Repeated Low-Level Blast Exposure: A Descriptive Human Subjects Study.

The relationship between repeated exposure to blast overpressure and neurological function was examined in the context of breacher training at the U.S. Marine Corps Weapons Training Battalion Dynamic Entry School. During this training, Students are taught to apply explosive charges to achieve rapid ingress into secured buildings. For this study, both Students and Instructors participated in neurobehavioral testing, blood toxin screening, vestibular/auditory testing, and neuroimaging. Volunteers wore instrumentation during training to allow correlation of human response measurements and blast overpressure exposure. The key findings of this study were from high-memory demand tasks and were limited to the Instructors. Specific tests showing blast-related mean differences were California Verbal Learning Test II, Automated Neuropsychological Assessment Metrics subtests (Match-to-Sample, Code Substitution Delayed), and Delayed Matching-to-Sample 10-second delay condition. Importantly, apparent deficits were paralleled with functional magnetic resonance imaging using the n-back task. The findings of this study are suggestive, but not conclusive, owing to small sample size and effect. The observed changes yield descriptive evidence for potential neurological alterations in the subset of individuals with occupational history of repetitive blast exposure. This is the first study to integrate subject instrumentation for measurement of individual blast pressure exposure, neurocognitive testing, and neuroimaging.

The Importance of Leisure Activities in the Relationship between Physical Health and Well-Being in a Life Span Sample.

BACKGROUND: Previous studies have examined the relationships between physical health and leisure activities and between leisure activities and well-being, but, to our knowledge, none has examined these relationships simultaneously. OBJECTIVE: This study investigated the relationships between leisure activities, health and well-being considering the role of age, and whether leisure activities mediate the relationship between physical health and well-being. METHODS: Utilizing a cross-sectional database of 259 adults (ages 18-81 years) who completed several questionnaires, linear regression models and mediation models were tested. RESULTS: Regression analyses indicated that physical health was related to leisure activities and leisure activities were related to well-being. When physical health was measured by subjective ratings, age had a stronger relationship with leisure activities. However, when physical health was indicated by health restrictions, physical health had a stronger relationship with leisure activities than did age. Leisure activities were a partial mediator of the relationship between physical health and well-being. CONCLUSION: The results demonstrated that the reduction in leisure activities with age has more to do with physical health limitations than with older age itself. In addition, regardless of age, the benefits of physical health for well-being are due in part to the level of leisure activity participation. These results highlight the importance of leisure activities for successful aging throughout the adult life span. Interventions designed to improve well-being through increasing leisure activity participation should take physical health into consideration, particularly for older adults.

Challenges Experienced at Age 100: Findings From the Fordham Centenarian Study.

This article examines the challenges experienced by very old individuals and their consequences for well-being and mental health. In order to capture unique issues experienced in very old age, 75 participants of the population-based Fordham Centenarian Study answered open-ended questions on everyday challenges. Theme-based coding was then used to categorize and quantify responses. The challenges mentioned most often were challenges faced in the functional (e.g., physical health/activities of daily living restrictions, mobility, sensory impairment), psychological (e.g., loss of well-liked activity, dependency, negative emotions, death), and social (e.g., family loss) life domains. Functional challenges were negatively associated with aging satisfaction and positively associated with loneliness. Psychological challenges were positively linked to aging satisfaction. Social challenges were marginally related to loneliness. Notably, challenges were not related to depression. In conclusion, the challenges experienced in very old age are multidimensional and multifaceted, unique in nature, and have differential relations to mental health. Functional, psychological, and social challenges affect very old individuals' lives and therefore need to be better understood and addressed. Given their consequences, it is imperative for policy makers to develop an awareness for the different types of challenges faced by centenarians, as there may be unique policy implications related to each.

Improving Mental Health Treatment Initiation among Depressed Community Dwelling Older Adults.

OBJECTIVE: Depression screening has been widely implemented in community settings to increase detection of late-life depression. Rates of treatment initiation are low without additional structured follow-up, however. The current study evaluates the effectiveness of a brief psychosocial intervention, Open Door, designed to improve initiation of mental health treatment among clients of aging service meals programs. DESIGN: Older adult social service clients with depressive symptoms were randomized to either the Open Door intervention or a Service Referral control condition. In Open Door, the counselor collaborates with the client to identify and address both attitudinal and structural barriers to seeking mental health treatment. Independent research assessments were conducted 12 and 24 weeks after baseline to document treatment initiation (at least one session). RESULTS: At follow up, 64.6% (104 out of 161) of participants had initiated a provider visit. Participants in Open Door were more likely to initiate treatment compared with those in the control condition (χ(2) = 5.83, df = 2, p = 0.016). Among participants with at least mild depressive symptoms, Open Door remained significantly more effective than the control condition (p < 0.05). In multivariate analyses controlling for gender differences, both participation in the Open Door group and depression severity predicted treatment initiation (χ(2) = 15.18, df = 3, p = 0.002). CONCLUSIONS: High rates of depression have been documented among older adults receiving social services (case management or home meals). The Open Door program offers a useful strategy to overcome the barriers to treatment initiation while fitting within the responsibilities of aging service staff. The intervention can improve initiation of late-life depression care.

Physical, cognitive, social and mental health in near-centenarians and centenarians living in New York City: findings from the Fordham Centenarian Study.

BACKGROUND: Despite their strong increase, the population of the very old, including near-centenarians and centenarians, represent an unstudied and underserved population. Available studies mostly concentrate on predictors of exceptional longevity, but rarely extend their focus to other areas of functioning. Also, little is known about what contributes to experiencing a quality life in very old age. The present population-based study aims at providing a comprehensive picture of key domain of functioning, including physical, cognitive, social and mental function in very old individuals and to determine predictors of mental health indicators. METHODS: A total of 119 individuals aged 95 to 107 living in private dwellings and residential care facilities were recruited based on the New York City Voters Registry. Participants answered questions regarding their health and activities of daily living. Their cognitive functioning was determined using the Mini-Mental State Examination and the Global Deterioration Scale. Social resources were measured with number of children and the Lubben Scale. Mental health was assessed with the Geriatric Depression Scale and the Satisfaction with Life Scale. RESULTS: An unexpectedly large proportion of the sample lived in the community. On average, cognitive functioning was high. Although five diseases were reported on average, participants reported good health. Functional status was reduced. Most participants had at least one person for communication/social support. On average, depression was below cut-off, and most participants reported high life satisfaction. Regression analyses indicated that individual differences in depression were associated with subjective health, IADL and relatives support. For life satisfaction, subjective health, ADL and number of children were most important. Demographic characteristics, number of illnesses or cognitive status were not significant. CONCLUSIONS: Despite reduced levels of physical functioning and social resources, very old participants were in good mental health suggesting high resilience and ability to adapt to age-associated challenges. That a large proportion of them lived in the community further highlights their desire for leading an autonomous life, which may have been facilitated by New York service culture. More research is necessary to provide guidance for the development of well-suited services for this very old population.

Outcomes of Occupational Self-Efficacy in Older Workers.

Because of the increasing number of older workers, it is important to develop models of work-related constructs for this population. The present article developed a model surrounding occupational self-efficacy, testing its relation to other factors (e.g., intrinsic job motivation), predictors (e.g., self-perceptions of aging), and outcomes (e.g., job satisfaction). Employed adults of ages 50 and older (n = 313) were recruited via organizations and social media sites. Study participants (M = 59.7, SD = 6.1, range = 50-78) volunteered to fill out an Internet survey. Occupational self-efficacy predicted job satisfaction, and intrinsic job motivation fully mediated this relationship. More negative self-perceptions of aging predicted poorer occupational self-efficacy. Occupational self-efficacy also predicted life satisfaction. Expected retirement age and job performance were unrelated to occupational self-efficacy. These findings may inform workplace interventions that seek to maintain or increase older worker job and life satisfaction.

Prevalence of hypersexual behavior in Parkinson's disease patients: Not restricted to males and dopamine agonist use.

This study investigates the prevalence and demographic characteristics of hypersexuality in Parkinson's disease (PD). Impulse control disorders in PD patients have been associated with dopamine agonist therapy. Moreover, hypersexuality and pathological gambling have been associated with males, while females may be inherently thought to be more likely to participate in compulsive shopping and binge-eating behaviors. In this study, a screening mail-in survey was sent to all PD patients at a single Movement Disorders Center. One hundred forty one of 400 (35.3%) research packets were returned completed. Fifteen of 141 patients met initial screening criteria for hypersexual behavior. After detailed interview, only 6/141 (4.3%) of PD patients met criteria for pathologic hypersexual behavior. These behaviors included: compulsive masturbation, prostitution, and paraphilias. Patients with a younger age of PD onset were more likely to exhibit hypersexual behavior. Unlike previous report, no significant association was found between hypersexuality and gender or dopamine agonist use. Rather, this study suggests that physicians should be vigilant for hypersexual behavior in all PD patients, regardless of gender and PD medication regimen. Ultimately, given the innate sensitivity of the topic and survey limitations, it is very likely that hypersexual behavior in our cohort, as it is in the general PD population, has been under-reported.