Health Problems In Later Life Research Articles

Incredible years parenting program buffers prospective association between parent-reported harsh parenting and epigenetic age deceleration in children with externalizing behavior

Harsh parenting has been shown to increase the risk of physical and mental health problems in later life. To improve our understanding of these risks and how they can be mitigated, we investigated associations of harsh parenting with a clinically relevant biomarker, epigenetic age deviation (EAD), using data from a randomized-control trial of the Incredible Years (IY) parenting program. This study included 281 children aged 4–8 years who were screened for heightened externalizing behavior and whose parents were randomly allocated to either IY or care-as-usual (CAU). Parents reported on their own parenting practices and their child’s externalizing behavior at baseline and at a follow-up assessment approximately three years later. Epigenetic age, based on the Pediatric Buccal Epigenetic (PedBE) clock, was estimated from child DNA methylation derived from saliva collected at the follow-up assessment. PedBE clock estimates were regressed on chronological age as a measure of EAD. Moderation analyses using multiple regression revealed that harsher parenting at baseline predicted epigenetic age deceleration in children that received CAU (b = −.21, 95% CI[-0.37, −0.05]), but no association was found in children whose parents were allocated to IY (b = −.02, 95% CI [-0.13, 0.19]). These results highlight a prospective association between harsh parenting and children’s EAD and indicate a potential ameliorating effect of preventive intervention. Future work is needed to replicate these findings and understand individual differences in children’s responses to harsh parenting in relation to epigenetic aging.

The effectiveness of extended postpartum comprehensive health care bundle selected outcomes of women with preeclampsia at 6 months: protocol of a randomized controlled trial

Background: Women who have experienced pre-eclampsia (PE) may also face additional health problems in later life, as the condition is associated with an increased risk of death from 2-fold increased risk of long-term cardiovascular disease (CVD), hypertension, stroke, an approximate 5-12-fold increased risk of end-stage renal disease (ESRD), metabolic syndrome, and diabetes. Methods: Method was randomized controlled trial. Women with PE who delivered in PGIMER will be enrolled and will be allocated into experimental ad control group using a computer random table with allocation concealment. Enrolment will be done at the time of discharge; baseline assessment will be done 6 weeks and the intervention bundle will be implemented to the women in experimental group. The women in control group will receive routine care. Women in both the groups will be followed up at 6 months. Conclusions: This study aims to determine the effectiveness of “extended postpartum comprehensive health care bundle (EP CHC bundle)” on selected outcomes of women with preeclampsia at 6 months. The comprehensive health care bundle will be designed with the inputs from all stakeholders, has the potential to suit the dynamic nature of management of women with preeclampsia after delivery. CTRI registration number: CTRI/2021/04/032749 ON 12/4/2021

Daily Functional Characteristics and Health Among Older Adults During COVID-19: A Structural Equation Modeling Approach.

Within a few years, 1 in 6 people will be aged 60 years or older. Extreme situations, such as the COVID-19 crisis, constitute a challenge to older adults. However, the literature on the daily functional characteristics of older adults in the past and during the COVID-19 crisis and their relationships to their physical and mental health is scarce. This study aimed to examine the past and present daily functional factors associated with physical and mental health in older adults. Using an online platform, 204 Israelis aged 60 years and older reported their physical health symptoms and anxiety levels. They completed questionnaires about past (negative life events and childhood daily functional self-actualization) and present (adulthood daily functional self-actualization, functional cognition and sleep quality) factors. Structural equation modeling revealed correlations between functional cognition and childhood daily functional self-actualization (β = -.18) and anxiety (β = .15); adulthood daily functional self-actualization and past negative life events (β = -.18), anxiety (β = -.50), and physical symptoms (β = -16); and sleep quality and past childhood daily functional self-actualization (β = -.19), negative life events (β = .22), anxiety (β = .18), and physical symptoms (β = .40). These findings shed light on potential functional factors for older adults' health, indicating that these functional factors play a vital role in reducing health problems in later life.

A qualitative exploration of stakeholder perspectives on the implementation of a whole school approach to mental health and emotional well-being in Wales.

Early intervention to support mental health and well-being of school-aged children may be of significant benefit in preventing escalation of mental health problems in later life. While there are limitations to current understanding of the best ways for schools to support mental well-being, a whole school approach (WSA), involving all those who are part of the school system in creating and sustaining a supportive environment where health is prioritized, may be effective. This research explored stakeholder views of this approach, as part of a contract commissioned by the Welsh Government to conduct an evaluability assessment of a WSA. Semistructured focus groups and interviews were completed with stakeholders from the health and education sectors, as well as parents, to explore how a WSA may operate in a Welsh context and barriers and facilitators to potential implementation and outcomes. Findings suggest that existing pressures on schools may impact implementation of a WSA, with school staff already time poor and many staff experiencing their own mental well-being challenges. Implementation may be supported by clear guidance at local and national levels, funding for staff time and training and stakeholder involvement at all stages. Long-term monitoring and evaluation are also needed to understand system changes.

EMOTION WORD USE AND CARDIOVASCULAR REACTIVITY DURING MARITAL INTERACTIONS

Abstract Cardiovascular reactivity in midlife may predict health problems in later life, but few studies have examined cardiovascular reactivity during marital interactions, as an important interpersonal context, and potentially modifiable linguistic correlates. This laboratory-based study examined emotion word use (i.e., positive and negative emotion words derived using automated language analysis) and cardiovascular reactivity (i.e., heart rate changes from baseline) across two marital interaction contexts (i.e., positive and conflict conversation) in 46 married couples (92 individuals; age: M = 42.6, SD = 8.5). Results showed that (1) spouses who used more negative emotion words during conflict showed higher cardiovascular reactivity. Moreover, (2) when husbands used a more diverse negative emotion word vocabulary during positive conversations, their wives showed higher cardiovascular reactivity and (3) when wives used a more diverse positive emotion vocabulary, their husbands showed lower cardiovascular reactivity. Findings highlight the relevance of couples’ emotion word use for cardiovascular reactivity in midlife.

Adulthood Employment Trajectories and Later Life Mental Health before and after the Onset of the COVID-19 Pandemic.

This life course study has two aims. First, to explore how diverse employment trajectories across adulthood are related to older people's mental health in Chile, a country with no research in this field, and second, to analyze these associations before and after the onset of the COVID-19 pandemic. We use data from the nationally-representative and longitudinal 'Chilean Social Protection Survey' sequence analysis to reconstruct employment trajectory types, and bivariate and multivariate analyses to measure their association with depressive symptoms. Our findings indicate that formal labor force patterns in adulthood show the lowest burden of depressive symptomology before and after the onset of the overwhelming COVID-19 pandemic when controlling for traditional risk factors. We emphasize that policymakers in both the labor market and public health domains must consider the relationship between informal employment pathways in adulthood and poorer mental health in old age. Public policies should improve the conditions and quality of jobs during adulthood and promote more formalization in the labor market to address the high uncertainty involving low social protection, which is strongly associated with severe mental health problems in later life.

Research on Attitudes towards Ageing, Social Participation and Depressive Symptoms Among Older Adults in China

AbstractDepressive symptoms are one of the most common mental health problems in later life. Although previous studies examined the social determinants of depressive symptoms, older adults’ attitudes towards ageing (ATA) and the underlying mechanisms are understudied, especially in developing country contexts such as China. The objective of this study was to examine the association between ATA and social participation, and their influences on depressive symptoms among older Chinese adults. The data were drawn from the 2014 baseline wave of the China Longitudinal Ageing Social Survey, and 8,568 respondents aged sixty years or older were included in this study. Path analysis was used to test the hypotheses. The results indicate that both psychological loss and psychological growth (i.e. two types of ATA) had a direct effect on depressive symptoms. In addition, ATA were likely to mediate the relationship between social participation and depressive symptoms among older people. In conclusion, this study emphasises the importance of older people’s ATA in reducing depressive symptoms and how engaging in social activities could modify ATA and further reduce the risk of depressive symptoms.

Intergenerational support and depressive symptoms among older adults in rural China: the moderating roles of age, living alone, and chronic diseases

BackgroundWhile depressive symptoms are recognized as major mental health problems in later life, there is a lack of study in examining potential moderators in the association between intergenerational support and depressive symptoms, especially in social contexts with low socioeconomic status and inadequate formal public support. This study set out to examine the association between intergenerational support and depressive symptoms among older adults in rural Northeast China, and the potential moderating roles of age, living alone, and number of chronic diseases on this link.MethodsA quota sampling approach was used to recruit 448 respondents aged 60 and above from rural Chinese communities. Depressive symptoms were the dependent variable. Intergenerational emotional, instrumental, and financial support were the main independent variables. Age, living alone, and number of chronic diseases were the moderators. Multiple linear regression models with interaction terms were conducted to test the proposed model.ResultsThe results showed that intergenerational emotional support was significantly associated with depressive symptoms in older adults when instrumental and financial support and covariates were controlled (β = -0.196, p < .001). Age was found to have a significant moderating effect on the relationship between intergenerational instrumental support and depressive symptoms (β = -0.118, p < .05). Among older respondents aged 74.51 years and older, instrumental support was positively associated with depressive symptoms, but this association was not significant for younger respondents. Furthermore, living alone and number of chronic diseases suffered moderated the association between intergenerational financial support and depressive symptoms, which was statistically significant only for those living alone and with more chronic diseases (interaction term between living alone and intergenerational financial support: β = -0.082, p < .05; interaction term between number of chronic diseases and intergenerational financial support: β = -0.088, p < .05.ConclusionsThe findings not only highlight the important role of intergenerational support in promoting mental health in later life in rural Chinese contexts, but also identify within-population heterogeneity in the identified associations. Policy and intervention implications are discussed.

A comparative study on psychiatric morbidity among elderly population residing in old-age homes and community.

Aims and Objectives:The objective of this study is to study, assess and compare the socio-demographic profile, psychiatric morbidity, cognitive functioning, quality of life and social support of senior citizens in care homes as well as in the communities.Material and Methods:Hundred subjects (50 were from old-age home and the rest were from the community) were assessed using intake pro forma details and an interview questionnaire. The Geriatric Mental Status questionnaire, Mini-Mental Status Examination, Quality of Life Support, and Multidimensional Scale of Perceived Social Support scales were then performed on each subject from the two groups in that order, and they were rated on all scales.Results:Individuals with lack of spouse and lack of children were higher and common attitude was death in old-age homes. Past history of psychiatric illnesses was more in the inmates of old-age homes. Memory disturbances, concentration problems, hypochondriasis, somatic dysfunction, error behaviour, thought disturbances, perceptual disturbances, persecution, expressed happiness and satisfaction were greater in the inmates of old-age care homes. The quality of life was poor in community group than in old-age home group.Conclusion:There is a need to increase community and health-care professional awareness of mental health problems in later life, as well as improve access to appropriate geriatric and mental healthcare.

Parenting Styles and Mental Health of Adolescents

Adolescence is a developmental phase marked with a heightened risk of inception of mental health disorders. The neglect in addressing mental health issues during childhood and adolescence could lead to the development of mental health problems in later life. The perspective with which children perceive their parent's parenting influences the children's mental health. Furthermore, the gender of the parent has its impacts on the shaping of a child's personality under the patriarchal society. The present research attempted to investigate the impact of different parenting styles (paternal) on adolescents' mental health. The study sample comprised 150 adolescents of 14-17 years in age from different schools located in the state of Haryana, India. Parenting Authority Questionnaire and General Health Questionnaire (GHQ-28) were used to assess parenting styles and mental health. The present study's findings suggest that adolescents with a permissive parenting style have poor mental health compared with authoritative and authoritarian parenting styles. The study recommends incorporating healthy practices in parenting styles to prevent mental health issues among adolescents.

Causes of overweight and obesity in children and adolescents

Obesity is caused by positive energy balance. Excessive body weight in children is classified by using charts for body mass index (BMI). The prevalence of overweight and obesity is a growing public health problem worldwide. Excess body fat may lead to serious health problems in later life, so it is important to know the main reasons causing weight gain. Those could be classified as genetic and non-genetic factors. The second ones include medical problems (e.g. endocrine and neurological diseases), family and social impact, environmental influence, bad eating habits, sedentary lifestyle, cultural factors. There are two most important phases in life such as infancy and puberty, which may determine development of overweight or obesity. It is crucial to pay special attention on those periods to prevent weight gain development.

Is exposure to family member incarceration during childhood linked to diabetes in adulthood? Findings from a representative community sample

Objectives:Diabetes is a prevalent and serious public health problem, particularly among older adults. A robust literature has shown that adverse childhood experiences contribute to the development of health problems in later life, including diabetes. Family member incarceration during childhood is an under-investigated yet increasingly common adverse childhood experience in the United States. The purpose of this study was to investigate the relationship between family member incarceration during childhood and diabetes in adulthood, while considering the role of gender as well as the impact of a range of potential confounds.Methods:A large representative community sample of adults aged 40 and older (n = 8790 men, 14,255 women) was drawn from the Behavioral Risk Factor Surveillance System 2012 optional adverse childhood experiences module to investigate the association between family member incarceration during childhood and diabetes. For each gender, nine logistic regression analyses were conducted using distinct clusters of variables (e.g. socioeconomic status and health behaviors).Results:Among males, the odds of diabetes among those exposed to family member incarceration during childhood ranged from 2.00 to 1.59. In the fully adjusted model, they had elevated odds of 1.64 (95% confidence interval = 1.27, 2.11). Among women, the odds of diabetes was much lower, hovering around 1.00.Conclusion:Findings suggest that family member incarceration during childhood is associated with diabetes in men, even after adjusting for a wide range of potential risk factors (e.g. sociodemographics, health behaviors, healthcare access, and childhood risk factors). Future research should explore the mechanisms linking family member incarceration during childhood and long-term negative health outcomes in men.

THE ASSOCIATION OF LONELINESS AND CHRONIC CLINICALLY SIGNIFICANT PAIN AMONG AFRICAN AMERICAN AND WHITE OLDER ADULTS

Loneliness and pain are significant public health problems in later life, yet limited research has examined how these factors interact among racially diverse older adults. Guided by the Biopsychosocial Model of Pain, we used data from Waves 2 and 3 of the National Social Life, Health, and Aging Project to investigate the relationship between loneliness and chronic pain among 1,102 African-American and White adults aged 50 and over. Using logistic regression analyses, our final models considered demographics, physical and mental health, functioning, medication, health behaviors and social factors. Approximately 32% of African Americans and 28% of Whites reported chronic loneliness. Compared to Whites African-Americans were 2.5 times more likely to experience chronic pain. Among White participants, loneliness was not associated with chronic pain; however, the interaction of being African-American and lonely was associated with decreased odds of chronic pain in main and gendered analyses. African American women were 4 times more likely than White women to report chronic pain. Our results address the objectives of the National Pain Strategy (2016) to elucidate the experiences of chronic pain among diverse elders in the US. Future work should seek a deeper understanding of loneliness and chronic pain among African Americans elders and how cultural dynamics may help explain our counter intuitive findings (e.g., “Superwoman Schema”).

The link between family violence in childhood and internalizing and externalizing problems in later life among college students in China: attachment as a mediator

ABSTRACTRelatively limited information about the relationship between family violence in childhood, attachment, and mental health problems in later life exits in mainland China. Given the growing demand for recognition of the international aspects of social work, this study examines the relationship between witnessing interparental violence, the experience of childhood abuse and mental health problems among college students in mainland China, and the role of attachment in this relationship. By utilizing a retrospective exploratory quantitative research design, 236 college students were recruited from one university in Beijing, China. Participants completed a series of questionnaires inquiring about their past experiences with childhood maltreatment and witnessing interparental violence measured by the Conflict Tactics Scale (Couple and Parent–Child Forms), adult attachment in current close relationships measured by the Experiences in Close Relationships Scale, and internalizing and externalizing mental health problems measured by Achenbach’s Adult Behavior Checklist. Results show that family violence, especially witnessing interparental psychological violence, has a significant relationship to mental health problems in later life, and insecure attachment works as a mediator in this relationship. The findings suggest strong global attention and action to build and nourish a violence-free and healthy family environment.

Impact of military service on physical health later in life: a qualitative study of geriatric UK veterans and non-veterans

ObjectivesMilitary veterans often experience physical health problems in later life; however, it remains unclear whether these problems are due to military service or are a feature of the ageing process....

A longitudinal study on the relationship among childhood emotional abuse, gratitude, and suicidal ideation of Chinese adolescents

Background and objectiveSuicidal ideation is a significant predictor of suicidal attempt. Based on the developmental psychopathology perspective and the resilience theory, this study examines whether trait gratitude mediates the relationship between childhood emotional abuse and adolescent suicidal ideation. Participants and settingA sample of 909 Grade 8 to Grade 9 adolescents aged 12–18 years in Hong Kong, a Special Administrative Region in China, was recruited from six secondary schools. MethodA two-wave longitudinal study was conducted. Participants completed the same measures on Gratitude Quesitonnaire-6, Suicidal Ideation Scale, emotional subscale of Child Abuse and Trauma Scale at two time points 12 months apart. ResultsResults of cross-lagged analyses showed that adolescents’ suicidal ideation was positively associated with childhood emotional abuse and negatively associated with gratitude; further, the association between childhood emotional abuse and suicidal ideation was mediated by gratitude. ConclusionsFindings of this study implied that while exposure to parental emotional abuse might have an adverse impact on the development of gratitude, adolescents’ current level of gratitude still exerts its protective effect by directly reducing their suicidal ideation. Gratitude or other resilience factors that might comprise additional mediating mechanisms from childhood emotional abuse to mental health problems in later life is worthy of further investigation.

Community intervention to prevent adolescent health behavior problems: Evaluation of communities that care in Australia.

A major challenge for health psychologists is to ensure the implementation of evidence-based interventions to improve population health. To reduce high rates of adolescent alcohol use and related health problems, trials of the Communities That Care (CTC) prevention process were implemented in Australia beginning in 2001. The process assists communities to strategically plan and monitor implementation of evidence-based preventative interventions. This article reports an evaluation of the effects in the first four Australian communities that completed the process. Trends were examined based on self-report surveys completed by 41,328 adolescents (average age 13.5 years, 51.7% female) across 109 municipal localities between 1999 and 2015. Multilevel modeling compared the 5 localities where the 4 coalitions completed the CTC process with the remaining 104 localities for trends in adolescent reports of lifetime alcohol, tobacco, and cannabis use and past year antisocial behavior. Relative to Australian trends, adolescents in CTC localities reported significantly steeper annual reductions in any lifetime alcohol (Adjusted odds ratio [AOR] = 0.94, 95% confidence intervals [CI] = [0.93, 0.95]), tobacco (AOR = 0.97, CI [0.96, 0.99]), cannabis use (AOR = 0.96, CI [0.93, 0.98]) and antisocial behavior (unstandardized regression coefficient [B] = -0.001, CI [-0.002, 0.000]). Implementation of the CTC process in Australia was associated with more rapid community reductions in adolescent health behavior problems. Supporting community coalitions to adopt evidence-based interventions appears a feasible means for health psychologists to improve the health of large adolescent populations and prevent related chronic health problems in later life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention.

The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention.

Exposure to caring parenting and adult mental health in extremely low birthweight survivors.

Individuals born at extremely low birthweight (ELBW; <1000 g) are exposed to early adversities that increase the risk of mental health problems in later life. Caring parenting has been shown to offset the negative effects of early adversity in general population samples. However, the long-term impact of caring parenting on the mental health of preterm survivors in adulthood is not known. Using data from the world's oldest longitudinally followed cohort of ELBW survivors (n = 179) and matched normal birthweight (NBW) control participants (n = 145), we examined if caring parenting moderated the link between preterm birth and mental health at 30-35 years of age. Participants reported on the parenting they received from their mothers using the parental bonding instrument. Self-esteem and internalising problems (i.e. depression, anxiety) were self-reported at 30-35 years of age using the Coopersmith Self-Esteem Inventory and Young Adult Self-Report questionnaire, respectively. A statistically significant interaction was found between birthweight status and caring maternal parenting on self-esteem and internalising psychopathology in adulthood. Stratified analyses demonstrated that caring parenting was associated with better self-esteem (P < 0.001) and lower levels of internalising symptoms (P = 0.001), but in NBW participants only. While the receipt of caring maternal parenting promoted mental health in adults born at NBW, it did not have the same protective effect on ELBW survivors. More research is needed to elucidate the aspects of parenting and the family environment that promote the long-term mental health of preterm survivors.

Long-term care, from neonatal period to adulthood, of children born small for gestational age.

.Children born small for gestational age (SGA) face an increased risk of health problems in later life, particularly persistent short stature, neurocognitive dysfunction, impaired renal and pulmonary function, decreased bone density, sensorineural hearing loss, premature adrenarche, and metabolic syndrome. Insulin resistance appears to be a key component underlying these metabolic complications. Long-term, continuous, GH treatments in short children born SGA lead to a normalization of height through childhood to adulthood. Recombinant human GH has been proven to be relatively safe. We recommend early surveillance in a growth clinic for children born SGA without catch-up growth. Obesity, insulin resistance, and the risk of metabolic syndrome increase with catch-up growth, but short stature and cognitive dysfunction increase without catch-up growth in children born SGA. A solution to this catch-up dilemma is breast feeding for a minimum of 6 to 12 mo. Because the overall prevalence of metabolic risk factors is very low, routine evaluation of metabolic parameters is not recommended for all children born SGA, but it may be useful to consider metabolic evaluations in overweight or obese children born SGA. Since children born SGA have many risk factors, long-term management from neonate to adulthood is very important.