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.

Dyadic loneliness, age, and cognitive functioning among midlife and older Black couples.

Objectives: Within marriages, loneliness has been linked with individuals' own and their partners' cognitive health. Yet little research has situated Black older adults within a relational, dyadic context.Method: This study analyzed longitudinal dyadic data from the Health and Retirement Study (2010-2016; n = 1270 participants from 635 couples) from both partners in opposite-sex midlife and older couples where at least one partner reported being Black or African American.Results: Results indicated (1) husbands' loneliness was associated with worse cognitive functioning 4 years later for wives who had high baseline cognitive functioning themselves; (2) wives' loneliness was associated with worse cognitive functioning 4 years later only for oldest-old husbands; and (3) wives' cognitive functioning was associated with slower increases to husbands' loneliness 4 years later.Conclusion: Findings indicate that loneliness has dyadic consequences for cognitive functioning among older Black couples, but that context is crucial for determining who is at greatest risk of harmful repercussions from a partner's loneliness.

Employment Dynamics Among Adult Children at the Onset of Parental Dementia: Variation by Sociodemographic Characteristics.

OBJECTIVES: To examine the influence of sociodemographic factors on employment changes among adult children following onset of parental Alzheimer's disease and related dementia (ADRD). METHODS: We used Health and Retirement Study (2010-2018; N = 20,110) data to examine adult child (ages 50-70) changes in employment and work hours at onset of parental ADRD and potential variation by gender, age, race, ethnicity, and education. RESULTS: Parental ADRD onset was not associated with changes in adult child employment overall, although associations differed substantially across subpopulations defined by education level. Sons with the lowest education were least likely to cease employment, while daughters with the lowest education were most likely to reduce work hours. Sons at older ages were increasingly likely to reduce work hours or end employment following parental ADRD onset. DISCUSSION: The potential impact of parental ADRD on adult child employment is complex and should be considered in the context of sociodemographic factors.

Preventive Healthcare Screening Completion Among Midlife and Older Adults With Intellectual and Developmental Disabilities.

Individuals with intellectual and developmental disabilities (IDD) face several barriers to healthcare, making them less likely to receive numerous routine preventive health screenings. Preventive healthcare is a critical aspect to maintaining health and wellness, particularly for people with complex health needs. This study examines individual- and state-level factors associated with mammogram and colonoscopy screenings in mid- and later-life foradults with IDD receiving state services. Multilevel logistic regression models analyzed data from the 2012-2013 and 2018-2019 waves of the National Core Indicators In-Person Survey (NCI-IPS). Results indicated that factors such as age, living situation, transportation access, and community involvement were associated with completion of both preventive screenings. Medicaid expansion was associated with a significantly greater likelihood of completing a colonoscopy screening only among younger persons in the sample (i.e., in their 50s). These findings may have implications for completion of preventive health screenings for adults with IDD.

Neighborhood Social Cohesion and Loneliness in Mid- and Later Life: Are Benefits Contingent on Race/Ethnicity or Neighborhood Disorder?

OBJECTIVES: Connections between social integration and health throughout the life span are well established, including at the neighborhood level and among older adults. Less explored is how pathways between neighborhood social cohesion and well-being may differ by race/ethnicity or by neighborhood disorder. This study investigates whether perceived neighborhood social cohesion is associated with loneliness in adults aged 50 and older, and whether this association is moderated by race/ethnicity or perceived neighborhood disorder. METHODS: We used pooled cross-sectional data from the 2016 and 2018 waves of the Health and Retirement Study and respondents to the Leave-behind Questionnaire age 50 and older, living in the community (N = 10,713). Data were analyzed using multivariate ordinary least squares regression. RESULTS: Perceived social cohesion was negatively associated with loneliness (B = -0.13, p < .001); however, this effect was strongest among White respondents, and significantly weaker for respondents who were Black (B = 0.02, p < .05), Hispanic (B = 0.03, p < .05), or of another race/ethnicity (B = 0.03, p < .05). Further, neighborhood disorder moderated the association between social cohesion and loneliness (B = 0.02, p < .001), reducing the strength of relationship for those in areas of high disorder. Inclusion of this interaction also attenuated the interaction between neighborhood cohesion and race for Black older adults. DISCUSSION: Findings show that neighborhood social cohesion matters for midlife and older adults' loneliness, but that this relationship varies by race/ethnicity and neighborhood disorder. As such, neighborhood racial/ethnic makeup and both social and objective neighborhood characteristics should be considered when designing interventions to reduce loneliness.

Longitudinal Dyadic Associations Between Loneliness and Cognition Among Older Couples in the United States.

OBJECTIVES: Loneliness is associated with diminished health and cognition for older individuals. However, little research has examined dyadic loneliness-that is, loneliness of both partners in a relationship-and its potential consequences for cognitive functioning among both spouses, nor whether one partner's cognition may affect both partners' loneliness over time. METHODS: We analyze 3-wave dyadic Health and Retirement Study data (2010-2020; N = 1,061 dyads) to determine (a) whether loneliness predicts participants' own and/or their partners' episodic memory and verbal fluency over 8 years, and (b) whether cognitive functioning predicts older spouses' own or their partners' loneliness over the same period. RESULTS: Loneliness predicted participants' own and their partners' loneliness at follow-up, at both time points. Loneliness was also associated with own episodic memory at follow-up, but not with verbal fluency. Episodic memory and verbal fluency predicted one another over time. Neither episodic memory nor verbal fluency predicted loneliness at follow-up. Significant dyadic mediation was established such that Time 1 loneliness was linked with partner's Time 3 episodic memory via that partner's Time 2 loneliness. DISCUSSION: Lonelier older adults displayed worse trajectories of episodic memory over time, yet poor memory did not precede changes to loneliness. Further, having a lonely partner was linked with poorer episodic memory 8 years later, indicating that both one's own and-to a lesser extent-a partner's emotional well-being may be consequential for maintaining cognitive functioning with age. Associations were more clearly established with episodic memory than with verbal fluency, suggesting potential domain-specific effects of loneliness.

Relationships between Interpersonal Goals and Loneliness in Older Adults: A Cross-Sectional Study.

Loneliness is linked to many physiological and psychological issues and disproportionately affects older adults. Interpersonal goals (compassion and self-image) are essential to interpersonal relationships; however, how they relate to loneliness in older adults is unknown. We investigated the impact of interpersonal goals on loneliness using the Ecosystem-Egosystem Theory of Social Motivation. This study, adopting a descriptive cross-sectional correlational design, used data from the 2016 Health and Retirement Study. Participants (n = 3212) included people aged >65 years (mean age: 75; female: 60.1%). We performed exploratory factor analysis with principal axis factoring and varimax rotation to examine the suitability of compassionate and self-image goals as separate factors. The complex samples general linear model was used to assess the relationship between loneliness and interpersonal goals. Interpersonal goals were significantly negatively associated with loneliness. Respondents with higher compassion and self-image goals reported lower loneliness levels. Our results contribute to understanding how interpersonal goals relate to loneliness in older adults. These initial findings warrant further investigation.

Caregiving and Self-Esteem in Mid and Later Life: Is There Variation by Age, Parental Status, and Gender?

Caregiving may prove either beneficial or harmful for caregiver well-being, depending on the circumstances surrounding care provision. Using data from the two most recent waves of the National Survey of Midlife Development in the United States (MIDUS, 2004-2014; N = 1,100), we examine whether providing care for an adult at both time points (i.e., 8-10 years apart) is associated with changes to self-esteem over the ten-year period, in comparison with providing care at only one time point, or not at all. We also examine moderation by caregivers' age, parental status, and gender. Findings indicated (1) caregiving at both waves was associated with decreases in self-esteem among younger and midlife adults, but this effect weakened and even reversed with age; and (2) caregiving at both waves was associated with increased self-esteem among participants without children, but not among those with children. We discuss implications for identifying caregivers at greatest risk of diminished well-being.

Loneliness and HbA1c among older Irish couples: Retirement as life stage context.

Loneliness is an important determinant of health and mortality among the aging population, including for cardiometabolic health. Yet research has largely focused on individual experiences of loneliness, rather than taking intimate relationships into account. However, recent studies have highlighted that loneliness of a partner may have implications for one's own health and well-being as well. Indeed, this is particularly true among older couples, as life events and shifting time horizons (e.g., retirement, reduced social networks) can lead to greater prominence and salience of one's closest relationships. This study uses dyadic structural equation modeling (SEM) to estimate actor-partner interdependence models (APIM) examining associations between loneliness and HbA1c levels among 1331 older married couples from The Irish Longitudinal Study on Aging (TILDA, 2009-2011). Furthermore, we test whether any such actor or partner effects vary by employment status. Results indicated that one's own loneliness was not significantly linked with HbA1c, irrespective of employment status. However, loneliness of a dyadic partner was significantly associated with elevated HbA1c among retired persons only. These findings underscore that relationship and life course context are crucial when considering the dyadic implications of loneliness for health among the older population.

A systematic review of loneliness in bereavement: Current research and future directions.

Bereaved people suffer from loneliness and loneliness is associated with poor mental health. In this study, this topic is reviewed. An agenda is suggested for future research. Research that is theory-driven, addresses measurement consistency, correlates of loneliness in bereaved and non-bereaved, and treatment is necessary for prevention and intervention.

Loneliness in Bereavement: Measurement Matters.

The role of loneliness in the bereavement experience has been reported as substantial, with the death of a close person leaving a considerable void in the life of the bereaved. Yet, there is lack of agreement about its precise role and, notably, whether loneliness should be included as a core symptom for diagnosis of grief complications. The ongoing threat of heightened social isolation due to the COVID-19 pandemic underlines the need to understand the impact of loneliness, and to accurately chart its prevalence, intensity, duration, and associated difficulties in the context of bereavement. Assessment issues are central to this endeavor. In this article, we review the scientific literature to examine how loneliness after bereavement has been operationalized and measured. Sixty-three articles analyzing 51 independent datasets were reviewed. Results show major disparities: approximately half of the projects assessed loneliness by means of one of two validated scales (spanning different versions); the remainder included only single- or few-item measures. Diverse instructions, content and answer categories were used. While one size does not fit all, awareness of assessment options and dis/advantages may aid selection of the most appropriate measure, to suit the goals of a particular study and the specific groups under investigation. Our conclusion is that, in selecting a loneliness measure, health care professionals should come to their own well-informed decision, aided by the information provided in our review.

Dyadic Loneliness and Changes to HbA1c Among Older US Couples: The Role of Marital Support as Stress Buffer.

Objectives: Both experiencing loneliness and having a lonely partner can be psychosocial stressors, with implications for health. Yet, marital support may buffer against the cardiometabolic effects of loneliness. This study examines (1) whether own and/or partner's loneliness predict changes in HbA1c over 4 years and (2) whether marital support moderates these effects. Methods: Actor-partner interdependence models analyzed data from 1,854 older couples who provided psychosocial and biomarker data at two timepoints (2008/2012 or 2010/2014) of the Health and Retirement Study. Results: Neither partner's loneliness predicted changes in HbA1c overall. However, significant interactions indicated that both own baseline loneliness and partner's baseline loneliness predicted significant increases to HbA1c over 4 years among those who reported below-average marital support. Discussion: Both the experience of loneliness and loneliness of a dyadic partner may have longitudinal consequences for cardiometabolic health. However, these effects are contingent upon perceived quality of the marriage, specifically marital support.

Depression and Elevated Inflammation Among Chinese Older Adults: Eight Years After the 2003 SARS Epidemic.

BACKGROUND AND OBJECTIVES: This study examined associations between exposure to the 2003 Severe Acute Respiratory Syndrome (SARS) epidemic and Chinese older adults' depression and inflammation 8 years after the crisis. Further, this study investigated the buffering effects of perceived social support and social participation. RESEARCH DESIGN AND METHODS: Data were drawn from the 2011 China Health and Retirement Longitudinal Survey, including N = 4,341 Chinese adults aged 60 years and older. For the survey, local officials identified whether the 2003 SARS outbreak was one of the major disasters in the history of their communities. Depression was assessed by the Center for Epidemiological Studies-Depression scale and inflammation was measured by C-reactive protein (CRP) collected from participants via venous blood draws. RESULTS: Results from multilevel logistic regression models revealed that Chinese older adults living in communities exposed to SARS were more likely to have elevated CRP compared to those not living in such communities. Moreover, community SARS exposure was associated with greater risks of depression for Chinese older adults who had no perceived social support. Among Chinese older adults who had low levels of social participation, community SARS exposure was more strongly related to elevated CRP. DISCUSSION AND IMPLICATIONS: Findings suggest community-level exposure to the SARS epidemic had enduring consequences for Chinese older adults' health. However, active social participation and supportive social ties provided important resources that may buffer against negative effects of exposure to the SARS epidemic.

Cognitive Functioning, Gender, and Marital Quality Among Older Married Couples: A Dyadic Approach.

This study examines associations of older husbands' and wives' cognitive functioning with both partners' marital quality. Generalized structural equation modeling analyzed data from 1,432 opposite-sex couples drawn from the 2016 wave of the Health and Retirement Study. Findings revealed that wives' poorer cognitive functioning was associated with wives reporting greater closeness and enjoyment of time with a spouse, whereas husbands' poorer cognitive functioning was associated with wives reporting greater marital strain, lower marital support, lower closeness, and less enjoyment of time with a spouse. This suggests that cognitive functioning has dyadic consequences for marital quality, which are highly gendered.

Grieving a Grandparent: The Importance of Gender and Multigenerational Relationships.

Objective: This study examined adult grandchildren's experience of losing a grandparent in the context of a multigenerational family. Background: Although the death of a grandparent in adulthood is often an expected life event, this loss may still result in grief for adult grandchildren. Furthermore, bereavement is not merely an individual experience, but a family one. Characteristics of the relationship between bereaved adult grandchildren and their bereaved middle-generation parents may influence adult grandchildren's grief responses. This includes both structural (e.g., gender of parent; coresidence with parent) and emotional (e.g., relationship quality; worry about parent) aspects of this tie. Method: Young adult grandchildren from Wave 2 of the Family Exchanges Study (2013, N = 204) reported on their recent grandparent loss experiences (N = 216) and relationships with their middle-generation parents (N= 142). Results: Three-level multilevel models revealed that (a) grandsons who lost a grandmother reported significantly fewer grief symptoms than all other gender combinations; (b) worry about a middle-generation parent was associated with higher grief symptoms, but; (c) this effect was significantly stronger when the middle-generation parent was a mother, and when adult grandchildren were coresident with that bereaved parent. Finally, relationship quality with the middle-generation parent was not associated with grief symptoms, irrespective of context. Conclusion: Results highlight the intersection of emotional and structural aspects of multigenerational relationships following the death of a family member.

Social Integration, Daily Discrimination, and Biological Markers of Health in Mid- and Later Life: Does Self-Esteem Play an Intermediary Role?

BACKGROUND AND OBJECTIVES: This cross-sectional study examines associations of social integration and daily discrimination with 4 biological markers of inflammation and cardiovascular health and tests whether self-esteem may mediate any of these effects. RESEARCH DESIGN AND METHODS: Data came from 746 participants of the National Survey of Midlife Development in the United States (MIDUS) Refresher (2011-2014) and MIDUS Refresher Biomarker Project (2012-2016). Structural equation modeling estimated direct and indirect associations of social integration and daily discrimination with glycosylated hemoglobin (HbA1c), high-density lipoprotein (HDL), C-reactive protein, and interleukin-6. RESULTS: Social integration and daily discrimination were both significantly associated with self-esteem, which was in turn associated with HbA1c, HDL, and interleukin-6 levels. Social integration was indirectly associated with HbA1c, HDL, and interleukin-6 via self-esteem. Daily discrimination was directly associated with HbA1c, C-reactive protein, and interleukin-6 and was indirectly associated with HDL and interleukin-6 via self-esteem. DISCUSSION AND IMPLICATIONS: Findings identify social correlates of inflammation and cardiovascular risk and suggest that self-esteem may serve as a pathway for effects. Overall, results were somewhat mixed: Daily discrimination was directly associated with both self-esteem and 3 of the 4 biological markers of health; however, although social integration was strongly associated with self-esteem, it was only weakly and indirectly associated with biological health markers. Moreover, the indirect effects of daily discrimination on the biomarker outcomes-while significant-were notably smaller than its direct effects. Implications for theory, practice, and future research are discussed, including the need for further study of self-esteem and physical health across mid- and later life.

Trajectories of rural-urban disparities in biological risks for cardiovascular disease among Chinese middle-aged and older adults.

This study examined rural-urban differences in age trajectories of biological risks for cardiovascular disease (CVD) among Chinese middle-aged and older adults. Data were from the 2011 wave of China Health and Retirement Longitudinal Study, including 11,528 respondents (Mage = 59.15) from 440 communities. CVD risk factors included C-reactive protein (CRP), high-density lipoprotein (HDL), body mass index (BMI), and waist circumference (WC). Multilevel models revealed that rural adults had higher levels of HDL and lower levels of CRP and BMI on average, compared to urban adults. We also found significant rural-urban differences in the age trajectories of CVD risks. Rural-urban disparities in CVD risks increased from middle to later life, and converged at later old age. Findings suggest that rural-urban differences in cardiovascular health are not static, but rather vary throughout adulthood.

Intergenerational Relationships, Family Caregiving Policy, and COVID-19 in the United States.

Families and intergenerational relationships are important sources of risk for COVID-19 infection, especially for older adults who are at high risk of complications from the disease. If one family member is exposed to the virus they could serve as a source of transmission or, if they fall ill, the resources they provide to others could be severed. These risks may be especially heightened for family members who work outside the home and provide care, or for those family members who care for multiple generations. Policies have the potential to help families bear the burden of these decisions. This essay argues that policies that address health, employment, and other social issues have implications for families, and that policies aimed at families and caregivers can affect the health, employment, and the general well-being of the nation.

Implications of Perceived Neighborhood Quality, Daily Discrimination, and Depression for Social Integration Across Mid- and Later Life: A Case of Person-Environment Fit?

BACKGROUND AND OBJECTIVES: Integration in one's social community may depend in part upon feeling safe and secure within one's physical community, or neighborhood. Moreover, high-quality neighborhoods may serve as a supportive resource, potentially "buffering" against the harmful influence of experiences such as discrimination or depression that could otherwise erode adults' sense of belonging. This study examines longitudinal associations of perceived neighborhood quality, daily discrimination, and depression with social integration among midlife and older adults, and tests whether perceived neighborhood quality is of increased importance with age and/or in the contexts of discrimination and depression. RESEARCH DESIGN AND METHODS: Multilevel random intercept models analyzed 6,016 observations of 3,102 individuals drawn from the 3 waves of the National Survey of Midlife Development in the United States (MIDUS, 1995-2014). RESULTS: Perceived neighborhood quality was associated with greater social integration throughout adulthood, though its impact was slightly attenuated with age. Moreover, depression was harmful for social integration across the age range, yet its influence was significantly buffered by perceived neighborhood quality. Daily discrimination was not associated with social integration, net of covariates. DISCUSSION AND IMPLICATIONS: Findings underscore the importance of physical place and person-environment fit for social well-being throughout adulthood, and confirm the deleterious effects of depression for adults' social integration. Further, results highlight perceived neighborhood quality as a critical component for successful "aging in place," particularly as a social resource adults may call upon in the context of depression.

Dyadic quality of life among heterosexual and sexual minority breast cancer survivors and their caregivers.

PURPOSE: The number of informal caregivers to cancer survivors is increasing, and limited information is available about caregivers to sexual minority breast cancer survivors. The purpose of this study was to assess dyadic quality of life among sexual minority cancer survivors and their caregivers compared with heterosexual cancer survivors and their caregivers. METHODS: We recruited 167 survivors of non-metastatic breast cancer of different sexual orientations and their caregivers, who were surveyed via telephone after obtaining consent. We used inverse propensity score weighting to account for differences by sexual orientation in age and length of the survivor-caregiver relationship, and simultaneous equation models consistent with the needs for analyzing dyadic data. RESULTS: About 6-7 years after diagnosis, survivors and caregivers reported quality of life scores consistent with population norms, and there were no differences by survivors' sexual orientation. With few exceptions, caregivers' and survivors' quality of life influenced one another directly, and these effects were stronger among sexual minority dyads than heterosexual dyads. CONCLUSIONS: Because of the strength of sexual minority, survivors' and their caregivers' mutual influence on each other's quality of life, interventions, and clinical care for sexual minority breast cancer survivors should consider their caregivers.