Lifestyle for brain health and cognitive functioning in midlife to early late-life New Zealanders: Utility of the LIBRA index.

OBJECTIVES: There is enormous potential to improve brain health and reduce the risk of cognitive decline and dementia based on modifiable risk factors. The Lifestyle for Brain Health (LIBRA) index was developed to quantify modifiable dementia risk or room for brain health improvement. The objective of the study was to investigate the utility of the LIBRA index in relation to cognitive functioning in a midlife to early late-life sample of New Zealanders. METHODS: A subsample (n = 1001) of the longitudinal New Zealand Health, Work and Retirement (NZHWR) study completed face-to-face cognitive assessments using the 'Kiwi' Addenbrooke's Cognitive Examination-Revised (ACE-R) in 2010 and again in 2012, in addition to completing biennial NZHWR surveys on socioeconomic, health and wellbeing aspects. The LIBRA index was calculated incorporating information on 8 out of 12 modifiable health and lifestyle factors for dementia. Unadjusted and adjusted regression models and mixed effects models were used to inspect associations of LIBRA with cognitive functioning, cognitive impairment, and cognitive decline. RESULTS: The analytical sample (n = 881 [88.0%], after considering exclusion criteria and missing data) had a mean age of 63.1 (SD = 6.5) years, 53.3% were female, 26.2% were Maori, and 61.7% were highly educated. Higher LIBRA scores (indicating higher modifiable dementia risk) were associated with lower cognitive functioning (B = -0.33, 95% CI = -0.52;-0.15, p < 0.001) and a higher likelihood of cognitive impairment (OR = 1.22, 95% CI = 1.04; 1.42, p = 0.013), but did not predict cognitive decline over 2 years (B = -0.03, 95% CI = -0.22; 0.16, p = 0.766), adjusted for age, age2, gender, education, and ethnicity. CONCLUSIONS: The LIBRA index indicated promising utility for quantifying modifiable dementia risk in midlife and early late-life New Zealanders. For local use, refinement of the LIBRA index should consider cultural differences in health and lifestyle risk factors, and further investigate its utility with a wider range of modifiable factors over a longer observation period.

Work Preferences, Control, and Independence among Midlife and Older Adults in Aotearoa/New Zealand.

In 2023, current life expectancy for adults aged 65 and over in Aotearoa/New Zealand ranged from 84.6 to 89.2 years. Mandatory retirement has been abolished, but pension age eligibility remains at age 65. However, some older adults prefer to continue working, often experiencing a mismatch between current and preferred work statuses. The current study used data drawn from the 2020 wave of the New Zealand Health, Work and Retirement study (HWR; N = 3,916; Mage = 66.84) to examine associations between work preferences and perceptions of control and independence. We found that those not working but who preferred to work reported the lowest levels of perceived control and independence. Conversely, work preference match and higher levels of perceived control and independence were positively related to life satisfaction. The current study adds to our understanding of the centrality of work status, perceived control, and perceived independence among midlife and older adults, particularly in Aotearoa/New Zealand.

Longitudinal assessment of the health-related quality of life among older people with diabetes: results of a nationwide study in New Zealand.

BACKGROUND: The current work examined experiences of Health-Related Quality of Life (HRQOL) among older adults with a diagnosis of Diabetes Mellitus (DM) over time compared to those without a diagnoses DM. METHODS: The sample was drawn from six biennial waves of the New Zealand Health, Work and Retirement survey, a prospective population-based cohort study of older adults 55-70 years at baseline. Data on sociodemographic factors, health behaviours, chronic disease diagnoses and physical and mental HRQOL (SF-12v2) were obtained using six biennial surveys administered 2006-2016. Generalised Estimating Equation models, adjusted for time-constant and -varying factors, were employed to compare HRQOL and its determinants over time for older adults with and without a diagnosis of DM. RESULTS: DM was negatively associated with physical HRQOL [ß (95% CI) - 7.43 (- 8.41, - 6.44)] with older adults affected by DM reporting scores 7.4 points lower than those without DM. Similarly, the mean Mental HRQOL score was lower among those affected by DM [ß = - 4.97 (- 5.93, - 4.01)] however, scores increased over time for both groups (p < 0.001). Greater age, more chronic conditions, sight and sleep problems, obesity, lower annual income, and fewer years of education were predictors of poorer HRQOL among older adults. CONCLUSIONS: Older adults affected by diabetes experienced poorer physical and mental HRQOL compared to those not affected when controlling for a range of sociodemographic and health related indices. A management aim must be to minimise the gap between two groups, particularly as people age.

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.

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.

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.

Scared behind the wheel: what impact does driving anxiety have on the health and well-being of young older adults?

BACKGROUND: Driving anxiety can range from driving reluctance to driving phobia, and 20% of young older adults experience mild driving anxiety, whereas 6% report moderate to severe driving anxiety. However, we do not know what impact driving anxiety has on health and well-being, especially among older drivers. This is problematic because there is a growing proportion of older adult drivers and a potential for driving anxiety to result in premature driving cessation that can impact on health and mortality. The purpose of the current study was to examine the impact of driving anxiety on young older adults' health and well-being. METHOD: Data were taken from a longitudinal study of health and aging that included 2,473 young older adults aged 55-70 years. The outcome measures were mental and physical health (SF-12) and quality of life (WHOQOL-8). RESULTS: Hierarchical multiple regression analyses demonstrated that driving anxiety was associated with poorer mental health, physical health, and quality of life, over and above the effect of socio-demographic variables. Sex moderated the effect of driving anxiety on mental health and quality of life in that, as driving anxiety increased, men and women were more likely to have lower mental health and quality of life, but women were more likely to have higher scores compared to men. CONCLUSION: Further research is needed to investigate whether driving anxiety contributes to premature driving cessation. If so, self-regulation of driving and treating driving anxiety could be important in preventing or reducing the declines in health and quality of life associated with driving cessation for older adults affected by driving anxiety.

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.

Quality of life in indigenous and non-indigenous older adults: assessing the CASP-12 factor structure and identifying a brief CASP-3.

PURPOSE: We assessed whether the original three-factor structure of the older adult CASP-12 Quality of Life (QOL) scale was stable for both indigenous and non-indigenous older adult populations in the same non-European country (i.e. New Zealand). METHOD: A total of 3076 New Zealanders aged 50-84 (Maori = 1,130; non-Maori sample = 1,946) completed a postal survey for the first data collection wave of the New Zealand Longitudinal Study of Ageing in 2010. The survey included the CASP-12, a chronic health conditions checklist, CES-D-10, de Jong Gierveld loneliness scale, and the WHOQOL single-item QOL indicator. RESULTS: Exploratory factor analysis revealed that the CASP-12 responses resulted in a revised two-factor structure for both Maori and non-Maori we called the NZCASP-11, which included a new three-item global indicator of QOL (CASP-3) that consistently cross-loaded on both factors. Confirmatory factor analysis supported the NZCASP-11 factor structure over the original CASP-12 model, and further assessment validated both the utility of the NZCASP-11 as an indicator of QOL in New Zealand and illustrated the utility of the CASP-3 as a brief screen for global QOL. CONCLUSION: While CASP items coalesce to provide a robust QOL indicator of indigenous and non-indigenous QOL in a single-country setting, the actual factor structure underpinning this CASP indicator (i.e. the NZCASP-11) is not entirely reflective of that found in the United Kingdom. Furthermore, we revealed that three CASP items (i.e. the CASP-3) may reflect a stable brief indicator of QOL applicable for assessing QOL across cultures within a single setting.

Accounting for differences in cognitive health between older adults in New Zealand and the USA.

BACKGROUND: National differences in cognitive health of older adults provide an opportunity to shed light on etiological factors. We compared the cognitive health of older adults in New Zealand and the USA, and examined differences in known risk factors. METHODS: Two nationally representative samples were derived from the 2010 waves of the New Zealand Longitudinal Study of Ageing (n = 953) and the US Health and Retirement Study (HRS) (n = 3,746). Data from comparable measures of cognitive function, gender, age, income, education, prevalence of cancer, diabetes, heart disease, hypertension and stroke, exercise, alcohol consumption, smoker status, depression, and self-reported health were subjected to hierarchical regression analysis to examine how national differences in cognitive function might be explained by differences in these risk factors. RESULTS: The New Zealand sample scored 4.4 points higher on average than the US sample on the 43 point cognitive scale. Regression analyses of the combined samples showed that poorer cognitive health is more likely in those who are male, older, less educated, have suffered a stroke, consume alcohol less frequently, are more depressed, and report worse overall health. Controlling for age and sex reduced the mean difference to 2.6 and controlling for risk factors further reduced it to 2.3. CONCLUSIONS: Older New Zealand adults displayed better cognitive function than those in a US sample. This advantage can be partially explained by age and sex differences and, to some extent, by differences in known risk factors. However, the national advantage remained even when all measured risk factors are statistically controlled.

Effectiveness of dairy products to protect against cognitive decline in later life: a narrative review.

As the world's population ages the prevalence of age-related health concerns is increasing, including neurodegeneration disorders such as mild cognitive impairment, vascular dementia and Alzheimer's disease. Diet is a key modifiable risk factor for the development of neurodegeneration, likely due to gut-brain axis interactions related to neuroinflammation. Analyses of dietary patterns identified dairy as being part of a cognitively healthy diet; however, its contribution to cognitive outcomes is difficult to discern. This narrative review evaluates the literature to determine whether there is sufficient evidence that the consumption of dairy products helps to maintain cognitive function in later life. A search using the terms (dairy OR milk OR cheese OR yogurt OR yogurt) AND ("mild cognitive impairment" OR dementia OR "Alzheimer's disease") identified 796 articles. After screening and sorting, 23 observational studies and 6 intervention studies were identified. The results of the observational studies implied that the relationship between total dairy consumption and cognitive outcomes is inverse U-shaped, with moderate consumption (1-2 servings per day) being the most beneficial. The analysis of the intake of different types of dairy products indicated that fermented products, particularly cheese, were most likely responsible for the observed benefits. The experimental studies all used dairy-derived peptides produced during fermentation as the dietary intervention, and the results indicated that these could be an effective treatment for early-stage cognitive impairment. Further experimental studies with whole dairy products, particularly fermented dairy, are needed to determine whether the regular consumption of these foods should be recommended to maximize the likelihood of healthy cognitive aging.

Understanding the use of Flexible Work Arrangements Among Older New Zealand Caregivers.

Flexibility in the workplace has been suggested to promote prolonged employment among older workers. This study focuses on the question of whether the use of flexible work arrangements (FWAs) differs between caregivers and non-caregivers and how potential differences can be explained. Participants were 296 carers and 1611 non-carers (aged 55-70 years) who completed the 2018 Health, Work and Retirement survey and were in paid employment. Hierarchical regression was used to investigate caregiving as an independent predictor of use of FWAs after controlling for demographic and work-related variables. Results show that caregivers on average used more FWAs than non-caregivers, including flexible work hours, flexible schedules and time off. Differences in FWAs use between caregivers and non-caregivers cannot be explained by differences in socio demographic and work characteristics. The use of FWAs warrants attention in discussions about prolonged employment and reconciliation of care and work among older adults.

Reconciling Paid Work and Informal Caregiving Among Older Adults: Implications for Work Interference With Family.

Background and Objectives: Many older adults who combine paid work and informal caregiving responsibilities are often in work arrangements that differ from their preference. There is reason to believe that such work status incongruence may lead to work interference with family (WIF). In response, many governments have policies that support flexible work arrangements (FWA) to help individuals manage work and family commitments. This paper examines whether work status preferences contribute to WIF for older adults who combine work and care and whether the use of flexible work arrangements moderates this relationship. Research Design and Methods: The study included 610 informal caregivers (aged 55-70 years) in paid employment who participated in either the 2018 or 2020 waves of the New Zealand Health, Work and Retirement study. Using a simple moderation analysis with demographic controls, the effects of work status preferences and FWAs on WIF were estimated. Results: After controlling for confounds, significant main effects were found for both work status preferences and flexible work arrangements on WIF. The moderation analysis revealed that involuntary part-timers using flexible time-off arrangements reported lower levels of WIF. However, other types of flexible work arrangements did not moderate the relationship between work status preferences and WIF. Discussion and Implications: These findings suggest that work status preferences can contribute to WIF, but not all types of flexible work arrangements alleviate it. Policy initiatives designed to reduce WIF for those combining work and care should consider accounting for differences in the work status preferences of older workers.

Predictors of work ability and quality of life in older New Zealanders with and without an arthritis diagnosis.

OBJECTIVE: To determine predictors of work ability and quality of life in a population of older working New Zealanders with and without an arthritis diagnosis. METHODS: Participants aged 55-85 (Mean = 71 years) were drawn from the New Zealand Health, Work and Retirement study. A cross-sectional survey was conducted with a sample of N = 1154 (n = 696 with arthritis and matched sample (on gender only) of n = 458 without arthritis). RESULTS: Older adults diagnosed with arthritis reported lower levels of work ability and poorer quality of life in comparison with older adults without arthritis. Pain and fatigue were associated with poorer outcomes for all participants. Pain moderated the relationship between arthritis and work ability. CONCLUSIONS: An ageing population will lead to an increase in older workers in the workforce. Chronic age-related diseases such as arthritis may impact older workers' ability to continue to work and enjoy a good quality of life.

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.

The concurrent accuracy of the modified telephone interview for cognitive status and mini-mental state examination tools in detection of cognitive impairment among older adults.

Due to the need for face-to-face administration of many cognitive screening tests, it is not always feasible to screen large-scale samples. Objective: This study aimed to assess the discriminant validity of the Persian version of Telephone Interview for Cognitive Status (P-TICS-m) and Mini-Mental State Examination in the middle-aged Iranian population. Methods: The P-TICS-m and MMSE were administered to 210 randomly selected middle-aged community-dwelling adults who had been registered in the Neyshabur Longitudinal Study on Ageing. Participants also underwent psychological examination by two neurologists to assess cognitive impairment based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. To evaluate the discriminant validity of P-TICS-m and MMSE with DSM-V criteria, the sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (LR+ and LR-) were calculated. Results: The mean age of the participants was 59.6±6.8 years. The TICS and MMSE were highly correlated (r=0.635, p<0.001). The sensitivity, specificity, PPV, NPV, LR+, and LR- to discriminate cognitive impairment were, respectively, 83%, 92%, 68%, 96%, 10, and 0.182 for MMSE and 100%, 13%, 19%, 100%, 1.16, and 0 for TICS-m. The receiver operating characteristic curve analysis results showed no statistically significant differences between P-TICS-m and MMSE. Conclusions: Our findings indicate that the TICS-m test can be used as a screening tool instead of the MMSE. Due to the low specificity and low PPV of the TICS-m compared to MMSE, the diagnosis should be confirmed using definitive diagnostic tests when a subject is classified as having cognitive impairment.

Diante da necessidade de administração face a face de muitos testes de triagem cognitiva, nem sempre é viável rastrear amostras em grande escala. Objetivo: O objetivo deste estudo foi avaliar a validade discriminante da versão persa do Telephone Interview for Cognitive Status (TICS-m) e do Miniexame do Estado Mental (MMSE) na população iraniana de meia-idade. Métodos: A versão persa do TICS-m (P-TICS-m) e do MMSE foi administrada a 210 adultos de meia-idade residentes na comunidade e selecionados aleatoriamente, que haviam sido registrados no Neyshabur Longitudinal Study on Ageing. Os participantes também foram submetidos a exame psicológico por dois neurologistas para serem avaliados quanto ao comprometimento cognitivo com base nos critérios do Manual de Diagnóstico e Estatística de Transtornos Mentais (DSM-V). Para avaliar a validade discriminante do P-TICS-m e do MMSE com os critérios do DSM-V, foram calculados a sensibilidade, a especificidade, os valores preditivos positivo e negativo (PPV e NPV) e a razão de verossimilhança positiva e negativa (LR+ e LR-). Resultados: A média de idade dos participantes foi de 59,6±6,8 anos. O TICS e o MMSE foram altamente correlacionados (r = 0,635, p <0,001). A sensibilidade, a especificidade, o PPV, o NPV, a LR+ e a LR- do MMSE para discriminar comprometimento cognitivo foram 83, 92, 68, 96%, 10, 0,182; e, para TICS-m, foram 100, 13, 19, 100%, 1,16 e zero, respectivamente. Os resultados da análise da curva característica de operação do receptor (ROC) não mostraram diferenças estatisticamente significativas entre P-TICS-m e MMSE. Conclusões: Nossos achados mostram que o teste TICS-m pode ser utilizado como ferramenta de triagem em vez do MEEM. Por causa da baixa especificidade e do baixo PPV do TICS-m em relação ao MMSE, o diagnóstico deve ser confirmado por meio de testes diagnósticos definitivos quando um indivíduo é classificado como portador de comprometimento cognitivo.

Driving anxiety and fear in young older adults in New Zealand.

BACKGROUND: driving anxiety and fear can have a marked impact on mobility and independence, although there is no data on the prevalence of this problem, and specific information about the rate of driving anxiety and fear in older adults is unknown. METHODS: the present study examines the prevalence of self-reported driving anxiety and fear in a sample of 2,491 adults aged 55-72 from a longitudinal survey of health and ageing in New Zealand. RESULTS: most of the sample (90%) described themselves as drivers who drove daily or weekly. Around 70% of the sample reported no driving anxiety or fear, yet 17-20% endorsed a mild and 4-6% rated a moderate to severe level of driving anxiety and fear. Women reported higher levels of anxiety and fear about driving than men, but there were no age differences. Those who reported some level of driving anxiety engaged various alternative modes of transport, and a small number (2.4%) reported that their driving anxiety had affected their usual activities or work for at least a day in the previous month. Duration of driving anxiety was highly variable, from relatively recent onset to being present for much of some participants' lifetimes. CONCLUSION: driving anxiety and fear may be a significant problem for some young older adults that is likely to affect their independence and mobility. Further research to clarify the content and nature of driving anxiety, pathways to driving anxiety and the effect of factors associated with ageing on driving anxiety is needed in order to better understand this experience for older adults and develop effective interventions.

Factors affecting perceived quality of life of older persons with self-reported visual disability.

PURPOSE: The purpose of this paper was to determine the extent to which factors thought to be related to quality of life (QoL) among older persons with a visual disability impact on their perceived QoL (PQol). METHOD: Analysis was conducted on responses from the second wave of a large population-based longitudinal study of those aged 57-72 years (i.e., HWR Study). The sample was split between those who identified as having difficulty seeing newsprint (n = 265) and those who did not (n = 1987). The groups were compared on 11 variables thought to affect QoL plus their response to a single-item measure of PQoL. Variables found to differ across the groups were entered into a standard multiple regression to determine the extent to which they predicted PQoL among those who had difficulty seeing. RESULTS AND CONCLUSIONS: Significant differences were found between the groups on PQoL and seven of the other variables assessed. Of those, three were found to make a significant and unique contribution to the prediction of PQoL. These were satisfaction with life, ability to get around, and number of diagnosed health conditions reported in that order. Together, they accounted for 64% of the observed variance in PQoL.

What factors enable mid-life carers to re-enter the labour market in New Zealand?

OBJECTIVE: To assess the characteristics of carers and the caregiving situation associated with return to paid employment among older unemployed carers in New Zealand. METHODS: A baseline sample of 280 unemployed carers was identified from responses by people aged 55-70 to the 2012-2016 biennial waves of the New Zealand Health, Work and Retirement longitudinal survey. Multiple logistic regression analysis was used to assess characteristics uniquely predicting employment status at two-year follow-up. RESULTS: Sixteen percent were employed at follow-up. Economic living standards, physical health and preference to be in paid employment were positively associated with being employed at follow-up. There were no statistical differences according to age, gender, ethnicity, marital status, education and care characteristics. CONCLUSION: Individual preferences were the strongest predictor of return to paid employment. Despite New Zealand employment legislation allowing all employees to request flexible working arrangements, economic and health differences in workforce retention among carers persist.