Measuring Multidimensional Aspects of Health in the Oldest Old Using the NIH Toolbox: Results From the ARMADA Study.

OBJECTIVE: The percentage of older adults living into their 80s and beyond is expanding rapidly. Characterization of typical cognitive performance in this population is complicated by a dearth of normative data for the oldest old. Additionally, little attention has been paid to other aspects of health, such as motor, sensory, and emotional functioning, that may interact with cognitive changes to predict quality of life and well-being. The current study used the NIH Toolbox (NIHTB) to determine age group differences between persons aged 65-84 and 85+ with normal cognition. METHOD: Participants were recruited in two age bands (i.e., 65-84 and 85+). All participants completed the NIHTB Cognition, Motor, Sensation, and Emotion modules. Independent-samples t-tests determined age group differences with post-hoc adjustments using Bonferroni corrections. All subtest and composite scores were then regressed on age and other demographic covariates. RESULTS: The 65-84 group obtained significantly higher scores than the 85+ group across all cognitive measures except oral reading, all motor measures except gait speed, and all sensation measures except pain interference. Age remained a significant predictor after controlling for covariates. Age was not significantly associated with differences in emotion scores. CONCLUSIONS: Results support the use of the NIHTB in persons over 85 with normal cognition. As expected, fluid reasoning abilities and certain motor and sensory functions decreased with age in the oldest old. Inclusion of motor and sensation batteries is warranted when studying trajectories of aging in the oldest old to allow for multidimensional characterization of health.

Culturally responsive psychological assessment with racially and ethnically diverse older adults.

The older adult population in the United States (U.S.) is becoming more racially and ethnically diverse, whereas most practicing neuropsychologists are white. Psychologists hold social privilege of which they may not be aware and work in health care systems that benefit the racial majority. System-level change is necessary to create a more equitable and accessible health care system for racially and ethnically diverse older adults. It is vital for the field of psychology to understand how oppression, power, and privilege impact the accessibility, reliability, and effectiveness of psychological assessment. The aim of this article is to address how historical medical injustices, poor education quality, barriers to communication, biases, and intersectionality influence psychological evaluations. Via a selective literature review, we illustrate how these issues apply to working with racially and ethnically diverse older adults. We discuss the historical context of the multicultural approach to assessment; system- and interpersonal-level manifestations of oppression; and age-cohort-related considerations. A clinical vignette illustrates how oppression, power, and privilege can manifest in the context of an evaluation. We issue a commentary and call to action, charging psychologists to implement individual- and system-level change. We provide recommendations for culturally responsive psychological assessments. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sleep Behaviors in Persons With Alzheimer's Disease: Associations With Caregiver Sleep and Affect.

Poor sleep in persons with Alzheimer's disease (AD) is a common stressor for family caregivers. Retrospective reports support associations between sleep disturbance in persons with AD and worse caregiver mood; however, prospective associations between sleep in persons with AD and caregiver outcomes have not been studied. The current study determined associations between affect and sleep of persons with AD and their caregivers using daily diary data. Multilevel mediation models indicated that sleep in persons with AD is linked to caregiver affect; furthermore, these associations are mediated by sleep characteristics in caregivers and affect in persons with AD. Daily fluctuations in sleep behaviors in persons with AD-rather than average values-were most strongly associated with caregiver outcomes. Interventions to improve sleep in persons with AD may decrease their negative affect and improve caregiver mood.

Greater negative affect and mixed emotions during spontaneous reactions to sad films in older than younger adults.

Older adults may be better able to regulate emotion responses to negative experiences than younger persons when provided instructions, but age group differences in spontaneous emotion responses are poorly understood. The current study determined age group differences in spontaneous reactivity and recovery in negative and positive affects, as well as the co-occurrence of negative and positive affects, following a laboratory mood induction. Younger (n = 71) and older adults (n = 44) rated negative and positive affects before and several times after a negative mood induction involving sad film clips. ANCOVA and multilevel longitudinal modeling in HLM were utilized to determine age group differences in spontaneous reactivity to and recovery from the mood induction, as well as age group differences in co-occurrence of negative and positive affects. Relative to younger adults, older adults reported greater negative affect reactivity to and recovery from the mood induction. Older adults also reported greater co-occurrence of negative and positive affects in response to the mood induction, as compared to younger adults. Thus, older adults reacted more strongly to sad film clips than younger persons, exhibited efficient recovery, and reported greater co-occurrence of negative and positive affects. A fruitful line of future research might determine whether affect co-occurrence facilitates effective emotion regulation.

Older and younger adults differently judge the similarity between negative affect terms.

OBJECTIVES: Theoretical models of aging suggest changes across the adult lifespan in the capacity to differentiate emotions. Greater emotion differentiation is associated with advantages in terms of emotion regulation and emotion resiliency. This study utilized a novel method that directly measures judgments of affect differentiation and does not confound affective experience with knowledge about affect terms. Theoretical predictions that older adults would distinguish more between affect terms than younger persons were tested. METHOD: Older (n = 27; aged 60-92) and younger (n = 56; aged 18-32) adults rated the difference versus similarity of 16 affect terms from the Kessler and Staudinger ( 2009 ) scales; each of the 16 items was paired with every other item for a total of 120 ratings. Participants provided self-reports of trait emotions, alexithymia, and depressive symptoms. RESULTS: Older adults significantly differentiated more between low arousal and high arousal negative affect (NA) items than younger persons. Depressive symptoms were associated with similarity ratings across and within valence and arousal. CONCLUSION: Findings offer partial support for theoretical predictions that older adults differentiate more between affect terms than younger persons. To the extent that differentiating between negative affects can aid in emotion regulation, older adults may have an advantage over younger persons. Future research should investigate mechanisms that underlie age group differences in emotion differentiation.

Perceptions of emotion and age among younger, midlife, and older adults.

OBJECTIVES: Older adults report greater emotional well-being than younger persons, yet negative stereotypes about aging are pervasive. Little is known about age group perceptions of emotion in adulthood, particularly for familiar persons. Thus, this project determined perceptions of general affect in familiar younger and older adults. METHOD: In two studies, participants (Study 1, younger adult n = 123, older adult n = 43; Study 2, younger adult n = 34, midlife adult n = 41, older adult n = 16) provided self-report data about their affect in general, as well as reported on the affect of a familiar younger person (aged 18--34) and a familiar older person (aged 65 or older). Emotion scales assessed high- and low-arousal positive and negative affect. RESULTS: Results suggest a less favorable perception of emotion experiences of older adults compared to younger adults. Specifically, participants of all age groups rated older adults as having lower positive emotions and higher negative emotions than is found in self-report data. CONCLUSION: Perceptions of emotion in older adulthood reflect stereotypes of negative functioning. Older adult participants were not immune to holding negative views about older adults. Negative perceptions about emotion experiences in later life may be detrimental to the physical and mental health of older adults.

Judgment and classification of emotion terms by older and younger adults.

OBJECTIVES: Theoretical models of adult development suggest changes in emotion systems with age. This study determined how younger and older adults judged and classified 70 emotion terms that varied in valence and arousal, and that have been used in previous studies of adult aging and emotion. The terms were from the Positive and Negative Affect Schedule - Expanded (PANAS-X) and the (KS) affect scales. METHOD: Older (n = 32) and younger adults (n = 111) engaged in a card sort task which determined how the 70 emotion terms were classified (i.e. grouped) in relation to one another. Activation and valence ratings of emotion terms were collected. RESULTS: There were 17 age group differences in item ratings for activation and 19 for valence. Older adults tended to rate emotion terms and scales as more positive and activating than younger persons. Card sort data indicated similarity in conceptualizations of emotion terms across groups with exceptions for serene, sad, and lonely. CONCLUSIONS: Research that utilizes self-report emotion data from older and younger persons should consider how perceptions of emotion terms may vary systematically with age. The constructs of sadness, loneliness, and serene may be age-variant and necessitate age-based adjustments in assessment and intervention. Further, older adults may perceive some emotion terms to be more activating and positive than younger persons.

Apathy, alexithymia, and depressive symptoms: Points of convergence and divergence.

This study determined convergence and divergence in the constructs of alexithymia, apathy, and depressive symptoms. Understanding of similarities and differences between these constructs will improve diagnostic accuracy for clinical and research purposes. Community-dwelling participants (N=622, M age=35.6 years, SD=13.1) completed online measures of alexithymia, depression, and apathy; 12.2% were alexithymic, 37.8% reported significant depressive symptoms, and 24.9% reported significant apathy. Exploratory Factor Analyses (EFAs) determined the best factor structure for the apathy, alexithymia, and depressive symptoms was comprised of three factors and accounted for 45.1% of item variance. The Depression, Apathy, and Alexithymia factors were defined most strongly by item content that is at the core of each construct. Depression was defined most highly by items assessing sadness, low self-esteem, and loneliness. The strongest item loadings for Alexithymia were difficulty identifying and describing feelings. Apathy was characterized by poor motivation, low interest, and lack of initiative. However, each of these core and defining features had significant cross-loadings on one of the other two factors. Negative affect shared variance with Apathy, low motivation shared variance with Depression, and difficulty describing and identify feelings shared variance with Depression and Apathy. Clinical and research implications are discussed.