Journals of Gerontology Series B-Psychological Sciences and Social Sciences最新文献

Objectives: Caring for a spouse with Alzheimer's disease (AD) can elicit considerable distress but there are also positive moments. A growing body of work has examined caregivers' ambivalence in the care relationship and linked it to negative caregiver outcomes such as depression, but dyadic assessments of both parties' perspectives are missing. We examined ambivalence in both people with AD and their spousal caregivers, seeking to identify the correlates and well-being outcomes of such ambivalence in this unique context.

Methods: Participants included 72 couples managing early-stage AD. People with AD and spousal caregivers independently self-reported positive and negative relationship qualities (used to indirectly calculate their ambivalence) and life satisfaction. Caregivers reported both partners' demographic characteristics and their spouses' behavioral and psychological symptoms of dementia (BPSD), focusing on memory-related behaviors and psychological symptoms.

Results: Path analyses revealed that the number and frequency of psychological symptoms in people with AD were positively associated with their own and caregivers' ambivalence. Caregivers' distress ratings of memory-related behaviors and psychological symptoms were positively associated with their ambivalence. Greater ambivalence was associated with lower life satisfaction in both spouses. BPSD directly affected both spouses' life satisfaction but there were also indirect effects via ambivalence.

Discussion: This study utilizes a dyadic approach to assess ambivalence in dementia care. Findings reveal the conflicting emotions that couples experience as they cope with early-stage AD, identify sources of such ambivalence, and shed light on the development of dyadic interventions that can promote positive outcomes in both partners.

Objectives: This study aimed to examine age, period, and cohort effects contributing to the prevalence of diabetes and hypertension among older Koreans. Additionally, it sought to investigate how sociodemographic characteristics interact with period and cohort effects to influence the disease prevalence.

Methods: Using the 2004-2020 data from the National Survey of Older Koreans, a nationally representative sample of older adults aged 65 or older, hierarchical age-period-cohort cross-classified random effects models (HAPC-CCREMs) were employed to estimate separate age, period, and cohort components of the recent trends in diabetes and hypertension. Sociodemographic characteristics were tested for their interactions with period and cohort effects.

Results: Significant period effects were observed, indicating a steady increase in the likelihood of being diagnosed with diabetes and hypertension over time. Age effects revealed a quadratic trend, with disease risks generally increasing with age, but the rate of increase diminishing at older ages. Cohort effects exhibited an inverted U-shaped pattern, with higher risks observed in the 1930s and early 1940s cohorts compared to earlier and later cohorts. Gender and educational attainment emerged as significant moderators. Women than men born in the early 1930s exhibited higher risks of diabetes and hypertension, whereas individuals with lower educational attainment showed a steadily increasing risk of hypertension over time.

Discussion: The results underscore the complex interplay of age, period, and cohort effects in shaping disease prevalence among older Koreans. Our findings highlight the importance of considering historical context and sociodemographic factors in understanding disease trends and designing targeted interventions to mitigate health disparities.

Objectives: This study aimed to investigate the association between falls and social frailty and its components among older Japanese adults.

Methods: This is a cross-sectional study. Participants were categorized into 3 groups based on the number of falls in the past year: no fall (none), a single fall (occasional), and more than one fall (recurrent). The participants who met 2 or more of the following criteria were defined as socially frail: living alone, going out less frequently compared with the previous year, rarely visiting friends, feeling unhelpful to friends or family, and not talking with someone daily.

Results: A total of 4,495 older Japanese adults living in a community analyzed in this study (51.0% women). Of the participants in this study, 3,851 (85.7%) were categorized as none, 443 (9.9%) as occasional, and 201 (4.5%) as recurrent. The proportion of participants considered socially frail was 11.5% in this study. Recurrent falls were associated with social frailty, even after adjusting for covariates (odds ratio [OR]: 1.49; 95% confidence interval [CI]: 1.01-2.19). The experience of recurrent falls was associated with the following components: "feeling unhelpful to friends and family" (OR: 1.62; 95% CI: 1.14-2.31) and "going outside less frequently compared with last year" (OR: 1.57; 95% CI: 1.06-2.31).

Discussion: Among older Japanese adults, recurrent falls were associated with social frailty and with 2 of its components in particular: social roles and social participation. Future longitudinal studies should be conducted to gain insight into any causal relationships between these variables.

Objectives: The first three rounds of the National Social Life, Health, and Aging Project (NSHAP) were in-person. Preparing for Round Four (R4), NSHAP began developing ways to collect complex questionnaire and biomeasure data remotely. R4 was scheduled to begin in 2020, but due to the coronavirus pandemic, NSHAP delayed R4 data collection and instead conducted a study on respondents' experiences during the pandemic, as well as pretests to strengthen NSHAP's remote data collection capability. This paper describes the methodology, results, and lessons learned from these efforts which were undertaken as a bridge between NSHAP's all in-person past and multimode future.

Methods: The Covid-19 Study was a multimode survey of NSHAP respondents to assess the impact of the pandemic. The multimode approach allowed evaluation of the feasibility of using different modes of data collection with older adults. NSHAP adapted its in-person questionnaire for phone and web administration and conducted pretests of the full phone questionnaire and sections of the web questionnaire. The project developed and tested a "BioBox," a kit containing all the supplies and instructions for respondents to self-collect biomeasures remotely. The BioBox was tested through an in-lab and in-home pilot, followed by two larger-scale pretests.

Results: The Covid-19 Study and pretests achieved NSHAP respondent participation in remote questionnaire and biomeasure collection, despite being accustomed to fully in-person data collection.

Discussion: Our findings and experiences will inform the collection of NSHAP data in future rounds and could inform other panel studies of older adults considering multimode data collection.

Objectives: This paper describes the changes made to the collection of cognitive measures when the National Social Life, Health, and Aging Project (NSHAP) introduced remote modes of data collection.

Methods: In Round 4 (2021-23), the longitudinal study transitioned from being conducted in-person to collecting data via multiple modes including in-person and remote modes: web, phone, and paper-and-pencil. The team began with the measures used in Rounds 2 and 3 of NSHAP-the survey-adapted Montreal Cognitive Assessment (MoCA-SA)-and evaluated which measures could be administered remotely, introducing new measures for each cognitive subdomain, as needed, to compensate for items that could not be administered remotely.

Results: Cognitive items used in Rounds 2 and 3 that could not be administered remotely were dropped from the respective modes, and items selected from the Rush Alzheimer's Disease Center's (RADC) global cognition battery were added as substitutes. For comparison, the RADC substitute items were added to the in-person mode making it longer in R4.

Discussion: The changes in cognitive measures resulted in different numbers of cognitive items across the four modes of survey administration in Round 4. Analysts should be aware of these changes when creating a single global cognition score for the entire NSHAP sample in Round 4, and aware that there may be mode effects that could impact cognition scores.

Objectives: An individual's past, and reflections on it, may influence current and future well-being. Recent qualitative studies suggest retirees' recollections about their careers relate to well-being in retirement. We investigated associations between life course events and subjective career evaluations, gender differences in these associations, and their subsequent association with retirement adjustment.

Methods: We used data from three waves (2015, 2018, and 2023) of the (NIDI Pension Panel Study (NPPS), a longitudinal survey of Dutch older workers. Using a sample of 6,109 respondents, we used ordinary least squares (OLS) regression models to investigate associations between employment stability facilitators and inhibitors (e.g., promotion, demotion, unemployment) and personal shocks (e.g., divorce, widowhood) and subjective evaluations of satisfaction with the work and family domains of career between genders. Using a follow-up sample (N=4,106), we employed ordinal logistic regression models to investigate the impact of these baseline subjective evaluations on retirement adjustment at follow-up.

Results: Employment stability factors such as demotion and unemployment, and personal shocks such as poor psychological health were associated with subjective evaluations of the work and family career domains. Gender differences in these associations were found. Evaluations in both the work and family domains were associated with retirement adjustment at follow-up.

Discussion: Our results demonstrate the importance of life course events on older workers' evaluations of their careers and the long-term impact of subjective career evaluations. Further research is needed to evaluate the predictive utility of these evaluations for other outcomes in older adulthood.

Objectives: This paper examines whether perceived neighborhood disorder is associated with trajectories of cognitive functioning and whether religion mitigates this association among US older adults.

Methods: Data are drawn from the 2006-2016 Health and Retirement Study (N=12,669). Religious belief and religious attendance are assessed as potential moderators. Growth curve models are used to estimate trajectories of cognitive functioning over time.

Results: We find that perceived neighborhood disorder is associated with lower cognitive functioning at baseline; however, religious belief mitigates the impact of perceived neighborhood disorder on the level of cognitive functioning. For instance, individuals with high religious belief, despite experiencing high perceived neighborhood disorder, show better cognitive functioning at baseline compared to those with high disorder but low belief. While frequent religious attendance is associated with higher cognitive functioning at baseline, it does not moderate the impact of perceived neighborhood disorder on cognitive functioning.

Discussion: This study underscores the protective role of religious belief against cognitive aging in the face of neighborhood disorder, suggesting that personal faith may provide a cognitive reserve or coping mechanism. Our findings also imply that the absence of religious belief, combined with high perceived neighborhood disorder, may produce a compounded negative impact on cognitive aging.

Objectives: We investigate how adults of different ages experience changes in their social relationships during significant life events. Based on different goal priorities, younger adults may benefit more from establishing new social contacts during a significant life event, whereas older adults may benefit more from maintaining existing relationships.

Methods: To test these hypotheses, we conducted multilevel modelling with a sample of N = 6,688 participants aged 18 to 90 years who reported at least one significant life event in the past two years.

Results: Both establishing new social relationships and maintaining existing relationships during significant life events were associated with higher levels of well-being. As predicted, these associations were moderated by age. Establishing new social relationships was more strongly associated with mental health and life satisfaction in younger adults, whereas maintaining existing relationships was more strongly associated with subjective well-being, physical health, and loneliness in older adults.

Discussion: These findings provide valuable insights into the role of age in the change and stability of social relationships during significant life events.

Objectives: We investigate the impact of data collection mode on responses to variables in NSHAP Round 4 and discuss how potential mode differences should (and should not) be addressed in substantive analyses.

Methods: Among the set of respondents who were eligible to be contacted remotely in Round 4, we randomly selected 398 to be contacted instead for an in-person interview. We compare response rates and the distributions of selected key outcomes among those 398 respondents to those among the control group who were initially approached remotely. As a contrast, we compare all R4 respondents according to the mode in which they completed the interview, including those not part of the randomized experiment.

Results: Among those included in the experiment, there was no evidence of systematic differences in responses to physical and mental health questions between remote and in-person modes, nor in responses to number recall measures. In-person respondents scored moderately lower on cognitive function measures requiring careful attention to a figure and/or task, though this difference became less with each similar item. Remote respondents named fewer social network members. Comparing all respondents according to their final mode yielded substantially different results in all cases.

Discussion: Mode did not appear to affect reports of physical and mental health based on a randomized comparison, though it did moderately affect other items in predictable ways. Naïve estimates of mode effects based on comparing all respondents according to mode yielded misleading results, and should not be used to adjust for mode differences in analyses.

Objectives: Bridge employment and encore careers are 2 prevalent retirement pathways that have different goals and outcomes. Yet, "changing jobs in later life" is the shared prequel that blurs the distinction between them in empirical studies. This study proposes a set of criteria-voluntariness of career transition and the duration of work in the posttransition job-to distinguish various retirement pathways and investigates the predictors that distinguish the workers' choice of these pathways.

Methods: I conducted multinomial logistic regression to examine the predictors that distinguish between bridge employment, encore career, and direct workforce exit using the longitudinal sample of respondents with full-time career jobs in the Health and Retirement Study 1992-2020 (HRS, N = 2,038). To examine the predictors that distinguish between bridge employment and encore careers, I conducted logistic regression on the subsample of respondents who chose either bridge employment or encore careers (n = 927).

Results: The results show that the accumulated human capital from career jobs, physical and mental health conditions before leaving career jobs, and self-identified retirement status when transitioning to new jobs distinguish the workers' choices of taking on different retirement pathways.

Discussion: Maintaining the labor force participation of older workers is an important human resource agenda for policymakers. This study suggests that increasing the number of quality jobs for older workers would promote bridge employment and encore careers by raising the benefits of making career transitions as well as improving older workers' health.