Longitudinal Mediation Research Articles

A sensitivity analysis for temporal bias in cross-sectional mediation.

For over three decades, methodologists have cautioned against the use of cross-sectional mediation analyses because they yield biased parameter estimates. Yet, cross-sectional mediation models persist in practice and sometimes represent the only analytic option. We propose a sensitivity analysis procedure to encourage a more principled use of cross-sectional mediation analysis, drawing inspiration from Gollob and Reichardt (1987, 1991). The procedure is based on the two-wave longitudinal mediation model and uses phantom variables for the baseline data. After a researcher provides ranges of possible values for cross-lagged, autoregressive, and baseline Y and M correlations among the phantom and observed variables, they can use the sensitivity analysis to identify longitudinal conditions in which conclusions from a cross-sectional model would differ most from a longitudinal model. To support the procedure, we first show that differences in sign and effect size of the b-path occur most often when the cross-sectional effect size of the b-path is small and the cross-lagged and the autoregressive correlations are equal or similar in magnitude. We then apply the procedure to cross-sectional analyses from real studies and compare the sensitivity analysis results to actual results from a longitudinal mediation analysis. While no statistical procedure can replace longitudinal data, these examples demonstrate that the sensitivity analysis can recover the effect that was actually observed in the longitudinal data if provided with the correct input information. Implications of the routine application of sensitivity analysis to temporal bias are discussed. R code for the procedure is provided in the online supplementary materials. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A LIFESPAN DEVELOPMENTAL ANALYSIS OF RECIPROCAL RELATIONS BETWEEN HEAVY DRINKING AND SLEEP PROBLEMS

Abstract In recent years, numerous studies have begun to explore the ways in which problem drinking behavior is affected by different lifespan developmental changes. However, while there currently exists a plethora of research on adolescence and young adulthood, there is far less research with midlife and older adults examining lifespan developmental changes and problem drinking. As part of larger NIAAA-funded project investigating aging, health, and alcohol use, the current study investigated cross-sectional and longitudinal associations among heavy drinking and sleep problems in a sample of midlife and older adults. One particularly noteworthy analysis used path analysis in Mplus to test a longitudinal moderated mediation model involving sleep problems, sleep-related motives for drinking, and heavy drinking. Results showed an interaction between sleep problems and sleep-related drinking motives. Interestingly, sleep problems appear to significantly reduce the risk for heavy drinking among most participants. However, when combined with high sleep-related drinking motives, sleep problems appear to significantly increase risk for heavy drinking. This phenomenon may help explain the occasionally contradictory results found in previous studies examining the impact of sleep disturbances on drinking behavior and may prove to be an area worth investigating in future studies. From a lifespan-developmental perspective, these findings highlight how there are likely important differences across stages of adulthood in the most relevant factors that affect heavy drinking. Health-related factors including sleep problems, coupled with motives to use alcohol to cope with such problems, appear to be a pathway to heavy drinking that increases in importance across the adult lifespan.

AGE DIFFERENCES AMONG WITHIN-PERSON INDICATORS OF STRESS AND DEPRESSION

Abstract Although older adults tend to regulate their emotions and resist stress better than midlife or younger adults (Charles & Carstensen, 2007), research suggests that when older adults do negatively react to stress they may have more difficulty recovering (Charles, 2010). Research reveals that various indicators of stress relate to greater depression – even suggesting that stress causes the depression (van Praag, 2004). Individual perceived stress (PS) as well as perceived stress reactivity (PSR) influence how stress impacts well-being (Folkman et al., 1986). Thus, we examined age differences in the within-person relationships among PS, PSR, and depression, and potential causal determinants of depression with a longitudinal mediation model. We used data from 572 participants in the Notre Dame Study of Health & Well-being (M(age) = 59.77; sd(age) = 14.22) who completed two to four waves of yearly assessments. Sequentially built multilevel models, in which year was nested within person, illustrated that only midlife adults experience an exacerbated effect of within-person fluctuations in PSR on the relationship between within-person PS and depressive levels (gamma41 = -0.004, p < .01). The longitudinal mediation model revealed that PSR at Time 2 mediated the relationship between PS at Time 1 and Depression at Time 3. Findings suggest that older adults illustrate successful emotion regulation strategies at the yearly level --resisting the negative ramifications of years of greater PS and PSR, whereas midlife adults who experience years of greater PSR would particularly benefit from stress management interventions and monitoring of depressive levels.

The Impact of Everyday ICT Use on Depressive Symptoms Among Older Adults in China: A Subjective Social Status Perspective.

While numerous studies have highlighted the positive effects of everyday information and communication technology (EICT) use among older adults, emerging evidence signals potential detriments to mental health, particularly among younger demographics. This study aims to examine the effect of EICT on depressive symptoms among Chinese older adults. We hypothesize that EICT use among older adults will contribute to higher amounts of depressive symptoms, mediated by a decline in subjective social status. We conducted a longitudinal mediation analysis with data from the China Family Panel Studies (CFPS), a nationally representative survey. A total of 3,234 older adults aged 60 years and older were selected from Wave 2016 (T1), Wave 2018 (T2), and Wave 2020 (T3) of the CFPS. Structural equation modeling was used to construct complete longitudinal path model. EICT use at T1 predicted a decline in subjective social status at T2 (β = -0.215, p = .001), which in turn predicted higher depressive symptoms at T3 (β = -0.375, p = .005). The mediating effect of subjective social status was statistically supported (indirect effect 0.081, p = .042). We reveal the potential negative impact of EICT use among older adults and its underlying mechanism. It lays the groundwork for the formulation of relevant public health initiatives, critical for stemming and mitigating the burgeoning incidence of depressive symptoms within China's aging population.

ADVERSE EFFECTS OF INTERNET USE ON SUBJECTIVE SOCIAL STATUS AND DEPRESSION SYMPTOMS AMONG CHINESE OLDER ADULTS

Abstract Internet use has been found to be associated with decreases in depressive symptoms among older adults. However, past evidences may have had publication bias due to the negative consequences of internet use demonstrated in other age groups. Thus, this study aims to investigate the adverse effect of older adults’ internet use on depressive symptoms and its mechanism. The inverse subjective social status (SSS) in depressive symptoms is a well-established research finding. Based on this, we hypothesize that older adults’ internet use could expand their reference group and exposing them to more ageist content, thus reducing their SSS which in turn increases depressive symptoms. We examined how older adults’ internet use influences SSS and how SSS mediates the effect of internet use on depressive symptoms in China. The data were from wave 3 (2016, T1), 4 (2018, T2), and 5 (2020, T3) of the China Family Panel Studies, a nationally representative survey. The longitudinal mediation analysis included 3,237 participants who were aged 60 and above at T1 (wave 3) and were followed through waves 4 and 5. As expected, Internet use at T1 predicted lower levels of SSS at T2. Lower levels of SSS at T2 predicted higher levels of depressive symptoms at T3. This medicating effect was significant. This time-varying mediation which appeared to be explained by the relative deprivation and ageism following internet use among older adults. This study theorizes and provides evidence for previously overlooked psychosocial pathway through which internet use among older adults produces negative consequences.

NEIGHBORHOOD CHARACTERISTICS AND SLEEP PROBLEMS: MEDIATING ROLES OF HEALTH BEHAVIORS AND MENTAL HEALTH

Abstract Existing studies have well-documented the relationship between the neighborhood environment and health among older adults. Yet very few have focused on how the neighborhood environment predicts late-life sleep quality. Using longitudinal data (Rounds 7-9) from the National Health and Aging Trends Study, this study examined the cross-sectional and longitudinal associations between neighborhood characteristics (physical disorder and social cohesion) and sleep problems among Americans aged 65 or older, as well as whether health behaviors and mental health mediated these associations. The analytical sample included 4,029 adults aged 65 or older. Logistic regressions with a lagged dependent variable were adopted to test longitudinal associations. Longitudinal mediation analyses were also used to examine the mediation effects of health behaviors and mental health. The results suggested that neighborhood physical disorder was a significant predictor of sleep problems cross-sectionally, whereas social cohesion was both cross-sectionally and longitudinally associated with sleep problems. Moreover, mediation analysis revealed that health behaviors and mental health significantly mediated the longitudinal relationship between social cohesion and sleep problems, though the strength of the indirect effect diminished over time. These findings suggest that neighborhood physical disorder and social cohesion are significant predictors of late-life sleep problems among older Americans. The study also highlighted older adults’ resilience and adaptability to adverse neighborhood environments and the long-term health benefits of social cohesion in late-life sleep quality. Therefore, community health interventions that facilitate older adults’ physical and social activity, along with mental health programs, may help community-dwelling older adults improve their sleep quality.

SOCIAL INTEGRATION, COGNITION, AND FUNCTIONAL OUTCOME IN OLDER ADULTS FOLLOWING TRAUMATIC BRAIN INJURY

Abstract Persons aged 65 and older have the highest rates of traumatic brain injury (TBI), and this injury is known to be related to significant, persistent functional changes. What is not known is what factors may mediate these changes. The current study aimed 1) to examine interrelationships among social integration, functional outcome, and cognition in older adults at years 1, 2, and 5 post-traumatic brain injury (TBI) and 2) to examine if functional outcome mediates the concurrent and longitudinal relationships between social integration and cognitive function post-TBI in older adults. This is a secondary analysis of data obtained from Traumatic Brain Injury Model System National Database (TBIMS-NDB). Included subjects from the database were persons aged 65 years and older at the time of injury (N=1469). We used longitudinal mediation analysis to address study aims. We found that social integration had a direct effect on functional outcome and cognition at 1, 2, and 5-years post-TBI. Functional outcome had a positive direct effect on concurrent cognitive function. Regarding mediation, social integration and cognition were mediated by concurrent functional outcome. However, there were no significant mediating effects of concurrent functional outcome on concurrent social integration or subsequent cognitive function. Our findings suggest there are positive relationships between social integration, functional outcome, and cognition over time. With a better understanding of these interrelationships, tailored interventions that target social integration, such as activities fostering a sense of belonging in the community and cultural diversity programs may promote improved functional and cognitive outcomes.

Effects of accelerometer-based sedentary time and physical activity on DEXA-measured fat mass in 6059 children

Globally, childhood obesity is on the rise and the effect of objectively measured movement behaviour on body composition remains unclear. Longitudinal and causal mediation relationships of accelerometer-based sedentary time (ST), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with dual-energy X-ray absorptiometry-measured fat mass were examined in 6059 children aged 11 years followed-up until age 24 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort. Over 13-year follow-up, each minute/day of ST was associated with 1.3 g increase in fat mass. However, each minute/day of LPA was associated with 3.6 g decrease in fat mass and each minute/day of MVPA was associated with 1.3 g decrease in fat mass. Persistently accruing ≥60 min/day of MVPA was associated with 2.8 g decrease in fat mass per each minute/day of MVPA, partly mediated by decrease insulin and low-density lipoprotein cholesterol. LPA elicited similar and potentially stronger fat mass-lowering effect than MVPA and thus may be targeted in obesity and ST prevention in children and adolescents, who are unable or unwilling to exercise.

Longitudinal associations among the Big Five personality traits and healthcare utilization in the U.S.

ObjectiveOne critical component of individual and public health is healthcare utilization, or the extent to which individuals have routine check-ups, schedule treatments, or use emergency services. However, we know little about who uses healthcare services and what types, the conditions that exacerbate utilization, or the factors that explain why people seek out services. The present study fills these gaps in the literature by investigating the role of personality factors in predicting various forms of healthcare utilization, how these associations vary by age, socioeconomic resources, and chronic conditions, as well as one potential psychological mediating mechanism (i.e., sense of control). MethodsWe use data from a large longitudinal sample of Americans (N = 7108), with three assessments spanning 20 years. Participants reported on their Big Five personality traits using the Midlife Development Inventory, healthcare utilization across three domains (routine visits, scheduled treatment, urgent care), age, income, insurance, chronic conditions, and sense of control. ResultsMultilevel models showed that people who were more agreeable and neurotic tended to use more healthcare services. Moreover, on occasions when people were more extraverted and open, they tended to use more healthcare services. There were several nuances in personality-healthcare utilization associations depending on the type of healthcare service, age, and socioeconomic resources. Longitudinal mediation analyses demonstrated sense of control as one mechanism linking personality traits to healthcare utilization in the U.S. ConclusionsWe discuss the theoretical and practical implications of interactions between individuals and structural systems for promoting the health of aging U.S. Americans.

Longitudinal relationship between internet self-control and problematic internet use among Chinese adolescents: mediating role of meaning in life.

While studies indicate that high self-control may serve as a safeguard against problematic internet use, there's evidence suggesting that problematic internet use can, in turn, diminish self-control. This study aimed to elucidate the longitudinal interplay between internet self-control and problematic internet use in adolescents, employing cross-lagged panel modeling. Furthermore, drawing from a positive psychology perspective, we examined the potential role of 'meaning in life' as a protective mediator within this longitudinal relationship. We then constructed a mediation model to explore protective factors against problematic internet use. Through a questionnaire, we tracked 659 adolescents (331 males and 328 females; mean age=13.61) in a longitudinal design across two time points, spaced at five-month intervals, to assess their internet self-control, problematic internet use, and meaning in life. Results of the cross-lagged panel models showed that: Internet self-control had a significant negative impact on problematic internet use after five months (β = -0.094, p < 0.01). Conversely, problematic internet use had a significant negative impact on internet self-control after five months (β = -0.099, p < 0.05). Results from the longitudinal mediation model showed that: Meaning in life mediated the effect of internet self-control on problematic internet use after five months (βinternet self-control(T1)-meaning in life(T2) = 0.142, p < 0.01; βmeaning in life(T1)-problematic internet use (T2) = -0.075, p < 0.05). Our study uncovers a reciprocal predictive relationship between internet self-control and problematic internet use, while highlighting the mediating role of meaning in life within this relationship. These findings suggest that fostering internet self-control and cultivating a sense of meaning in life among adolescents can serve as effective prevention and intervention strategies for addressing the issue of problematic internet use.

Parental harsh discipline in intergenerational transmission of anxiety in China: A longitudinal actor-partner interdependence analysis.

The present study investigated the intergenerational transmission of anxiety from both mothers and fathers to children in Chinese migrant families and the mediating roles of both parents' harsh discipline (psychological aggression and corporal punishment). Four hundred seventy nine intact families with at least one migrant child were followed prospectively, with data collected from multiple informants at three time points half a year apart. A longitudinal multiple mediation model in combination with an actor-partner interdependent model (APIM) was used to examine the mediating roles of both parents' harsh discipline in the intergenerational transmission of anxiety. Results indicated that anxiety was transmitted across generations from mothers (but not fathers) to migrant children. Significant actor effects of mothers' and fathers' anxiety on their own harsh discipline were found, while no significant partner effects were observed. Mothers' psychological aggression played an important role in the intergenerational transmission of anxiety from mothers to migrant children. The findings suggest that interventions and prevention efforts focusing on reduction of children's anxiety would benefit from decreasing mothers' anxiety and psychological aggression. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Associations between parental depression, communication, and self-worth of siblings bereaved by cancer.

A child's death from cancer may increase the risk for poor self-worth in bereaved siblings. Furthermore, bereaved parents may experience depressive symptoms and communicate differently with their surviving children. However, limited research has examined family factors associated with self-worth in bereaved siblings. Thus, we examined: (a) differences in parental depressive symptoms, parent-child communication, and sibling self-worth between bereaved and nonbereaved families and (b) indirect effects of parental depressive symptoms and communication quality on the association between bereavement and sibling self-worth. Bereaved parents and siblings were recruited 3-12 months after a child's death from cancer. Bereaved (n = 72) and nonbereaved families of classmates (n = 58) completed home-based questionnaires upon enrollment (T1), and 48 bereaved and 45 nonbereaved families completed 1-year follow-up (T2). Relative to controls at T1 and T2, bereaved mothers, but not fathers, reported more depressive symptoms. Bereaved siblings reported poorer maternal and similar paternal communication, and similar levels of self-worth compared to controls. Both cross-sectional and longitudinal serial mediation models for mothers were significant. Bereaved mothers were at greater risk for depressive symptoms, which adversely affected sibling self-worth over time through disrupted mother-child communication. The father sample was limited, but the cross-sectional model was nonsignificant. Mothers and fathers may grieve differently and may require different therapeutic approaches. Family-centered interventions should target bereaved mothers' emotional adjustment and communication to enhance sibling self-worth. Additionally, clinicians should bolster other sources of support for bereaved siblings to promote adaptive outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining the indirect effect of income on well-being via individual-based relative deprivation: Longitudinal mediation with a random intercept cross-lagged panel model.

Although the positive relationship between income and well-being is well established, the psychological mechanisms underlying this process are less understood. One underexplored explanation is that objective wealth (or lack thereof) fosters relative comparisons, which, in turn, predicts well-being. Extant work has, however, mostly focused on objective indicators of relative deprivation rather than on how people perceive their societal status. We address this oversight by examining the longitudinal indirect effects of income on well-being via perceived individual-based relative deprivation (IRD) using traditional and random intercept cross-lagged panel models. Averaged across 10 annual assessments in a nationwide longitudinal panel sample of adults (N = 66,560), our results revealed reliable indirect effects of income on well-being via IRD. Specifically, within-person increases in income predicted within-person decreases in IRD, which then predicted within-person increases in personal well-being over time. Our results replicated across robustness checks, including one using a general life satisfaction measure. We thus extend previous work by highlighting the need to consider one's perceptions of their relative societal position as a mechanism underlying the effects of income on well-being over time.

More about being fun: Making friends to maximize social status.

Children perceived by peers as someone who is fun reap interpersonal rewards, but little is known about what makes someone fun or how being fun leads to social success. The present study is designed to identify what qualities makes someone fun and how being fun leads to social success. Two studies of children in primary and middle school are reported. Participants in the present investigation attended a public-school representative of Florida school children in terms of ethnicity and income. In the first study, 351 (179 girls, 172 boys) students (8-11 years old) completed surveys twice (M = 8.5 weeks apart) during an academic year, describing the qualities of "someone who is fun." At both time points, kindness and humor were rated as more important than buffoonery. In the second study, 394 (210 girls, 184 boys) students (8-13 years old) completed peer nomination surveys thrice (M = 8.5 weeks apart) during an academic year. Replicating previous findings, being fun predicted increases in social status (i.e., likeability and popularity). Unique to this study, full longitudinal mediation analyses indicated that being perceived as fun early in the school year predicted friend gain from the beginning to the middle of the school year, which, in turn, predicted increases in perceived likeability and popularity from the middle to the end of the school year. The findings were unique to being fun. Kindness and humor did not predict friend gain.

Gender-specific association of the accumulation of chronic conditions and disability in activities of daily living with depressive symptoms

BackgroundIn the era of rapid aging with a rising prevalence of multimorbidity, complex interactions between physical and psychological conditions have challenged the health care system. However, little is known about the association of the accumulation of chronic conditions and disability in activities of daily living with depressive symptoms, especially in developed countries. MethodsThis population-based cohort study used data from the Health and Retirement Study. A total of 22,335 middle-aged and older adults participated in the 2014 (T1), 2016 (T2), and 2018 (T3) waves of the cohort were included. The accumulation of chronic conditions and disability were defined as the number of chronic diseases and the five activities of daily living. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale. A longitudinal mediation model with a cross-lagged panel model was run. As robust check, the models were applied with a longer follow-up period (from 2012 to 2018). Additionally, results were estimated in China. ResultsBidirectional associations have been found among the accumulation of chronic conditions, disability, and depressive symptoms, especially between disability and depression. Disability (T2) mediated 11.11 % and 16.87 % of the association between the accumulation of chronic conditions (T1) and depression (T3) for men and women in the United States. The results were consistent in robust analysis. ConclusionsThis study found that men and women routinely experienced disability and depressive symptoms because of the accumulation of chronic conditions. In terms of depressive symptoms, women were more sensitive to the accumulation of chronic conditions through disability.

Lower Socioeconomic Status, Psychological Distress, and Self-reported Hypertension: A Longitudinal Moderated Mediation Analysis.

Lower socioeconomic status (SES) has been associated with hypertension; however, the mediators and moderators of this association remain understudied. We examined the mediation effect of psychological distress on the link between lower SES and self-reported hypertension and the racial and sex moderation effects. We analyzed the data collected from 2009 to 2019 among adults from the Panel Study of Income Dynamics (PSID). Lower SES was defined as one of 3 indicators: education ≤12 years, unemployed, or individual annual income <$27,800. Psychological distress was assessed using the Kessler K6 scale. Cox proportional hazard regression was conducted. Mediation analyses were performed using the PROCESS macro. In the sample of heads of family who did not have self-reported hypertension in 2009 (N = 6,214), the mean age was 41 years, 30.6% were female, 32.9% were African American. The cumulative incidence of self-reported hypertension was 29.8% between 2009 and 2019. Cox proportional hazard regression analysis showed that after controlling for covariates, lower SES (score > 0 vs. score = 0) was associated with self-reported hypertension (hazard ratio = 1.27, 95% confidence interval = 1.14-1.42). SES had indirect effect on self-reported hypertension through psychological distress and the indirect effect (0.02 in females, 0.01 in males, P < 0.05) was moderated by sex but not by race. The association of SES and self-reported hypertension was mediated by psychological distress and sex moderated the mediation effect. Interventions focused on reducing contributors to SES and psychological stress should be considered to reduce hypertension risk.

Associations between metabolic syndrome and anxiety, and the mediating role of inflammation: Findings from the UK Biobank

ObjectivesTo investigate the association between metabolic syndrome (MetS) and anxiety and to explore the mediating role of inflammation indicators in this relationship based on the UK Biobank prospective cohort. MethodsThis population-based retrospective cohort study analyzed data from 308,352 participants. MetS was defined according to criteria jointly developed by the American Heart Association, the National Heart, Lung, and Blood Institute, and the International Diabetes Federation. Anxiety was defined using ICD-10 codes. Cox proportional risk regression models were used to explore the hazard ratios (HRs) between MetS, components of MetS, number of MetS components, and anxiety. The mediating effect of inflammation on the association between MetS and anxiety was explored using longitudinal mediation analysis. ResultsA total of 308,352 participants were included in this study. Of these, 9471 (3.071 %) developed anxiety over a mean follow-up of 12.05 years. In the fully adjusted model, MetS increased the risk of anxiety by 13.6 % (HR: 1.136, 95 %CI: 1.085–1.189). All MetS components significantly increased the risk of anxiety, with HRs ranging from 1.066 to 1.165. When MetS was treated as a linear variable, the risk of anxiety increased by 6.5 % per component increment. Age-stratified results showed that the risk of MetS for anxiety was higher among those <55 years (HR: 1.23, 95 %CI: 1.13–1.33) than among those ≥55 years (HR: 1.12, 95 %CI: 1.06–1.18). The mediating effects of platelets, lymphocytes, neutrophils, C-reactive protein, leukocytes, and INFLA scores on the association between MetS and anxiety were significant, with mediating effects of 2.30 %, 7.20 %, 15.9 %, 20.7 %, 22.0 %, and 25.3 %, respectively, and a combined mediating effect of these inflammatory factors was 30.8 % (except for INFLA scores). ConclusionsMetS and its components significantly increased the risk of anxiety, which increased with the number of components. This association may be partially mediated by serum inflammatory indicators, suggesting that MetS may increase the risk of anxiety by elevating the level of chronic inflammation.

Gerotranscendence and wisdom in Polish older adults. The longitudinal mediation analysis of forgiveness

Objectives: The goal of the present study was to investigate whether forgiveness played a mediating role in the relationships between gerotranscendence and wisdom among people in late adulthood. Method: The study included 416 participants aged 60 to 75 years. The following measures were used: the Gerotranscendence Scale Type 2 (GST2), the Heartland Forgiveness Scale and the Self-Assessed Wisdom Scale (SAWS). To verify the hypothesis, a longitudinal three-wave field study was conducted. Results: The results suggest that an increase in gerotranscendence is associated with an increase in forgiveness and wisdom. In addition, greater willingness to forgive co-occurs with higher levels of wisdom. Moreover, dispositional forgiveness mediates the relationship between gerotranscendence and wisdom – a higher gerotranscendence leads to a higher wisdom through an increase in forgiveness. Conclusion: The results of our research add to the knowledge of the mechanism of the relationship between gerotranscendence and wisdom and support the thesis that late adulthood presents individuals with new challenges and opportunities for creative personal development.

The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact.

To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus. Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes. Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus. There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.

Longitudinal mediation effects of activity meaning on the association between activity performance and quality of life among older adults with disabilities

BackgroundPhysical limitations may hinder older adults with physical disabilities’ capability to perform various activities, which can affect their quality of life (QOL). Accomplishing meaningful activities may mitigate the impact of limited activity performance on their QOL. This longitudinal study aims to investigate how activity meaning mediates the relationship between activity performance and QOL among older adults with disabilities.MethodsData for this longitudinal study was collected from 813 community-dwelling older adults aged 60 and above who had physical disabilities, over a two year interval. Path analysis was used to examine the cross-sectional and longitudinal mediation effects from activity performance, through activity meaning, to QOL.ResultsAt the same wave, high IADL performance or social activity performance, and high QOL was indirectly associated through high IADL meaning or social meaning. As for longitudinal association, high T1 IADL performance was associated with better T2 QOL through high T1 and T2 IADL meaning. Similarly, high T1 social activity performance also contributed to T2 QOL through high T1 and T2 social activity meaning. Additionally, social activity performance exhibited higher influence on QOL than that of IADL.ConclusionsBoth IADL and social activities have distinct impacts on the QOL of older adults with disabilities. To improve the current and future QOL of older adults with disabilities, professionals must prioritize their involvement in the most meaningful activities while being sensitive to and supportive of their preferences and valued lifestyles.