Perception of one's social environment and loneliness: results of the nationally representative "Old age in Germany (D80+)" study.

OBJECTIVES: To examine the association between perception of one's social environment (in terms of residential attachment and neighborhood trust) and loneliness among the oldest old and whether these associations differ by living arrangement. METHODS: We used data from the nationally representative "Old Age in Germany (D80+)" study that included individuals residing in private households and institutionalized settings. The analytic sample was 9,621 individuals (average age: 85.5 years, SD: 4.1 years; 62% female). Data collection took place from November 2020 to April 2021. Multiple linear regressions were conducted with adjustment for relevant covariates. RESULTS: Higher residential attachment (ß=-0.02, p < .05) and higher neighborhood trust (ß=-0.12, p < .001) were associated with less loneliness. The latter association was moderated by living arrangement (ß=-0.09, p = .04) such that the association between neighborhood trust and loneliness was stronger among individuals living in institutionalized settings compared to individuals in private households. CONCLUSION: Greater residential attachment and neighborhood trust, particularly among individuals living in institutionalized settings, are associated with less loneliness among the oldest old. Finding ways to improve perceived attachment and trust may assist in avoiding loneliness among older individuals.

Purpose in life and grip strength: An individual-participant meta-analysis of 115,972 participants from 24 countries across four continents.

This research examines the replicability and generalizability of the association between purpose in life and grip strength. An individual-participant meta-analysis of 27 samples (total N=115,972) from 24 countries that spanned four continents (Asia, Europe, North and South America) with self-reported purpose in life and dynamometer-assessed grip strength. Purpose in life was associated with stronger grip strength in every sample and aggregated in a random-effects meta-analysis (meta-analytic estimate=.06, p<.001). The association was similar across samples from different world regions and not moderated by methodological factors (e.g., scale content). The association was apparent across age, sex, race, and education and slightly stronger among males and participants with relatively less education. Every standard deviation in purpose was associated with a 23% lower likelihood of weak grip strength (meta-analytic OR=.81, 95% CI=.79-.84, p<.001) based on a standard threshold. Purpose in life is associated with grip strength, a marker of overall musculoskeletal health. The association replicates across diverse locations around the world and generalizes across sociodemographic groups.

Momentary Associations Between Physical Activity, Affect, and Purpose in Life.

BACKGROUND: Physical activity is associated with both the hedonic (e.g., affect) and eudaimonic (e.g., purpose in life) aspects of well-being. While there is evidence linking momentary physical activity and affect in daily life, the examination of momentary purpose remains largely unexplored. PURPOSE: This study investigates the bidirectional associations between physical activity, positive and negative affect, and momentary purpose using Ecological Momentary Assessment (EMA) and accelerometer data. METHODS: Middle-aged participants (40-70 years old, n = 291) wore accelerometers and completed three daily EMA surveys on momentary experiences for 8 consecutive days. Physical activity (active time and counts) from 20- to 60-min periods before and after EMA surveys were used in the analyses. Multilevel models were adjusted for temporal and contextual factors, age, sex, education, work status, and race/ethnicity. RESULTS: When participants were more physically active than usual, they reported feeling more purpose-driven and positive affect. Similarly, when participants reported feeling more purpose-driven or experiencing positive affect, they engaged in more physical activity in the subsequent time period. These associations were similar for physical activity from 20- to 60-min periods before and after the EMA survey. Physical activity and negative affect were not related in either direction. CONCLUSIONS: In middle-aged adults' daily lives, physical activity has bidirectional relations with purpose and positive affect. This study highlights the dynamic associations between physical activity and the positive aspects of both hedonic and eudaimonic well-being. Future interventions or public health programs should integrate physical activity and mental well-being to maximize mutual benefits.

This study examined how physical activity relates to feelings of purpose and positive and negative affect in daily life among middle-aged adults (aged 40­70). Participants wore activity trackers and completed surveys on their smartphones about their feelings three times a day for 8 days. The study found that when participants were more physically active than usual, they experienced higher levels of purpose and more positive emotions. Conversely, feeling more purposeful or positive also led to more physical activity later on. The results suggest that physical activity and positive well-being are interconnected and reinforce each other in daily life.

Effect of hormone therapy on personality traits: preliminary evidence in older men and women.

OBJECTIVE: Findings concerning the effects of hormone therapy (HT) on cognition and dementia are mixed, with some trials suggesting increased harm at older ages. Personality, like cognition, changes with dementia, but no clinical trials to date have examined the effects of HT on personality traits. This study aimed to determine the effects of HT on personality traits in older men and women. METHOD: Secondary data analysis was performed from randomized, double-blind, placebo-controlled cross-over studies of menopausal HT in women and testosterone therapy (TT) in men. Participants were community-dwelling cognitively normal adults (mean age = 75.2 years), including 29 men and 22 women. Three months of hormone intervention (for women, 0.625 mg/day conjugated equine estrogen with or without 2.5 mg/day medroxyprogesterone acetate; for men, 200 mg intramuscular testosterone enanthate every 2 weeks) were crossed over with 3 months of identical placebo with a 3-month washout between intervention phases. The main outcome measure was neuroticism and conscientiousness personality domains and facets assessed with the Revised NEO Personality Inventory (NEO-PI-R) after the active and placebo intervention phases. RESULTS: In linear mixed-effect models, HT in women decreased conscientiousness (p < 0.01) and the conscientiousness facet of achievement striving (p < 0.01), and increased vulnerability, a facet of neuroticism (p < 0.05). Testosterone in men decreased conscientiousness (p < 0.05) and the conscientiousness facet of dutifulness (p < 0.05), and increased vulnerability (p < 0.05). CONCLUSION: In a preliminary study of healthy older adults, HT and TT formulations produced adverse changes in vulnerability and conscientiousness facets that parallel personality changes in dementia.

Purpose in Life and Cognitive Function in the Malaysian Ageing and Retirement Study.

OBJECTIVES: Evidence for the association between purpose in life and cognitive health is primarily from North American and European samples. This study evaluates this association in a large sample from Malaysia, an upper-middle-income country in Southeast Asia. METHODS: Participants (N = 5,579) from the Malaysian Ageing and Retirement Study reported on their purpose in life and subjective memory and were administered tasks that measured episodic memory, verbal fluency, and overall cognitive function. RESULTS: Purpose was associated with better subjective memory (ß=.13), episodic memory (ß=.06), verbal fluency (ß=.12), and overall cognitive function (ß=.07) (ps < .001). The associations were similar across sex and retirement status; purpose was more strongly related to subjective memory and overall cognitive function among older participants. Behavioral/social factors accounted for up to one-third of the associations, but all associations remained statistically significant. CONCLUSIONS: The positive association between purpose and cognition generalizes to a middle-income country in Southeast Asia. Similar to Western samples, behavioral and social factors accounted for part but not all the association. More research is needed in lower- and other middle-income countries to fully evaluate generalizability. CLINICAL IMPLICATIONS: Purpose may help support healthier cognitive aging across diverse populations and be a useful target to improve cognitive aging outcomes.

Neuroticism, loneliness, all-cause and cause-specific mortality: A 17-year study of nearly 500,000 individuals.

BACKGROUND: Neuroticism is related to mental and physical health. This study examined whether neuroticism and its underlying components were associated with risk of all-cause and cause-specific mortality. METHODS: Community-dwelling adults (N = 491,323) in the UK Biobank completed a neuroticism scale between 2006 and 2010. Vital status was tracked up to December 2022 via linkage with the UK National Health Service. RESULTS: Over 17 years of follow-up, 43,400 (8.8 %) participants died. Accounting for age, sex, and ethnicity, participants who scored 1 SD higher on neuroticism had a 10 % greater risk of dying (HR = 1.10, 95%CI = 1.09-1.11), an association that remained significant but was explained partly by socioeconomic status, health behaviors, and chronic conditions. Item-level analyses found that loneliness was the neuroticism item most predictive of mortality (HR = 1.46, 95%CI = 1.43-1.49), especially in males. Neuroticism and loneliness were more predictive of mortality among relatively younger adults and those with lower education. Among the causes of death, neuroticism and loneliness had the strongest association with deaths due to intentional self-harm, respiratory and digestive system diseases. LIMITATIONS: Loneliness was assessed with a single item. The associations could be due to increases in neuroticism and loneliness approaching death. However, contrary to expectations from reverse causality, the associations were similar when excluding deaths within the first five or ten years of follow-up. Future research should examine whether findings from this high-income country replicate in middle- and lower-income communities. CONCLUSIONS: Loneliness was the component of neuroticism most strongly associated with premature mortality, including from intentional self-harm, respiratory, and digestive system causes of death.

The mediational role of hearing acuity in the association between personality and memory: Evidence from the health and retirement study and the English Longitudinal Study of Ageing.

OBJECTIVES: Personality traits (i.e., the enduring patterns of thoughts, feelings, and behaviors) are associated with cognition across adulthood. There is interest in identifying potential mechanisms to explain this association, but none has focused on sensory function. Therefore, the present study examined whether an objective measure of hearing acuity mediates the association between personality and memory. METHODS: Participants were from the Health and Retirement Study (HRS, N = 5497, 60 % women, Mean age = 65.66, SD = 9.00) and the English Longitudinal Study of Ageing (ELSA, N = 4706, 57 % women, Mean age = 64.47, SD = 7.59). In the HRS, participants had data on personality and demographic variables in 2012/2014, hearing acuity in 2016/2018, and memory in 2020. In ELSA, participants had data on personality and demographic variables measured in 2010/2011, hearing acuity in 2014/2015, and memory in 2018/2019. RESULTS: In both HRS and ELSA, higher hearing acuity partially mediated the association between lower neuroticism (4 % and 5 % proportion effect mediated), higher conscientiousness (6 % and 15 %) and higher openness (3 % and 7 %) and better memory performances at follow-up. CONCLUSIONS: The present study provides novel evidence that hearing acuity mediates the association between personality and cognition.

Perceived Weight Discrimination and General Coping Strategies.

BACKGROUND: Perceived weight discrimination is associated consistently with worse health outcomes. Coping strategies may be one mechanism of this association. The present research examined the association between perceived weight discrimination and strategies used to cope with general stress (not weight-specific) and whether these strategies accounted for part of the association with markers of health. METHOD: Participants (N = 1882) completed a cross-sectional survey with a comprehensive measure of coping strategies and reported on their perceived experience of weight discrimination and markers of physical, mental, and social health. RESULTS: Perceived weight discrimination was associated with greater use of disengaged coping strategies (ß = .19, p < .01) and was unrelated to active and support coping strategies. Disengaged coping mediated the association between weight discrimination and worse physical, mental, and social health (proportion of mediation ranged from 14 to 47%). This pathway was independent of body mass index (BMI). Individuals in the obesity weight category (BMI ≥ 30 kg/m2) were less likely to use active (ß = - .11, p < .01) and support (ß = - .09, p < .01) coping strategies, which did not consistently mediate the association with health. CONCLUSION: Perceived experiences of weight discrimination are associated with disengaged coping strategies to manage stressful experiences, and these strategies are one mechanism that may contribute to the worse health associated with unfair treatment due to weight.

Purpose in life and stress: Momentary associations from a micro-longitudinal study.

Purpose in life is an aspect of well-being associated with less subjective stress. The present research sought to expand this literature by testing the association between both dispositional and momentary purpose with stress in daily life using a micro-longitudinal study design. Participants (N = 303) reported their dispositional purpose at baseline and reported their momentary purpose and stress three times a day for 8 days. Between-person, dispositional purpose was associated with less momentary stress across the 8 days tested with linear regression (ß = -0.29, 95% CI = -0.39, -18, p < 0.001); it was unrelated to variability in stress (ß = 0.05, 95% CI = -0.05, 0.14, p = 0.310). In contrast, the within-person analysis tested with multilevel modelling indicated that in moments when participants felt more purpose-driven than their average, they felt more stressed (b = 0.09, 95% CI = 0.06, 0.12, SE = 0.01, p < 0.001). This association was slightly stronger among participants with relatively lower dispositional purpose (binteraction = -0.04, SE = 0.02, 95% CI = -0.08, -0.01, p = 0.032). This study replicated the negative association between dispositional purpose and subjective stress when stress was measured at moments in daily life. It also found that feeling more purpose-driven than usual in the moment is stressful, a counterintuitive finding that, if replicated, suggests that striving for purpose can be stressful in the moment, even if feeling more purposeful in general is associated with lower stress.

Chronic loneliness and chronic social isolation among older adults. A systematic review, meta-analysis and meta-regression.

OBJECTIVES: We performed a systematic review and meta-analysis to examine the prevalence and antecedents/consequences of chronic loneliness and social isolation (i.e. enduring or persistent experience that extends over a certain period of time) among older adults. Moreover, we conducted a meta-regression to explore sources of heterogeneity. METHOD: A search was conducted in four electronic databases. We included observational studies that reported prevalence and, where available, antecedents/consequences of chronic loneliness or chronic social isolation amongst older adults. Key characteristics of the studies were extracted. RESULTS: Across 17 studies included in the meta-analysis, the estimated prevalence of chronic loneliness was 20.8% (95% CI: 16.1-25.5%), including 21.7% among women (95% CI: 16.1-27.4%) and 16.3% among men (95% CI: 10.6-21.9%). One study reported chronic social isolation (13.4%) and found that chronic social isolation predicted higher depression scores. Meta-regressions indicated that loneliness was less prevalent when assessed with single-item measures. Regarding antecedents/consequences, spousal loss can contribute to chronic loneliness which in turn may contribute to adverse health-related outcomes. CONCLUSION: About one in five older adults experiences chronic loneliness reflecting the need to address chronic loneliness. More longitudinal research is needed on chronic loneliness and social isolation, particularly from low and middle-income countries.

Personality and Transition From Mild Cognitive Impairment to Normal Cognition vs Dementia.

OBJECTIVES: Mild cognitive impairment (MCI) is a critical stage preceding incident dementia, but not all individuals with MCI progress to dementia and some revert to normal cognition. This study examined whether personality is associated with the probability of transition from MCI to normal cognition or dementia. DESIGN: Longitudinal observational study. SETTING AND PARTICIPANTS: Older adults with MCI from the Health and Retirement Study (N = 1608, 56% female, mean age = 72.29, SD = 9.91). Personality traits; cognitive status; and demographic (age, sex, education, race, and ethnicity), clinical (diabetes, hypertension), behavioral (smoking, physical activity), psychological (depressive symptoms), and genetic (apolipoprotein E ε4) covariates were obtained in 2006/2008. Follow-up data on cognitive status were collected every 2 years up to the 2020 wave. METHODS: Cox regression analyses tested the association between personality and reversion from MCI to normal cognition and progression to dementia, controlling for demographic, clinical, behavioral, psychological, and genetic covariates. RESULTS: Controlling for demographic factors, lower neuroticism and higher openness and conscientiousness were associated with a higher likelihood of reversion from MCI to normal cognition and a lower risk of progression to dementia over time. Higher agreeableness was related to a lower risk of progression to dementia. Clinical, behavioral, psychological, and genetic factors partially accounted for these associations. There was little evidence that demographic, genetic factors, or baseline cognition moderated these associations. CONCLUSIONS AND IMPLICATIONS: Personality traits can help identify individuals who are more likely to revert from MCI and not progress to dementia. These findings suggest that even during mild impairment, personality may modulate dementia risk and thus inform targeted interventions.

Personality traits and measures of neuropsychiatric symptoms.

OBJECTIVES: Changes in personality and behavioral symptoms are a core clinical criterion for the diagnosis of dementia. This study examines the association between caregiver-rated personality traits and multiple measures of neuropsychiatric symptoms. METHOD: Caregivers of individuals with dementia (N = 191) or cancer (N = 137) provided premorbid and concurrent personality trait ratings using the Big Five Inventory-2. Caregivers also completed the Mild Behavioral Impairment Checklist, Neuropsychiatric Inventory Questionnaire, and Revised Memory and Behavior Problems Checklist. RESULTS: In the combined sample, high concurrent neuroticism was associated with emotional dysregulation (r = 0.51), low agreeableness with impulse dyscontrol (r=-0.40), and low conscientiousness with decreased motivation (r=-0.42). Associations were similar across neuropsychiatric symptom scales, similar across cancer and dementia, but stronger with concurrent than premorbid personality ratings, and stronger for the individuals with mild than moderate-severe dementia. CONCLUSION: Personality was associated with neuropsychiatric symptoms, including with the measure for mild behavioral impairment. Personality had stronger associations when concurrently assessed, indicating that personality traits co-develop with neuropsychiatric symptoms. The associations were similar across cancer and dementia, suggesting transdiagnostic processes not limited to dementia. Neuropsychiatric symptoms are partly an expression of personality; accounting for personality traits could help with diagnosis and disease monitoring, tailoring interventions, and fostering person-centered care.

Life Events and Incident Dementia: A Prospective Study of 493,787 Individuals Over 16 Years.

OBJECTIVES: Life events can be stressful and have a detrimental impact on health, but evidence is inconclusive regarding life events and dementia risk. The present study tests whether life events are associated with incident dementia, whether experiencing multiple events has cumulative effects, and whether the associations vary across age, sex, race/ethnicity, socioeconomic status, and genetic vulnerability. METHODS: UK Biobank participants (N = 493,787) reported on 6 life events that occurred within the past 2 years: serious illness, injury, assault to yourself or close relative, death of a spouse/partner or close relative, marital separation/divorce, and financial problems. Incident all-cause dementia was ascertained through health records from the UK National Health Service over a 16-year follow-up. RESULTS: Serious illness, injury, or assault to yourself, marital separation/divorce, and financial difficulties were associated with a higher risk of dementia; serious illness, injury, or assault of a close relative was associated with a lower risk of dementia. When combined, experiencing 3-4 events was associated with a more than 2-fold increase in dementia risk. The association for marital separation/divorce was stronger within the first 5 years of follow-up (consistent with reverse causality). Death of a spouse/partner or close relative was mostly unrelated to dementia risk. With few exceptions, the associations were similar across age, sex, race/ethnicity, socioeconomic status, and apolipoprotein E e4 status groups. DISCUSSION: Severe illness, injury, or personal assault, marital separation or divorce, and financial hardships may raise risk of dementia, particularly when these events occur together.

Balance, Strength, and Risk of Dementia: Findings From the Health and Retirement Study and the English Longitudinal Study of Ageing.

BACKGROUND: Slow gait speed has been consistently associated with an increased risk of dementia. This study examined whether measures of balance and lower limb strength are similarly related to the risk of developing dementia. METHODS: Participants from the Health and Retirement Study (HRS, N = 5 658, mean age = 73.23, standard deviation [SD] = 6.22) and the English Longitudinal Study of Ageing (ELSA, N = 3667, mean age = 69.90, SD = 7.02) completed measures of gait speed, semi-tandem balance, chair stand (ELSA only), and cognitive status at baseline. Cognitive status was assessed over up to 15 years. RESULTS: Baseline slower gait speed (hazard ratio [HR]HRS = 1.52, 95% confidence interval [CI] = 1.32-1.75, p < .001; HRELSA = 1.73, 95% CI = 1.37-2.18, p < .001); and balance impairment (HRHRS = 1.58, 95% CI = 1.26-1.96, p < .001; HRELSA = 1.97, 95% CI = 1.24-3.14, p < .01) were related to a higher risk of incident dementia, adjusting for demographic factors. The combination of slower gait and impaired balance was associated with a two-to-three times higher risk of dementia in HRS and ELSA. Worse performance on the chair stand at baseline was associated with a higher risk of dementia in ELSA (HR = 1.56, 95% CI = 1.23-1.99, p < .001). All performance measures remained significant when entered simultaneously and accounted for obesity, diabetes, blood pressure, physical activity, smoking, and depressive symptoms. There was little evidence that age, sex, or APOE ε4 moderated the association. CONCLUSIONS: Similar to gait speed, measures of balance and strength are associated with a higher risk of incident dementia. The findings have implications for clinical practice, given that these routinely used geriatric assessment tools are similarly related to dementia risk.

Personality nuances and risk of dementia: Evidence from two longitudinal studies.

Personality traits are broad constructs composed of nuances, operationalized by personality items, that can provide a more granular understanding of personality associations with health outcomes. This study examined the associations between personality nuances and incident dementia and evaluated whether nuances associations replicate across two samples. Health and Retirement Study (HRS, N = 11,400) participants were assessed in 2006/2008, and the English Longitudinal Study of Ageing (ELSA, N = 7453) participants were assessed in 2010/2011 on personality and covariates. Dementia incidence was tracked for 14 years in the HRS and 8 years in ELSA. In both HRS and ELSA, higher neuroticism domain and nuances (particularly nervous and worry) were related to a higher risk of incident dementia, whereas higher conscientiousness domain and nuances (particularly responsibility and organization) were associated with a lower risk of dementia. To a lesser extent, higher extraversion (active), openness (broad-minded, curious, and imaginative), and agreeableness (helpful, warm, caring, and sympathetic) nuances were associated with a lower risk of dementia, with replicable effects across the two samples. A poly-nuance score, aggregating the effects of personality items, was associated with an increased risk of incident dementia in the HRS and ELSA, with effect sizes slightly stronger than those of the personality domains. Clinical, behavioral, psychological, and genetic covariates partially accounted for these associations. The present study provides novel and replicable evidence for specific personality characteristics associated with the risk of incident dementia.

German population norms of the preference to solitude scale and its correlates.

AIM: Our first aim was to present norm values for the Preference for Solitude Scale by sex, age, and other sociodemographic groups. Our second aim was to evaluate the correlates of preference for solitude. METHODS: Data were collected in August/September 2023 from a sample of individuals (N = 5000) living in Germany aged 18 to 74 years (ensuring representativeness in terms of sex, age group and federal state for the German general adult population). The established and valid Preference for Solitude Scale (range 0 to 12, with higher values reflecting a stronger preference for solitude) was used to quantify the preference for solitude. Norm values were provided by sex and age groups. Multiple linear regressions were used to examine the correlates of preference for solitude. RESULTS: Average preference for solitude score was 7.6 (SD = 3.0; 0 to 12). The average score was 7.3 (SD = 3.0) among males and 7.9 (SD = 2.9) among females. Regressions showed that a stronger preference for solitude was associated with being female (ß = .51, p < .001), being older (e.g., being 40 to 49 years compared to 18 to 29 years, ß = .85, p < .001), being single (e.g., divorced compared to being single, ß = -.78, p < .01), higher level of education (secondary education compared to primary education, ß = .43, p < .01), never been a smoker (e.g., daily smoker compared to never smokers, ß = -.61, p < .001), absence of alcohol consumption (e.g., drinking once a week compared to never drinking, ß = -1.09, p < .001), no sports activity (e.g., 2-4 hours per week compared to no sports activity, ß = -.60, p < .001), poorer self-rated health (ß = .28, p < .001) and more depressive symptoms (ß = .05, p < .001). Sex-stratified regressions yielded similar results. CONCLUSION: Norm values provided in this study can be used as a benchmark for comparison with other countries and can guide further research dealing with preferences for solitude. We demonstrated the importance of several sociodemographic factors (e.g., marital status), lifestyle-related factors (e.g., sports activity), and health-related factors (e.g., depressive symptoms) for the preference for solitude. Such knowledge about the correlates of preference for solitude may help to characterize them. This is essential to ensure a good balance between social interaction and being alone. This is important because preference for solitude is associated with poor self-rated health and depression, but also with healthy behaviors such as abstaining from smoking and drinking.

Personality traits and polypharmacy: meta-analysis of five samples.

OBJECTIVE: The present study examined the prospective relationship between personality traits and the risk of polypharmacy. METHODS AND MEASURES: Participants (age range: 16-101 years; N > 15,000) were from the English Longitudinal Study of Ageing (ELSA), the Midlife in the United States Study (MIDUS), the Health and Retirement Study (HRS), the Wisconsin Longitudinal Study of Aging (WLS), and the Longitudinal Internet Studies for the Social Sciences (LISS). In each sample, personality traits and demographic factors were assessed at baseline. Number of medications was obtained from 2 to 20 years later. RESULTS: Random-effect meta-analyses revealed that higher neuroticism was related to a higher risk of polypharmacy (Odd Ratio = 1.30; 95% CI 1.17-1.46) and excessive polypharmacy (Odd Ratio = 1.44; 95% CI 1.18-1.77) whereas higher conscientiousness (Odd Ratio = 0.84; 95% CI 0.74-0.95) and extraversion (Odd Ratio = 0.85; 95% CI 0.73-0.98) were associated with a lower risk of polypharmacy. Openness and agreeableness were unrelated to polypharmacy. Body mass index, number of chronic conditions, and depressive symptoms partially mediated the association between personality and the number of medications. CONCLUSION: The present study provides replicable and robust evidence that neuroticism is a risk factor for simultaneous use of multiple medications, whereas conscientiousness and extraversion may play a protective role.

Prevalence and factors associated with probable depression among the oldest old during the Covid-19 pandemic: evidence from the large, nationally representative 'Old Age in Germany (D80+)' study.

BACKGROUND: To date, most studies examining the prevalence and determinants of depression among individuals aged 80 and over have used geographically limited samples that are not generalisable to the wider population. Thus, our aim was to identify the prevalence and the factors associated with probable depression among the oldest old in Germany based on nationally representative data. METHODS: Data were taken from the nationally representative 'Old Age in Germany (D80+)' study (n = 8386; November 2020 to April 2021) covering both community-dwelling and institutionalised individuals aged 80 and over. The Short Form of the Depression in Old Age Scale was used to quantify probable depression. RESULTS: Probable depression was found in 40.7% (95% CI: 39.5% to 42.0%) of the sample; 31.3% were men (95% CI: 29.7% to 32.9%) and 46.6% women (95% CI: 44.9% to 48.3%). The odds of probable depression were positively associated with being female (odds ratio (OR): 1.55, 95% CI: 1.30 to 1.84), being divorced (compared to being married, OR: 1.33, 95% CI: 1.01 to 1.76), being widowed (OR: 1.14, 95% CI: 1.00 to 1.30), having a low education (e.g., medium education compared to low education, OR: 0.86, 95% CI: 0.74 to 0.99), living in an institutionalised setting (OR: 2.36, 95% CI: 1.84 to 3.02), living in East Germany (OR: 1.21, 95% CI, 1.05 to 1.39), not having German citizenship (German citizenship compared to other citizenship, OR: 0.55, 95% CI: 0.31 to 0.95), poor self-rated health (OR: 0.31, 95% CI: 0.28 to 0.34), and the number of chronic conditions (OR: 1.12, 95% CI: 1.09 to 1.14). CONCLUSION: About four out of 10 individuals aged 80 and over in Germany had probable depression, underlining the importance of this challenge. Knowledge of specific risk factors for this age group may assist in addressing older adults at risk of probable depression.

Purpose in life and stress: An individual-participant meta-analysis of 16 samples.

Background: Purpose in life is a psychological resource that has been associated with better regulation of stress. The present research reports a coordinated analysis of the association between purpose in life and subjective stress and evaluates potential sociodemographic and mental health moderators of this association. Methods: With individual participant data from 16 samples (total N=108,391), linear regression examined the association between purpose in life and general subjective feelings of stress, controlling for sociodemographic characteristics. Results: Greater purpose in life was associated with less subjective stress (meta-analytic estimate=-.228, 95% Confidence Interval=-.292, -.164; p<.001). Interaction terms between sociodemographic factors and purpose tested in the individual samples and synthesized with meta-analysis were not significant, which indicated that the association between purpose and stress was similar across age, sex, race, ethnicity, and education. The association was also not moderated by psychological distress. Meta-regressions further indicated that this association was generally similar across scale length, content of the purpose measure, and across samples from Eastern and Western countries. Limitations: The associations reported are observational. Experimental work is needed to evaluate causality. Conclusions: Purpose in life is associated with less subjective stress across populations. Less subjective stress may be one mechanism through which purpose contributes to better mental and physical health.

Personality traits and the risk of urinary incontinence: Evidence from three longitudinal samples.

OBJECTIVE: Urinary incontinence (UI) is a common condition with a substantial negative impact on older adults' quality of life. This study examines whether individual differences in behavioral, cognitive, and emotional traits assessed by the five major dimensions of personality are related to the risk of concurrent and incident UI. METHODS: Participants were older women and men (N > 26,000) from the Midlife in the United States Survey, the Health and Retirement Study, and the English Longitudinal Study of Aging. In each cohort, personality traits (measured with the Midlife Development Inventory) and demographic (age, sex, education, and race), clinical (body mass index, diabetes, blood pressure), and behavioral (smoking) factors were assessed at baseline. UI was assessed at baseline and again 8-20 years later. Results for each cohort were combined in random-effect meta-analyses. RESULTS: Consistently across cohorts, higher neuroticism and lower conscientiousness were related to a higher risk of concurrent and incident UI. To a lesser extent, extraversion, openness, and agreeableness were also related to lower risk of concurrent and incident UI. BMI, diabetes, blood pressure, and smoking partially accounted for these associations. There was little evidence that age or sex moderated the associations. CONCLUSIONS: The present study provides novel, robust, and replicable evidence linking personality traits to UI. The higher vulnerability for UI for individuals who score higher on neuroticism and lower on conscientiousness is consistent with findings for other multifactorial geriatric syndromes. Personality traits can help identify individuals at risk and may help contextualize the clinical presentation of comorbid emotional, cognitive, and behavioral symptoms.