Profiles of centenarians' functioning: linking functional and cognitive capacity with depressive symptoms.

BACKGROUND: Despite most centenarians facing age-related declines in functional and cognitive capacities, the severity of these declines varies among individuals, as does the maintenance of good mental health (e.g., depressive symptoms) despite these declines. This study aims to examine this heterogeneity in centenarians from the Second Heidelberg Centenarian Study, which collected data from 112 centenarians living in Germany. In our study, we focus on a subsample of 73 centenarians who provided self-reports for our measures of interest (M age = 100.4, SD age = 0.55). METHODS: We examined correlations between functional capacity (i.e., PADL, IADL), cognitive capacity (i.e., MMSE), and depressive symptoms (i.e., GDS), and the existence of different profiles using hierarchical clustering. RESULTS: Higher functional capacity was related to higher cognitive capacity and to fewer depressive symptoms. Yet, higher cognitive capacity was associated with more depressive symptoms. Hierarchical clustering analysis elucidated this contradiction by identifying three profiles: low-capacity individuals (i.e., 24 individuals had low functional and cognitive capacities, with low depressive symptoms), high-capacity individuals (i.e., 33 individuals with high functional and cognitive capacities, with low depressive symptoms), and low-functional-high-cognitive-capacity individuals (i.e., 16 individuals showed low functional but high cognitive capacity, with high depressive symptoms). Our post-hoc analyses highlighted arthritis and pain as risk factors for functional dependence and depression. CONCLUSIONS: Our findings emphasize the importance of identifying centenarian subgroups with specific resource- and risk profiles to better address their needs, and of treating pain to improve functional capacity and mental health in centenarians.

Mental health among centenarians living in Switzerland.

BACKGROUND: Given the increasing number of people achieving exceptionally long lifespans, there is an urgent need for a better understanding of mental health in centenarians. This study aimed to understand the prevalence of mental health conditions-depressive symptoms, anxiety, sleep disturbances, disinhibition, and aberrant motor behaviour-among centenarians in Switzerland. METHODS: Data were collected from N = 169 participants via telephone interviews or paper questionnaires, either directly from centenarians or through proxy informants. Half the data were collected during a period when protective measures were imposed due to the COVID-19 pandemic, and half were collected after the measures were lifted. RESULTS: Mental health conditions were prevalent in our sample, particularly depressive symptoms (44.51%) and anxiety (42.17%). Significant positive associations were found between depressive symptoms and anxiety, and between disinhibition and aberrant motor behaviour. Furthermore, we identified statistical predictors for the occurrence of mental health conditions. Notably, institutionalised living increased the odds of depressive symptomatology, while those with higher education levels or an absence of cognitive impairment experienced more sleep disturbances. Finally, cognitive impairment was linked to increased disinhibition and aberrant motor behaviour. CONCLUSIONS: The high prevalence of mental health conditions underscores the need for proactive mental health care strategies in advanced old age. Moreover, it is vital to consider the interconnected nature of mental health conditions and to prioritise vulnerable groups, such as centenarians in institutional settings.

Perceptions of Successful Aging among Asian Americans.

The current study explored Asian Americans' lay perceptions of successful aging and examined the differences and similarities between Asian Americans and White/Caucasian Americans. One hundred forty-five Asian American adults and 86 White/Caucasian adults were asked how they view successful aging. Open-ended responses were coded for recurring themes. The theme most often mentioned by Asian Americans was health, followed by quality of life, activities/interests, and social resources. Compared to White/Caucasian participants, Asian Americans' meaning of successful aging in the current study did not differ greatly in terms of major themes mentioned, but Asian Americans were more likely to mention certain themes, such as physical appearance and youthful look. In sum, the findings suggest that Asian Americans have a multifaceted understanding of successful aging, and reinforce the importance of cultural variations of the perceptions of successful aging.

Coping Patterns in Advanced Old Age: Findings from the Fordham Centenarian Study.

INTRODUCTION: Research on coping in advanced old age is scarce. In the present study, we explored coping patterns in near-centenarians and centenarians, and characteristics associated to using a specific coping pattern. METHODS: We analyzed the frequency with which participants (N = 87, MAge = 99.05; SDage = 2.6; age range 95-107) reported using specific coping strategies (i.e., coping strategy use) and the relative preference for specific strategies (i.e., relative coping preferences) in data from the Fordham Centenarian Study. Moreover, we applied cluster analysis to detect coping patterns, and we compared cluster characteristics. RESULTS: Very old individuals reported using emotion control and acceptance the most. Cluster analysis further revealed two distinct groups: The high coping group reported significantly higher coping strategy use than the low coping group (p < 0.001). The two groups also favored different strategies (p < 0.001), with the high coping group showing significantly higher relative preferences than the low coping group for active problem-solving, proactive prevention, and strategic planning (all ps < 0.05). The groups furthermore differed significantly in psychological strengths (i.e., personality, self-efficacy, ps < 0.001) and well-being outcomes (i.e., life satisfaction, p = 0.05). DISCUSSION: This study provides evidence for a general preference for acceptance and emotion control in very old individuals, supporting theories of a developmental coping shift in old age, yet our findings also document the existence of groups with different coping patterns. More frequent coping use, and particularly continued use of active problem-solving and proactive prevention, may enable well-being in very old age.

Social Loneliness after Divorce: Time-Dependent Differential Benefits of Personality, Multiple Important Group Memberships, and Self-Continuity.

BACKGROUND: Critical events in the second half of life, such as divorce, pose a significant threat to well-being. Individuals undergoing divorce often experience feelings of social loneliness and may benefit differently from available resources depending on how much time has passed since the event. Personality traits have been found to be related to adaptation, with particularly strong effects immediately after the critical event. Other resources, such as identity-stabilizing mechanisms (i.e., valued social groups and self-continuity), may play a role only later in adaptation. However, little is known about the benefits of these resources and their potentially time-dependent effects on social loneliness when one is overcoming later-life divorce. OBJECTIVES: This study investigates the role of psychological (e.g., personality, self-continuity, multiple important group memberships) and social resources (e.g., new partner, having someone to help deal with divorce) for social loneliness in two post-divorce phases, using a married group as the reference, controlling for sociodemographic aspects and health. METHODS: A representative sample of 850 divorced (aged 40-79 years) and 869 married individuals (aged 40-78 years) living in Switzerland were compared, using multiple regression analyses. RESULTS: Differential predictive patterns for social loneliness between the two divorced groups and the married group were observed. For the short-term divorced (up to 2 years after divorce), higher extroversion and agreeableness and lower neuroticism were associated with lower levels of loneliness. For the long-term divorced (2-5 years after divorce) and for those who remained married, extroversion was similarly important for loneliness. Additionally, higher levels of self-continuity and multiple group memberships predicted lower loneliness, but the short-term divorced did not benefit from them. Having someone to help overcome the divorce benefited members of both divorced groups. A new partner was related to less loneliness, but only in the long-term divorced group. CONCLUSIONS: Our findings demonstrate that the effects of psychological and social resources on social loneliness vary by adaptation phase. Although extroversion is beneficial for all divorced and married individuals, other personality traits play a more decisive role in the initial adaptation phase. Identity-promoting resources (i.e., multiple group memberships, perceived self-continuity) are beneficial only later in the adaptation process. To be successful, professional interventions must be tailored as needed.

Maladaptive daydreaming: Evidence for an under-researched mental health disorder.

This study explores the recently described phenomenon of Maladaptive Daydreaming (MD) and attempts to enhance the understanding of its features. It documents the experiences of 340 self-identified maladaptive daydreamers who spend excessive amounts of time engaged in mental fantasy worlds, in comparison to 107 controls. Our sample included a total of 447 individuals, aged 13-78, from 45 countries who responded to online announcements. Participants answered quantitative and qualitative questions about their daydreaming habits and completed seven questionnaires assessing mental health symptoms. Findings demonstrated that MD differs significantly from normative daydreaming in terms of quantity, content, experience, controllability, distress, and interference with life functioning. Results also demonstrated that Maladaptive Daydreamers endorsed significantly higher rates of attention deficit, obsessive compulsive and dissociation symptoms than controls. In sum, findings suggested that MD represents an under-acknowledged clinical phenomenon that causes distress, hinders life functioning and requires more scientific and clinical attention.

Development and validation of the Maladaptive Daydreaming Scale (MDS).

This study describes the development of the Maladaptive Daydreaming Scale (MDS), a 14-item self-report instrument designed to gauge abnormal fantasizing. Our sample consisted of 447 English-speaking individuals from 45 different countries. A 3-correlated-factors model best presented the underlying dimensions Yearning, Kinesthesia and Impairment, capturing related rewarding experiences as well as psychological impairment of maladaptive daydreaming. MDS scores were associated with obsessive-compulsive behavior and thoughts, dissociative absorption, attention deficit, and high sense of presence during daydreaming, but less with psychotic symptoms. The MDS and its subscale demonstrated good validity, sound internal consistency and temporal stability and discriminated well between self-identified individuals with and without maladaptive daydreaming. Considering the instrument's high sensitivity and specificity levels, it seems an excellent measure for future investigation of MD that will, hopefully, shed light on the etiology and psycho-biological mechanisms involved in this mental condition, as well as on the development of effective MD treatment methods.

Childhood Antecedents and Maintaining Factors in Maladaptive Daydreaming.

This study explored the fantasy activity of 16 individuals who were seeking online peer-support and advice for maladaptive daydreaming (MD). MD is an under-researched mental activity described as persistent vivid fantasy activity that replaces human interaction and/or interferes with important areas of functioning. We employed a grounded theory methodology that yielded seven common themes presented as a sequential descriptive narrative about the nature, precursors, and consequences of MD. The presented "storyline" included the following themes: (1) daydreaming as an innate talent for vivid fantasy; (2) daydreaming and social isolation-a two-way street; (3) the role of trauma in the development of MD; (4) the rewards of daydreaming; (5) the insatiable yearning for daydreaming; (6) shame and concealment; (7) unsuccessful treatment attempts. A main conclusion of our study is that there is an urgent need for early identification of MD and its correct diagnoses in adulthood.

Physical, cognitive, social and mental health in near-centenarians and centenarians living in New York City: findings from the Fordham Centenarian Study.

BACKGROUND: Despite their strong increase, the population of the very old, including near-centenarians and centenarians, represent an unstudied and underserved population. Available studies mostly concentrate on predictors of exceptional longevity, but rarely extend their focus to other areas of functioning. Also, little is known about what contributes to experiencing a quality life in very old age. The present population-based study aims at providing a comprehensive picture of key domain of functioning, including physical, cognitive, social and mental function in very old individuals and to determine predictors of mental health indicators. METHODS: A total of 119 individuals aged 95 to 107 living in private dwellings and residential care facilities were recruited based on the New York City Voters Registry. Participants answered questions regarding their health and activities of daily living. Their cognitive functioning was determined using the Mini-Mental State Examination and the Global Deterioration Scale. Social resources were measured with number of children and the Lubben Scale. Mental health was assessed with the Geriatric Depression Scale and the Satisfaction with Life Scale. RESULTS: An unexpectedly large proportion of the sample lived in the community. On average, cognitive functioning was high. Although five diseases were reported on average, participants reported good health. Functional status was reduced. Most participants had at least one person for communication/social support. On average, depression was below cut-off, and most participants reported high life satisfaction. Regression analyses indicated that individual differences in depression were associated with subjective health, IADL and relatives support. For life satisfaction, subjective health, ADL and number of children were most important. Demographic characteristics, number of illnesses or cognitive status were not significant. CONCLUSIONS: Despite reduced levels of physical functioning and social resources, very old participants were in good mental health suggesting high resilience and ability to adapt to age-associated challenges. That a large proportion of them lived in the community further highlights their desire for leading an autonomous life, which may have been facilitated by New York service culture. More research is necessary to provide guidance for the development of well-suited services for this very old population.

Parallel lives: A phenomenological study of the lived experience of maladaptive daydreaming.

This qualitative study describes the lived experience of maladaptive daydreaming (MD), an excessive form of unwanted daydreaming that produces a rewarding experience based on a created fantasy of a parallel reality associated with a profound sense of presence. A total of 21 in-depth interviews with persons who self-identified as struggling with MD were analyzed utilizing a phenomenological approach. Interviewees described how their natural capacity for vivid daydreaming had developed into a time-consuming habit that resulted in serious dysfunction. The phenomenology of MD was typified by complex fantasized mental scenarios that were often laced with emotionally compensatory themes involving competency, social recognition, and support. MD could be activated if several requirements were met. Because social interaction seems to be incompatible with this absorbing mental activity, solitude was necessary. In addition, kinesthetic activity and/or exposure to evocative music also appeared to be essential features. Besides delivering a firsthand description of key characteristics of MD, the study also indicates that MD is associated with dysfunctionality for which participants expressed a substantial need for help.

Life at Age 100: An International Research Agenda for Centenarian Studies.

Living a long life is desired by many individuals, and this dream is likely to become reality in more and more industrialized societies. During the past 3 decades, the number of very old individuals has increased significantly, creating a global demographic challenge with consequences at the individual, family, and societal levels. Yet, life in very old age is still poorly understood in terms of its unique characteristics and challenges. Besides specific content areas, very old age represents an understudied field of research. This lack of knowledge may be one reason that the very old also are an underserved population. This special issue introduces an international network of three centenarian studies that describe and compare the life circumstances and characteristics of centenarians across Germany, Portugal, and the United States. Our parallel studies comprehensively assess centenarians' physical, cognitive, social, and psychological functioning to create a knowledge base regarding their capacities and needs. A specific focus lies in the investigation of psychological aspects, social resources, and societal/cultural contexts, factors that may contribute to longevity and successful aging. Determining key characteristics of this very old population and investigating similarities and differences across countries is timely and urgent, both from an applied and a policy standpoint.

Whom Do Centenarians Rely on for Support? Findings From the Second Heidelberg Centenarian Study.

This paper provides a detailed picture of the sources and types of informal support available to centenarians, depending on their housing and care arrangements. Participants were 112 centenarians and 96 primary contacts of centenarians enrolled in the population-based Second Heidelberg Centenarian Study. Findings indicate that children of centenarians were their primary source of support in daily life. Those without living children had overall less help. Most frequently reported was help with administrative tasks, regardless of centenarians' residence or living arrangement. All other types of help (e.g., with activities of daily living and housework) were reported by about one-third and were mostly provided by children; centenarians without children were more likely to have friends/neighbors involved in some of these tasks. The one category reported by a third of the centenarians regardless of residence, living arrangements, or presence of a child was help with socializing/companionship. Findings constitute an important step toward identifying and meeting the support needs of centenarians and their families. Policy implications are discussed.

Challenges Experienced at Age 100: Findings From the Fordham Centenarian Study.

This article examines the challenges experienced by very old individuals and their consequences for well-being and mental health. In order to capture unique issues experienced in very old age, 75 participants of the population-based Fordham Centenarian Study answered open-ended questions on everyday challenges. Theme-based coding was then used to categorize and quantify responses. The challenges mentioned most often were challenges faced in the functional (e.g., physical health/activities of daily living restrictions, mobility, sensory impairment), psychological (e.g., loss of well-liked activity, dependency, negative emotions, death), and social (e.g., family loss) life domains. Functional challenges were negatively associated with aging satisfaction and positively associated with loneliness. Psychological challenges were positively linked to aging satisfaction. Social challenges were marginally related to loneliness. Notably, challenges were not related to depression. In conclusion, the challenges experienced in very old age are multidimensional and multifaceted, unique in nature, and have differential relations to mental health. Functional, psychological, and social challenges affect very old individuals' lives and therefore need to be better understood and addressed. Given their consequences, it is imperative for policy makers to develop an awareness for the different types of challenges faced by centenarians, as there may be unique policy implications related to each.

Measuring attachment to life in old age: the Portuguese version of the Positive Valuation of Life Scale (Positive VOL).

PURPOSE: This study aims to present the psychometric properties of the Portuguese version of the Positive Valuation of Life Scale (Lawton et al. in J Aging Ment Healt 13:3-31, 2001). METHOD: Sample included 207 community-dwelling elders (129 women; M Age = 77.2 years, SD = 7.5). The data collection included the translated and adapted Portuguese version of Positive Valuation of Life Scale, Life Satisfaction Index Z, Meaning in Life Questionnaire and Geriatric Depression Scale. RESULTS: From exploratory factor analysis, two factors emerged, existential beliefs and perceived control, explaining 49 % of the total variance. Both factors were positively related with meaning in life and life satisfaction and negatively related with depression (p < 0.05). The values obtained for internal consistency for the total scale and for each subscale were good (α > 0.75). CONCLUSION: The Portuguese version of Positive VOL Scale represents a reliable and valid measure to capture the subjective experience of attachment to one's life. The two-factor structure is an update to Lawton's previous work and in line with findings obtained in the USA (Dennis et al. in What is valuation of life for frail community-dwelling older adults: factor structure and criterion validity of the VOL, Thomas Jefferson University, Center for Applied Research on Aging and Health Research, 2005) and Japan (Nakagawa et al. in Shinrigaku Kenkyu 84:37-46, 2013). Future research is required to investigate VOL predictors and the potential changes toward the end of the life span.

Sensory impairments and their associations with functional disability in a sample of the oldest-old.

PURPOSE: Research focusing on the consequences of sensory impairments for the everyday competence of the oldest-old is emerging. The two main goals of this study were to document the prevalence of self-reported vision, hearing, and dual sensory impairment and to explore associations of these impairments with functional disability in near-centenarians and centenarians. METHODS: Centenarians and near-centenarians (N = 119; average age = 99) were recruited, with about 80% living in the community. In-person interviews included self-ratings of vision and hearing impairment and functional disability conceptualized as having difficulties performing personal and instrumental activities of daily livings (PADLs and IADLs). RESULTS: Based on self-report ratings, 17% of participants were classified as having a visual impairment only, 18% as having a hearing impairment only, and 38% with both a visual and hearing impairment (dual sensory impairment). Regression analyses demonstrated that having a vision impairment only and being dual sensory impaired were the strongest predictors of functional disability. They were associated with higher levels of functional disability over and above higher levels of depressive symptomatology, interference of health with desired activities, and living in a nursing home. CONCLUSIONS: Sensory impairments-especially dual sensory impairment-are prevalent in the oldest-old. Having dual sensory impairment or a single visual impairment among other factors are strongly associated with less-optimal everyday functioning in the oldest-old.

A comparative analysis of colour-emotion associations in 16-88-year-old adults from 31 countries.

As people age, they tend to spend more time indoors, and the colours in their surroundings may significantly impact their mood and overall well-being. However, there is a lack of empirical evidence to provide informed guidance on colour choices, irrespective of age group. To work towards informed choices, we investigated whether the associations between colours and emotions observed in younger individuals also apply to older adults. We recruited 7393 participants, aged between 16 and 88 years and coming from 31 countries. Each participant associated 12 colour terms with 20 emotion concepts and rated the intensity of each associated emotion. Different age groups exhibited highly similar patterns of colour-emotion associations (average similarity coefficient of .97), with subtle yet meaningful age-related differences. Adolescents associated the greatest number but the least positively biased emotions with colours. Older participants associated a smaller number but more intense and more positive emotions with all colour terms, displaying a positivity effect. Age also predicted arousal and power biases, varying by colour. Findings suggest parallels in colour-emotion associations between younger and older adults, with subtle but significant age-related variations. Future studies should next assess whether colour-emotion associations reflect what people actually feel when exposed to colour.

Multimorbidity and Quality of Life: The Mediating Role of ADL, IADL, Loneliness, and Depressive Symptoms.

Background and Objectives: The ubiquity of multimorbidity makes it crucial to examine the intermediary factors linking it with quality of life (QoL). The objective was to examine to what extent the association between multimorbidity and QoL was mediated by functional and emotional/mental health and how these mediation pathways differed by sociodemographic factors (age, gender, education, and financial strain). Research Design and Methods: Data from Waves 4 to 8 of 36,908 individuals from the Survey of Health, Aging, and Retirement in Europe (SHARE) were included. Multimorbidity (exposure) was defined as having 2 or more chronic conditions. Mediators included limitations with (instrumental) activities of daily living (ADL and IADL), loneliness, and depressive symptoms. QoL (outcome) was assessed with the CASP-12 scale. Longitudinal model-based causal mediation analyses were performed to decompose the total association between multimorbidity and QoL into direct and indirect effects. Moderated mediation analyses tested for differences in mediation pathways by sociodemographic factors. Results: Multimorbidity was significantly associated with lower QoL (direct effect: b = -0.66). This association was mediated by ADL limitations (percentage mediated 0.97%), IADL limitations (3.24%), and depressive symptoms (16.70%), but not by loneliness. The mediation pathways were moderated by age, education, financial strain, and gender. Discussion and Implications: ADL, IADL, and depressive symptoms are crucial intermediary factors between multimorbidity and QoL in older European adults, with changing importance according to age, education, financial strain, and gender. The findings may help to increase the QoL of individuals with multimorbidity and redirect care efforts to these factors.

Evolution of the income-related gap in health with old age: evidence from 20 countries in European and Chinese panel datasets.

Some studies show that the protective effect of higher income on health weakens with old age (age-as-leveller pattern), whereas others show that it strengthens with old age (cumulative advantage/disadvantage pattern). Many existing studies are limited in that they use single-country and/or single-timepoint designs. To overcome these limitations and better understand how the income-health gradient evolves in older age, we used cross-national and longitudinal data of the Survey of Health, Ageing and Retirement in Europe (2004-2019, N = 73,407) and the China Health and Retirement Longitudinal Study (2011-2018, N = 10,067). We operationalised health using multimorbidity and three alternative indicators (functional disability, mobility disability, and memory). We performed Poisson growth curve modelling to capture the between-participant effects of age and the within-participant effects of aging. We obtained three consistent and robust findings for Europe (patterns were observed in most countries) and China. First, the protective effect of higher income on multimorbidity, functional disability, and mobility disability was weaker for older than for younger adults (between-participant age-as-leveller pattern). Second, only the protective effect of higher income on mobility disability weakened over the later life course (within-participant age-as-leveller pattern). Third, the protective effect of higher income on memory was stronger for older than for younger adults and strengthened over the later life course (between-participant and within-participant cumulative advantage/disadvantage pattern). Longitudinal data, growth curve modelling distinguishing the between-participant from within-participant effect, and adjustments for potential confounders based on the hypothesised causal structure enabled us to better navigate the landscape of causal inference. Findings suggest that the income-related gap in physical health but not in cognitive health narrows in old age for both Europe and China.

Exposure to the 1959-1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective.

Child undernutrition and later-life non-communicable diseases (NCDs) are major global health issues. Literature suggests that undernutrition/famine exposure in childhood has immediate and long-term adverse health consequences. However, many studies have theoretical and methodological limitations. To add to the literature and overcome some of these limitations, we adopted a life course perspective and used more robust methods. We investigated the association between exposure to the 1959-1961 Chinese famine and later-life NCDs and if this association depends on: life stage at exposure, famine severity, and sex. We conducted a secondary data analysis of a large-scale, nationally representative, longitudinal study-the China Health and Retirement Longitudinal Study (2011-2018, 11,094 participants). We measured famine exposure/severity using self-reported experience, life stage using age at exposure, and health using the number of NCDs. We performed Poisson growth curve models. We obtained three findings. First, compared with unexposed participants, those exposed before age 18 had a higher risk of later-life NCDs, particularly if exposed in-utero (IRR = 1.90, 95% CI [1.70, 2.12], p < .001) and in the "first 1,000 days" of life (IRR = 1.86, 95% CI [1.73, 2.00], p < .001; for 0-6 months group, IRR = 1.95, 95% CI [1.67, 2.29], p < .001). Second, the famine effects among participants moderately and severely exposed were similar (IRR = 1.18, 95% CI [1.09, 1.28], p < .001 and IRR = 1.24, 95% CI [1.17, 1.32], p < .001). Third, the famine effects did not differ between females and males (IRR = 0.98, 95% CI [0.90, 1.07], p = .703). In an individual's life course, in-utero and the "first 1,000 days" are a particularly sensitive time period with marked long-term implications for NCDs if undernutrition/famine is experienced in this period. However, this window remains open until young adulthood. This highlights the need to invest more in preventing and treating child/adolescent undernutrition to tackle later-life NCDs.