Three facets of emotion regulation in old and very old age: Strategy use, effectiveness, and variability.

The ability to regulate emotions in stressful situations is an important building block for high well-being across the lifespan. Yet, very little is known about how old and very old adults regulate their emotions. In this study, 123 young old adults (Mage = 67.18, SD = 0.94) and 47 very old adults (Mage = 86.70, SD = 1.46) were prompted 6 times a day for 7 consecutive days to report both their stressors and 10 emotion regulation strategies. Overall, there was little indication of age differences in the use of emotion regulation strategies during exposure to stressors, but very old, as compared with young old, individuals used three of the 10 strategies considered here more intensively. The 10 emotion regulation strategies were similarly effective across age groups based on their association with perceived overall emotion regulation success. We also did not find age group differences in within-strategy variability, defined as the variation in using a given strategy across stressor situations. By contrast, between-strategy variability, defined as the selective use of fewer rather than many strategies across stressor situations, was lower for very old participants. Only between-strategy, and not within-strategy, variability contributed to overall emotion regulation success. There was no age group difference in this regard. Taken together, the evidence suggests small age differences in emotion regulation if at all. This is noteworthy given the advanced age of the very old subsample in this study and the deficits in multiple domains of functioning reported in the literature for this advanced age. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Bidirectional Links of Daily Sleep Quality and Duration With Pain and Self-rated Health in Older Adults' Daily Lives.

BACKGROUND: Sleep and health perceptions, such as self-ratings of pain and health are closely linked. However, the temporal ordering of such associations is not well understood, and it remains unclear whether sleep quality and sleep duration show similar or differential associations with health perceptions. METHODS: We used ecological momentary assessment data from 123 young-old (66-69 years, 47% women) and 47 old-old adults (84-90 years, 60% women). Across 7 consecutive days, participants reported their sleep quality and sleep duration each morning and rated their momentary pain and health 6 times per day. We applied dynamic structural equation models to examine bidirectional links of morning reports of sleep quality and duration with daily levels of self-rated pain and health. RESULTS: In line with the hypotheses, results showed that when participants reported better sleep quality than what is typical for them, they reported less pain and better self-rated health on the day that followed. Longer sleep duration was not linked with subsequent pain or self-rated health. On days when people rated their health as better than usual, they reported better sleep quality but not longer sleep duration the following night. These associations were not moderated by age, gender, or chronic pain. CONCLUSION: Findings suggest that in old age, sleep quality is more relevant for health perceptions than sleep duration. Associations between sleep quality and self-rated health seem to be bidirectional; daily pain was linked to prior but not subsequent sleep quality.

Long-term aging trajectories of the accumulation of disease burden as predictors of daily affect dynamics and stressor reactivity.

Multiple-timescale studies provide new opportunities to examine how developmental processes that evolve at different cadences are intertwined. Developmental theories of emotion regulation suggest that the long-term, slowly evolving age-related accumulation of disease burden should shape short-term, faster evolving (daily) affective experiences. To empirically examine this proposition, we combined data from 123 old adults (65-69 years, 47% women) and 32 very old adults (85-88 years, 59% women) who provided 20 + year within-person longitudinal data on physician-rated morbidity and subsequently also completed repeated daily-life assessments of stress and affect six times a day over 7 consecutive days as they were going about their daily-life routines. Results from models that simultaneously articulate growth and intraindividual variability processes (in a dynamic structural equation modeling framework) revealed that individual differences in long-term aging trajectories of the accumulation of disease burden were indeed predictive of differences in three facets of affective dynamics that manifest in everyday life. In particular-over and above mean levels of disease burden-older adults whose disease burden had increased more over the past 20 years had higher base level of negative affect in their daily lives, more emotional reactivity to the experience of daily stressors, and more moment-to-moment fluctuations in negative affect that was unrelated to stressors (affective systemic noise). We highlight that developmental processes evolving over vastly different timescales are intertwined, and speculate how new knowledge about those relations can inform developmental theories of emotion regulation and daily-life functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Emotion regulation in old and very old age.

Prominent life span theories have suggested that the ability to downregulate negative emotions remains stable or even increases well into old age. However, past evidence for continued growth during old age is mixed. In this laboratory study, 130 young old individuals (Mage = 66.72 years, SD = 1.03, range = 65 to 69 years, 48% female) and 59 very old individuals (Mage = 86.03 years, SD = 1.44, range = 83 to 89 years, 58% female) watched negative emotion evoking film clips under different emotion regulation instructions. Subjective feelings, cardiovascular reactions, and facial behavioral expressions were assessed in response to each film. Emotion regulation competence was operationalized as difference in the intensity of negative emotions during a trial with no regulation instruction versus three trials with regulation instruction, asking participants to engage in detached reappraisal, behavioral suppression, or positive reappraisal. In comparison to young old individuals, very old individuals were less able to regulate their self-reported negative feelings. These age-related deficits were partly associated with age differences in fluid cognitive abilities. Notably, however, emotion regulation deficits in very old individuals observed in self-reports of emotions were not evident at the levels of cardiovascular arousal and facial expressivity. Together this evidence speaks against one-sided views on emotional aging as uniform process of either growth or decline, even in old and very old age. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Emotional reactivity to daily stressors: Does stressor pile-up within a day matter for young-old and very old adults?

Over the past decade, many studies have reported individual differences in negative emotional reactions to daily stressful events. However, whether and how individual and age-related differences in emotional reactivity also depend on the temporal characteristics of stressors has received little attention. In this project, we focused on the temporal characteristics of stressor occurrence and examined the pile-up of stressors within a day-referring to multiple stressors encountered within a relatively narrow time window. To do so, we used data from 123 young-old (66-69 years, 47% women) and 47 very old adults (84-90 years, 60% women). Participants reported their momentary feelings and exposure to stressors six times a day over 7 consecutive days in their everyday life. Emotional reactivity to stressor pile-up over the day followed an exponential decay trajectory, with higher stressor burden in close proximity to the stressor occurrence. The exact shape of the decay trajectory differed among participants. Most importantly, both stressor pile-up and ongoing stress predicted greater emotional reactivity. We also found interaction effects of stressor pile-up and current stressor occurrence in that increases in negative affect under ongoing stress were stronger when stressors had piled-up before. No evidence was found for increased vulnerability to stressor pile-up in very old adults; rather, the impact of preceding stressors attenuated faster for individuals in this age group. The findings highlight the utility of comprehensively studying how stressor characteristics such as their pile-up within short time periods shape emotional reactivity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Between-person and within-person associations of sleep and working-memory in the everyday lives of old and very old adults: initial level, learning, and variability.

STUDY OBJECTIVES: Sleep duration affects various aspects of cognitive performance, such as working-memory and learning, among children and adults. However, it remains open, whether similar or even stronger associations exist in old and very old age when changes in sleep and cognitive decrements are common. METHODS: Using repeated daily-life assessments from a sample of 121 young-old (66-69 years old) and 39 old-old adults (84-90 years old), we assessed links between sleep duration and different aspects of working-memory (initial level, practice-related learning, and residualized variability) between and within persons. Participants reported their sleep durations every morning and performed a numerical working-memory updating task six times a day for seven consecutive days. RESULTS: Both people who slept longer and those who slept shorter than the sample average showed lower initial performance levels, but a stronger increase of WM over time (i.e. larger learning effects), relative to people with average sleep. Sleep duration did not predict performance variability. Within-person associations were found for people sleeping relatively little on average: For them, working-memory performance was lower on days with shorter than average sleep, yet higher on days with longer than average sleep. Except for lower initial levels of working-memory in old-old adults, no differences between young-old and old-old adults were observed. CONCLUSION: We conclude that sufficient sleep remains important for working-memory performance in older adults and that it is relevant to include different aspects of working-memory performance, because effects differed for initial performance and learning.

Momentary subjective age is associated with perceived and physiological stress in the daily lives of old and very old adults.

Subjective age, that is the age people feel in relation to their chronological age, can vary on a day-to-day and even momentary basis. Previous long-term and daily-diary studies have shown that elevated stress covaries with older subjective age. However, it is an open question whether such links can also be observed at the momentary level within a given day and go beyond self-reports of stress. Moving ahead, we investigated how two indicators of stress (self-reported: perceived stress; physiological: salivary cortisol) are associated with the age people feel on a momentary basis. We examined data from 118 older (Mage = 66.67 years) and 36 very old adults (Mage = 85.92 years) who reported their momentary subjective age and perceived stress and also provided saliva samples up to seven times a day over seven consecutive days. Dynamic structural equation models showed that both higher momentary perceived stress and higher cortisol levels preceding the measurement predicted an older momentary subjective age. In contrast, subjective age at the previous measurement did not predict subsequent stress. These effects were moderated by participant age group and grip strength, albeit not consistently. Our results corroborate and extend earlier findings that both self-reported and physiological stress are important explanatory variables for people's subjective age variation even on relatively short time scales and shed light on differential time-ordered dynamics between stress and subjective age in daily life. Findings also inform theoretical models of subjective age that highlight the importance of contextual, momentary influences on how old people feel and help better understand how biological and psychological processes are intertwined in later life. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Good night-good day? Bidirectional links of daily sleep quality with negative affect and stress reactivity in old age.

Bidirectional links between sleep quality and emotional experiences are complex and not yet well understood-especially in old age when substantial changes occur in sleep and emotional experiences. Because previous research rarely considered the role of stressors, we examine if older adults' sleep quality is directly associated with subsequent negative affect (NA) or more indirectly via affective reactivity to stressors. Specifically, we investigate whether and how older adults' sleep quality predicts negative affect and affective reactivity to stress on the following day, and vice versa. For seven consecutive days, 325 older adults (61-90 years, 49% women) reported their sleep quality each morning as well as momentary negative affect and stressful events multiple times a day. Results from multilevel structural equation models showed that after nights of lower sleep quality, older adults reported more negative affect, but not higher affective reactivity to stressors. In turn, after days with increased affective reactivity but not more negative affect, participants reported worse sleep quality. We discuss whether older adults are able to regulate the effects of low sleep quality, but have difficulties downregulating stress and its effects on sleep. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"I felt so old this morning." Short-term variations in subjective age and the role of trait subjective age: Evidence from the ILSE/EMIL ecological momentary assessment data.

Subjective age, how old people feel compared to their chronological age, is a central indicator of age identity and highly predictive for developmental outcomes. While mostly used as a trait-like concept in previous research, recent studies employing experimental designs and daily assessments suggest that subjective age can vary after experimental manipulations or between days. However, less is known about whether subjective age varies over even shorter time frames such as within moments on a given day, how such short-term variability differs by age and its association with trait subjective age. We examined these questions with data obtained from 123 young-old (Mage = 67.19 years) and 47 old-old adults (Mage = 86.59 years) who reported their momentary subjective age six times a day over 7 consecutive days as they were going about their everyday lives. Participants felt younger on a large majority of occasions, and 25% of the total variability in subjective age could be attributed to within-person variation. Within-person variability in subjective age amounted to an average of about 3 years from one moment to the next and did not differ between age groups. However, those with younger trait subjective ages exhibited larger moment-to-moment variation. Our findings extend the literature on subjective age by showing that how old people feel can vary on a momentary basis and that state and trait components of subjective age are related. Further research should investigate the contextual predictors of variability in subjective age and the links between trait and state concepts and developmental outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Positive and negative affect are associated with salivary cortisol in the everyday life of older adults: A quantitative synthesis of four aging studies.

Research on time-fluctuating links between positive affect and cortisol is inconsistent and mostly based on young to middle-aged samples. The current project investigated how moment-to-moment changes in positive and negative affect are associated with moment-to-moment changes in cortisol levels in older adults' daily lives and whether those associations are moderated by differences in health status (as indicated by the number of comorbidities). Affect and cortisol data collected in four separately conducted momentary assessment studies with parallel protocols were pooled to obtain a sample of N=476 individuals aged 56-88 years (Mage=71.9, SD=6.6; 52% female). Participants provided affect reports and collected salivary cortisol 5-7 times a day for a 7-day period and reported the presence of 13 different health conditions. Data were analyzed using multilevel models, with time since waking, daily behaviors associated with cortisol secretion, age, and sex controlled. Feeling more positive affect than usual was associated with lower momentary cortisol. In contrast, feeling more negative affect than usual was associated with higher momentary cortisol. Associations of momentary positive and negative affect with cortisol were weaker among participants in worse as compared to those in better health. Trait positive affectivity was associated with more curvature of waking cortisol profiles and trait negative affectivity was associated with smaller cortisol awakening responses. Findings suggest that HPA axis responses fluctuate with everyday changes in positive and negative affect in older adults, and that higher HPA reactivity may indicate preserved health in this age group.

Association of Low-Dose Whole-Body Computed Tomography With Missed Injury Diagnoses and Radiation Exposure in Patients With Blunt Multiple Trauma.

Importance: Initial whole-body computed tomography (WBCT) for screening patients with suspected blunt multiple trauma remains controversial and a source of excess radiation exposure. Objective: To determine whether low-dose WBCT scanning using an iterative reconstruction algorithm does not increase the rate of missed injury diagnoses at the point of care compared with standard-dose WBCT with the benefit of less radiation exposure. Design, Setting, and Participants: This quasi-experimental, prospective time-series cohort study recruited 1074 consecutive patients admitted for suspected blunt multiple trauma to an academic metropolitan trauma center in Germany from September 3, 2014, through July 26, 2015, for the standard-dose protocol, and from August 7, 2015, through August 20, 2016, for the low-dose protocol. Five hundred sixty-five patients with suspected blunt multiple trauma prospectively received standard-dose WBCT, followed by 509 patients who underwent low-dose WBCT. Confounding was controlled by segmented regression analysis and a secondary multivariate logistic regression model. Data were analyzed from January 16, 2017, through October 14, 2019. Interventions: Standard- or low-dose WBCT. Main Outcomes and Measures: The primary outcome was the incidence of missed injury diagnoses at the point of care, using a synopsis of clinical, surgical, and radiological findings as an independent reference test. The secondary outcome was radiation exposure with either imaging strategy. Results: Of 1074 eligible patients, 971 (mean [SD] age, 52.7 [19.5] years; 649 men [66.8%]) completed the study. A total of 114 patients (11.7%) had multiple trauma, as defined by an Injury Severity Score of 16 or greater. The proportion of patients with any missed injury diagnosis at the point of care was 109 of 468 (23.3%) in the standard-dose and 107 of 503 (21.3%) in the low-dose WBCT groups (risk difference, -2.0% [95% CI, -7.3% to 3.2%]; unadjusted odds ratio, 0.89 [95% CI, 0.66-1.20]; P = .45). Adjustments for autocorrelation and multiple confounding variables did not alter the results. Radiation exposure, measured by the volume computed tomography dose index, was lowered from a median of 11.7 (interquartile range, 11.7-17.6) mGy in the standard-dose WBCT group to 5.9 (interquartile range, 5.9-8.8) mGy in the low-dose WBCT group (P < .001). Conclusions and Relevance: Low-dose WBCT using iterative image reconstruction does not appear to increase the risk of missed injury diagnoses at the point of care compared with standard-dose protocols while almost halving the exposure to diagnostic radiation.