouse had a negative impact on the social network, group activities, and the satisfaction with human relationships. Conclusions: Middle-aged one-person households and one-person households with no spouse had a negative effect on economic preparation for retirement, when labor activity and asset variables were not considered. However, statistical significance was not found when these variables were considered.
Sleep Disturbance Among Older Korean Immigrants
Authors: Song Yeonsu , Kim Haesook , Lee Diane , Ryan Gery , Kramer B Josea , Martin Jennifer , Hays Ron , Choi Sarah
Published: December 2021

Little is known about sleep disturbance among older Korean immigrants living in the United States. In this exploratory study, we conducted focus groups with 6 and phone interviews with 22 older Korean immigrants to explore and understand their sleep experiences. Three members of the research team fluent in Korean independently coded each focus group and phone interview transcript to identify underlying themes. The following themes emerged: Daytime naps were acceptable behaviors, particularly among those who were retired or not employed. Many reported worry and anxiety rumination behaviors that interfered with their sleep. In addition, praying, reading the bible, and singing hymns often occurred while in bed, and smartphone or tablet use was a frequent activity as well. Drinking alcohol and taking sleeping pills were used as a last resort to help with sleep, particularly among those who lived alone. Internal (e.g., biological urge, snoring, medical conditions) and external distractions (e.g., noise) contributed to nighttime awakenings. Living alone and worrying about the future made it difficult for some to return to sleep after awakening. Seeking advice from peers was a common behavior but did not seem to help with sleep. Calming activities such as reading a book, taking a shower, watch television, or writing a diary were routinely performed before bedtime. These findings are consistent with unhealthy sleep behaviors shown in other racial/ethnic minority older adults with poor sleep. Sleep education programs in Korean-speaking churches may be used to target those who are socially isolated and may benefit older Korean immigrants.
Trajectories of K-12 Schools and Demographic Differences: Evidence From 2017 Life History Mail Survey
Authors: Yu Wenshan , Li Xuefei , Smith Jacqui
Published: December 2021

Besides information about the highest degree, little information about early-life education is available in most population surveys. This study identified the trajectories of K-12 education history among older adults in the Health and Retirement Study born between 1930 and 1960, and examined the associations with demographic variables. Drawing on 2017 Spring and Fall Life History Mail Survey (LHMS; n = 3,206), we used sequence analysis to determine and classify trajectories of school types across the education history. We identified five trajectories: 1) always private school with White students, 2) always public school with White students, 3) always public school with Non-White students, 4) mostly private school with Non-White students, and 5) no report of school types. The trajectories showed that changes in school type (i.e. private to public) often happened in grade 9. Changes rarely happened across race/ethnicity groups (i.e. mostly White to mostly non-White). We used multinomial logistic regression to examine the relationship between demographic variables and education trajectories. We found that compared to Black participants, White participants were significantly less likely to be in mostly Non-White schools (public and private schools, p<0.001). The 1940s and 1950s cohort were more likely to join mostly White private schools than the 1930s cohort (odds ratio: 1.70 for 1940s and 1.62 for 1950s separately, p<0.005). Our findings illustrate a novel application of sequence analysis with life history data, as well as new evidence on recial segregation in early-life education within the last century.
Positive Peripheral Social Network Members in Older Age: Global and Daily Appraisals of Social Partners
Authors: Growney Claire , English Tammy
Published: December 2021

Socioemotional selectivity theory suggests older adults maintain relationships with close social partners with whom they experience positive emotions. It is unclear how age and closeness predict social partner appraisals in different contexts. We examine semantic and experiential appraisals of positivity, as well as emotional outcomes. Participants (N = 258) aged 25-85 (M = 52.05, SD = 16.31) reported their general experience of enjoyment and conflict with social partners of varying closeness. In an experience sampling procedure (6x/day for 10 days), participants reported their current experience of emotions and information about their most recent social interaction: pleasure, discomfort, and relationship closeness with their social partner. Semantic (global) appraisals of relationships positively predicted experiential (daily) appraisals, and this association was stronger among relatively older adults. Results revealed older adults gave less negative appraisals compared to younger adults, regardless of closeness. Older adults reported more positive appraisals than younger adults for non-close relationships, whereas close relationships were evaluated positively regardless of age. For younger adults, interaction pleasure with non-close partners was less strongly linked to subsequent positive emotions than pleasure with close partners. For older adults, however, interaction pleasure predicted greater subsequent positive emotions regardless of relationship closeness. Overall, these findings suggest older adults’ positive appraisals of partners are not simply the result of emotionally gratifying memory distortions. Older adults may be able to derive emotional benefits from a wider variety of social interactions than younger adults, suggesting peripheral social network members can be leveraged to enhance emotional well-being in later adulthood.
Sensorimotor, Cognitive and Affective Barriers to Social Relations in Aging: A Dynamical Framework
Authors: Tognoli Emmanuelle , Wead Alice , McKinley Joseph , Beetle Christopher , Williams Christine
Published: December 2021

Social interactions of all sorts (e.g. conversing, playing tennis, singing, strolling, etc.) rely on information flows between participants. The process of aging, however, can alter individuals’ sensorial, motor, cognitive and affective functioning in ways that may compromise their affinity for social interactions. For instance, hearing deficits or cognitive difficulties associated with word retrieval may contribute to disengagement from conversation and other forms of social interaction, which can lead to social retreat of the affected individuals. Strategies for mitigating such effects must take into account not only individuals’ own functional capacities, but also those of their partners in varying social contexts. Indeed, varied social contexts and diversity in partners can offer a beneficial balance of relational effort and comfort. For example, instead of comfortably strolling exclusively with partners of comparable cognitive and motor capabilities, strolling with faster partners can improve social engagement and long-term prospects for a wider range of social interactions. This work reviews an array of possible changes in individual abilities arising from both normal healthy aging and complications due to medical conditions, with an emphasis on their impact on interactions in varying social contexts and diverse groups of social partners. We incorporate theoretical models to explore a wide range of potential mitigation strategies, both for affected individuals and for other members of the social groups surrounding them. Our work focuses on healthy social aging over the long term, which is known to protect physical wellbeing, cognition and brain function.
Technology and Social Isolation, Loneliness, and Health Inequities Among Older Adults
Authors: Jutai Jeffrey , Tuazon Joshua
Published: December 2021

Because of the COVID-19 pandemic, older adults have been advised to stay-at-home to reduce the risk of infection. Social distancing and quarantine measures increase their vulnerability to adverse health outcomes like depression and cardiovascular disease. Technology is an effective tool to promote social connectedness among older adults affected by the pandemic; however, its role in reducing loneliness and health inequities is not well understood. The goal of this project was to construct a model for how technologies may be deployed to mitigate the impact of a pandemic on social isolation, loneliness, and health inequities for older adults. PubMed, SCOPUS, and PsychINFO were searched for the following keywords: “social isolation,” “loneliness,” “social support,” “resilience,” “technology,” “pandemic,” and “health inequities.” Articles selected for full analysis attempted to understand or observe how technology alleviates social isolation and/or loneliness among older adults. Research evidence indicates that using technology reduces loneliness directly and indirectly (by reducing social isolation) and can strengthen social support, which in turn promotes resilience among older adults. Video-based technologies encourage care-seeking behaviors in this population. There is insufficient evidence to determine technology’s relationship to health inequities experienced by older adults. The model we have proposed should help advance research on the relationship between technology and health inequities among older adults that may be aggravated by pandemic-like situations. We hypothesize that technology interventions for social support and functional competence should be sequenced in order to have the best effects on reducing health disparities.