Mental Well-being In Later Life Research Articles

Religious Doubt and Mental Well-Being in Later Life: Is Humility a Protective Resource?

This study sought to integrate the study of virtue into the study of religious doubt and mental health by considering how a salient virtue, humility, may moderate the relationship between religious doubt and lower mental well-being. Drawing on data from a national sample of midlife and older adults ( N = 1,443) from the United States, regression results suggest that religious doubts were associated with greater depression and lower life satisfaction, and that humility was independently associated with lower depression and greater life satisfaction. Humility was also found to buffer the pernicious association between religious doubt and both indicators of mental well-being. Taken together, our study makes an important contribution by adding the study of the virtue of humility to a growing body of work on religious doubt. The process of dealing with religious doubt is complex and difficult, but the attempt to develop the virtue of humility may be efficacious in thwarting the deleterious consequences of managing the ebbs and flows of faith.

MIGRATION OVER THE LIFE COURSE AND LATER-LIFE DEPRESSION IN CONTEMPORARY CHINA

Abstract Migrating between rural and urban areas over the life course profoundly shapes the conditions of later life. In the Chinese context, living in urban areas with an urban Hukou is associated with socioeconomic advantage. This study is among the first attempt to investigate how migration into urban areas in China is related to these processes and the association with risk of depression in later life by focusing on the timing and the type of migration (rural-urban residential mobility and/or institutional transition of Hukou status) of migration. Using data from China Health and Retirement Longitudinal Study, we found strong associations between migration over the life course and risk of depression in later life in China. The timing and type of migration appears to play an important role. In-situ urbanisation is associated with lower depression scores in later life, and these effects are greater for in-situ urbanisation occurring in middle age compared with young adulthood. Forced urban-rural migration is associated with improved mental wellbeing. Formal social protection, particularly having a private pension, contributes substantially to the mental health advantage of social groups with an urban Hukou. Having an urban Hukou origin has an independent protective role in shaping mental wellbeing in later life in China, potentially partly due to the entitlement to a private pension attached to this status. When informal support has weakened in contemporary China, enhanced formal social protection in the form of adequate pensions should be put in place to mitigate structural inequalities associated with migration in old age.

EFFECT OF EARLY-LIFE DISCRIMINATION IN PARENTING ON THE PHYSICAL AND MENTAL HEALTH OF MIDDLE-AGED AND OLDER ADULTS

Abstract This study aimed to explore the early-life discrimination in parenting on the physical and mental well-being of middle-aged and older adults, while also exploring the potential mediating role of early-life health. By combined data from the China Health and Retirement Longitudinal Study (CHARLS) in 2018 and related life history survey in 2014, 8204 females and 7305 males aged 45-84 were analyzed in this study. Logistic regression was employed to analyze the association between early-life discrimination in parenting and the incidence of chronic diseases as well as depression in middle-aged and older individuals. The KHB method was used to assess the mediating effect of early-life health in these connections. Regarding gender-based discrimination in parenting, parental preference for sons during early life was found escalated the probability of chronic diseases by 18% (OR=1.18, 95%CI: 1.01-1.38) and increased depression risk by 16% (OR=1.16, 95%CI: 1.03-1.31) among middle-aged and older females. In terms of sibling-related discrimination, parental inclination towards specific siblings heightened the likelihood of depression during middle and older years among females (OR=1.17, 95%CI: 1.03-1.34). However, these effects were not significant in males. The study further identified that early-life health partially mediated the influence of gender-based parental preferences on the mental well-being of middle-aged and older females, accounting for 8.603% of the overall effect. These findings underscored the potential for early-life discrimination within parenting to impact both the physical and mental health of middle-aged and older females by shaping their early-life health status, consequently resonating throughout their mental well-being in later life.

Association Between Social Isolation and Mental Well-Being in Later Life. What is the Role of Loneliness?

In this study, we evaluate whether the association between three types of social isolation (SI) and mental well-being (MWB) is mediated by loneliness. We include a pooled sample (N = 8,525) of people aged 65 or older, participating in the 2016 European Quality of Life Survey (EQLS). MWB is assessed with the World Health Organization Well-Being Index (WHO-5), and SI is operationalised as living alone, having no or little contact with family members, or having no or little contact with friends and neighbours. We assess a full mediation model with loneliness as a mediator between each type of SI and MWB, which we compare with a partial mediation model and control for age, gender, urbanity, and subjective income. Estimates for the full mediation model indicate that each type of SI is associated with enhanced loneliness, which in turn is negatively associated with MWB. In addition, the total effect of each type of SI on MWB is negative, with the strongest negative path from living alone to MWB. However, when including the direct effects of each type of SI on MWB in the partial mediating model, the total effect of contact with family members on MWB loses statistical significance. The specific indirect effects of the three facets of SI on MWB remain significant and negative. These findings suggest that different aspects of SI have distinct relationships with MWB, and that absence of contact with family members influences MWB only if they activate the feeling of loneliness.

Perceived healthcare discrimination and well-being among older adults in the United States and Brazil

Despite well-documented evidence illustrating the relationship between discrimination and health, less is known about the influence of unfair treatment when receiving medical care. Moreover, our current knowledge of cross-national and racial variations in healthcare discrimination is limited in aging populations. This article addresses these gaps using two harmonized data sets of aging populations to clarify the relationship between healthcare discrimination and health in the United States and Brazil. We use nationally representative, harmonized data from the Health and Retirement Study in the United States and the Brazilian Longitudinal Study of Aging to examine and compare perceived discrimination in the healthcare setting and its relationship to self-rated health, depression diagnosis, and depressive symptoms across national contexts. Using Poisson regression models and population attributable risk percent estimates, we found that aging adults reporting healthcare discrimination were at higher risk of poor self-rated health, diagnosed depression, and depressive symptoms. Our results also suggest that reducing perceived healthcare discrimination may contribute to improved self-rated health and mental well-being in later life across racialized societies. In two comparative settings, we highlight the differential impact of healthcare discrimination on self-rated health and depression. We describe the implications of our study's findings for national public health strategies focused on eliminating discrimination in the healthcare setting, particularly among aging countries.

Technology for Healthy Aging and Wellbeing: Co-producing Solutions.

Methods to facilitate co-production in mental health are important for engaging end users. As part of the Technology for Healthy Aging and Wellbeing (THAW) initiative we organized two interactive co-production workshops, to bring together older adults, health and social care professionals, non-governmental organizations, and researchers. In the first workshop, we used two activities: Technology Interaction and Scavenger Hunt, to explore the potential for different stakeholders to discuss late life mental health and existing technology. In the second workshop, we used Vignettes, Scavenger Hunt, and Invention Test to examine how older adults and other stakeholders might co-produce solutions to support mental wellbeing in later life using new and emerging technologies. In this paper, we share the interactive materials and activities and consider their value for co-production. Overall, the interactive methods were successful in engaging stakeholders with a broad range of technologies to support mental health and wellbeing and in co-producing ideas for how they could be leveraged and incorporated into older people’s lives and support services. We offer this example of using interactive methods to facilitate co-production to encourage greater involvement of older adults and other under-represented groups in co-producing mental health technologies and services.

Evaluation of intervention fidelity of a complex psychosocial intervention Lifestyle Matters: a randomised controlled trial

ObjectivesRobust research of complex interventions designed to promote mental well-being in later life is required to inform service development. An essential component is ensuring that such interventions are delivered as...

Discovering Grace at the Table? Prayers at Mealtime, Marital Status, and Life Satisfaction in Later Life.

This study examines the effects of prayers at mealtime on change in life satisfaction among older U.S. adults. In addition, it assesses the ways that marital status conditions these psychological effects of prayers at mealtime. Using two waves of longitudinal data from the Religion, Aging, and Health Survey (2001-2004), a representative sampling of adults aged 65 and older, the analyses reveal that the frequency of prayers at mealtime is associated with an increase in life satisfaction over time. Further, the positive effects of prayers at mealtime on change in life satisfaction are greater for nonmarried older adults than their married counterparts. The findings in the study reinforce claims of the beneficial effects of religion on mental well-being in later life. Moreover, they elaborate on the resource substitution thesis by showing that religion provides greater psychological benefits for older adults who do not have alternative resources for well-being-a marital partner.

The relationship between rural to urban migration in China and risk of depression in later life: An investigation of life course effects.

Migrating between rural and urban areas over the life course profoundly shapes the conditions of later life. In the Chinese context, living in urban areas with an urban Hukou is associated with socioeconomic advantage. This study attempts to investigate how migration into urban areas in China is related to these processes and the association with risk of depression in later life by focusing on the timing and the type of migration (rural-urban residential mobility and/or institutional transition of Hukou status). We use sequence analysis to identify migration trajectories in the China Health and Retirement Longitudinal Study. Then we estimate how and why these trajectories are associated with risk of depression at older ages using a random intercept hierarchical linear model, distinguishing between three levels: city, household and individual. The type of migration path taken over the life course is differentially associated with mental wellbeing in later life in China. Urban migration with rural-urban Hukou conversion during young adulthood is associated with lower levels of depression in later life. Urban migration at older ages regardless of Hukou transitions is protective against depression in old age. Formal social protection, particularly having a private pension, contributes substantially to the mental health advantage of social groups with an urban Hukou. Informal social mechanisms such as familial support are relevant, but only explain a small part of the differences in mental health. Having an urban Hukou has an independent protective role in shaping mental wellbeing in later life in China, potentially in part due to the entitlement to a private pension attached to this status. With weakening informal support in contemporary China, enhanced formal social protections in the form of adequate pensions should be put in place to mitigate structural inequalities associated with migration in old age.

Humor Training Program on Sense of Humor among Older Adults: A Randomized Controlled Trial

Introduction: Several studies have a well-documented positive association between sense of humor and physical and mental well-being in later life. However, there is evidence to indicate that sense of humor declines with age. This study was conducted to examine humor training program on the sense of humor among older adults. Methods: This community-based randomized controlled trial study was conducted in 2019. There were 18 older adults in the intervention group and 20 older adults in the control group. The intervention group received the 7 Humor Habits Program in eight training sessions, whereas the control group was waitlisted. The Multidimensional Sense of Humor Scale (MSHS) was used to measure the sense of humor before and after the intervention. A series of paired samples t-tests and difference-in-differences approach using IBM SPSS Version 23.0 were conducted to assess changes from pre-test to post-test. The significance level of p ≤ .05 was considered for the statistical analysis. Results and Discussion: The mean age of the participants in the intervention and control groups was 66.50, (SD=6.14) and 67.60, (SD= 5.64) years, respectively. The results of a series of paired samples t-tests revealed a statistically significant increase in the total score of sense of humor from pre-test (M =77.28, SD = 13.62) to post-test (M=101.11, SD=17.06), (t= -6.77, p<.001), in intervention group. Other paired samples t-tests showed statistically significant changes from pre-test to post-test for subscales of humor including enjoyment of humor (t= -4.59, p<.001), laughter (t= -7.83, p<.001), verbal humor (t= -4.73, p<.001), finding humor in everyday life (t= -4.19, p<.001), laughing at yourself (t= -6.36, p<.01), and humor under stress (t= -2.54, P≤.05) in intervention group. Moreover, the results of the difference-in-differences approach revealed a significant increase in the sense of humor for the intervention group compared to the control group (F=43.54, p<.001). No statistically significant changes were observed in any outcome variables in the control group. Conclusion: The results of this study provided support that the sense of humor can be improved using a training program in later life.

Social Isolation and Psychological Distress During the COVID-19 Pandemic: A Cross-National Analysis.

Background and ObjectivesThe coronavirus disease 2019 (COVID-19) pandemic resulted in social isolation globally, creating heightened levels of stress and anxiety. This study investigates the link between social isolation and mental well-being in later life, and how it varies across countries.Research Design and MethodsWe draw on a subset of older adults from Global Behaviors and Perceptions in the COVID-19 pandemic, a unique global online survey of 13,660 participants from 62 countries. We use mixed-effects models to analyze the data.ResultsSocial isolation (distancing) significantly predicts poor mental health operationalized as coronavirus-induced distress (p < 0.01). At the aggregate level, average distress varies positively across countries with higher numbers of coronavirus-related deaths (p < 0.10) and more fragile state capacity (p < 0.05), while varying negatively across those with more stringent anti-coronavirus policies (p < 0.05). Finally, we report several cross-level interactions between social isolation and the total number of deaths (p = 0.025), policy stringency (p =0.065), state fragility (p = 0.061), and globalization index (p = 0.071).Discussion and ImplicationsOur study shows that a proper understanding of the impact of COVID-19 on the mental well-being of older adults should consider the moderating role of national context.

The price of mental well-being in later life: the role of financial hardship and debt

Objective This study investigated the associations between various financial hardship and debt indicators and mental health status among older adults. Methods Using data from the Health and Retirement Study (HRS), we considered the association between different forms of financial hardship and debt of those who were identified as having high levels of depressive symptoms (N = 7678) and anxiety (N = 8079). Financial hardship indicators: difficulty paying bills, food insecurity, and medication need; debt indicators: credit card and medical debt. Associations were tested using multiple logistic regression analyses and are reported as relative risk (RR) ratios and 95% confidence intervals (CIs). Results Participants who had difficulty paying bills were more likely to have high levels of depressive symptoms (RR = 2.06, CI = 1.75–2.42, p < 0.001) and anxiety (RR = 1.46, CI = 1.02–2.05, p < 0.001) compared to those who did not have financial difficulty. Similarly, medical debt was associated with depressive symptoms (RR = 1.43, CI = 1.14–1.74, p < 0.01) and anxiety (RR = 1.20, CI = 0.96–1.50, p < 0.01). Credit card debt was not significantly associated with either mental health outcome. Conclusion Indicators of financial hardship and medical debt were associated with depressive symptoms and anxiety in a cohort of older adults. In contrast, the influence of credit card debt appeared to be more complex and vary by individual. These findings indicate that doing without meeting personal salient needs has a particularly adverse effect on psychological well-being.

"When I Retire, I'll Move Out of the City": Mental Well-being of the Elderly in Rural vs. Urban Settings.

This study examines the influence of risk factors on mental well-being at older ages focusing on the level of rurality of the living environment. We used cross-sectional, nationally representative survey data for Catalonia (Spain) from 2015 to 2017 to explain the mental well-being of the population aged 65 years and over. Based on a sample of 2621 individuals, we created a score of current mental well-being using the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). Using logistic regression and non-parametric tests, we identified the sociodemographic, health and lifestyle variables which, in combination with the features of the rural and urban settings of the living space, were associated with poor SWEMWBS scores. Our results reveal that adequate social support is linked to expectations of good mental well-being in later life. Poor self-perceived health and ageing limitations are associated with less deterioration of the well-being for the elderly living in rural areas, whereas living in urban areas is linked to a higher risk of suffering from emotional distress attributable to economic difficulties or low educational attainment. Incentivizing older people to live in rural environments could result in greater well-being in the last stages of life; appropriate prospective studies are needed to test this positive outcome.

The prospective association between frequency of contact with friends and relatives and quality of life in older adults from Central and Eastern Europe

PurposeStudies suggest that frequent contact with friends and relatives promote mental wellbeing in later life, but most evidence comes from Western populations. We investigated the prospective relationship between frequency of contact with friends and relatives and quality of life (QoL) among older Central and Eastern European (CEE) adults and whether depressive symptoms mediated the hypothesised longitudinal relationship.MethodsData from 6106 participants from the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study were used. Frequency of contact with friends and relatives was measured at baseline. QoL, at baseline and follow-up, was measured by the Control, Autonomy, Self-realisation, and Pleasure (CASP) 12-item scale. After assessing the prospective association using multivariable linear regression, the mediational hypothesis was tested using path analysis.ResultsThere was a significant prospective association between frequency of contact with friends and relatives and CASP-12 score (0–36) in fully adjusted models. Per every one unit increase in frequency of contact, there was a 0.12 (95% CI 0.06, 0.17) increase in CASP-12 score at follow-up, accounting for sociodemographic, health-related and baseline QoL. Pathway results showed that 81% of the longitudinal effect of frequency of contact on QoL was mediated through depressive symptoms.ConclusionsFrequent contact with friends and relatives improves QoL of older Central and Eastern European adults, partly through buffering against depressive symptoms. Interventions to improve QoL at older ages should incorporate effective management of common mental disorders such as depression.

The Relationship between Rural to Urban Migration in China and Risk of Depression in Later Life: An Investigation of Life Course Effects

Background: In the Chinese context, living in urban areas with an urban Hukou is associated with socioeconomic advantage. This study investigates how migration into urban areas in China is associated with risk of depression in later life by focusing on the timing and the type (rural-urban residence and/or Hukou status) of migration. Methods: We use sequence analysis to identify migration trajectories in the China Health and Retirement Longitudinal Study. Then we estimate how and why these trajectories are associated with risk of depression at older ages. Findings: We found strong associations between migration over the life course and depression in later life. The timing of migration appears to play an important role. In-situ urbanisation is associated with lower depression scores in later life, and these effects appear to be greater for in-situ urbanisation occurring in middle age compared with young adulthood. Forced urban-rural migration is also associated with improved later life mental wellbeing. Formal social protection, particularly having a private pension, contributes substantially to the mental health advantage of social groups with an urban Hukou. Informal familial support only explains small differences. Interpretation: Having an urban Hukou origin has an independent protective role in shaping mental wellbeing in later life in China, potentially in part due to the entitlement to a private pension attached to this status. When informal support has weakened in contemporary China, enhanced formal social protection in the form of adequate pensions should be put in place to mitigate structural inequalities associated with migration in old age. Funding Statement: The authors stated that none exist. Declaration of Interests: The authors declared that none exist. Ethics Approval Statement: The Ethics Review Committee of Peking University granted ethical approval for the study. All the participants provided signed, informed consent at the time of participation.

PARENT-CHILD RELATIONSHIPS AND SLEEP QUALITY AMONG CHINESE AGING PARENTS

Relationships with adult children play an important role in older adults’ well-being. However, little is known about the association between parent-child relations and aging parents’ sleep quality, which is an emerging health issue that is closely related to individuals’ physical and mental well-being in later life. With the largest aging population, China has experienced rapid changes of family structure and traditional norms regarding parent-child ties. This study focused on different dimensions of parent-child relationships (i.e., upward/downward financial and instrumental support, emotional closeness) in Chinese aging families. This study examined the association between parent-child relationships and older parents’ sleep quality, comparing one-child and multiple-children Chinese families. Utilizing the 2014 wave of the Chinese Longitudinal Aging and Social Survey, we analyze data from 8,450 respondents (aged 60+) who had at least one living child. Descriptive analysis showed that parents with multiple children engaged in more intense financial exchanges, less frequent instrumental support, and lower levels of emotional closeness with their adult children compared to their counterparts with only one child. Logistic regression models revealed that older parents who received more instrumental support were more likely to report sleep difficulty in both one-child and multiple-children families. For parents with multiple children, the overall level of financial transfers from children was negatively associated with having sleep difficulties, while the variability of financial transfers across multiple children was positively associated with having sleep difficulty. Findings highlight the importance of considering family dynamics in studying sleep quality among Chinese older adults.

A VIEW OF OLDER ADULTS’ DEMOGRAPHIC, HEALTH, AND ECONOMIC PROFILES BY RETIREMENT CHOICE STATUS

Gerontologist, economists, and other scientists have documented that involuntary or forced retirement is a more common occurrence among middle-aged adults than previously thought. Prevailing research has further indicated that involuntary retirement and off-time transitions are associated with poorer physical and mental well-being in later life. However, few studies have sought to gain a comprehensive understanding of who compromises the population of involuntary retirees and how these individuals compare to voluntary retirees. This study used the 2014 wave of the Health and Retirement Study (N=9,409) to analyze a United States representative sample of fully retired individuals aged 55 and older in order to develop a demographic, health, and economic profile of voluntary versus involuntary retirees. Analyses showed that that male, younger age group, minority race, separated/divorced, less educated, and south and west region residing individuals have significantly greater representation in the involuntary retirement group compared to the voluntary retirement group. Further, involuntary retirees reported significantly poorer physical and mental health and fewer financial resources than voluntary retirees. A supplementary longitudinal analyses also revealed that while health steadily declines for both of the retirement choice status groups, involuntary retirees maintained significantly poorer health than voluntary retirees over time. Observations from this study highlight the importance of identifying predictors of involuntary retirement and utilizing longitudinal analyses to gain greater insight into how health and economic characteristics factor into retirement decisions as well as how retirement decisions impact future health and economic characteristics.

The EMMY Project: Promoting mental wellbeing among the oldest old – The Finnish Case

Abstract Background The European Welfare Models and Mental Wellbeing in Final Years of Life (EMMY, 2017-19) project covers interdisciplinary and mixed method studies on mental wellbeing among the oldest old in Finland, Italy, Norway and Spain. The overarching aim is to strengthen the understanding of how welfare models and related policies could be adapted to support mental wellbeing in the oldest old. Project results will be incorporated in a new tool for assessing the mental wellbeing impact of welfare policies. Methods 23 focus group interviews were conducted, including 117 participants aged 80 years or older. Six of these were conducted in Finland (N = 28) and the data was analysed using qualitative content analysis. In a policy analysis, relevant national legislation, plans and programmes were identified from the four countries. Five key stakeholders in each country validated the identified policies in interviews. The policy items were systematically coded (N = 42 in Finland), focusing on their correspondence with older adults’ own views on their mental wellbeing and its protective factors. Results The findings highlight that although functional status undeniably plays an important role for experienced wellbeing in general, it is not the principal component of the experienced mental wellbeing among the oldest-old. The Finnish policy case pinpoints both promising policy examples, but also development needs such as the inclusion of issues related to e.g. digitalization and social challenges including loneliness. Conclusions These findings have significant multi-level implications, showcasing the importance of coordinated actions at societal and individual levels alike. Actions to enhance social participation, especially for individuals with reduced social networks are needed, as well as a more holistic approach in general considering the multi-dimensional nature of experienced mental wellbeing in later life. Key messages Results support the exchange of good policies between EU Member States to incorporate a change of focus from mental disorders to mental wellbeing among older people and its protective factors. Country-specific case studies highlight the relevance of context,pinpointing the various pathways to increased mental wellbeing that could be translated into policy.

Older People's Experiences of Mobility and Mood in an Urban Environment: A Mixed Methods Approach Using Electroencephalography (EEG) and Interviews.

There are concerns about mental wellbeing in later life in older people as the global population becomes older and more urbanised. Mobility in the built environment has a role to play in improving quality of life and wellbeing, as it facilitates independence and social interaction. Recent studies using neuroimaging methods in environmental psychology research have shown that different types of urban environments may be associated with distinctive patterns of brain activity, suggesting that we interact differently with varying environments. This paper reports on research that explores older people’s responses to urban places and their mobility in and around the built environment. The project aim was to understand how older people experience different urban environments using a mixed methods approach including electroencephalography (EEG), self-reported measures, and interview results. We found that older participants experience changing levels of “excitement”, “engagement” and “frustration” (as interpreted by proprietary EEG software) whilst walking between a busy built urban environment and an urban green space environment. These changes were further reflected in the qualitative themes that emerged from transcribed interviews undertaken one week post-walk. There has been no research to date that has directly assessed neural responses to an urban environment combined with qualitative interview analysis. A synergy of methods offers a deeper understanding of the changing moods of older people across time whilst walking in city settings.

Mental Well-Being in Later Life: The Role of Strengths Use, Meaning in Life, and Self-Perceptions of Ageing

Population ageing requires an understanding of the factors that enhance optimal functioning in later life. Moreover, for individual and societal well-being it demands a more balanced view of the ageing process that also accentuates human capital and realisation of potential. This study therefore explored the relationships between strengths use, mental well-being, meaning in life, self-perceptions of ageing, and socio-demographic characteristics of older adults. The study sample consisted of 88 older individuals (ages 55–88 years) who completed the following measures: Strengths Use Scale, Warwick-Edinburgh Mental Well-being Scale, Meaning in Life scale, and Attitude Toward Own Ageing. An open-ended question was added to explore contextual factors that may enable older adults to use their strengths more. Correlation analyses showed that greater strengths use was associated with higher levels of mental well-being in older individuals. Hierarchical regression analysis revealed strengths use as a significant predictor of mental well-being. Participants with more positive self-perceptions of ageing were applying their strengths to a greater extent. Although self-perceptions of ageing was not an additional predictor of strengths use. Furthermore, mediation analyses showed a significant and large indirect effect of strengths use on mental well-being through meaning in life. Various contextual factors such as appreciation of older adults and opportunities for work and engagement have been indicated as avenues to support greater strengths use. Results suggest that practicing strengths is important for positive mental health and the process of ageing well. Strategies to enhance greater strengths use in the ageing population are discussed.