One Year of Continuous Positive Airway Pressure Adherence Improves Cognition in Older Adults With Mild Apnea and Mild Cognitive Impairment.

BACKGROUND: Mild cognitive impairment frequently represents a predementia stage of Alzheimer's disease. Although obstructive sleep apnea is increasingly recognized as a common comorbidity of mild cognitive impairment, most apnea research has focused on middle-aged adults with moderate-to-severe obstructive sleep apnea. Mild obstructive sleep apnea, defined as 5-14 apneas or hypopneas per hour slept, is common in older adults. Little is known about the effect on cognition of adherence to continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea in older adults with mild obstructive sleep apnea and mild cognitive impairment. OBJECTIVE: The objective of this study was to explore the effect of CPAP adherence on cognition in older adults with mild obstructive sleep apnea and mild cognitive impairment. METHODS: We conducted a secondary analysis of data from Memories 1, a 1-year quasiexperimental clinical trial on the effect of CPAP adherence in older adults with mild cognitive impairment and obstructive sleep apnea. Those with mild obstructive sleep apnea were divided into two groups based on their CPAP adherence over 1 year: (a) CPAP adherent group (mild cognitive impairment + CPAP) with an average CPAP use of ≥4 hours per night and (b) CPAP nonadherent group (mild cognitive impairment - CPAP) with an average CPAP use of <4 hours per night. Individuals currently using CPAP were not eligible. A CPAP adherence intervention was provided for all participants, and an attention control intervention was provided for participants who chose to discontinue CPAP use during the 1-year follow-up. Descriptive baseline analyses, paired t tests for within-group changes, and general linear and logistic regression models for between-group changes were conducted. RESULTS: Those in the mild cognitive impairment + CPAP group compared to the mild cognitive impairment - CPAP group demonstrated a significant improvement in psychomotor/cognitive processing speed, measured by the Digit Symbol Coding Test. Eight participants improved on the Clinical Dementia Rating Scale, whereas six worsened or were unchanged. Twelve participants rated themselves as improved on the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change Scale, whereas three reported their status as worsened or unchanged. The mild cognitive impairment + CPAP group had greater than an eightfold increased odds of improving on the Clinical Dementia Rating and greater than a ninefold increased odds of improving on the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change Scale, compared to the mild cognitive impairment - CPAP group. DISCUSSION: CPAP adherence may be a promising intervention for slowing cognitive decline in older adults with mild obstructive sleep apnea and mild cognitive impairment. A larger, adequately powered study is needed.

Older Adults' Empathy and Daily Support Exchanges.

Older adults' empathy may shape the frequency and types of support that they exchange with their social partners as well as the implications of these exchanges. This study drew on the Daily Experiences and Well-being Study, which included adults aged 65 and over and tracked them across 5 to 6 days using mobile phone surveys. Participants (n = 293) rated their empathy and reported their daily support exchanges (e.g., emotional support, instrumental support, advice) as well as mood. Findings showed that more empathic older adults provided each type of support more often. They also received more emotional support than less empathic older adults. Moreover, older adults' empathy moderated the associations between providing support and their daily mood. More empathic older adults maintained their mood regardless of whether they provided support. By contrast, less empathic older adults reported reduced positive mood on days when they provided emotional support and increased positive mood when they provided instrumental support. Greater empathy is associated with more frequent support exchanges; however, more empathic older adults appear immune to such exchanges in terms of their mood. Interestingly, less empathic older adults may find providing emotional support draining but instrumental support rewarding, probably because they are less equipped to cope with others' emotions.

Positive Encounters as a Buffer: Pain and Sleep Disturbances in Older Adults' Everyday Lives.

Objectives: To test whether older adults' pain was bidirectionally associated with nighttime sleep disturbances and whether daily positive encounters attenuated these associations. Methods: Participants (N = 292, mean = 73.71 years old) from the Daily Experiences and Well-being Study indicated pain and positive encounters with close partners (e.g., family and friends) and nonclose partners (e.g., acquaintances and service providers) every 3 hours throughout each day across 4-6 days. They also reported nighttime sleep disturbances the following morning. Results: Multilevel models revealed that participants with more prior nighttime sleep disturbances reported more severe pain the next day. This link was attenuated on days when participants had a greater proportion of positive encounters or viewed encounters as more pleasant, especially when these encounters occurred with close partners. Discussion: This study identifies benefits of positive encounters to older adults and sheds light on ways that may alleviate their pain from a social perspective.

Interpersonal Tensions and Pain Among Older Adults: The Mediating Role of Negative Mood.

OBJECTIVES: To examine whether (a) negative social encounters and physical pain are linked throughout the day, (b) negative mood mediates these associations, and (c) these associations vary by closeness with social partners. METHOD: Adults aged 65+ (n = 313) completed ecological momentary assessments and reported their negative social encounters, physical pain, and mood every 3 hr throughout the day for 5-6 days. RESULTS: Multilevel models revealed that negative social encounters were associated with greater pain at each 3-hr interval and that this association was mediated by negative mood during the same interval. Negative encounters with less close partners were associated with pain, but negative encounters with close partners were not. DISCUSSION: Regulating older adults' negative emotions may be crucial to improving their daily pain. Further, interventions focusing on negative encounters with less close partners in daily life may help mitigate older adults' experiences of pain throughout the day.

Does Empathy Have a Cost? Older Adults and Social Partners Experiencing Problems.

BACKGROUND AND OBJECTIVES: Empathy underlies older adults' awareness and responses to their social partners' needs, but it is unclear whether such awareness is beneficial or harmful to older adults' well-being. We examined whether older adults' empathy was associated with having encounters with social partners incurring problems and their own well-being throughout the day. RESEARCH DESIGN AND METHODS: Participants were adults aged more than 65 years from the Daily Experiences and Well-being Study. These older adults (n = 313) rated empathy and indicated social partners' problems (e.g., health, emotional, and financial problems) in a baseline interview. They also reported encounters with social partners and their mood every 3 hr over 5-6 days. RESULTS: Multiple regressions showed that more empathic older adults reported a greater proportion of social partners with major life problems than less empathic older adults. Older adults' empathy was not associated with their contact or negative encounters with social partners experiencing problems. Multilevel models revealed that encounters with these social partners had negative consequences for older adults' mood throughout the day; however, these consequences were reduced in more empathic older adults. DISCUSSION AND IMPLICATIONS: This study emphasizes the importance of empathy in late life and refines our understanding of older adults' social lives and well-being. Findings carry implications for interventions that aim to protect older adults' well-being when their close others incur crises.

Empathy and Close Social Ties in Late Life.

OBJECTIVES: Older adults with stronger social ties often lead longer, healthier, and happier lives, but these ties may differ based on older adults' ability to share and understand others' emotions (i.e., empathy). This study asked how empathy was associated with the way that older adults construct and engage in their social worlds. METHOD: We drew on the Daily Experiences and Well-being Study to examine how older adults' empathy was associated with the structure (e.g., network size and contact), function (e.g., support), and quality (e.g., affection and conflict) of their close social ties. Participants (N = 333) self-rated empathy and listed their social partners using three concentric convoy circles. RESULTS: Empathy was not associated with older adults' social network structure, but more empathic older adults exchanged support with more social partners and reported greater affection for their social partners. We did not observe a significant link between older adults' empathy and conflict with social partners. DISCUSSION: Examining empathy advances our understanding of individual differences in older adults' close social ties. This study suggests that empathy may play a promising role with regard to promoting older adults' social experiences and strengthening their close ties.

Midlife Adults' Daily Support to Children and Parents: Implications for Diurnal Cortisol.

Objectives: We examined whether providing daily support to generations above and below has a differential impact on midlife adults' diurnal cortisol. Method: Midlife adults (N = 151) from the Family Exchanges Study Wave 2 reported daily practical support, emotional support, and advice to adult children and aging parents and collected saliva samples four times a day for 4 days. Results: Midlife adults experienced steeper cortisol awakening responses and steeper declines in cortisol (favorable cortisol functioning) on days when they provided support to children. Yet, they experienced higher overall cortisol levels (unfavorable cortisol functioning) on days when they provided support to aging parents. Discussion: Providing daily support to children may be rewarding to midlife adults, but support to parents may be associated with physiological stress. Findings advance understanding of midlife adults' helping behaviors to multiple generations and carry implications for older adults' well-being by encouraging effective support strategies.