Old-old Adults Research Articles

Adaptation to changes in COVID-19 pandemic severity: Across older adulthood and time scales.

The COVID-19 pandemic has been observed to negatively affect older adults' psychological health compared with prepandemic levels. However, older adults' coping efficacy may differ depending on their age, and little is known about effects of fluctuations in pandemic severity. Two longitudinal studies tested the hypothesis that pandemic severity would affect psychological health and be moderated by age. In Study 1 (N = 111), older adults (aged 62-96) were assessed semiannually before and after the first United States COVID-19 case over up to 10 years. Depressive symptoms and stress, but not cognitive difficulties, were higher during COVID-19; pandemic severity had little effect. Estimated increases were smaller for a 65-year-old than for an 85-year-old. In Study 2 (N = 221), older adults (aged 51-95) were assessed weekly over up to 8 weeks during the COVID-19 pandemic. Higher national pandemic severity was associated with more cognitive difficulties, more depressive symptoms, and more stress. In an opposite pattern from Study 1, estimated increases were larger for a 65-year-old than for an 85-year-old. Old-old adults might be most susceptible to long-term psychological effects of the pandemic era, as in Study 1, but more resilient to short-term effects, as in Study 2. Coping strategies associated with increasing age may be less efficacious for more chronic and severe problems. Conversely, the same coping strategies may be more efficacious for shorter, less severe problems. Differentiating between reactivity to longer term and shorter term pandemic stressors can identify the most resilient or vulnerable ages within older adulthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Relationship between low back pain and physical activity and sitting time among community-dwelling older adults: A cross-sectional study

Objectives Japan has a high prevalence of low back pain among older adults requiring long-term care, which results in increasing expenses; therefore, prevention measures are necessary. This study aimed to examine the relationship between low back pain and physical activity and sitting time according to sex and age (65-74 years [young-old adults]; ≥75 years [old-old adults]) who had not received long-term care certification.Methods A self-administered survey was mailed to 7,080 adults >65 years of age residing in Tsuru City (Yamanashi Prefecture, Japan) from January to February 2018, and had not received long-term care certification. Demographic information, health status (body mass index and medical history), lifestyle (dietary habits, alcohol consumption, and smoking), presence of low back pain, physical activity, sitting time, and social participation were measured. Low back pain was evaluated by asking, "Did you experience pain in parts of the body other than the knees for the past month?" Those who answered, "experienced low back pain" were categorized as "with low back pain". The short form of the International Physical Activity Questionnaire was used to assess physical activity, which was categorized into three groups: <150, 150-299, and ≥300 min/week. Sitting time was divided into two groups: <480 and ≥480 min/day. Multiple logistic regression analysis was used to determine the association between low back pain and physical activity and sitting time, according to sex and age.Results Of the 7,080 individuals surveyed, 4,877 responded (2,217 male, 2,660 female), corresponding to a response rate of 68.9%. The number of older adults with low back pain was 1,542 (31.6%) including 673 (30.4%) males and 869 (32.7%) females. The rate of low back pain in young-old adults was 29.8% and 33.6% in old-old adults. There was no significant relationship between lower back pain and physical activity among the young-old adults. In the old-old adults, there was a significant relationship in the male ≥300 min group (odds ratio [OR] 0.66 [95%CI 0.48-0.89]), and in both female 150-299 (OR 0.69 [95%CI 0.48-0.99]) and ≥300 (OR 0.59 [95%CI 0.44-0.80]) min/week groups.Conclusion The complaint rate for low back pain was approximately 30%, regardless of sex or age. These results suggest that interventions to prevent low back pain are necessary. Moreover, physical activity, but not sitting time, was associated with low back pain in both males and females among the old-old adults.

Association between personality traits, leisure activities, and cognitive levels and decline across 12 years in older adults.

The engagement in cognitively stimulating activities has been found to be associated with slower rates of cognitive decline in old age. In which type of activities people engage in may depend on their personality traits, which thus might have an impact on later cognitive fitness. To study these potential links, we examined the associations between Neuroticism, Extraversion, and Openness; different types of leisure activities (e.g., social, mental, physical); and cognitive ability levels and decline in older adults. Analyses were based on a sample of young-old (60-72 years old; n = 1,609) and old-old (78 years or older; n = 1,085) adults from the Swedish National Study on Aging and Care in Kungsholmen, who participated in up to five repeated measurements of cognitive abilities spanning 12 years. We used latent growth curve models to estimate cognitive levels and decline, as well as the correlations with initial personality trait levels and leisure activity engagement. In both groups, lower Neuroticism, higher Extraversion, and higher Openness levels were moderately associated with stronger engagement in all types of activities. Lower Neuroticism, higher Extraversion, and a more activity lifestyle were weakly to moderately associated with slower cognitive decline in the old-old age group. There, personality traits and activities explained 9.3% of the variance in cognitive decline after controlling for age, sex, education, and chronic diseases (which explained 9.0%). Taken together, this study provides further evidence for the connection between personality traits, activity engagement, and later cognitive decline in old age. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Transitions in Social Networks From Young-Old to Old-Old Stage of Life Using Latent Transition Analysis.

Introduction: This study aimed to identify the different types of social networks among young-old adults, and to examine the transitions in social networks as they become old-old adults. Methods: This is a secondary data analysis using the longitudinal data (N = 1092) from the National Social Life, Health, and Aging Project. Latent class analysis was conducted to identify optimal number of classes and latent transition analysis was conducted to examine the transition probabilities. Results: Young-old adults in Class 1: family-oriented, social (close, external) transitioned into Class 2: family-oriented, non-social over time. In contrast, young-old adults in Class 2: family-oriented, non-social and Class 3: less family-oriented, social (close) were less likely to transition to another class. Conclusion: Older adults engaged in less social activities over time. Older adults should be encouraged to continue their social engagement with close social network of friends and relatives, and to maintain their relationship with family members.

Do walking and social support always relate to autonomic nervous system function in later life? Reexamining an age-based moderating model

Although walking and social support relate to healthy function of the autonomic nervous system (ANS) in later life, it is unclear whether age groups moderate the relationships of walking frequency and social support with ANS function. To address this area of limited research, we conducted a cross-sectional study with 300 older adults to examine these moderating relationships. Results of multiple regression analysis indicated that walking frequency and social support correlated positively with ANS function. The correlation between walking frequency and ANS function was moderated by age groups, but that between social support and ANS function was not. Therefore, increasing frequency of walking and levels of social support should be considered critical elements of healthy ANS function in later life. However, increasing frequency of walking may be ineffective for old-old adults. We recommend that healthcare practitioners guide old-old adults in seeking sources of social support to promote ANS function.

Social Connection and Lifestyle Factors Associated With Happiness in Urban Older Adults in China: A Cross-Sectional Study With a Community Sample

The current cross-sectional study aimed to investigate social connection and lifestyle factors associated with happiness in urban older adults in mainland China. A total of 709 community-dwelling older adults aged 60 to 99 years completed a comprehensive survey covering demographics, happiness, cognition, lifestyle, sleep, nutrition, and social connections. Samples were divided by age into two groups for analysis: young-old (aged 60 to 69 years) and old-old (aged 70 to 99 years). Social connection factors, including relationships with friends and spouse and use of social media applications, were important predictors for happiness in people in their 60s. Lifestyle factors, including nutritional status and extent of physical activity, were associated with happiness in old-old adults. Sleep quality predicted happiness for both age groups. Living with children and happiness were not significant for either age group. Results suggest that social connection and lifestyle are important factors in promoting happy and healthy successful aging in urban older adults in China. [Research in Gerontological Nursing, 16(3), 147-160.].

The COVID-19 pandemic as traumatic stressor: Distress in older adults is predicted by childhood trauma and mitigated by defensive functioning.

It has been broadly anticipated that COVID-19 pandemic-related experiences may constitute traumatic stressors, and that older adults' might be especially at risk of experiencing mental health symptoms during the pandemic. The present study aimed to examine older adults' psychological distress: posttraumatic stress, Covid-related fears, anxiety, and depression during the pandemic, and the relationship between present distress, defensive functioning, and childhood trauma. We also explored potential differences between older adults (between 65 and 74 years), and older-older adults (75 years and above). A large-scale online survey was conducted during the early months of the pandemic, for the present study, we included participants above 65 years old (N = 1,225) mainly from the United States and Canada. Results showed that age, adverse childhood experiences, and overall defensive functioning were significantly related to posttraumatic stress, anxiety, and depression. Specifically, younger age and more reported childhood adversity were related to higher distress, whereas the use of more adaptive defenses was related to less distress. Covid-related fears were not associated with age. Our final model showed that defensive functioning mediated the relationship between childhood trauma and distress. Our results support the relative resilience of older-older adults compared to older adults, as well as the long-lasting impact of childhood adversity through defensive functioning later in life, specifically in times of heightened stress, such as the COVID-19 pandemic. Future studies are warranted to identify further factors affecting defensive functioning as adults age, as well as processes that are associated with resilience in response to stressors in older adulthood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Evaluating the association between anthropometric parameters and successful aging in older adults.

This study aimed to determine the relationship between successful aging (SA) and anthropometric parameters in older adults. We used body mass index (BMI), waist circumference, hip circumference, and calf circumference to reflect anthropometric parameters. SA was assessed by the following five aspects: self-rated health, self-rated psychological status or mood, cognitive function, activities of daily life, and physical activity. Logistic regression analyses were employed to examine the relationship between anthropometric parameters and SA. Results showed that larger BMI, waist circumference, and calf circumference are related to a higher prevalence of SA in older women; greater waist circumference and calf circumference are associated with a higher rate of SA in old-old adults. These findings suggest that the greater BMI, waist circumference, hip circumference, and calf circumference are associated with a higher rate of SA in older adults, and the associations are influenced to some extent by the sex and age.

Understanding changes in mental health symptoms from young-old to old-old adults by sex using multiple-group latent transition analysis.

Older adults are classified into three homogeneous groups: young-old (age 65-74), old-old (age 75-84), and oldest-old (age 85 and over). Mental health symptoms are likely to change over time, especially when older adults transition from one age group to another. Yet, little is known on changes in mental health symptoms as they transition to another age group, and if these changes differ by sex. This is a secondary data analysis using the longitudinal data from the National Social Life, Health, and Aging Project. A total of 1183 young-old adults at wave 1 was included. Mental health symptoms were depression, anxiety, loneliness, perceived stress, and happiness. Multiple-group latent transition analysis was conducted to model the transition probabilities of latent classes and to compare these differences between sex. Descriptive and inferential statistics were conducted to obtain demographic characteristics and to test for differences. Three latent classes were identified based on severity: class 1-mild, class 2-moderate, and class 3-severe. Regardless of sex, young-old adults remained in the same class from waves 1 to 2. However, they moved to a less severe group when transitioning into the old-old from waves 2 to 3. Statistically significant differences were found in their demographic characteristics among the latent classes. Older adults, when transitioning from young-old to old-old, are likely to transition to latent classes with less severe mental health symptoms in both sex. Clinicians need to provide a comprehensive assessment to all older adults, regardless of the severity of their mental health symptoms, to promote well-being.

The relationship between depressive symptoms, metamemory, and prospective memory in older adults

ABSTRACT Introduction Depression has been associated with impairments in different cognitive domains in younger adults, including prospective memory (PM; the ability to plan and execute intended actions in the future). However, it is still not well documented nor understood whether depression is also associated with impaired PM in older adults. The current study aimed to examine the association between depressive symptoms and PM in young-old and old-old adults, and to understand the potential influence of underlying factors, such as age, education, and metamemory representations (one’s belief about their memory abilities). Method Data of 394 older adults from the Vivre-Leben-Vivere study were included in the analyses (Mage = 80.10 years, SD = 6.09; range = 70–98 years). Results Bayesian ANCOVA revealed a 3-way interaction between depressive symptoms, age, and metamemory representations, indicating that the association between depressive symptoms and PM performance depended on age and metamemory representations. In the lower depressive symptoms group, old-old adults with higher metamemory representations performed as well as young-old adults independently of their metamemory representations. However, in the higher depressive symptoms group, old-old adults with higher metamemory representations performed more poorly than young-old adults with higher metamemory representations. Conclusion This study indicates that metamemory representations may buffer the negative effect of age on PM performance only in old-old individuals with low depressive symptoms. Importantly, this result provides new insight into the mechanisms underlying the association between depressive symptoms and PM performance in older adults as well as into potential interventions.

Self-harm characteristics of younger-old and older-old adults admitted to emergency departments: a nationwide study

Self-harm characteristics of younger-old and older-old adults admitted to emergency departments: a nationwide study

NOT ONE AND THE SAME: VARIED EXPERIENCES OF BENEVOLENT AGEISM IN OLDER ADULTHOOD

Abstract Prior work has explored benevolent and hostile attitudes toward older adults (Chasteen &amp; Cary, 2015) and their paternalistic, mixed incompetent-warm perceptions within the Stereotype Content Model (SCM; Fiske et al., 2002); however, older adults’ perspectives of these attitudes have not received similar attention. This study assessed older adults’ experiences with benevolent and hostile ageism using an adapted version of the Ambivalent Ageism Scale (AAS; Cary et al., 2017; α=.85) and using a mean split, examined if there are differences among the younger- and older-older adults. Within a sample of older adults (Nf202) that ranged in age from 65–90 (M=71.6), we found that when comparing those aged 65–70 and 71 and above, those who were older (M=1.76, SD=.44) reported more experiences with benevolent ageism than their younger counterparts (M=1.56, SD=.42), t(200)=3.30, p =.001). These groups did not significantly differ in hostile ageism, t(200)= -.05, p = .96. When participants were asked why they have been treated thusly as described by the AAS items, 18% of the participants believed it was due to their age, in comparison to those who attributed it to personality (41%), gender (9%), or unknown factors (11%). Benevolent ageism is clearly not a monolithic experience for older adults as those who are older report more patronization, and not all participants felt age was the defining reason for their treatment. Further work should assess how these experiences are qualitatively different across diverse age groups of older adults, as ageism reduction interventions may need to be tailored appropriately.

BIDIRECTIONAL LINKS OF DAILY SLEEP QUALITY AND DURATION WITH PAIN AND SELF-RATED HEALTH IN OLD AGE

Abstract Sleep and physical well-being (e.g., pain, self-rated health) are closely linked, but the temporal ordering, especially regarding day-to-day variations, is not well understood. Furthermore, sleep quality and duration are only moderately correlated and may differ in their association with physical wellbeing. Using data from 123 young-old (66-69 years, 47% women) and 47 old-old adults (84-90 years, 60% women) who rated sleep quality and duration as well as pain and self-rated health on seven consecutive days, we examined bidirectional links between sleep and physical well-being. Supporting our hypotheses, results showed that after longer and better than usual sleep, participants reported better self-rated health; only better sleep quality significantly predicted lower pain. In turn, both lower pain intensity and increased self-rated health predicted better subsequent sleep quality, but not duration. We discuss conceptual and practical implications of our findings.

Association of sleep duration with underweight and obesity in older adults: A cross-sectional study of the Chinese longitudinal healthy longevity survey.

Underweight and obesity are two of the main health concerns as they are associated with adverse health outcomes and nutrition disorders. This study determined the association of sleep duration with both underweight and obesity in Chinese older adults. This cross-sectional secondary data analysis was conducted using data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey. There were 13 917 participants aged 65 and above in the analysis. Body mass index (BMI) was categorized into underweight, normal weight and overweight, and obesity. Self-reported sleep duration was divided into short, normal, and long sleep duration. Logistic regression models were used to examine the association of sleep duration with underweight and obesity. The prevalence of underweight was 16.7% and the prevalence of obesity was 8.0% in Chinese older adults aged 65 and older. Compared to the normal sleep duration group, the short sleep duration group had a higher incidence of underweight (AOR=1.29, 95% CI: 1.01-1.65), and the long sleep duration group showed a higher incidence of obesity (AOR=1.57, 95% CI: 1.07-2.30) in older men. A greater incidence of underweight was found in the short sleep duration group (AOR=1.19, 95% CI: 1.02-1.40) in old-old adults after adjusting for covariates. Short sleep duration is associated with being underweight and long sleep duration is linked with obesity in older men. Short sleep duration is also a risk factor for the underweight of old-old adults.

The detection of vulnerable road users by younger and older drivers

The detection of vulnerable road users (VRUs), especially under time constraints, may be impaired in elderly drivers, due to their visual and cognitive decline. This represents a major concern for road safety. The objective of the present study was to investigate the effect of aging on the detection of VRUs. A further aim was to investigate the impact of external factors on VRU detection. Twenty-two young adults, 20 younger-old adults, and 32 older-old adults were included in the study. A series of photographs were displayed for 500 ms. Participants were asked to detect the VRU, which could be a motorcyclist, a cyclist, or a pedestrian. The VRU was located at one of two distances (near/far), one of two locations (off-centered/centered), and in two car-DRL (daytime running lights) environments (on/off). The ability to correctly detect a VRU was measured. An eye-tracker was used to record eye movements. The main findings showed that VRU-detection performance decreased with aging, even in the younger-old group (ages 55–68). The ability to correctly detect a VRU by older-old adults was poorer particularly when the VRU was a motorcyclist or a cyclist. As a whole, the older-old adults made more fixations to correctly detect the VRU than the other two age groups did. Moreover, the visual angle between the gaze of the participant’s last fixation and the target in the older-old group was lower than in the other two groups, particularly when the VRU was off-centered. This finding suggests that older-old adults compensated for their visual-field decline by doing more visual exploration than the other two groups did to correctly detect the VRU. The results are discussed with regards to age-related cognitive and visual deficits.Word count: 279.

Executive dysfunction and effectiveness of physical program in older adults: which association?

Little is known about the association between executive function and the magnitude of improvement from personalised exercise interventions on gait performance among older-old adults. We examined whether the effectiveness of personalised intervention on gait performance is dependent on the patient's baseline dysexecutive syndrome, as assessed by the Frontal Assessment Battery. A total of 175 older community-dwellers (83.57 ± 5.2years; 70.2% female) were recruited from the day centre for after-care and rehabilitation in the Nantes Ambulatory Centre of the Clinical Gerontology (France), and were followed during a pre-post-intervention, single-arm retrospective design. The intervention consisted of an individual personalised rehabilitation program over a period of 7weeks, with twice-weekly sessions (45min each). Gait speed in four conditions (preferred, fast, and under two dual-task conditions), Timed Up and Go test, and handgrip strength test were assessed. Using a pre-post analysis of covariance, a significant increase in dual-task gait speed while counting (+ 0.10m/s; + 15%) and in dual-fluency gait speed (+ 0.06m/s; + 10%), and in Timed Up and Go performance (- 2.9s; + 17.8%) was observed after the rehabilitation program, regardless the baseline executive status. An individual personalized intervention is effective to improve mobility performance and the dual-task gait speed in older-old adults. The magnitude of those effects is independent of the patient's baseline characteristics including the executive function status. Even the most deficient baseline characteristics of patients should not be viewed as clinical barrier for implementing a beneficial individual intervention in high-risk older adults.

Suicide among young-old and old-old adults in rural China: A case-control psychological autopsy study.

Late-life suicide is a vital public health concern. Though gerontological research suggested the young-old and old-old phases were heterogeneous, age differences in the elderly suicide have not been well studied due to the lack of comparable control groups and small samples. The study aimed to examine the age-specific suicidal characteristics and risk factors among the young-old (60-79) and old-old (over 80) elderly. Two hundred and forty two suicide decedents and 242 living comparisons were enrolled in a 1:1 matched case-control psychological autopsy study in rural China: 173 young-old and 69 old-old in each group. Suicidal characteristics, demographic characteristics, living arrangements, physical health, mental disorder, and psychosocial factors were collected. We used logistic regression models to assess risk factors of suicide and test for interactions between age and each risk factor. Pesticide suicide was more prevalent among young-old suicides than old-old suicides (56.07% vs. 40.58%, p=0.029). Non-currently married, unemployment, mental disorder, higher disability in physical activities of daily living, higher hopelessness and higher depressive symptom were significantly associated with suicide among older adults. The effect of poor function in physical activities of daily living on suicide was significantly greater during younger ages (p for interaction=0.038). Findings indicated that most suicidal characteristics and risk factors for completed suicide were generally similar among young-old and old-old adults. But poor function in physical activities of daily living predicted increase suicide risk only at younger ages. In addition to common risk factors, age-specific factors should also be noted in suicide prevention. According to the ICMJE, purely observational studies (those in which the assignment of the medical intervention is not at the discretion of the investigator) will not require registration. Our study was not registered because this is a case-control study. But all procedures of the study were carried out in accordance with the latest version of the Declaration of Helsinki. The study were approved by the Institutional Review Boards of the Central South University, Shandong University, and Guangxi Medical University.

Older adults with lower working memory capacity benefit from transcranial direct current stimulation when combined with working memory training: A preliminary study.

Aging is a very diverse process: successful agers retain most cognitive functioning, while others experience mild to severe cognitive decline. This decline may eventually negatively impact one’s everyday activities. Therefore, scientists must develop approaches to counteract or, at least, slow down the negative change in cognitive performance of aging individuals. Combining cognitive training and transcranial direct current stimulation (tDCS) is a promising approach that capitalizes on the plasticity of brain networks. However, the efficacy of combined methods depends on individual characteristics, such as the cognitive and emotional state of the individual entering the training program. In this report, we explored the effectiveness of working memory training, combined with tDCS to the right dorsolateral prefrontal cortex (DLPFC), to manipulate working memory performance in older individuals. We hypothesized that individuals with lower working memory capacity would benefit the most from the combined regimen. Thirty older adults took part in a 5-day combined regimen. Before and after the training, we evaluated participants’ working memory performance with five working memory tasks. We found that individual characteristics influenced the outcome of combined cognitive training and tDCS regimens, with the intervention selectively benefiting old-old adults with lower working memory capacity. Future work should consider developing individualized treatments by considering individual differences in cognitive profiles.

Changes of Meta-Representational Skills in Ageing: First Empirical Evidence on the Relation between Metalinguistic Competence and Attributions of Mental States

Background. The present paper focuses on meta-representational changes occurring in ageing by studying the decline in Definitional Competence, an ability so far little studied in this period of life.&#x0D; Purpose. The paper hypothesises a relation between Theory of Mind (ToM) and Definitional Competence, in a view that posits the former as a preparatory and facilitating competence for a more complex linguistic production, that is lexicographic definition. The effects of levels of education on the decline in ageing for Definitional Competence and ToM are also investigated.&#x0D; Methods. We recruited 24 adults (age range 21–55), 25 young-old adults (age range 60–70) and 25 old-old adults (age range 71–85) and administered them the Eyes task to measure ToM and the Co.De. Scale to assess Definitional Competence.&#x0D; Results. Results suggest that Definitional Competence declines earlier on than ToM, mirroring the well-known process according to which in semantic knowledge, during ageing, taxonomic relations are lost before thematic ones. Our results also show that better levels of education are associated with better performance in both our key constructs and that ToM predicts Definitional Competence, in line with our expectations.&#x0D; Conclusion. The paper offers one of the first systematic studies on the changes in Definitional Competence during the last phase of life and it provides theoretical insights into the relation between ToM and Definitional Competence in ageing.&#x0D; Implications. The paper is informative for future interventions aimed at enhancing linguistic and metalinguistic skills in ageing through the preservation of better levels of awareness and the assumption of a decentralised perspective in interpersonal communication.

Bidirectional Links of Daily Sleep Quality and Duration With Pain and Self-rated Health in Older Adults' Daily Lives.

Sleep and health perceptions, such as self-ratings of pain and health are closely linked. However, the temporal ordering of such associations is not well understood, and it remains unclear whether sleep quality and sleep duration show similar or differential associations with health perceptions. We used ecological momentary assessment data from 123 young-old (66-69 years, 47% women) and 47 old-old adults (84-90 years, 60% women). Across 7 consecutive days, participants reported their sleep quality and sleep duration each morning and rated their momentary pain and health 6 times per day. We applied dynamic structural equation models to examine bidirectional links of morning reports of sleep quality and duration with daily levels of self-rated pain and health. In line with the hypotheses, results showed that when participants reported better sleep quality than what is typical for them, they reported less pain and better self-rated health on the day that followed. Longer sleep duration was not linked with subsequent pain or self-rated health. On days when people rated their health as better than usual, they reported better sleep quality but not longer sleep duration the following night. These associations were not moderated by age, gender, or chronic pain. Findings suggest that in old age, sleep quality is more relevant for health perceptions than sleep duration. Associations between sleep quality and self-rated health seem to be bidirectional; daily pain was linked to prior but not subsequent sleep quality.