Spatial Distribution of Salmonella enterica in Poultry Shed Environments Observed by Intensive Longitudinal Environmental Sampling.

Detection of salmonellae within poultry environments is an important component of many food safety programs, but sampling approaches vary greatly and may not enable the detection of salmonellae when bacteria are present at a low prevalence or concentration. Intensive longitudinal sampling within caged sheds enabled us to undertake a longitudinal analysis of the spatial distribution of salmonellae in caged shed environments. Both the number of samples collected and location of sample collection within a poultry shed were important to ensure the best chance of detecting Salmonella spp. Differences in the within-shed spatial distribution of Salmonella enterica subspecies enterica serovar Typhimurium [χ2(27, 1,538) = 54.4; P < 0.001] and Salmonella enterica subspecies enterica serovar Infantis [χ2(27, 1,538) = 79.8; P < 0.0001] were identified. More than one Salmonella enterica serovar was detected in each shed on the same sampling occasion; 5% of all samples contained more than one serovar. Samples collected on the north side of the shed (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.17-2.68), on the sheltered side of the shed (OR, 1.90; 95% CI, 1.26-2.89), and during winter (OR, 48.41; 95% CI, 23.56-104.19) were more likely to be positive for salmonellae. The within-shed differences observed in the both the sample prevalence and spatial location of the serovar detected indicate that there are important shed microenvironmental factors that influence the survival and/or distribution of salmonellae. These factors should be taken into consideration when environmental surveillance is undertaken for salmonellae in flocks housed in cage sheds.IMPORTANCE Routine epidemiological surveillance for salmonellae in poultry relies initially on environmental sampling. Intensive, spatially homogenous sampling, as conducted within this study, confirmed that the sampling methodology conducted within a poultry environment is a nontrivial part of sampling design. The frequency of sampling is especially important when the prevalence of Salmonella spp. is low. These factors must be taken into consideration in the design of studies for the detection of salmonellae in poultry sheds.

Is retirement associated with physical health benefits? A longitudinal investigation with older New Zealanders.

OBJECTIVES: the impact of retirement on physical health is an important focus of ageing research; however, research findings vary greatly. To investigate under what conditions retirement might benefit health, we examined physical functioning 8 years pre- and post-retirement. METHODS: using longitudinal data from the New Zealand Health, Work and Retirement Study, multiple linear trajectories of physical functioning were estimated. Growth mixture analysis indicated three distinct trajectory profiles. RESULTS: Profile 1 displayed good but declining physical functioning from 8 years pre-retirement until retirement, which continued to decline more slowly post-retirement. Profile 2 was characterised by poor and declining physical functioning pre-retirement that improved post-retirement. Profile 3 displayed good and stable physical functioning pre-retirement and a slow decline post-retirement. Significant differences were identified across profiles in smoking behaviour, pre-existing chronic conditions, marital status and educational level. Profile 2 also showed increased economic living standards post-retirement. DISCUSSION: findings indicate that retirement can be beneficial for those with poor health and limited resources. For the wealthy and healthy, retirement does not necessarily advantage health. Universal superannuation initiatives may partly address inequalities experienced by older persons in poor health and socio-economic circumstances prior to retirement.

Traditional Salmonella Typhimurium typing tools (phage typing and MLVA) are sufficient to resolve well-defined outbreak events only.

Between 1991 and 2014 the per capita notification rate of salmonellosis in Australia increased from 31.9 to 69.7 cases per 100,000 people. Salmonella Typhimurium accounted for nearly half the human cases until the end of 2014. In this study, we used cluster analysis tools to compare S. Typhimurium isolates from a chicken-meat study with those reported to the National Enteric Pathogen Surveillance System (NEPSS) from the coincident human and non-human populations. There was limited phage type diversity within all populations and a lack of specificity of MLVA profiling within phage types. The chicken-meat study isolates were not significantly clustered with the human cases and at least 7 non-human sources, based on typing profiles (PT/MLVA combination), could be implicated as a source of human cases during the same period. In the absence of a strong surveillance system representative of all putative sources, MLVA and phage typing alone or in combination are insufficient to identify the source of human cases.

Risk and protective factors for wellbeing in older veterans in New Zealand.

Objectives: To compare indicators relating to aging and health among veterans and non-veterans, and identify factors associated with subjective wellbeing (SWB) of older New Zealand veterans. Methods: Self-reported data were obtained from participants in a longitudinal cohort study of New Zealand older adults. Responses from 352 veterans and 1500 non-veterans (age range of 55-86 and gender matched) were selected as a comparison group on indicators related to health and aging. The association of these indicators with veterans' SWB were assessed using hierarchical regression. Results: Apart from being older, smoking more, and having more chronic conditions, veterans did not differ from non-veterans on indicators of health and wellbeing. Mental health, physical health, purpose in life, housing satisfaction, and capabilities (choice and freedom) accounted for a significant amount of variance in veterans' SWB. Conclusion: Our results suggest that older veterans do not differ greatly on indices of health and aging from their non-veteran peers. Results support previous findings that lower mental and physical health is associated with lower SWB for veterans. Building upon prior findings, the current results demonstrate that interventions focusing on enhancing a sense of purpose in life, supporting one's capability to achieve, and strengthening social and physical environment through social connectedness, may serve as protective factors for SWB in veterans.

The sensitivity of the MOS SF-12 and PROMIS® global summary scores to adverse health events in an older cohort.

PURPOSE: To compare the predictive validity of two self-reported outcome measures, the Patient-Reported Outcome Measurement Information System (PROMIS) Global Health measure and the 12-item Health Survey (SF-12). METHODS: Data were obtained from 1286 persons (55% female) aged 61-77 responding to a longitudinal survey. Inter-correlations of the SF-12 and PROMIS physical and mental summary scores were examined. ROC and AUC analyses were conducted to compare mental health score sensitivity to high levels of depression symptoms. Multiple regression was used to assess physical health score sensitivity to adverse health events over 12-month follow-up. RESULTS: All scores displayed negatively skewed distributions. The respective SF-12 and PROMIS physical (r = .78) and mental (r = .62) health scores displayed strong associations. Mental health scores provided useful discrimination of persons reporting high depression symptoms (AUCSF12 = 0.90; AUCPROMIS = 0.84), although the SF-12 provided better case discrimination. Decreases in physical health over time were associated with recurrent falls (BSF12 = - 1.62; BPROMIS = - 1.14) and hospitalisations (BSF12 = - 1.69; BPROMIS = - 1.11). CONCLUSIONS: The SF-12 and PROMIS brief measures of physical and mental health assess related but distinct health constructs. However, they display comparable sensitivity to adverse health outcomes. Results from studies utilising the SF-12 and PROMIS global health measures should be compared with sensitivity to differences in the content and scoring of these measures.

The use of social network analysis to examine the transmission of Salmonella spp. within a vertically integrated broiler enterprise.

To better understand factors influencing infectious agent dispersal within a livestock population information is needed on the nature and frequency of contacts between farm enterprises. This study uses social network analysis to describe the contact network within a vertically integrated broiler poultry enterprise to identify the potential horizontal and vertical transmission pathways for Salmonella spp. Nodes (farms, sheds, production facilities) were identified and the daily movement of commodities (eggs, birds, feed, litter) and people between nodes were extracted from routinely kept farm records. Three time periods were examined in detail, 1- and 8- and 17-weeks of the production cycle and contact networks were described for all movements, and by commodity and production type. All nodes were linked by at least one movement during the study period but network density was low indicating that all potential pathways between nodes did not exist. Salmonella spp. transmission via vertical or horizontal pathways can only occur along directed pathways when those pathways are present. Only two locations (breeder or feed nodes) were identified where the transmission of a single Salmonella spp. clone could theoretically percolate through the network to the broiler or processing nodes. Only the feed transmission pathway directly connected all parts of the network.

Longitudinal health and disaster impact in older New Zealand adults in the 2010-2011 Canterbury earthquake series.

Pre-existing longitudinal studies of people affected by disasters provide opportunities to examine the effects of these events on health. Data used in the current investigation were provided by participants in the New Zealand Health, Work and Retirement longitudinal surveys conducted in 2010, 2012 and 2014 (n = 428; aged 50-83), who lived in the Canterbury region of New Zealand during the 2010-2011 earthquakes. Latent profile growth analyses were used to identify groups of respondents who had similar pre-post-disaster physical and mental health profiles. These groups were compared in terms of demographic factors, personal impact of the earthquakes assessed in 2012 and the overall negative-positive impact of the earthquake assessed in 2014. There was little evidence of change in health status overtime. Groups did not differ in their experiences of threat or disruption, however those in poorest health reported greatest distress and a more negative overall impact of the earthquake. Although results suggest little impact of disasters on health of surviving older adults, pre-disaster vulnerabilities were associated with distress. Social workers and agencies responsible for disaster response can play a key role in pre-disaster planning and assessment of vulnerabilities of older adults to enhance potential for positive outcomes post-disaster.

Present and future selves in Parkinson's disease.

The study of the self in neuropsychological patients raises not only theoretical questions on the relationships between the self, autobiographical memory (AM), and episodic future thinking but also clinical issues for patients' daily life and care. We addressed this issue in Parkinson's disease patients for whom AM and future thinking impairments have been documented. All patients and controls generated and dated up past and future self-images and provided associated past and future events. Our findings suggest a subtle pattern of preservation/impairment of different dimensions (quantitative and qualitative) of self-images, which rely partially on the episodic quality of past and future events.

Reconciling Work and Caregiving Responsibilities among Older Workers in New Zealand.

There are 432,000 individuals in New Zealand who provide unpaid care for someone who is ill or disabled and 65% of these carers are also in paid employment. The number of older people in the paid workforce is projected to increase in the next two decades. With the median age of carers in 2013 at 49 years, the ageing of both the population and workforce suggests that many carers may still be in paid work as they themselves age. Family care is an essential part of the health care system. Informal care provides many benefits including improved patient outcomes, reduced unnecessary re-hospitalisations and residential care placements, and considerable savings in health care expenditure. However, combining paid work and informal care is problematic for many carers and can impact on their health and wellbeing, and on work-related outcomes by way of reduced work hours, absenteeism, and employment exit. Recent policy initiatives have been implemented to support family carers in New Zealand to remain in or re-enter the workforce. This paper explores the challenges presented to older New Zealanders who combine paid work with caregiving responsibilities. We provide a profile of older workers (aged 55+) who are providing care and analyse the impact of combining paid work and care on their health, wellbeing and economic living standards. Finally, we situate these findings within the policy framework in New Zealand.

Development of an ovine efferent mammary lymphatic cannulation model with minimal tissue damage.

BACKGROUND: Two mammary lymphatic cannulation models in sheep have been described with minimal use in the past 50 years. The purpose of this study was to investigate a new surgical technique to allow long term monitoring of mammary lymph flow and composition from the mammary glands, with rapid ewe recovery and minimal complications post-surgery. RESULTS: We developed a modified methodology for cannulating the efferent mammary lymphatic from the mammary lymph node with minimum tissue damage. Compared to the previous models, our method required only a small incision on the aponeurosis of the external abdominal oblique muscles and thus reduced the difficulties in suturing the aponeurosis. It allowed for lymph collection and assessment for at least one week post-surgery with concurrent milk collection. CONCLUSION: This method allows for good ewe recovery post-surgery and in vivo sampling of efferent mammary lymph from the mammary lymph nodes in real-time and comparison with milk parameters.

The health and wellbeing of Australian farmers: a longitudinal cohort study.

BACKGROUND: Isolation, long work days, climate change and globalization are just some of the many pressures that make farming a vulnerable occupation for incurring mental health issues. The objective of this study was to determine whether farming in Australia is associated with poorer wellbeing, physical and mental health, and less health service use. METHODS: The Australian Rural Mental Health Study, a longitudinal cohort study was analysed over four time points comparing farmers with non-farming workers (n = 1184 at baseline). Participants were recruited from rural NSW, Australia. A number of physical, mental health, wellbeing, service use outcomes were assessed using generalised estimating equations including all waves in each model. Barriers to seeking help were also assessed. RESULTS: Farmers who lived remotely reported worse mental health (ß -0.33, 95 % CI -0.53, -0.13) and wellbeing (ß -0.21(95 % CI -0.35, -0.06) than remote non-farm workers regardless of financial hardship, rural specific factors eg drought worry, or recent adverse events. All farmers were no different to non-farming workers on physical health aspects except for chronic illnesses, where they reported fewer illnesses (OR 0.66, 95 % CI 0.44, 0.98). All farmers were half as likely to visit a general practitioner (GP) or a mental health professional in the last 12 months as compared to non-farm workers regardless of location (OR 0.59, 95 % CI 0.35, 0.97). Rural workers felt that they preferred to manage themselves rather than access help for physical health needs (50 %) or mental health needs (75 %) and there was little difference between farmers and non-farm workers in reasons for not seeking help. CONCLUSIONS: Remoteness is a significant factor in the mental health and wellbeing of farmers, more so than financial stress, rural factors and recent adverse events. Creative programs and policies that improve access for farmers to GPs and mental health professionals should be supported.

Detection and Differentiation of Entomopathogenic Serratia spp. to Inform Reintroduction of the Critically Endangered Lord Howe Island Stick Insect Dryococelus australis.

Once rodents have been successfully eradicated from Lord Howe Island, Australia, the critically endangered Lord Howe Island stick insect (Dryococelus australis (Montrouzier)) may be reintroduced, a century after it was thought to have become extinct. In captive populations of D. australis, elevated mortalities have been associated with bacterial pathogens. To better define the infectious risk posed by entomopathogens to the reintroduction program, we investigated the bacteria isolated from captive D. australis kept at Melbourne Zoo and on Lord Howe Island and from environmental samples and free-living invertebrates collected on various parts of the island. At Melbourne Zoo, Serratia and Pseudomonas spp. were the bacteria most frequently isolated between 2013 and 2019. Serratia spp. were also the organisms most frequently isolated from insects sampled in April 2019 from the captive population on Lord Howe Island. In addition, Serratia spp. were isolated from a range of environmental samples collected on Lord Howe Island during March-April 2019. These environmental isolates had a broader range of biochemical and molecular characteristics than those obtained from the captive insect populations. A large proportion of these isolates were urease positive and had biochemical profiles previously not described for Serratia spp. This study highlights the need for better surveillance for potential pathogens in understudied regions and sites. We conclude that infections caused by Serratia spp. might pose a problem to the captive breeding program for D. australis but that the risk of introducing novel pathogens to Lord Howe Island through infected insects is low. Our study explores some of the potential risks involved in captive breeding and provides a valuable example of using pathogen surveillance to better inform an invertebrate conservation program.

Pasteurella multocida ST20 is widespread in Australian poultry farms and may infect wild waterbirds.

The bacterial agent that causes fowl cholera, Pasteurella multocida, was isolated from two deceased wild waterbirds in Victoria, Australia, in 2013. Whole genome sequence analysis placed the isolates into ST20, a subtype described in farmed chickens from Queensland, Australia and more recently in feedlot cattle and in pigs across a broader area of the continent. This study also found ST20 between 2009 and 2022 on three chicken farms and two turkey farms located in four Australian states. The sequences of 25 of these ST20 isolates were compared to 280 P. multocida genomes from 23 countries and to 94 ST20 Illumina datasets from Queensland that have been deposited in public databases. The ST20 isolates formed a single phylogenetic clade and were clustered into four sub-groups with highly similar genomes, possessing either LPS type 1 or type 3 loci. Various repertoires of mobile genetic elements were present in isolates from farmed, but not wild birds, suggesting complex histories of spill-over between avian populations and gene acquisition within farm environments. No major antimicrobial resistance was predicted in any of the ST20 isolates by the genomic analysis. The closest relative of these isolates was a ST394 bovine respiratory tract isolate from Queensland, which differed from ST20 by only one allele and carried beta-lactam and tetracycline resistance genes. These findings underline the importance of understanding the role of wild and commercial birds in the maintenance of fowl cholera, and of implementing regular epidemiological surveillance and biosecurity management programmes in wildlife, as well as free-range poultry farms.

Integrating and extending cohort studies: lessons from the eXtending Treatments, Education and Networks in Depression (xTEND) study.

BACKGROUND: Epidemiologic studies often struggle to adequately represent populations and outcomes of interest. Differences in methodology, data analysis and research questions often mean that reviews and synthesis of the existing literature have significant limitations. The current paper details our experiences in combining individual participant data from two existing cohort studies to address questions about the influence of social factors on health outcomes within a representative sample of urban to remote areas of Australia. The eXtending Treatments, Education and Networks in Depression study involved pooling individual participant data from the Australian Rural Mental Health Study (T0 N = 2639) and the Hunter Community Study (T0 N = 3253) as well as conducting a common three-year follow-up phase (T1 N = 3513). Pooling these data extended the capacity of these studies by: enabling research questions of common interest to be addressed; facilitating the harmonization of baseline measures; permitting investigation of a range of psychosocial, physical and contextual factors over time; and contributing to the development and implementation of targeted interventions for persons experiencing depression and alcohol issues. DISCUSSION: The current paper describes the rationale, challenges encountered, and solutions devised by a project aiming to maximise the benefits derived from existing cohort studies. We also highlight opportunities for such individual participant data analyses to assess common assumptions in research synthesis, such as measurement invariance, and opportunities for extending ongoing cohorts by conducting a common follow-up phase. SUMMARY: Pooling individual participant data can be a worthwhile venture, particularly where adequate representation is beyond the scope of existing research, where the effects of interest are small though important, where events are of relatively low frequency or rarely observed, and where issues are of immediate regional or national interest. Benefits such as these can enhance the utility of existing projects and strengthen requests for further research funding.

Construct validity of the Assessment of Quality of Life - 6D (AQoL-6D) in community samples.

BACKGROUND: The Assessment of Quality of Life - 6D scale (AQoL-6D) is a self-report instrument designed to provide a sensitive multidimensional evaluation of health related quality of life. The current paper assesses the construct, concurrent and convergent validity of the AQoL-6D in a combined longitudinal population sample drawn from across urban, regional and remote areas of Australia. METHODS: The AQoL-6D was administered within the Hunter Community Study and the Australian Rural Mental Health Study over time (mean years lag = 3.90, SD = 1.30). Observations with sufficient data were used to confirm the construct validity of the AQoL-6D domains and higher-order structure using confirmatory factor analyses (CFA, N = 7915). The stability of this structure across cohorts and over time was assessed using multi-group CFA. Additionally, the concurrent validity (against the SF-36) and convergent validity of AQoL-6D domains and factors were assessed. RESULTS: The construct validity of the AQoL-6D domains was considered satisfactory. Two higher-order factors, representing the physical and psychological components of quality of life were identified (CFA model fit: RMSEA = .07, SRMR = .03; TLI = .96, CFI = .98). These factors displayed group and temporal invariance, as well as concurrent and convergent validity against a range of measures. Recommendations for the derivation of summary scores are provided, together with a provisional set of norms. CONCLUSIONS: The AQoL-6D is a useful tool for assessing quality of life impairment in epidemiological cohort studies, both cross-sectionally and over time. It displays appropriate levels of construct, concurrent and convergent validity. Conceptualisation of higher-order factors as representing the physical and psychological aspects of quality of life impairment may increase the sensitivity and appeal of the AQoL-6D, particularly for studies examining predictors of and changes in social and psychological outcomes.

Quality of life impact of cardiovascular and affective conditions among older residents from urban and rural communities.

BACKGROUND: The demographic, health and contextual factors associated with quality of life impairment are investigated in older persons from New South Wales, Australia. We examine the impact of cardiovascular and affective conditions on impairment and the potential moderating influence of comorbidity and remoteness. METHODS: Data from persons aged 55 and over were drawn from two community cohorts sampling from across urban to very remote areas. Hierarchical linear regressions were used to assess: 1) the impact of cardiovascular and affective conditions on physical and psychological quality of life impairment; and 2) any influence of remoteness on these effects (N = 4364). Remoteness was geocoded to participants at the postal code level. Secondary data sources were used to examine the social capital and health service accessibility correlates of remoteness. RESULTS: Physical impairment was consistently associated with increased age, male gender, lower education, being unmarried, retirement, stroke, heart attack/angina, depression/anxiety, diabetes, hypertension, current obesity and low social support. Psychological impairment was consistently associated with lower age, being unmarried, stroke, heart attack/angina, depression/anxiety and low social support. Remoteness tended to be associated with lower psychological impairment, largely reflecting overall urban versus rural differences. The impacts of cardiovascular and affective conditions on quality of life were not influenced by remoteness. Social capital increased and health service accessibility decreased with remoteness, though no differences between outer-regional and remote/very remote areas were observed. Trends suggested that social capital was associated with lower psychological impairment and that the influence of cardiovascular conditions and social capital on psychological impairment was greater for persons with a history of affective conditions. The beneficial impact of social capital in reducing psychological impairment was more marked for those experiencing financial difficulty. CONCLUSIONS: Cardiovascular and affective conditions are key determinants of physical and psychological impairment. Persons affected by physical-psychological comorbidity experience greater psychological impairment. Social capital is associated with community remoteness and may ameliorate the psychological impairment associated with affective disorders and financial difficulties. The use of classifications of remoteness that are sensitive to social and health service accessibility determinants of health may better inform future investigations into the impact of context on quality of life outcomes.

Relatives' experiences of frontal-variant frontotemporal dementia.

In this article we address how relatives of people with frontal-variant frontotemporal dementia (fvFTD) experience the illness and how it impacts their lives. We interviewed 6 participants and carried out interpretative phenomenological analysis. We report on 11 themes that reflect distinctive challenges. Five themes relate to witnessing bizarre and strange changes: changed appetites and drives, loss of planning ability, loss of inhibition leading to social embarrassment, risky behavior, and communication problems. Four relate to managing these changes and two to the impact on the person and his or her relationships. Relatives must live with unusual changes in the person with fvFTD and the stigma this carries in social settings. They learn to act assertively for their relatives and put effort into promoting quality of life, using strategies adapted for fvFTD. Relatives grieve the loss of the person with fvFTD and their mutual relationship, but nonetheless find sources of solace and hope.

Social support and age influence distress outcomes differentially across urban, regional and remote Australia: an exploratory study.

BACKGROUND: The variation of determinants of mental health with remoteness has rarely been directly examined. The current research aims to examine whether the association of psychosocial factors with psychological distress outcomes varies with increasing remoteness. METHODS: Participants were persons aged 55 and over from two community cohorts sampling from across rural and urban New South Wales (N = 4219; mean age = 69.00 years; 46.1% male). Measures of social support from these studies were calibrated to facilitate comparison across the sample. Remoteness was assessed using a continuous measure, the Accessibility/Remoteness Index of Australia. The association between demographic characteristics, social support, remoteness, and their interactions with remoteness in the prediction of high psychological distress (cut-off > 21 on the Kessler 10) were examined using logistic regression. RESULTS: Not being in a married or defacto relationship (OR 0.69; 99% CI 0.51-0.94), lower education (OR 0.52; 99% CI 0.38-0.71) and decreased social support (OR 0.36; 99% CI 0.31-0.42) significantly predicted psychological distress. There was a significant interaction of age and remoteness (OR 0.84; 99% CI 0.67-1.00), indicating that as remoteness increases, older persons are less likely to be highly distressed, as well as a significant interaction of social support and remoteness (OR 1.22; 99% CI 1.04-1.44), indicating that as remoteness decreases, persons with low levels of social support are more likely to be highly distressed. CONCLUSIONS: Remoteness may moderate the influence of social support and age on psychological distress outcomes.

Older People as Active Agents in Their Neighborhood Environments: Moving House Can Improve Quality of Life.

BACKGROUND AND OBJECTIVES: Neighborhood environments are an important aspect of well-being for older people. Developments of the general ecological model recognize older people as active agents who adapt their environments to fit their changing needs. We provide empirical support for a model suggested by Wahl et al., by examining interactions between neighborhood environments, personal situations, relocation, and quality of life (QoL) among older people. RESEARCH DESIGN AND METHODS: Two statistical models were tested with a sample of community-dwelling participants (aged 55-89) in the New Zealand Health, Work, and Retirement longitudinal surveys conducted in 2016 (T1) and 2018 (T2). Multiple linear regression assessed the association of perceptions of housing and neighborhood with QoL at T1 (n = 3682). RESULTS: QoL was predicted by housing satisfaction, and neighborhood satisfaction, accessibility, and trust (controlling for age, gender, marital status, home ownership, socioeconomic status, physical health, and mental health). Mixed analysis of variance showed that those who moved house between T1 and T2 reported lower housing and neighborhood satisfaction than nonmovers at T1. Over time T1-T2, movers reported less decline in housing satisfaction, and more positive change on all neighborhood perceptions, with higher perceptions of neighborhood accessibility than nonmovers at T2. DISCUSSION AND IMPLICATIONS: These findings support the theoretical model and provide the impetus for a more detailed study of the effects of the environment on well-being in older age. Housing and neighborhood environments are a very practical focus for social policy change at local and national levels.

Longitudinal Cohort Study of Depression and Anxiety Among Older Informal Caregivers Following the Initial COVID-19 Pandemic Response in Aotearoa New Zealand.

OBJECTIVES: To assess the impact of providing care and conditions of care on psychological wellbeing among older informal caregivers following the initial period of COVID-19 pandemic restrictions in Aotearoa New Zealand. METHODS: Data were from population-based cohorts of older adults participating in the 2020 Health, Work and Retirement longitudinal survey (n = 3839, 17.4% informal caregivers). Changes in symptoms of depression and anxiety over 2018-2020 surveys associated with sociodemographic factors, caregiving, cohabitation with the care recipient, assistance provided with activities of daily living, support in providing care, and opportunity cost of care were assessed. RESULTS: Increased depression, but not anxiety, was associated with providing informal care. Among caregivers, lower living standards and cohabitation were associated with increased depression. Lower living standards, unemployment, and lower help from friend/family networks were associated with increased anxiety. DISCUSSION: Economic hardship and social capital provide targets for supporting psychological wellbeing of older caregivers during periods of pandemic restrictions.