APOE ϵ4, rated life experiences, and affect among centenarians.

OBJECTIVES: The purpose of this study was to assess the relationship between apolipoprotein E (APOE), life events and engagement, and subjective well-being (as measured by positive and negative affect) among centenarians. Based on the life stress paradigm, we predicted that higher levels of stress would allow APOE to influence positive and negative affect. METHOD: 196 centenarians and near-centenarians (98 years and older) of the Georgia Centenarian Study participated in this research. The APOE, positive and negative affect, the number of recent (last 2 years) and lifelong (more than 20 years prior to testing) events, as well as a number of life engagement tasks were assessed. RESULTS: Results suggested that centenarians carrying the APOE ϵ4 allele rated lower in positive affect, the number of lifelong events, and in engaged lifestyle, when compared to centenarians without the APOE ϵ4 allele (t = 3.43, p < .01; t = 3.19, p < .01; and t = 2.33, p < .05, respectively). Blockwise multiple regressions indicated that the APOE ϵ4 predicted positive but not negative affect after controlling for demographics. Gene-environment interactions were obtained for the APOE ϵ4 and lifelong events, suggesting that carriers of the APOE ϵ4 allele had higher scores of negative affect after having experienced more events, whereas noncarriers had reduced negative affect levels after having experienced more events. CONCLUSION: APOE ϵ4 is directly related to positive affect and is related to negative affect in interaction with life events.

Correlates of functional capacity among centenarians.

This study investigated correlates of functional capacity among participants of the Georgia Centenarian Study. Six domains (demographics and health, positive and negative affect, personality, social and economic support, life events and coping, distal influences) were related to functional capacity for 234 centenarians and near centenarians (i.e., 98 years and older). Data were provided by proxy informants. Domain-specific multiple regression analyses suggested that younger centenarians, those living in the community and rated to be in better health were more likely to have higher functional capacity scores. Higher scores in positive affect, conscientiousness, social provisions, religious coping, and engaged lifestyle were also associated with higher levels of functional capacity. The results suggest that functional capacity levels continue to be associated with age after 100 years of life and that positive affect levels and past lifestyle activities as reported by proxies are salient factors of adaptation in very late life.

Life events and personality predicting loneliness among centenarians: findings from the Georgia Centenarian Study.

Regarding the purpose of this study, the researchers analyzed the roles that both life events (life-time positive events and life-time negative events) and personality (Neuroticism, Extraversion, Trust, Competence, and Ideas) played in participants of the Georgia Centenarian Study. The researchers analyzed these variables to determine whether they predicted loneliness. Analyses indicated that life-time negative events significantly predicted loneliness. In essence, the higher was the number of life-time negative life events, the higher was the loneliness score. Moreover, Neuroticism, Competence, and Ideas were all significant predictors of loneliness. The higher was the level of Neuroticism and intellectual curiosity, the higher was the level of loneliness, whereas the lower was the level of Competence, the higher was the level of loneliness. In addition, both life-time positive and life-time negative life events were significant predictors of Neuroticism. The higher was the number of life-time positive events, the lower was the level of Neuroticism, and the higher was the number of life-time negative events, the greater was the level of Neuroticism. These results indicated that life-time negative events indirectly affect loneliness via Neuroticism. Last, our results indicated that the Competence facet mediated the relationship between lifetime negative life events and loneliness. Life-time negative life events significantly affected centenarians' perceived competence, and Competence in turn significantly affected the centenarians' loneliness. These results as a whole not only add to our understanding of the link between personality and loneliness, but also provide new insight into how life events predict loneliness.

Multidimensional predictors of fatigue among octogenarians and centenarians.

BACKGROUND: Fatigue is a common and frequently observed complaint among older adults. However, knowledge about the nature and correlates of fatigue in old age is very limited. OBJECTIVE: This study examined the relationship of functional indicators, psychological and situational factors and fatigue for 210 octogenarians and centenarians from the Georgia Centenarian Study. METHODS: Three indicators of functional capacity (self-rated health, instrumental activities of daily living, physical activities of daily living), two indicators of psychological well-being (positive and negative affect), two indicators of situational factors (social network and social support), and a multidimensional fatigue scale were used. Blocked multiple regression analyses were computed to examine significant factors related to fatigue. In addition, multi-group analysis in structural equation modeling was used to investigate residential differences (i.e., long-term care facilities vs. private homes) in the relationship between significant factors and fatigue. RESULTS: Blocked multiple regression analyses indicated that two indicators of functional capacity, self-rated health and instrumental activities of daily living, both positive and negative affect, and social support were significant predictors of fatigue among oldest-old adults. The multiple group analysis in structural equation modeling revealed a significant difference among oldest-old adults based on residential status. CONCLUSION: The results suggest that we should not consider fatigue as merely an unpleasant physical symptom, but rather adopt a perspective that different factors such as psychosocial aspects can influence fatigue in advanced later life.

Comparing the Support-Efficacy Model among Centenarians Living in Private Homes, Assisted Living Facilities, and Nursing Homes.

We investigated the influence of social relations on health outcomes in very late life by examining the support-efficacy convoy model among older adults who resided in three different residential environments (centenarians in private homes, n = 126; centenarians in assisted living facilities, n = 55; centenarians in nursing homes, n = 105). For each group, path analytic models were employed to test our hypotheses; analyses controlled for sex, mental status, education, perceived economic sufficiency, and activities of daily living. The hypothesized relationships among the models' variables were unique to each of the three groups; three different models fit the data depending upon residential environment. The direct and indirect effects of social relations assessments were positive for the mental and physical health of very old adults, suggesting that participants welcomed the support. However, residential status moderated the associations between the assessments of social relations, self-efficacy, and both outcomes, physical and mental health.

The Relationship between Physical Health and Psychological Well-Being among Oldest-Old Adults.

The purpose of this study was to evaluate the relationship between physical health and psychological well-being among oldest-old adults. Structural equation modeling was performed to examine health influences on psychological well-being among 306 octogenarians and centenarians from the Georgia Centenarian Study. Latent variables were created to reflect subjective health, as measured by self-ratings of health and objective health, as measured by physical health impairment (i.e., health problems, past and present diseases, hospitalization) and biomarkers (i.e., hemoglobin and albumin). Psychological well-being was measured by positive and negative affect. There were significant direct effects of subjective health on affect and significant indirect effects of objective health through subjective health on positive affect and negative affect. Subjective health took the role of a mediator between objective health and psychological well-being. These results highlight the status and perceptions of health as a critical indicator for well-being in extreme old age.

Affect and loneliness among centenarians and the oldest old: the role of individual and social resources.

OBJECTIVES: Affect and loneliness are important indicators of mental health and well-being in older adulthood and are linked to significant outcomes including physical health and mortality. Given a large focus on young-old adults within gerontological research, the primary aim of this study was to examine the ability of individual and social resources in predicting affect and loneliness within a sample of oldest-old individuals including centenarians, an understudied population. METHODS: Participants were assessed during the most recent cross-sectional data collection of the Georgia Centenarian Study. The eligible sample included 55 octogenarians (M = 83.70 years, SD = 2.68; range = 81-90) and 77 centenarians (M = 99.78 years, SD = 1.64; range = 98-109). Subjects scored 17 or greater on the Mini-Mental Status Exam and completed mental health assessments. RESULTS: Hierarchical regression analyses were conducted to examine the relation of affect and loneliness with demographic characteristics, physical and social functioning, cognition, and personality. Within this sample of cognitively intact oldest old, measures of executive control and cognitive functioning demonstrated limited association with mental health. Personality, specifically neuroticism, was strongly related to mental health indicators for both age groups and social relations were particularly important associates of centenarians' mental health. DISCUSSION: Findings indicate the distinctiveness of mental health indicators and the need to distinguish differential roles of individual and social resources in determining these outcomes among octogenarians and centenarians.

Predicting successful aging in a population-based sample of georgia centenarians.

Used a population-based sample (Georgia Centenarian Study, GCS), to determine proportions of centenarians reaching 100 years as (1) survivors (43%) of chronic diseases first experienced between 0-80 years of age, (2) delayers (36%) with chronic diseases first experienced between 80-98 years of age, or (3) escapers (17%) with chronic diseases only at 98 years of age or older. Diseases fall into two morbidity profiles of 11 chronic diseases; one including cardiovascular disease, cancer, anemia, and osteoporosis, and another including dementia. Centenarians at risk for cancer in their lifetime tended to be escapers (73%), while those at risk for cardiovascular disease tended to be survivors (24%), delayers (39%), or escapers (32%). Approximately half (43%) of the centenarians did not experience dementia. Psychiatric disorders were positively associated with dementia, but prevalence of depression, anxiety, and psychoses did not differ significantly between centenarians and an octogenarian control group. However, centenarians were higher on the Geriatric Depression Scale (GDS) than octogenarians. Consistent with our model of developmental adaptation in aging, distal life events contribute to predicting survivorship outcome in which health status as survivor, delayer, or escaper appears as adaptation variables late in life.

Understanding centenarians' psychosocial dynamics and their contributions to health and quality of life.

While it is understood that longevity and health are influenced by complex interactions among biological, psychological, and sociological factors, there is a general lack of understanding on how psychosocial factors impact longevity, health, and quality of life among the oldest old. One of the reasons for this paradox is that the amount of funded research on aging in the US is significantly larger in the biomedical compared to psychosocial domains. The goals of this paper are to highlight recent data to demonstrate the impact of four pertinent psychosocial domains on health and quality of life of the oldest old and supplement recommendations of the 2001 NIA Panel on Longevity for future research. The four domains highlighted in this paper are (1) demographics, life events, and personal history, (2) personality, (3) cognition, and (4) socioeconomic resources and support systems.

Family history and adaptation among centenarians and octogenarians.

BACKGROUND: The purpose of this study was to analyze various 'family history' variables (i.e. childhood health, financial situation while growing up, living with grandparents before age 17, and number of children) among participants of the Georgia Centenarian Study. OBJECTIVE: To determine whether family history variables predict critical outcome areas such as cognitive functioning, activities of daily living, mental health, and economic dependence. METHODS: A total of 318 older adults (236 centenarians and 82 octogenarians) were assessed with regard to their mental status, ADL (activities of daily living) functioning, depression, family history, loneliness, and perceived economic status. RESULTS: Analyses indicated that the number of children significantly predicted the ability to engage in activities of daily living and loneliness. In essence, the more children, the higher the activities of the daily living score and the lower the loneliness scores. In addition, childhood health significantly predicted loneliness. The poorer one's health in childhood, the higher the loneliness scores. CONCLUSION: The results of this study confirm the importance of distal family history variables on present-day functioning.

Predicting happiness among centenarians.

BACKGROUND: Happiness is believed to evolve from the comparison of current circumstances relative to past achievement. However, gerontological literature on happiness in extreme old age has been limited. OBJECTIVE: The purpose of this study was to determine how perceptions of health, social provisions, and economics link past satisfaction with life to current feelings of happiness among persons living to 100 years of age and beyond. METHODS: A total of 158 centenarians from the Georgia Centenarian Study were included to conduct the investigation. Items reflecting congruence and happiness from the Life Satisfaction Index were used to evaluate a model of happiness. Pathways between congruence, perceived economic security, subjective health, perceived social provisions, and happiness were analyzed using structural equation modeling. RESULTS: Congruence emerged as a key predictor of happiness. Furthermore, congruence predicted perceived economic security and subjective health, whereas perceived economic security had a strong influence on subjective health status. CONCLUSION: It appears that past satisfaction with life influences how centenarians frame subjective evaluations of health status and economic security. Furthermore, past satisfaction with life is directly associated with present happiness. This presents implications relative to understanding how perception of resources may enhance quality of life among persons who live exceptionally long lives.

Depression among centenarians and the oldest old: contributions of cognition and personality.

BACKGROUND: An estimated 20% of adults over the age of 55 experience clinical mental disorders such as depression and anxiety. For older adults, mental health concerns are often undetected, concomitant with physical challenges, and ultimately go untreated. These realities have significant implications for older adults' day-to-day functioning, particularly among the oldest old. OBJECTIVE: The present study examined the ability of cognition and personality in explaining depression within a sample of octogenarians and centenarians. METHODS: Participants were assessed during the most recent cross-sectional data collection of the Georgia Centenarian Study. The final eligible sample included 76 octogenarians (mean: 84.25 years, SD: 2.82; range: 81-90) and 158 centenarians and near centenarians (mean: 99.82 years, SD: 1.72; range: 98-109). RESULTS: Hierarchical regression analyses were conducted to examine the relation between key variables and depressive symptoms in the two age groups. Blocks entered into the analyses included: demographics (i.e. age group, residential status, sex, and ethnicity) and functioning, memory and problem-solving ability, and personality (i.e. extraversion and neuroticism). Models differed for octogenarians and centenarians. Decreased problem-solving ability was related to greater depressive symptoms among octogenarians. For centenarians, institutional residence and increased neurotic tendencies were related to greater depressive symptoms. CONCLUSION: Study findings demonstrate the need to examine a variety of factors which influence mental health in later life and to consider the unique contexts and differential experiences of octogenarians and centenarians.

Distal and proximal resource influences on economic dependency among the oldest old.

BACKGROUND: As exceptional survivors, centenarians may have characteristics that reduce their dependency on family and community support systems despite the expectation that their extreme age creates a burden on those systems. The Georgia Centenarian Study obtained information about assistance for income, medical care, and caregiving of all types for a sample of centenarians and octogenarians. Previous studies have not established which characteristics may contribute to economic dependency among the oldest old. OBJECTIVE: To identify distal and proximal resource influences on economic dependency, considering past lifestyle, proximal health, economic resources, personality, and coping behavior. METHODS: Analysis sample sizes ranged from 109 to 138 octogenarians and centenarians. Blockwise multiple regressions predicted whether they received income assistance, number of medical care events, number of caregiving types, and total caregiving hours. RESULTS: Past life style, gender, ethnicity, socioeconomic status, functional health, and coping were not related to economic dependency. With the exception of the number of types of care, centenarians were not more dependent than octogenarians. Cognitive ability had the strongest effects for medical care and caregiving services. 'Extraversion', 'ideas', 'neuroticism', and 'competence' personality factors had significant effects for caregiving types and total hours of care received. CONCLUSION: Monitoring and intervention to maintain cognitive ability are critical practices for autonomy and reduced economic dependency among the oldest old. Psychological resources are more important influences on social support than functional health and other proximal economic resources.

Correspondence of perceptions about centenarians' mental health.

OBJECTIVES: The goals of this study were to uncover the criteria by which centenarians, proxy/caregivers, and interviewers rated centenarians' mental health. Often proxy and interviewer reports are obtained in studies of the oldest-old and become a primary source of information. METHODS: Data were from a population-based sample of mentally competent US centenarians in northern Georgia. The dependent variables were based on alternative reports for the centenarians' mental or emotional health. Regression analysis was used to predict each source's rating of mental health separately with the same set of variables. These variables included information obtained from the centenarians and proxies about their distal experiences, demographics, and proximal resources including Mini-Mental Status Examination (MMSE), health, personality, socioeconomic resources, and coping behaviors. RESULTS: Examination of mean-level differences between sources revealed similarity across mental health ratings. For centenarians and proxies, perceived economic status was a very important predictor of mental health. For centenarians and interviewers, personality (neuroticism and extraversion) was an important common predictor. The interviewer and proxy mental health ratings were strongly associated with MMSE, but that was not the case for centenarians. CONCLUSION: Mean-level findings and the comparative regression results provide corroborating evidence that centenarians' self-reports of mental health are similar based on average ratings and presence of common associations with other raters (i.e., perceived economic status and personality). Implications of differences across rater pairs are discussed as guidance about the comparative value of substitution of proxies as informants for addressing specific influences on mental health.

Engaged Lifestyle, Personality, and Mental Status Among Centenarians.

This study assessed engaged lifestyle activities (e.g., volunteering, traveling, and public speaking) for centenarians of the Georgia Centenarian Study. A total of 285 centenarians and near-centenarians (i.e., 98 years and older) and their proxy informants participated in this study. The Mini-Mental Status Examination (MMSE) was assessed for all centenarians, and proxy informants reported on lifestyle activities and personality traits of the centenarians. Results suggested that participants who had volunteered, traveled, and those who had given public talks and balanced their checkbooks were more likely to show relatively high mental status scores (i.e., MMSE > 17). Personality traits were found to be moderators in the relationship between engaged lifestyle and mental status: Participants with high levels of Emotional Stability, Extraversion, Openness, and Conscientiousness and with high levels of engaged lifestyle were more likely to show relatively high mental status scores (i.e., MMSE > 17), whereas participants with low levels of Emotional Stability, Extraversion, Openness, Agreeableness, and Conscientiousness and with low levels of engaged lifestyle were more likely to show relatively low mental status scores (i.e., MMSE < 18). The results suggest that engaged lifestyle, particularly in combination with personality traits, plays an important role in the level of cognitive functioning among oldest old adults.

Personality and longevity: findings from the Georgia Centenarian Study.

Centenarians are thought of as unique and exceptional survivors. This study evaluated specific personality traits and configurations of traits among participants of the Georgia Centenarian Study. Two hundred and eighty five centenarians and their nominated proxies participated in this study. Self ratings and proxy informant ratings were obtained for different traits and facets of the Big-5 personality typology. Results suggested that centenarians overall had low levels of Neuroticism, but high levels of Extraversion, Competence, and Trust. When compared to centenarian self ratings, proxies provided significantly higher ratings for Neuroticism, Hostility, and Vulnerability, but lower ratings for Competence and Trust. Among Centenarians, the personality configuration of low Neuroticism, high Competence, and high Extraversion traits is over-represented relative to chance. The results confirm that centenarians show several unique single traits, but that a special combination of traits (i.e., low levels of Neuroticism, high Competence, and high Extraversion) are also notable in this group of exceptional survivors.