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.

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.

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.

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.

Trajectories of material living standards, physical health and mental health under a universal pension.

OBJECTIVE: Aged pension schemes aim to support material and non-material well-being of older populations. The current work aimed to describe dominant trajectories of material living standards in the decades prior to and following eligibility for an aged pension, and describe associated trajectories of physical and mental health. METHODS: Longitudinal data on living standards and indices of health Short Form 12 were collected over 2-12 years follow-up from 4811 New Zealand adults aged 55-76. Growth mixture models were used to identify dominant trajectories of living standards with age. Latent growth curve models were used to describe trajectories of physical and mental health associated with each living standards trajectory class. RESULTS: A group characterised by good living standards with age (81.5%) displayed physical and mental health scores comparable to those of the general adult population. Smaller groups experienced hardship but increasing living standards (11.8%) and hardship and declining living standards (6.8%). While both groups in hardship experienced poor health in the decade prior pension eligibility, mental health improved among those with increasing living standards, while physical and mental health declined among those with declining living standards. CONCLUSION: Under the current policy settings, a majority of older adults in New Zealand maintain a good level of living standards and health in later life. However, significant proportions experience material hardship and poor health in the decade prior to pension eligibility. Alleviation of material hardship may reduce health inequalities in later life.