Mental health among centenarians living in Switzerland.

BACKGROUND: Given the increasing number of people achieving exceptionally long lifespans, there is an urgent need for a better understanding of mental health in centenarians. This study aimed to understand the prevalence of mental health conditions-depressive symptoms, anxiety, sleep disturbances, disinhibition, and aberrant motor behaviour-among centenarians in Switzerland. METHODS: Data were collected from N = 169 participants via telephone interviews or paper questionnaires, either directly from centenarians or through proxy informants. Half the data were collected during a period when protective measures were imposed due to the COVID-19 pandemic, and half were collected after the measures were lifted. RESULTS: Mental health conditions were prevalent in our sample, particularly depressive symptoms (44.51%) and anxiety (42.17%). Significant positive associations were found between depressive symptoms and anxiety, and between disinhibition and aberrant motor behaviour. Furthermore, we identified statistical predictors for the occurrence of mental health conditions. Notably, institutionalised living increased the odds of depressive symptomatology, while those with higher education levels or an absence of cognitive impairment experienced more sleep disturbances. Finally, cognitive impairment was linked to increased disinhibition and aberrant motor behaviour. CONCLUSIONS: The high prevalence of mental health conditions underscores the need for proactive mental health care strategies in advanced old age. Moreover, it is vital to consider the interconnected nature of mental health conditions and to prioritise vulnerable groups, such as centenarians in institutional settings.

Activity Diversity and Well-Being in Daily Life: Evidence for Heterogeneity Between Older Adults.

OBJECTIVES: Although higher activity diversity is associated with higher well-being at the between-person level, it is unknown whether a day with higher activity diversity is related to higher well-being within persons. Within 24 hr per day, there are a limited number of activities on which individuals could spend their time and energy. Personal resources could influence the expenditure of energy and thus the experience with daily activities. This study examined daily associations between activity diversity and well-being and whether age and self-related health moderated the associations. METHODS: For seven times per day over 2 weeks, 129 retired older adults (Mage = 73.9 years, SDage = 5.6) reported their present activity engagement and positive and negative affect. Daily activity diversity was operationalized as the number of different activity types reported per day. Daily positive and negative affect were assessed as the average of a range of high- and low-arousal affective states. Self-rated health was assessed with an item from the 12-Item Short-Form Health Survey at baseline. RESULTS: Multilevel models showed that daily activity diversity was unrelated, on average, to daily positive or negative affect at the between- and within-person levels. Daily activity diversity was associated with lower daily positive affect in participants with lower self-rated health, but the Johnson-Neyman regions of significance were outside of the range of observed data. DISCUSSION: Divergent patterns were observed in the within-person associations between activity diversity and well-being across participants. Results are discussed in the context of time use and well-being in older age.

The Mediating Role of Affective States in Short-Term Effects of Activity Engagement on Working Memory in Older Age.

INTRODUCTION: It has been shown that activity engagement is associated with cognitive ability in older age, but mechanisms behind the associations have rarely been examined. Following a recent study which showed short-term effects of activity engagement on working memory performance appearing 6 h later, this study examined the mediating role of affective states in this process. METHODS: For 7 times per day over 2 weeks, 150 Swiss older adults (aged 65-91 years) reported their present (sociocognitive/passive leisure) activities and affective states (high-arousal positive, low-arousal positive, high-arousal negative, and low-arousal negative) and completed an ambulatory working memory task on a smartphone. RESULTS: Multilevel vector autoregression models showed that passive leisure activities were associated with worse working memory performance 6 h later. Passive leisure activities were negatively associated with concurrent high-arousal positive affect (and high-arousal negative affect); high-arousal positive affect was negatively associated with working memory performance 6 h later. A Sobel test showed a significant mediation effect of high-arousal positive affect linking the time-lagged relationship between passive leisure activities and working memory. Additionally, sociocognitive activities were associated with better working memory performance 6 h later. Sociocognitive activities were associated with concurrent higher high- and low-arousal positive affect, which, however, were not associated with working memory performance 6 h later. Thus, a mediation related to sociocognitive activities was not found. DISCUSSION: Passive leisure activities could influence working memory performance through high-arousal positive affect within a timeframe of several hours. Results are discussed in relation to an emotional, and possibly a neuroendocrine, pathway explaining the time-lagged effects of affective states on working memory performance.

The short-term effects of activity engagement on working memory performance in older age.

Does a single bout of activity engagement have short-term effects on cognition in daily life? Using a smartphone-based ambulatory assessment design, this study examined the duration of the effects of three types of activities (i.e., sociocognitive, passive leisure, and physical activities) on working memory performance. For seven times per day (i.e., approximately every 2 hr) over 15 days, 150 healthy older adults (aged 65-91 years) in Switzerland reported their present activities and completed working memory assessments. In an examination of within-person concurrent associations, results from a multilevel model showed that passive leisure activities were negatively associated with working memory. Extending this to time-lagged dynamics, results from multilevel vector autoregression models showed that the negative effect of passive leisure activities and a positive effect of sociocognitive activities on working memory performance appeared 6 hr later and faded out completely by 8 hr later. Follow-up analyses showed that the time-lagged effects of activity engagement were evident among relatively younger individuals with lower levels of formal education. In sum, our findings suggest that a single bout of activity engagement has an impact on cognitive performance as quickly as 6 hr. In line with the "use it or lose it" hypothesis, our findings highlight the importance of continuous and active engagement in sociocognitive activities in older age. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Daily activity diversity and daily working memory in community-dwelling older adults.

OBJECTIVE: Cross-sectional and long-term longitudinal studies have shown that engagement in diverse activities benefits cognitive performance in older age, but it is unknown whether the beneficial effect holds within persons on a daily basis. This study examines the within-person association between activity diversity and working memory on the same day and its time-lagged directionality between days. It also examines the effects of potential moderators on the within-person association, including age, education, processing speed, and crystallized intelligence, to understand who may benefit more from daily activity diversity. METHOD: We examined smartphone-based ambulatory assessment data from 150 community-dwelling older adults (aged 65-91 years) from Switzerland. Participants reported their present activity and completed a working memory task (i.e., numerical updating) seven times per day over 15 days. Activity diversity was calculated on a daily level and scores of working memory were averaged within a day. Age, education, processing speed, and crystallized intelligence were assessed in the laboratory at baseline. RESULTS: Multilevel models showed that, within persons, higher daily activity diversity was positively associated with higher daily working memory. Moreover, the prior day's greater activity diversity led to that day's higher working memory, but not vice versa. There were no moderating effects of age, education, and crystallized intelligence, but partial evidence of a moderating effect of processing speed. CONCLUSIONS: Our results on within-person concurrent and time-lagged associations between daily activity diversity and daily working memory strengthen the existing evidence on the beneficial effect of activity diversity on older adults' cognitive performance. Results are discussed in the context of cognitive reserve theory. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

GPS-Derived Daily Mobility and Daily Well-Being in Community-Dwelling Older Adults.

INTRODUCTION: Mobility as a multidimensional concept has rarely been examined as a day-to-day varying phenomenon in its within-person association with older adults' daily well-being. This study examined associations between daily mobility and daily well-being in community-dwelling older adults with a set of GPS-derived mobility indicators that were representative of older adults' daily mobility. METHODS: Participants wore a custom-built mobile GPS sensor ("uTrail") and completed smartphone-based experience sampling questionnaires on momentary affective states (7 times per day) and daily life satisfaction (in the evening). Analyses included data across 947 days from 109 Swiss older adults aged 65-89 years. RESULTS: Multilevel modeling showed that, within persons, a day with a larger life space area, more time spent in passive transport modes, and a higher number of different locations was associated with higher daily life satisfaction but not daily positive or negative affect. Follow-up analysis showed that the daily maximum distance from home was positively associated with daily life satisfaction, providing a first indication that exposure to non-habitual environments might be a possible underlying mechanism to explain the effects of mobility. CONCLUSIONS: Traveling a long distance away from home and visiting diverse locations may be a way to improve life satisfaction. Results are discussed in the context of research on healthy aging.

Alternating time spent on social interactions and solitude in healthy older adults.

Time spent on being with others (social interactions) and being alone (solitude) in day to day life might reflect older adults' agentic regulatory strategies to balance the needs to belong and to conserve energy. Motivated from a joint lifespan psychological and social relationship theoretical perspective, this study examined how time spent on social interactions and solitude alternatively unfolds within individuals in daily life, relating to individual differences in trait-level well-being and fatigue. Over 21 days, a total of 11,172 valid records of social interactions were collected from 118 older adults (aged 65-94 years) in a smartphone-based event-contingent ambulatory assessment study in Switzerland. On average, a social interaction episode lasted 39 min and a solitude episode lasted 5.03 hr. Multilevel models showed that, at the within-person level, a longer-than-usual social interaction preceded and was followed by a longer-than-usual solitude episode. Moderator analyses showed that older adults with higher trait life satisfaction and lower trait fatigue spent even more time in social interactions after longer solitude episodes, amplifying the solitude-then-interaction association. Our findings suggest that whereas social interaction is a means to improve well-being, solitude is also an integral part in older adults' daily life supporting energy recovery.

Eigenbehaviour as an Indicator of Cognitive Abilities.

With growing use of machine learning algorithms and big data in health applications, digital measures, such as digital biomarkers, have become highly relevant in digital health. In this paper, we focus on one important use case, the long-term continuous monitoring of cognitive ability in older adults. Cognitive ability is a factor both for long-term monitoring of people living alone as well as a relevant outcome in clinical studies. In this work, we propose a new potential digital biomarker for cognitive abilities based on location eigenbehaviour obtained from contactless ambient sensors. Indoor location information obtained from passive infrared sensors is used to build a location matrix covering several weeks of measurement. Based on the eigenvectors of this matrix, the reconstruction error is calculated for various numbers of used eigenvectors. The reconstruction error in turn is used to predict cognitive ability scores collected at baseline, using linear regression. Additionally, classification of normal versus pathological cognition level is performed using a support-vector machine. Prediction performance is strong for high levels of cognitive ability but grows weaker for low levels of cognitive ability. Classification into normal and older adults with mild cognitive impairment, using age and the reconstruction error, shows high discriminative performance with an ROC AUC of 0.94. This is an improvement of 0.08 as compared with a classification with age only. Due to the unobtrusive method of measurement, this potential digital biomarker of cognitive ability can be obtained entirely unobtrusively-it does not impose any patient burden. In conclusion, the usage of the reconstruction error is a strong potential digital biomarker for binary classification and, to a lesser extent, for more detailed prediction of inter-individual differences in cognition.

Partner Pain and Affect in the Daily Lives of Older Couples.

OBJECTIVES: The susceptibility of older adults' affect to fluctuations in their own health (within-person health sensitivity) indicates how they handle everyday health challenges. In old age, affective well-being is often increasingly influenced by close others, yet it is unknown whether older adults' affect is additionally susceptible to fluctuations in their spouse's health (within-partnership health sensitivity) and the extent to which age and relationship satisfaction moderate such associations. METHODS: Parallel sets of multilevel actor-partner interdependence models are applied to self-reported health (feelings of pain/discomfort) and positive and negative affect, obtained 6 times a day over 7 consecutive days from 2 independent samples, the Berlin Couple Dynamics Study (N = 87 couples; Mage = 75 years; M relationship length = 46 years) and the Socio-Economic Panel Couple Dynamics Study (N = 151 couples; Mage = 72 years; M relationship length = 47 years). RESULTS: Husbands and wives had lower positive affect and higher negative affect in moments when they reported more pain (within-person health sensitivity) and when their respective spouse reported more pain (within-partnership health sensitivity). Tests for moderation suggest that within-person, but not within-partnership, health sensitivity is lower at older ages and higher with more satisfying relationships. DISCUSSION: These findings empirically illustrate life-span notions that close relationships shape time-varying health-affect links and thus underscore the theoretical and practical utility of examining social-contextual antecedents of older adults' everyday affective well-being.

Charting everyday activities in later life: Study protocol of the mobility, activity, and social interactions study (MOASIS).

Prominent theories of aging emphasize the importance of resource allocation processes as a means to maintain functional ability, well-being and quality of life. Little is known about which activities and what activity patterns actually characterize the daily lives of healthy older adults in key domains of functioning, including the spatial, physical, social, and cognitive domains. This study aims to gain a comprehensive understanding of daily activities of community-dwelling older adults over an extended period of time and across a diverse range of activity domains, and to examine associations between daily activities, health and well-being at the within- and between-person levels. It also aims to examine contextual correlates of the relations between daily activities, health, and well-being. At its core, this ambulatory assessment (AA) study with a sample of 150 community-dwelling older adults aged 65 to 91 years measured spatial, physical, social, and cognitive activities across 30 days using a custom-built mobile sensor ("uTrail"), including GPS, accelerometer, and audio recording. In addition, during the first 15 days, self-reports of daily activities, psychological correlates, contexts, and cognitive performance in an ambulatory working memory task were assessed 7 times per day using smartphones. Surrounding the ambulatory assessment period, participants completed an initial baseline assessment including a telephone survey, web-based questionnaires, and a laboratory-based cognitive and physical testing session. They also participated in an intermediate laboratory session in the laboratory at half-time of the 30-day ambulatory assessment period, and finally returned to the laboratory for a posttest assessment. In sum, this is the first study which combines multi-domain activity sensing and self-report ambulatory assessment methods to observe daily life activities as indicators of functional ability in healthy older adults unfolding over an extended period (i.e., 1 month). It offers a unique opportunity to describe and understand the diverse individual real-life functional ability profiles characterizing later life.

Assessing the Transferability of Physical Activity Type Detection Models: Influence of Age Group Is Underappreciated.

Increasing the amount of physical activity (PA) in older adults that have shifted to a sedentary lifestyle is a determining factor in decreasing health and social costs. It is, therefore, imperative to develop objective methods that accurately detect daily PA types and provide detailed PA guidance for healthy aging. Most of the existing techniques have been applied in the younger generation or validated in the laboratory. To what extent, these methods are transferable to real-life and older adults are a question that this paper aims to answer. Sixty-three participants, including 33 younger and 30 older healthy adults, participated in our study. Each participant wore five devices mounted on the left and right hips, right knee, chest, and left pocket and collected accelerometer and GPS data in both semi-structured and real-life environments. Using this dataset, we developed machine-learning models to detect PA types walking, non-level walking, jogging/running, sitting, standing, and lying. Besides, we examined the accuracy of the models within-and between-age groups applying different scenarios and validation approaches. The within-age models showed convincing classification results. The findings indicate that due to age-related behavioral differences, there are more confusion errors between walking, non-level walking, and running in older adults' results. Using semi-structured training data, the younger adults' models outperformed older adults' models. However, using real-life training data alone or in combination with semi-structured data generated better results for older adults who had high real-life data quality. Assessing the transferability of the models to older adults showed that the models trained with younger adults' data were only weakly transferable. However, training the models with a combined dataset of both age groups led to reliable transferability of results to the data of the older subgroup. We show that age-related behavioral differences can alter the PA classification performance. We demonstrate that PA type detection models that rely on combined datasets of young and older adults are strongly transferable to real-life and older adults' data. Our results yield significant time and cost savings for future PA studies by reducing the overall volume of training data required.

Leveraging Daily Social Experiences to Motivate Healthy Aging.

Models of healthy aging highlight the motivating influence of social connections. Social experiences constantly shape our thoughts and behaviors throughout daily life, and these daily processes slowly and consistently influence our health and well-being. In this article, we discuss research that has moved from cross-sectional laboratory designs emphasizing individual behaviors to more naturalistic within-person paradigms linking daily social experiences to emotional, cognitive, and physical well-being. We mention research gaps that need to be filled to advance our knowledge of the powerful forces of the social environment for motivating healthy aging. We also offer future directions to move this research forward. We conclude with an outlook on how to leverage these powerful forces in novel intervention approaches that are sensitive to the constantly changing nature of the person and the environment.

"Hi This Is NESTORE, Your Personal Assistant": Design of an Integrated IoT System for a Personalized Coach for Healthy Aging.

In the context of the fourth revolution in healthcare technologies, leveraging monitoring and personalization across different domains becomes a key factor for providing useful services to maintain and promote well-being. This is even more crucial for older people, with aging being a complex multi-dimensional and multi-factorial process which can lead to frailty. The NESTORE project was recently funded by the EU Commission with the aim of supporting healthy older people to sustain their well-being and capacity to live independently. It is based on a multi-dimensional model of the healthy aging process that covers physical activity, nutrition, cognition, and social activity. NESTORE is based on the paradigm of the human-in-the-loop cyber-physical system that, exploiting the availability of Internet of Things technologies combined with analytics in the cloud, provides a virtual coaching system to support healthy aging. This work describes the design of the NESTORE methodology and its IoT architecture. We first model the end-user under several domains, then we present the NESTORE system that, analyzing relevant key-markers, provides coaching activities and personalized feedback to the user. Finally, we describe the validation strategy to assess the effectiveness of NESTORE as a coaching platform for healthy aging.

Functional Ability in Everyday Life: Are Associations With an Engaged Lifestyle Mediated by Working Memory?

OBJECTIVES: An engaged lifestyle has been linked to measures of functional ability in everyday life. However, the underlying mechanism of this link is still understudied. We propose working memory as a potential mediator of this relation. METHODS: Modeling data of 158 older adults with a latent-variables approach, we examined whether working memory mediated the relation between an engaged lifestyle, that is, intellectual, social, and physical activities, and functional ability, that is, self-reported everyday failures and test-based everyday performance. RESULTS: Working memory was found to fully mediate the relation between gaming activities and test-based everyday performance. Furthermore, we found a negative association between sports activities and self-reported everyday failures not mediated through working memory, indicating that individuals who reported high levels of sports activities reported fewer everyday cognitive failures. All other lifestyle activities were, however, neither directly nor indirectly associated with functional ability. DISCUSSION: Working memory is one pathway by which gaming activities are related to test-based measures of functional ability in everyday life. Given the overlapping cognitive demands of working memory, gaming activities, and the test-based measure of functional ability, the findings suggest that while an engaged lifestyle can benefit functional ability, those benefits may be limited to highly similar domains.

Intra- and interindividual differences in the within-person coupling between daily pain and affect of older adults.

The bidirectional interplay between chronic pain and negative affect is well-established in patient samples. However, less is known about the day-to-day relationship between pain and affect of older adults without severe illnesses and to what extent this association differs within and between individuals. A total of 224 participants (Mage = 77.6, SDage = 6.2) reported their daily experience of pain, impairment by their pain and affect during 21 consecutive days. Multilevel modeling results showed that on days with increased pain individuals also reported less positive affect and more negative affect. Time-lagged results indicated a temporal carry-over from yesterday's pain to today's negative affect but not to today's positive affect. Moreover, on days when individuals reported stronger impairment by their pain, they showed a stronger within-person coupling between daily pain and affect in contrast to days with a weaker experience of daily impairment. Yesterday's pain and today's negative affect were more strongly associated within individuals who reported higher levels of impairment. Interindividual differences in the within-person coupling between daily pain and affect were found with regard to general physical health conditions and general satisfaction with health. This study demonstrated the importance of focusing on within-person couplings between daily pain and affect beyond patient samples in order to better understand the maintenance of emotional stability despite daily hassles in older adults' everyday lives.

Lagged Coupled Changes Between White Matter Microstructure and Processing Speed in Healthy Aging: A Longitudinal Investigation.

Age-related differences in white matter (WM) microstructure have been linked to lower performance in tasks of processing speed in healthy older individuals. However, only few studies have examined this link in a longitudinal setting. These investigations have been limited to the correlation of simultaneous changes in WM microstructure and processing speed. Still little is known about the nature of age-related changes in WM microstructure, i.e., regionally distinct vs. global changes. In the present study, we addressed these open questions by exploring whether previous changes in WM microstructure were related to subsequent changes in processing speed: (a) 1 year later; or (b) 2 years later. Furthermore, we investigated whether age-related changes in WM microstructure were regionally specific or global. We used data from four occasions (covering 4 years) of the Longitudinal Healthy Aging Brain (LHAB) database project (N = 232; age range at baseline = 64-86). As a measure of WM microstructure, we used mean fractional anisotropy (FA) in 10 major WM tracts averaged across hemispheres. Processing speed was measured with four cognitive tasks. Statistical analyses were conducted with bivariate latent change score (LCS) models. We found, for the first time, evidence for lagged couplings between preceding changes in FA and subsequent changes in processing speed 2 years, but not 1 year later in some of the WM tracts (anterior thalamic radiation, superior longitudinal fasciculus). Our results supported the notion that FA changes were different between regional WM tracts rather than globally shared, with some tracts showing mean declines in FA, and others remaining relatively stable across 4 years.

Emotion Regulation, Subjective Well-Being, and Perceived Stress in Daily Life of Geriatric Nurses.

This daily diary study examined the within-person coupling between four emotion regulation strategies and both subjective well-being and perceived stress in daily life of geriatric nurses. Participants (N = 89) described how they regulated their emotions in terms of cognitive reappraisal and suppression. They also indicated their subjective well-being and level of perceived stress each day over 3 weeks. At the within-person level, cognitive reappraisal intended to increase positive emotions was positively associated with higher subjective well-being and negatively associated with perceived stress. Suppression of the expression of positive emotions was negatively associated with subjective well-being and positively associated with perceived stress. However, cognitive reappraisal intended to down-regulate negative emotions and suppression as a strategy to inhibit the expression of negative emotions were not associated with daily well-being or perceived stress. Off-days were rated as days with higher subjective well-being and lower perceived stress in contrast to working days. At the between-person level, individuals who reported more daily negative affect reported increased suppression of positive emotions, corroborating the within-person findings. Moreover, findings indicated that nurses with more years of experience in the job reported higher subjective well-being and less perceived stress. These results provide insights into important daily emotional processes of geriatric nurses, both at workdays and in their leisure time.