Playing Kioku Reduces Loneliness in Older Adults: A Pilot Study.

Introduction: Playing together increases social connectedness, and it may be a tool to reduce loneliness. Research into the mental health benefits of board games is underdeveloped. Objectives: The study aims to examine the effects of the Kioku board game on well-being outcomes. The Kioku board game was developed in order to enable small group interactions with a focus on encouraging participants to create stories through mutual attention and interaction. We hypothesized that following a weekly intervention for 12 weeks, players would report a decrease in loneliness and an increase in well-being, compared with nonplayers. Methods: During the summer of 2022, participants in groups of 4-5 players, chose a cube word and narrated a story. A sample of 151 older adults (Mean age = 75.05 ± 6.46 years) recruited from seven community activity centers in Israel was assigned by block randomization to an intervention (n = 72) or a control group (n = 79), awaiting 4-6 weeks for future participation. Loneliness (UCLA loneliness scale) and well-being (World Health Organization 5-item scale) were evaluated at baseline and at 12 weeks. Results: A two-way repeated measures analysis of covariance (ANCOVA) (Group × Time) controlling for age, country of origin, and marital status revealed significant interaction effects for loneliness [F(1, 146) = 178.04, n2 = 0.549, P < 0.001] and well-being [F(1, 146) = 69.14, n2 = 0.321, P < 0.001]. Loneliness decreased in the intervention group (mean difference: 0.62 points, P < 0.001), and increased in the control group (mean difference: 0.18 points, P = 0.001). Well-being increased in the intervention group (mean difference: 0.79 points, P < 0.001) and decreased in the control group (mean difference: 0.20 points, P < 0.001). Conclusions: Our findings support the effectiveness of the Kioku board game intervention for decreasing loneliness and promoting well-being in older adults, who might still be coping with the effects of the COVID-19 pandemic.

Dust in the Wind: Ageism as Portrayed in Attitudes Toward Songs in Adulthood and Old Age.

Ageism was found to be prevalent across various life domains, but not in the music domain. This study aimed to examine whether negative ageist attitudes toward older adults are associated with music preferences across life. Subjects (n = 214, age range 30-92, M = 56.14, SD = 16.39) were exposed to old (1910-1946), intermediate (1979-1987), and new (2014-2018) songs, chosen by a focus group, rated each song, and completed scales assessing ageism and socio-demographics. Ageist attitudes were negatively associated with liking for old songs among young and middle-aged participants. Young participants demonstrated a negative link between ageist attitudes and liking for intermediate songs. No significant results were reported regarding new songs. This provides an initial indication that ageism may be connected to attitudes toward music. Future studies can examine effects of perceived "oldness" in music on participants' ageist attitudes, and negative attitudes toward new and intermediate songs alongside with examining negative attitudes toward younger adults.

Attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning.

OBJECTIVE: To understand if attitudes to aging mediate the reciprocal effects of health anxiety and physical functioning among older adults with medical conditions. We examined: (1) if these effects are reciprocal; (2) if attitudes to aging (psychological loss, psychological growth, physical change) play a mediating role in these effects. DESIGN: A sample of 226 community-dwelling older adults (T1 age range = 65-94, mean age = 73.59, SD = 6.29) reporting at least one chronic medical condition completed two phone interviews across six months. MAIN OUTCOME MEASURES: Background measures, health anxiety, physical functioning, and attitudes to aging at T1 and T2. RESULTS: T2 attitudes to aging served as a mediator controlling for T1 attitudes. There was a direct effect of worse physical functioning at T1 on increased health anxieties at T2. Negative (but not positive) attitudes to aging mediated that effect. The reversed temporal sequencing (T1 health anxiety leading to T2 physical functioning) was significant only when mediated by negative attitudes to aging. CONCLUSIONS: Findings suggest that viewing aging as mostly a time of losses (but not as a time of gains) serves as an important mechanism through which health anxieties and physical functioning affect each other among older adults having chronic medical conditions.

Feeling Younger, Rehabilitating Better: Reciprocal and Mediating Effects between Subjective Age and Functional Independence in Osteoporotic Fracture and Stroke Patients.

INTRODUCTION: The current study aimed to find reciprocal effects between subjective age and functional independence during rehabilitation from osteoporotic fractures and stroke and whether these effects can be mediated by indicators of well-being. METHODS: Participants were 194 older adults (mean age = 78.32 years, SD = 7.37; 64.8% women) who were hospitalized following an osteoporotic fracture or stroke. Participants completed measures of subjective age and well-being (i.e., optimism, self-esteem, and life satisfaction) several times during rehabilitation. Functional Independence Measure (FIM) was completed by nursing personnel at admission and at discharge. RESULTS: Younger subjective age at admission predicted higher FIM scores at discharge. The reverse effect, that is, of FIM scores at admission on subjective age at discharge, was nonsignificant. Optimism during hospitalization mediated the effect of subjective age on subsequent FIM scores while self-esteem and life satisfaction did not. Sensitivity analyses further showed that the effect of subjective age on FIM was significant for both fracture and stroke patients. DISCUSSION: The findings highlight the effect of subjective age on rehabilitation outcomes among osteoporotic fractures and stroke patients and suggest several potential mechanisms behind this effect. Rehabilitation outcomes following osteoporotic fractures or strokes could improve if subjective age and an optimistic outlook are taken into consideration.

Daily fluctuations in subjective age and depressive symptoms: the roles of attitudes to ageing and chronological age.

Studies indicate that both subjective age-individuals' perception of their own age as older or younger than their chronological age, and attitudes to ageing are related to physical and mental health. Less is known about the possible dual effect of these two constructs of subjective views of ageing. In the current study, 334 participants (aged 30-90, M = 58.15) reported their daily subjective age and mental health along 14 consecutive days. Attitudes to ageing were measured at baseline. Results indicated that daily variation in subjective age was related to daily variation in depressive symptoms, such that people experienced more depressive symptoms at days they felt older. Furthermore, we found that attitudes to ageing (perceptions of losses, physical change, and psychological growth) moderated this relationship. The covariation between daily subjective age and daily depressive symptoms was stronger when attitudes to ageing were less favorable (e.g., high perceptions of losses and low psychological growth). The moderating effect of losses was especially prominent among older participants. This indicates that attitudes to ageing moderate the toll that feeling old takes on mental health, especially in older age. The results also emphasize the need to understand how different subjective views on ageing, measured in different time frames, operate interactively to shape individual's daily experiences.

The moderating effect of care-burden on formal caregiver's mental health during COVID-19.

BACKGROUND: Homecare organisations employ professionals (i.e. gerontologists, nurses, occupational therapists, physiotherapists and social workers) to help their clients gain rights and supervise non-professional formal caregivers. Formal caregivers, and especially those who work closely with impaired older people, are at greater risk of infecting or being infected by SARS-Cov-2 (COVID-19). During the first waves of COVID-19, older people were encouraged to stay home; and the care-burden inflicted on their caregivers has increased. OBJECTIVES: This study examined formal caregiver's mental health during the COVID-19 pandemic, that is, the association between anxiety and depression symptoms and how care-burden moderated this association. METHODS: A cross-sectional online survey conducted in the home care services sector throughout Israel. A sample of 400 formal caregivers of older people (Mage  = 47.7, SD = 13.8) completed a questionnaire regarding their levels of care-burden, general anxiety symptoms, and depressive symptoms. RESULTS: A significant positive relationship was found between anxiety and depressive symptoms among formal caregivers. The level of care-burden moderated this relationship, showing that caregivers with higher care-burden demonstrated a stronger association between anxiety and depressive symptoms. CONCLUSIONS: Professionals may use ADL/IADL as a practical index to assess care-burden and the risk of mistreatment. IMPLICATIONS FOR PRACTICE: Formal caregivers with higher care-burden should get enhanced professional's support to reduce adverse mental health outcomes.

Sense of Relationship Entitlement of Aging Parents Toward Their Offspring (SRE-ao)-A New Concept and Measurement Tool.

Our sense of entitlement influences our interactions and attitudes in a range of specific relational contexts, one of them being aging parents' relationships with their adult children. This study aimed to examine the factor structure of the Sense of Relational Entitlement-aging parents toward their offspring (SRE-ao), an 11-item questionnaire that assesses aging people's sense of relational entitlement toward their children, and examine the associations of its subscales with related personality and mental health constructs. One thousand and six participants (24.6% men), aged 65-99, with at least one child, completed the SRE-ao, Brief Symptom Inventory, Loneliness Scale, and General Belongingness scale. The SRE-ao demonstrated good construct structure using confirmatory factor analysis. Both SRE-ao subscales (restricted and inflated sense of entitlement) were significantly and positively associated with anxiety, depression, somatization and sense of loneliness and negatively with sense of belonging. When all variables were entered into a regression model, age, anxiety, and low sense of belonging, but not sense of loneliness, positively predicted both restricted and inflated sense of entitlement. Somatization negatively predicted inflated sense of entitlement. The SRE-ao is a reliable and valid scale that can be used in clinical practice and research to enhance our understanding of parent-child relationships throughout the lifespan.

COVID-19 Vaccinations and Anxiety in Middle-Aged and Older Jews and Arabs in Israel: The Moderating Roles of Ethnicity and Subjective Age.

Subjective age (i.e., feeling younger/older than one's chronological age) plays a significant role in older minority group members' psychological well-being. In light of the importance of vaccinations for fighting COVID-19, it is unclear whether ethnicity and subjective age moderate the connection between receiving COVID-19 vaccinations and anxiety in Israel. Jewish (n = 198) and Arab older adults (n = 84) provided information regarding COVID-19 vaccinations, subjective age, and anxiety symptoms, as well as additional socio-demographic and COVID-19-related health factors (age range= 40-100, M = 62.5, SD = 12.34). Results demonstrated that feeling older was associated with increased anxiety (p < .001) and that vaccinations were linked to increased anxiety among Jews (p < .05). Moreover, the association between COVID-19 vaccinations and anxiety was significant only among Jewish participants with an older subjective age (p < .05). We stress the importance of examining cultural diversities regarding the contribution of subjective age in the context of COVID-19 and psychological well-being.

The Association Between Views of Aging and Subjective Cognitive Complaints in Older Adults: Findings From Two Samples.

This cross-sectional study examined whether views of aging (VoA) relate to subjective cognitive complaints in two separate cohorts of older adults. Ageist attitudes, attitudes to aging (psychological loss, physical change, and psychological growth), subjective age, and subjective successful aging were examined. A moderating effect of chronological age was also examined. Samples included 572 adults aged 50 or older (Sample 1; mean age = 67.63, SD = 11.39, 49.4% female) and 224 adults aged 65 or older (Sample 2; mean age = 81.50, SD = 6.61, 75.3% female). More negative VoA (higher ageist attitudes, lower psychological growth, lower physical change, older subjective age, and less successful aging) were associated with more subjective cognitive complaints after controlling for covariates. An increase in chronological age strengthened some of these associations. Findings suggest that improving dimensions of VoA may have a complementary positive effect on subjective cognitive complaints in older adults.

Vaccination anxiety when vaccinations are available: The role of existential concerns.

This study examined how existential fears are related to COVID-19 vaccination anxiety and followed the Terror Management Theory (TMT) by examining the contribution of two existential concerns, subjective nearness-to-death (SNtD) and death anxiety, to COVID-19 vaccination anxiety during the first month of COVID-19 vaccinations. Data were collected during January 2021, when Israel was in lockdown, from a convenience sample of 381 Jewish Israelis (M = 55.39, SD = 17.17). Participants completed questionnaires examining demographics, SNtD, death anxiety and COVID-19 vaccination anxiety. A hierarchical regression analysis examined the connections between these variables and COVID-19 vaccination anxiety while controlling for demographics and for receiving COVID-19 vaccinations. In line with the hypotheses, SNtD and death anxiety were each positively associated with COVID-19 vaccination anxiety, and death anxiety levels moderated the positive connection between SNtD and COVID-19 vaccination anxiety, as this association was not significant for individuals with low death anxiety. The findings of this study provide preliminary evidence concerning the role of death anxiety in moderating the effect that SNtD has on COVID-19 vaccination anxiety. These findings are in line with the TMT and justify further investigation and may be utilized in future research in order to address COVID-19 vaccination anxiety more effectively.

Ageist Attitudes Are Associated with Will-to-Live and Moderated by Age, Medical Conditions and Attitudes toward Aging.

The extent to which older adults' ageist attitudes associate with their will-to-live has barely been studied. Moreover, whether this effect is moderated by older adults' age, medical conditions, and attitudes toward their own aging has not been investigated. These associations were examined by two studies. Study 1 examined the relationship between ageist attitudes and will-to-live among individuals aged 48-97, and the moderating roles of age and medical conditions on this connection. Study 2 reassessed this connection in a new sample of older adults (people aged 60-94 years) and examined the moderating role of their attitudes toward aging in this regard. In line with the hypothesis of the first study, ageist attitudes and will-to-live were negatively associated among older adults with more medical conditions. In accordance with the hypotheses of study 2, the ageist attitudes and will-to-live connection was reconstructed, and when regressed on the ageist attitudes × attitudes toward aging interaction, it remained significant only among those with increased ageist attitudes. These findings demonstrate the negative effect that ageist attitudes may have on will-to-live, especially among the very old, and particularly when their health deteriorates, and support the utility of interventions aimed at increasing their will-to-live.

Subjective accelerated aging moderates the association between COVID-19 health worries and peritraumatic distress among older adults.

BACKGROUND: The present study examined whether subjective accelerated aging moderated the relationship between COVID-19 health worries and COVID-19 peritraumatic distress among older adults. METHOD: The sample consisted of 277 older adults (M = 69.58, s.d. = 6.73, range 60-92) who answered an online questionnaire during the outbreak of COVID-19 pandemic in Israel. Participants completed the measures of background characteristics, exposure to COVID-19, COVID-19 health worries, subjective accelerated aging and COVID-19-based peritraumatic distress. RESULTS: Higher levels of COVID-19 health worries were correlated with higher levels of peritraumatic distress symptoms among older adults. Moreover, those reporting accelerated aging also reported a higher level of peritraumatic distress. Finally, the interaction between COVID-19 health worries and subjective accelerated aging predicted peritraumatic distress, suggesting that COVID-19 worries were associated with peritraumatic distress to a stronger degree among older adults who felt they were aging faster. CONCLUSIONS: These findings indicate that negative views of aging may serve as an amplifying factor for traumatic distress during the COVID-19 pandemic. Although preliminary, the findings provide insight for potential screening and interventions of older adults at risk of developing peritraumatic distress symptoms during the global pandemic.

No psychological vaccination: Vaccine hesitancy is associated with negative psychiatric outcomes among Israelis who received COVID-19 vaccination.

BACKGROUND: The widespread COVID-19 vaccination program, issued by the Israel Government, provides a unique opportunity to examine psychiatric morbidity and vaccine attitudes among individuals who have already been vaccinated. Accordingly, the current study examined how vaccine hesitancy contributes to clinical levels of depression, anxiety, and peritraumatic stress among individuals who had received COVID-19 vaccinations. METHODS: We analyzed data obtained from 254 vaccinated individuals, and assessed vaccine hesitancy, depression, anxiety, and peritraumatic distress, as well as several demographic, health, and COVID-19-related factors. RESULTS: Logistic regressions demonstrated that above and beyond socio-demographic, health, and COVID-19-related factors, COVID-19 vaccine hesitancy was the most prominent risk factor for anxiety, depression, and peritraumatic distress. Higher levels of vaccine hesitancy were found to double the risk for depression and peritraumatic stress (ORs > 2), and to triple the risk for anxiety (OR > 3). LIMITATIONS: A cross-sectional design; a preliminary study requiring further investigation CONCLUSIONS: This study points to the importance of vaccine hesitancy among vaccinated populations and provides knowledge regarding its associations with negative psychiatric outcomes. These findings may offer important information for healthcare practitioners and policy makers in their attempt to encourage individuals to receive COVID-19 vaccinations and emphasize the need to further understand the underlying mechanisms of psychiatric morbidity among vaccinated individuals.

Qualities of social relationships as mediators of the relationship between future perceptions and health.

OBJECTIVES: Foreshortened future perceptions relate to higher mental and physical morbidity. However, socioemotional selectivity theory (SST) maintains that psychological well-being improves as future perceptions narrow due to growing tendency to prioritize meaningful goals and close relationships. The objective of this study was to reconcile this contradiction by examining a model in which the focus on close relationships suppresses the direct relationship between narrow future perceptions and physical/mental morbidity. METHOD: Community-dwelling older adults (N = 249, mean age = 75.60, SD = 7.54) recruited through social clubs and day centers were interviewed at home. They filled self-report questionnaires measuring future time perspective, subjective nearness to death, positivity of relationships with others and inclusion of others in the self, while rating several physical/mental health indices. A structural equation modeling analysis tested direct and indirect effects. RESULTS: Narrow future perceptions related to higher mental (|ß| ranged .28 to .47, p < .001) and physical morbidity (|ß| ranged .37 to .45, p < .001) and, surprisingly, also to lower positivity of close relationships (|ß| ranged .24 to .31, p < .01) and less inclusion of others (|ß| ranged .17 to .21, p < .01). Both social indices mediated the relationship with lower physical health, while positivity of close relationships also mediated the relationship with psychological distress. CONCLUSION: The findings challenge SST assumptions by underscoring the negative effects of narrow future perceptions on social relationship, making the latter a mediator rather than suppressor in the link between future perceptions and physical/mental morbidity. The findings should be viewed in light of the study's limitations, including convenience sampling and cross-sectional design.

The role of emotion covariation and psychological flexibility in coping with chronic physical pain: an integrative model.

OBJECTIVE: This study focussed on the mutual role of emotion covariation and psychological flexibility in understanding the reciprocal effects of chronic pain and psychological distress. DESIGN: A longitudinal design was applied with a sample of 177 adults (mean age = 58.3, 57.1% women) suffering from chronic back/neck pain. MAIN OUTCOME MEASURES: Assessments were conducted at three timepoints: pain and psychological distress upon referral to a pain clinic (T1); emotion covariation (the correlation between daily reports of positive and negative emotions) and psychological flexibility (self-reported ability to withstand unpleasant experiences while acting upon personal values) during the weeks before undergoing an intrusive procedure (T2); pain and psychological distress one day prior to the procedure (T3). RESULTS: T2 psychological flexibility and emotion covariation mediated the effect of T1 pain on T3 psychological distress. However, T2 psychological flexibility and emotion covariation did not mediate the effect of T1 psychological distress on T3 pain. CONCLUSION: The findings highlight two complimentary mechanisms - emotion covariation and psychological flexibility - that mediate the relationship between pain and psychological distress for people with chronic back/neck pain. The findings inform future research on the effects of intervening on these mechanisms, which may lead to clinical interventions aimed at improving coping with pain.

Day-to-Day Variability in Subjective Age and Ageist Attitudes and Their Association With Depressive Symptoms.

OBJECTIVES: Evidence of daily fluctuations in subjective age and their association with older adults' well-being was recently obtained. Yet, neither the simultaneous tracking of two daily views on aging (i.e., daily subjective age and daily ageist attitudes) nor their interactive effect on mental health (i.e., depressive symptoms) has been explored. We hypothesized that (a) at days on which older adults feel older or report high ageist attitudes they would report higher depressive symptoms, (b) combined older subjective age and high ageist attitudes will be associated with the highest daily depressive symptoms. METHOD: Community-dwelling older adults (N = 134, mean age = 69.66) completed measures of subjective age, ageist attitudes, and depressive symptoms for 10 consecutive days. RESULTS: Daily older subjective age and higher ageist attitudes were related to higher depressive symptoms, but there was no combined effect of both on depressive symptoms. There was a significant three-way interaction between subjective age, ageist attitudes, and chronological age, demonstrating the interactive effect of subjective age and ageist attitudes on depressive symptoms only among the old-old respondents. Time-lagged analyses further showed that ageist attitudes during previous days predicted feeling older and more depressed on following days, but not vice versa. DISCUSSION: Results suggest that old-old individuals are more susceptible to a combination of negative views on aging on daily basis. Findings further support a daily assimilation process, whereby previous-day stereotypes are assimilated and manifested into one's identity and mental health, so that one feels older and more depressed on subsequent days.