Alcohol use among older adults

Alcohol use problems among older adults have been called the "invisible epidemic." As the population of older adults continues to grow, there is an increased need to reexamine alcohol use in this population. The authors provide an overview on alcohol use in the over-60 age group. The main areas of focus included research on the prevalence of drinking in that population, as well as comments on the best practices in assessment and psychological treatment. Several screening assessments have been recommended for use with older adults, such as the CAGE questionnaire, Michigan Alcohol Screening Test-Geriatric version, Alcohol-Related Problems Survey, and the Alcohol Use Disorders Identification Test. The authors note age-appropriate psychological treatment interventions that include brief interventions, family interventions, motivational counseling, and cognitive behavioral therapies. Barriers to assessment and treatment are also discussed.     

Stressful events and coping responses among older adults in two sociocultural groups

In this study of the way 32 men and women between the ages of 60 to 90 coped with stressful situations, two instruments were used: the Life Experiences Survey and the Ways of Coping Checklist. Overall, health-related concerns were more frequently reported by older adults than any other stressful event. When coping responses were categorized according to four modes--intrapsychic, inaction, direct action, and information seeking--the Appalachian group was found to use the information-seeking mode; the Cherokee group, the intrapsychic mode. Significant differences were found between males and females in coping modes and life-stress categories. When groups were combined, significant correlations were noted between life stress, particularly health-related stress, and the coping modes of intrapsychic and information seeking.     

Measuring experiential well-being among older adults

ABSTRACT

Experienced well-being measures tap a distinct form of subjective well-being (SWB) and have different age-related properties than the more widely studied evaluations of life satisfaction. Unlike evaluations of the quality of life as a whole, experiential measures capture affective reactions soon after they occur. Recent advances in measurement have allowed for the inclusion of such experiential measures even in large-scale studies. However, respondent burden remains a concern; hence, surveys have also employed shorter experiential modules. The psychometric properties of these brief measures are not well understood. We examine the psychometric characteristics, including the factor structure and correlations with theoretically relevant criteria, of experienced wellbeing measures included in two supplements to the Panel Study of Income Dynamics (PSID). The first supplement included a detailed time diary whereas the second included a brief review of the prior day. Results show that for the detailed time diaries a single index of affective experience provides a useful summary of the associations among individual affect items, both within and between participants. For the abbreviated method, two or more subscales better describe the underlying structure.     

Factorial validity of imagery measures

Two correlational studies and related factor analyses (N = 70. N = 76) were addressed to four psychometric hypotheses derived from the imagery-desensitization literature. Consistent with prior research, self-ratings of imaginal vividness correlated moderately positively across sense modalities. Vividness ratings were inconsistently related to imagery control scores however. The question of the extent to which imagery scales reflect the influences of response sets and general intelligence has been raised recently in this journal Behav. Res. and Therapy 10, 137 (1972). Acquiescence tendency does not appear to influence imagery questionnaire results and there is only a small contamination effect from the social desirability response style, thus suggesting that these questionnaires are substantially free of response bias invalidation. Verbal intelligence is unrelated to researched imaginal attributes, as measured by self-report scales and several behavioral measures, including location memory and spatial visualization. These behavioral measures, in turn, do not correlate with ratings of imagery characteristics, a finding in accord with previous literature. Although self-report imagery questionnaires stand up better to psychometric scrutiny than might have been expected, and thus prior research employing them cannot be dismissed summarily, it is argued that these questionnaires may not tap the variables most relevant to desensitization outcome or mediation. The necessity of using state rather than trait measures, and of relating these to physiological indices, is highlighted.     

Alternative theories of concept identification among older adults

The purpose of the present experiment was to investigate some predictions of hypothesis testing and S-R association (frequency) theories regarding memory for intratrial events on a conjunctive concept-identification task. They have received extensive study with young adults but not with older subjects. The individual events under investigation were feedback, responses, hypotheses, and stimuli. Hypothesis-testing theory requires subjects to retain information concerning the correct hypothesis from one trial to the next whereas frequency does not. 75 subjects (60-70 yr. old) participated in the study. Subjects had difficulty in recalling the correct hypothesis stated on previous trials. These errors occurred on problems with negative response trials, not with incorrect feedback. The results contradict predictions based on hypothesis-testing models but are consistent with frequency theory. Unlike in the studies based on younger adults, present subjects did not recall the hypothesis very well under the conditions in which hypothesis testing was made part of the primary task.     

Direct and indirect measures of memory for modality in young and older adults.

In 2 experiments, young and older adults demonstrated modality effects of similar magnitude in perceptual identification tasks. That is, both young and older adults demonstrated more repetition priming when study and test modalities matched than when they were different, suggesting that contextual information was equally available across age. However, when asked explicitly to retrieve modality information, older adults were less accurate than young adults. These results constitute evidence for a dissociation between direct and indirect measures of memory for modality information. They call into question hypotheses that memory impairment in old age is due to deficient encoding of contextual information and challenge current accounts of modality effects in repetition priming.     

Current perspectives on Rorschach performance among older adults

Review of empirical studies of Rorschach performance by older adults (age 65+) indicates that previous research findings of declining cognitive flexibility and impoverishment of personality may be artifacts of design methodologies that have failed to adequately account for biosocial-psychological differences between age groups and within the older age group itself. When findings are assessed in terms of variables reflective of age cohort as well as residential status, diagnosis, health status, and test-taking attitude, important data become available. Suggestions concerning test interpretation are offered in lieu of the current lack of age matched base rates for Rorschach scoring variables.     

Gender differences in social support among older adults

The purpose of this study was to determine whether exposure to life stress can help explain gender differences in the use of social support. Findings from a longitudinal study suggest that as the number of stressful life events increase, elderly men and women are equally likely to become more involved in their social network, while gender differences emerge only in response to chronic financial strain. Further analysis indicates that elderly women are more likely than elderly men to report that the support they received increased their feelings of personal control.     

Urinary incontinence and psychological distress among older adults

We examined the relationship between urinary incontinence and psychological distress in a sample of community-dwelling older adults. The data are from a probability sample of Washtenaw County, Michigan residents ages 60 years and older, who were interviewed in 1983 and 1984. A total of 747 women and 541 men were included in the analyses. Experiencing urinary incontinence, particularly in a severe form, was weakly related to depression, negative affect, and low life satisfaction. These relationships are partly explained by the fact that incontinent respondents are less healthy than are continent respondents.     

The mental health system and older adults in the 1990s.

Trends in mental health services for older adults during the past decade were used to predict salient issues for the current decade. These include overreliance on inpatient treatment, increased use of general hospitals as treatment sites, inadequate integration with the nursing-home industry, and insufficient mental health referrals from general medical providers. In the decade ahead, the mental health needs of older adults are unlikely to be an identified focus; rather the issues will overlap with other priorities (e.g., biomedical research on brain functioning, alternative treatment programs for the chronically mentally ill, and containing health care costs). Advocates for the elderly will be successful to the extent that they cast aging services within the context of these other concerns.     

The structure and validity of directional measures of appearance social comparison among emerging adults in China

We evaluated the structure and validity of the Upward Appearance Comparison Scale (UPACS) and Downward Appearance Comparison Scale (DACS) (O’Brien et al., 2009) in Chinese samples. In Study 1, principal component analysis on an initial sample (427 women, 123 men) and confirmatory factor analysis on another sample (447 women, 121 men) found that a 15-item, two component model had the best overall fit. Derived components had moderate correlations with most conceptually related measures and low correlations with less conceptually related indices. Study 2 participants (310 women, 201 men) completed the UPACS and DACS as well as measures of disordered eating, fatness concern, and negative affect; they were re-assessed one year later. Baseline UPACS scores predicted changes in disordered eating for women and fatness concerns for men, independent of initial disturbances, but DACS responses were not related to outcomes. Findings highlighted the potential utility of derived UPACS and DACS within a Chinese context.     

Long-term concentrative meditation and cognitive performance among older adults

ABSTRACT

Background: The general consensus that cognitive abilities decline with advancing age is supported by several studies that have reported that older adults perform more poorly on multiple tests of cognitive performance as compared to younger adults. To date, preventive measures against this cognitive decline have been mainly focused on dietary, physical, and lifestyle behaviors which could allow older adults to maintain their cognitive abilities into late life. However, much less stress has been laid on evaluating meditation as a preventive measure in such cases in spite of the fact that the role of meditation on attention has been proved in several studies. In the current study, we extend this preliminary idea, examining the practice of concentrative meditation and the differences in the cognitive performance of older adults who have or have not employed this practice long term. Methodology: This was a cross-sectional study comparing the cognitive performance of meditators and non-meditators in the geriatric age group. Twenty (age > 55 years) long-term practitioners of Vihangam Yoga meditation (>10 years of practice) were recruited in the present study and were applied six paper–pencil neuropsychological tests for assessment of short-term memory, perceptual speed, attention, and executive functioning. The tests used were: (1) the Digit Span test, (2) the Stroop Color Word test, (3) the Trailmaking test, (4) the Letter Cancellation Task, (5) the digit symbol substitution test, and (6) the Rule Shift Card Test. All the tests were also applied to 20 age- and education-matched geriatric adults who have not practiced the meditation technique. Results: Vihangam Yogis showed significantly better performances in all these tests of attention (p < .05) except for the digit backward test, where a trend (p = .08) was found in favor of meditators. Conclusion: Long-term Vihangam Yoga meditators have superior cognitive abilities than non-meditators in the old age group. This technique should be studied further for its ability to prevent age-related cognitive decline.     

Exercise adherence or maintenance among older adults: 1-year follow-up study.

Follow-up evaluation was conducted of 101 older men and women (mean age = 67 +/- 5 years) who had participated in a randomized study of physiological and psychological effects of aerobic exercise. Eighty-five subjects completed the follow-up evaluation, and almost all of them (94%) reported continuing with physical activity, as assessed by a self-report measure. Total energy expenditure was calculated as an indicator of exercise maintenance, and energy expenditure at follow-up was predicted from measures of physiological functioning, psychological well-being, and cognitive functioning obtained at the conclusion of the structured exercise program. Greater cardiorespiratory endurance, faster psychomotor speed, and lower anxiety predicted exercise behavior at follow-up, accounting for 13% of the variance in exercise behavior. Gender was not a significant predictor of exercise behavior.     

Cautiousness and visual selective attention performance among older adults

Cautiousness has been implicated in the literature as a possible factor responsible for observed performance decrements among older adults in a number of research paradigms. This study sought to assess whether the speed and accuracy of performance on a perceptual-cognitive task (the Stroop Color-Word Interference Test) differed significantly for more and less cautious older adults. The participants (N = 41), ranging from 55 to 81 years of age, were classified as either more cautious (n = 20) or less cautious (n = 21) on the basis of their responses on a personality test. Results indicated that cautiousness among older adults was manifested more in terms of the accuracy of response (fewer errors of commission) than in terms of the speed of response, and that level of cautiousness increased with increasing age.     

Correlates of subjective health in older adults: a meta-analysis

Age-associated changes of subjective health and associations of subjective health with physical health, functional health, and mental health were meta-analyzed in older adults (M age > 60 years). An age-associated decline of subjective health, which was stronger in old-old samples than in young-old samples, was found. Subjective health was correlated with the indicators of objective health, but the association with physical health was stronger than with functional health. Correlations of subjective health with physical health and functional health were lower in the old-old than in the young-old samples, whereas associations of subjective health with mental health were stronger in older samples. Furthermore, the size of the association between subjective and objective health varied by the method of assessment of objective health, showing highest associations with symptom checklists and results of medical examinations due to strict protocols.     

Conditional health threats: health beliefs, decisions, and behaviors among adults.

We combined the health belief model with the theory of subjective expected utility to derive hypotheses about the relations among health beliefs and preventive decisions. The central implication of this combination of theories is the importance of conceptualizing, measuring, and communicating about health threats in ways that are clearly conditional on action. It is important to distinguish, for example, between how susceptible to a disease a person thinks he or she would be if that person were and were not to take a preventive action. An experimental study of judgments about a hypothetical preventive action was conducted to test many of the theoretically derived hypotheses. A correlation study of dental flossing behavior was conducted to test the hypotheses as they apply to overt behavior rather than to judgment. Results of both studies supported most of the tested hypotheses, especially those related to the conditional conceptualization of health threats. Implications for theory, research methods, and practical applications are discussed.     

Memory and comprehension for health information among older adults: Distinguishing the effects of domain-general and domain-specific knowledge

While there is evidence that knowledge influences understanding of health information, less is known about the processing mechanisms underlying this effect and its impact on memory. We used the moving window paradigm to examine how older adults varying in domain-general crystallised ability (verbal ability) and health knowledge allocate attention to understand health and domain-general texts. Participants (n = 107, age: 60–88 years) read and recalled single sentences about hypertension and about non-health topics. Mixed-effects modelling of word-by-word reading times suggested that domain-general crystallised ability increased conceptual integration regardless of text domain, while health knowledge selectively increased resource allocation to conceptual integration at clause boundaries in health texts. These patterns of attentional allocation were related to subsequent recall performance. Although older adults with lower levels of crystallised ability were less likely to engage in integrative processing, when they did, this strategy had a compensatory effect in improving recall. These findings suggest that semantic integration during reading is an important comprehension process that supports the construction of the memory representation and is engendered by knowledge. Implications of the findings for theories of text processing and memory as well as for designing patient education materials are discussed.     

The structure and correlates of anxiety sensitivity in older adults

Anxiety sensitivity (AS) has been defined as the fear of symptoms of anxiety and panic, and is most frequently assessed with the Anxiety Sensitivity Index (Peterson & Reiss, 1987). To investigate the nature and structure of AS in an older sample, data were collected from a sample of 322 adults aged 65 to 97, with mean age 75. Confirmatory factor analysis indicated a hierarchical structure with three group factors (physical concerns, mental incapacitation concerns, and social concerns), as well as a general factor, consistent with previous investigations. Results suggest that the nature and structure of the AS trait in older adults are highly similar to those of younger adults.