Depressive Symptoms in Later Life in China: Situating "Long Arm" of Child Physical Maltreatment Within a Family Context.

Objective: This article intends to reveal the long-term effects of physical maltreatment in childhood on depressive symptoms in later life in China. Methods: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). 8676 respondents aged 45 and older were included in the study. In this study, we use ordinary least squares (OLS) regression models to estimate the long-term impact on children of physical punishment from their parents. Results: We found that individuals who recalled being hit by their mother in early life reported more depressive symptoms than those who recalled being punished by their father. Difficult family contexts (e.g., comparative poverty, family violence, and parent's poor mental health) had a weak association with higher risk of reporting physical maltreatment and more depressive symptoms among respondents in later life. Conclusion: This article extended the exploration of the long-term impact of child physical maltreatment beyond adolescence and into until later adult life. Effective policies to protect children from maltreatment in the form of physical punishment require further attention to the challenges posed by tradition and culture.

Meditation, Compassionate Love, and Mental Health in Later Life.

PURPOSE: Understanding of the mechanisms by which meditation imparts beneficial effects on later-life mental health is limited. The current study assessed the role of compassionate love in mediating the relationship between meditation and mental health in later life. METHOD: Using data from a nationwide web-based survey (N = 1,861), we examined the indirect effects of meditation on depressive symptoms and anxiety via compassionate love. RESULTS: Participants who practiced meditation (compared to those who did not) had significantly higher feelings of being loved (b = 0.11, p < 0.05); those who experienced more love had lower depressive symptoms (b = -2.10, p < 0.001) and anxiety (b = -0.99, p < 0.001). Meditation also had significant indirect effects (via compassionate love) on depressive symptoms (b = -0.23, p < 0.05) and anxiety (b = -0.11, p < 0.05). CONCLUSION: This study underscores the need for contemplative interventions that foster compassionate love to improve mental health in later life. [Journal of Gerontological Nursing, 50(3), 40-50.].

Dementia Knowledge in Chinese Newspapers (2005-2020): A Topic Modeling Analysis.

How public policies convey dementia is an important source of the public's understanding of dementia, and newspapers are critical to depicting and disseminating this information to the public. The present study used topic modeling strategies to analyze Chinese newspaper portrayals of dementia from 2005 to 2020 to trace changes in key areas of dementia knowledge in relevant policies. Using WiseNews, the largest Chinese media database, we chose 45 newspapers from mainland China and identified 12,719 articles related to dementia. Using latent Dirichlet allocation (LDA), we performed a topic modeling analysis and identified the six most prevalent topics on dementia across articles: lifestyle recommendations, neighborhood life, foundational scientific research, celebrity and media portrayals, dementia caregiving, and pharmaceutical innovations - all related to the dementia knowledge scale's four dimensions. Findings suggest a steady increase in the number of articles on dementia caregiving and a decline in lifestyle recommendations from 2005 to 2020. However, newspapers continued to stigmatize aging by regularly co-depicting dementia and old age and by using biased terminology. Among the first to investigate dementia's portrayals in mainland Chinese newspapers, this study illuminates the need for expanding mass media campaigns to raise the country's dementia knowledge to foster a dementia-inclusive society.

Feasibility and acceptability of the community-based program: Plan Ahead.

OBJECTIVES: In this article, we assess the feasibility and acceptability and the effect of the Plan Ahead for community dwelling older adults. In addition, we investigated the effects of the program. In addition, we aimed to examine whether the completion of the specific Future Care Planning depended on the participants' competence level. METHODS: In this single group feasibility study, trained facilitators delivered the program to a sample of 234 community-residing older adults. Participants completed both pre, post assessments about the acceptability of the program and their completion of the recommended future care planning activities. RESULTS: Based on participant's report on the usefulness and satisfaction of the program after the completion of the program, we found that participants reported high levels of acceptance of the program. Participation rates also confirmed the feasibility of the program. In terms of effects of program implementation, statistically significant changes were noted for several outcomes, such as resource building and FCP activities. In particular, we found that these gains were particularly robust for participants in the low competence group. CONCLUSION: Pilot program results suggest the feasibility of a short community program enhancing proactive planning for future care needs among older adults residing in their community.

The Effects of Osteoarthritis on Depressive Symptomatology Among Older U.S. Military Veterans.

Osteoarthritis (OA) is a leading cause of disability among older adults. By 2050, approximately 60 million will suffer from arthritis adding up to a total societal cost of $65 billion. Chronic illnesses resulting in pain, and functional decline have been associated with depression in previous studies.A causal model was developed and tested using structural equation modeling that examined depression scores of 503 older (age 50-85), male Veterans with moderate to severe symptomatic OA of the knee\hip.The results of the structural equation modeling produced a final model of depressive symptomatology that fit the data well (Chi square = 12.23, DF = 11, p = .346; TLI = .99; CFI = 1.00; RMSEA = .02).The findings indicate the central role that OA severity (pain, stiffness, and functional difficulties) plays in the mental health of older Veterans in terms of the level of reported depressive symptoms.

The Primacy of Compassionate Love: Loneliness and Psychological Well-Being in Later Life.

Despite emerging research on compassionate love's positive influence on later-life psychological well-being, investigations on the mediating processes accountable for such effects are scarce. Using data from a nationwide web-based survey (N = 1,861), we performed a mediation analysis to assess the role of loneliness in explaining the impact of compassionate love on psychological well-being. Even after controlling for emotional support, our model estimates suggest that older adults who felt loved had significantly lower levels of loneliness (ß = -0.84, p < 0.001), significantly fewer depressive symptoms (ß = -0.86, p < 0.001), and lower anxiety (ß = -0.25, p > 0.05). Loneliness completely mediated the effect of compassionate love on anxiety (ß = -0.82, p < 0.001) and significantly mediated compassionate love's influence on depressive symptoms (ß = -1.18, p < 0.001). Our findings underscore the need for interventions that increase compassionate love to reduce loneliness and improve psychological well-being in later life. [Journal of Gerontological Nursing, 49(4), 12-20.].

Prayer and Mental Health in Later Life: The Role of Positive Emotions.

Prayer is used as a coping resource to mitigate the adverse influences of stressful life situations on mental health. However, the mechanisms underlying its impact on mental health in later life still need to be better understood. In particular, scant research attention has been paid to the significance of prayer in enhancing positive emotions (e.g. compassionate love), which can lead to improved mental health. Using data from our nationwide web-based survey (n = 1,861), we evaluated if compassionate love mediates the relationship between prayer and mental health. Our findings suggest participants who prayed had significantly higher feelings of being loved (b = .19, p < .001) and lower depressive symptoms. Compassionate love significantly mediated prayer's effect on depressive symptoms (b = -0.40, p < .001) and anxiety (b = -0.19, p < .001). Our findings highlight the importance of prayer in enhancing positive emotions and well-being in later life.

The intersection of race and financial strain: The pain of social disconnection among women in the United States.

Objectives: Considerable attention has been directed at increased social isolation and loneliness during the COVID-19 pandemic and their impact on later-life psychological well-being. There is a dearth of research on the effect of financial strain and associated psychosocial mechanisms on loneliness among women across racial groups. It is unclear how racial status and financial strain intersect to impact later-life loneliness amid immense uncertainty, social isolation, and anxiety induced by the pandemic.Methods: Based on our nationwide Web-based survey (n = 1,301), we used ordinary least square regression to examine the effects of financial strain on loneliness among Black and White women and assessed the role of emotional support in contributing to such effects.Results: We found that Black women face significantly more financial strain than White women but also receive more emotional support and experience less loneliness. Findings show that women experiencing financial strain report increased loneliness, but the negative effects of financial strain are significantly greater for Black women than for White women. Our mediation analysis revealed that emotional support made a significant contribution to the effects of financial strain on loneliness in White women but not in Black women.Discussion: Despite shared vulnerability and social isolation across the general population, our findings suggest that negative effects of financial strain on loneliness among women continue to differ across race, even amid the pandemic. Our findings demonstrate how emotional support explains the relationship between financial strain and later-life loneliness in a racially distinct manner.

Process and Structure: Service Satisfaction and Recommendation in a Community-based Elderly Meal Service in Shanghai.

Informed by Donabedian's quality-of-care framework, this study aims to examine elderly clients' service satisfaction and service recommendation for community-based meal services in Shanghai. We analyzed secondary survey data from randomly sampled elderly clients of a community-based meal service in the old Jing'an District in Shanghai (N= 690). Quality of food and caregivers' attitudes were key to respondents' service recommendation while tidiness of tableware and interactions with caregivers were positively related to their service satisfaction. Overlaps and differences between structure and process factors are discussed. We also provide tailored policy recommendations.

The role of goal and meaning in life for older adults facing interpersonal stress.

Interpersonal stressful events (ISE) have been shown to be potent predictors of major depressive symptoms among older adults. This study examines the relationships between recent ISE and depressive symptoms in late life and explores whether having coping cognitive resource (e.g. finding meaning and goal in life) can buffer the effects of ISE on depressive symptoms for older adults. We utilized a sample of residents in Florida retirement communities (N = 588) who participated in a long-term-panel study using yearly assessments for six years. Additionally, we modeled within-person differences in ISE and depressive symptoms simultaneously with multilevel modeling. Then, we tested the moderating effect of coping resource (i.e. meaning in life and goal in life) in the association between ISE and depressive symptoms. We found that the mean level of ISE is associated with higher depressive symptoms and lower life satisfaction. In addition, higher levels of within-person meaning and goal buffered the negative effect of ISE on depressive symptoms for older adults. Similarly, within-person meaning and goal also attenuated the negative effect of ISE on life satisfaction.

Coping With Uncertainty: Use of Contemplative Practices Amid the COVID-19 Pandemic in the United States.

Scant research has attempted to understand the use and frequency of contemplative practices across social groups of older adults in the context of uniquely uncertain and stressful circumstances, such as the COVID-19 pandemic. Using data from a nationwide web-based survey (n = 1861), we examined the change in the frequency of contemplative practices and variation across sociodemographic, health, and psychological status and we documented a significant increase in the use of prayer and meditation since the beginning of the pandemic. Minority groups and those with lower income reported praying longer than their counterparts. Respondents who were unmarried, women, and more educated were more likely to meditate, whereas lower-educated respondents were more likely to pray during the pandemic. Greater use of these practices was found among participants with higher anxiety. Our study offers much-needed guidance for future intervention studies to improve psychological well-being among diverse groups of older adults facing stressful circumstances.

Dynamics of Financial Hardship in the United States: Health and Retirement Study 2006-2016.

The purpose of this study was to examine the temporal trends and dynamics of financial hardship among older adults in the U.S. between 2006 and 2016 using the Health and Retirement Study. Sample included a total of 13,537 eligible person observations with a median age of 68 years. Financial hardship included measures of difficulty paying bills, food insecurity, taking less medication due to cost, and ongoing financial strain. Regression analyses were performed using a three-wave quadrennial model to estimate the prevalence of financial hardship over time, to explore temporal patterns and identify persistent hardship. Findings reveal that 51% of respondents who experienced food insecurity at one or more waves were transient. This pattern was similar to respondents who experienced ongoing financial strain (52% transient). Respondents who reported difficulty paying bills (68%) and reduced medications due to cost (62%) were also transient. Significant predictors across all four domains of financial hardship include age, years of education, marital status, self-rated health. Being African American was positively associated with reduced medication use and food insecurity. This study provides insight into the temporal dynamics of financial hardship in later life. It also highlights the contiguous, intermediate and transient nature of financial hardship among older adult populations.

The price of mental well-being in later life: the role of financial hardship and debt.

OBJECTIVE: This study investigated the associations between various financial hardship and debt indicators and mental health status among older adults. METHODS: Using data from the Health and Retirement Study (HRS), we considered the association between different forms of financial hardship and debt of those who were identified as having high levels of depressive symptoms (N = 7678) and anxiety (N = 8079). Financial hardship indicators: difficulty paying bills, food insecurity, and medication need; debt indicators: credit card and medical debt. Associations were tested using multiple logistic regression analyses and are reported as relative risk (RR) ratios and 95% confidence intervals (CIs). RESULTS: Participants who had difficulty paying bills were more likely to have high levels of depressive symptoms (RR = 2.06, CI = 1.75-2.42, p < 0.001) and anxiety (RR = 1.46, CI = 1.02-2.05, p < 0.001) compared to those who did not have financial difficulty. Similarly, medical debt was associated with depressive symptoms (RR = 1.43, CI = 1.14-1.74, p < 0.01) and anxiety (RR = 1.20, CI = 0.96-1.50, p < 0.01). Credit card debt was not significantly associated with either mental health outcome. CONCLUSION: Indicators of financial hardship and medical debt were associated with depressive symptoms and anxiety in a cohort of older adults. In contrast, the influence of credit card debt appeared to be more complex and vary by individual. These findings indicate that doing without meeting personal salient needs has a particularly adverse effect on psychological well-being.

Depressive symptoms among elderly men and women who transition to widowhood: comparisons with long term married and long term widowed over a 10-year period.

This study explores gender differences in mental health sequelae of transition to widowhood among old-old retirement community dwellers. Data are based on a prospective panel survey of 748 older adults (mean age = 78) with follow-ups over a 10-year period. Mixed-effects models suggest that elderly widows and widowers experienced sharp increases of depressive symptoms subsequent to spousal loss. Men showed stable increases of depressive symptoms after widowhood whereas an inverted U-shape curve of depressive symptoms was prominent for older women. Findings indicate that women are more resilient and are better able to cope with spousal loss than are their male counterparts.

Racial differences in future care planning in late life.

Objectives: Although many older adults fear frailty and loss of independence in late life, relatively few make plans for their future care. Such planning is particularly limited among racial minorities. Given the benefits of future care planning (FCP), it is important to understand factors that facilitate or hamper FCP in late life. Our study explored racial, demographic, and dispositional influences on thinking about and engagement in FCP among community-dwelling older adults.Design: This study utilized data from the Elderly Care Research Center's longitudinal study of successful aging based on interviews with 409 older adults. Along with race, education and other demographic factors, we explored dispositional influences of optimism and religiosity on FCP using logistic regression.Results: African American older adults had significantly lower odds of executing FCP (ß = 0.36, p < .05) when compared to White older adults. However, this estimate was no longer statistically significant after controlling for education, disability status, optimism, and religiosity. Older adults with higher education had significantly higher odds of thinking about and executing FCP. Higher level of optimism was associated with lower odds of FCP.Conclusions: Limited educational resources and the greater prevalence of dispositions of religiosity and optimism among African American older adults may contribute to their reluctance to engage in FCP in comparison to their white counterparts. Our findings offer practice implications indicating a need for interventions to encourage older adults, particularly racial minorities, to recognize and actively plan for their future care needs.

Productive Activity Patterns and Functional Health: A Comparison of Urban and Rural Chinese Older Adults.

This study examines the association between productive activity patterns and functional health trajectories of Chinese older adults and whether this association varies by urban/rural residence. Using three waves of the China Health and Retirement Longitudinal Study from a sample of 7,503 older adults, we first performed latent class analysis (LCA) to identify productive activity patterns based on four activities (work, caregiving, informal help, and formal volunteering). Next, multilevel regression analyses were conducted to assess the association between the identified productive activity patterns and functional health trajectories among older adults. Four productive activity patterns are identified from LCA: nonengagers, working-caregivers, workers, and helpers. We find that participation in productive activities is associated with slower functional health decline. The moderation effects of urban/rural differences are prominent across identified groups. Our findings highlight the importance of the urban/rural context in understanding productive aging and its health consequences among Chinese older adults.

Successful Aging from the Viewpoint of Older Adults: Development of a Brief Successful Aging Inventory (SAI).

OBJECTIVE: Researcher-defined criteria for successful aging (SA) have been criticized for their limited perspective and failure to acknowledge subjective perceptions of older individuals. We assessed the extent to which older individuals consider specific factors, which they had suggested, to be important in defining SA. The present study had 2 objectives: (a) to develop a brief multidimensional questionnaire for assessing SA and to evaluate its psychometric properties; and (b) to examine age associations with each dimension of SA. METHODS: A survey was conducted with 550 participants in a panel study of older adult residents of an elderly retirement community and with community-dwelling older adults, regarding factors that they considered to be important for SA. The psychometric evaluation involved exploratory and confirmatory factor analyses, reliability and validity analyses, and measurement invariance testing. Partial correlations were used to examine the association of age with SA. RESULTS: The 4-factor solution provided a satisfactory fit to the data: proactive engagement, wellness resources, positive spirit, and valued relationships. Metric measurement invariance for this factor structure was confirmed across 2 age groups. The findings also suggest that the Successful Aging Inventory (SAI) scale might be a useful predictor of SA. DISCUSSION: Our findings highlight the value of considering more comprehensive models of SA that include social relationships and proactive engagement.

Social support and cognitive functioning as resources for elderly persons with chronic arthritis pain.

OBJECTIVE: Arthritis pain and depression are prevalent physical and psychological disorders in late life and co-occur frequently. We explored the stability and covariation of arthritis pain and depressive symptoms. We also addressed the influence of cognitive functioning and social support on the relationship between pain and depressive symptoms among community-dwelling older individuals. METHOD: This longitudinal study utilized a sample of 299 residents of Florida retirement communities who participated in a long-term panel study using yearly assessments across 4 years. Using multilevel modeling, we modeled the individual differences as well as stability in arthritis pain and depressive symptoms simultaneously. Further, we tested the role of cognitive functioning and social support in the association between arthritis pain and depressive symptoms. RESULTS: We found substantial within-person variation in both pain and depressive symptoms (between 58% and 65%) across 4 years even after controlling for a time effect. After controlling for arthritis pain, persons with higher social support and higher cognitive functioning reported lower levels of depressive symptoms. DISCUSSION: Findings suggest that fluctuations in pain and depressive symptoms are common for older adults. Furthermore, social support and intact cognitive functioning may serve as useful resources, as they buffer the negative impact of arthritis pain on depressive symptoms.

Proactive approaches to successful aging: one clear path through the forest.

The importance of successful aging is increasingly acknowledged in the field of gerontology. In this paper we contribute to ongoing efforts to clarify and operationalize this concept by presenting our revised Comprehensive Preventive Corrective Proactive (PCP) model that builds on relevant research traditions, our prior formulations and accumulating research evidence based on testing this model. Recognizing biopsychosocial challenges and contextual stressors that are normative for older individuals, we emphasize the critical role of proactive behavioral adaptations in ameliorating the adverse effects of stressors. We argue that competent actions to address age-related changes and stressors are necessary to achieve positive quality-of-life outcomes. We propose that future research may benefit from employing more complex methodological approaches and data analytic tools.

Changes over time in the utilization of disease-related Internet information in newly diagnosed breast cancer patients 2007 to 2013.

BACKGROUND: As the number of people with Internet access rises, so does the use of the Internet as a potentially valuable source for health information. Insight into patient use of this information and its correlates over time may reveal changes in the digital divide based on patient age and education. Existing research has focused on patient characteristics that predict Internet information use and research on treatment context is rare. OBJECTIVE: This study aims to (1) present data on the proportion of newly diagnosed breast cancer patients treated in German breast centers from 2007 to 2013 who used the Internet for information on their disease, (2) look into correlations between Internet utilization and sociodemographic characteristics and if these change over time, and (3) determine if use of Internet information varies with the hospitals in which the patients were initially treated. METHODS: Data about utilization of the Internet for breast cancer-specific health information was obtained in a postal survey of breast cancer patients that is conducted annually in Germany with a steady response rate of 87% of consenting patients. Data from the survey were combined with data obtained by hospital personnel (eg, cancer stage and type of surgery). Data from 27,491 patients from 7 consecutive annual surveys were analyzed for this paper using multilevel regression modeling to account for clustering of patients in specific hospitals. RESULTS: Breast cancer patients seeking disease-specific information on the Internet increased significantly from 26.96% (853/3164) in 2007 to 37.21% (1485/3991) in 2013. Similar patterns of demographic correlates were found for all 7 cohorts. Older patients (≥70 years) and patients with <10 years of formal education were less likely to use the Internet for information on topics related to their disease. Internet use was significantly higher among privately insured patients and patients living with a partner. Higher cancer stage and a foreign native language were associated with decreased use in the overall model. Type of surgery was not found to be associated with Internet use in the multivariable models. Intraclass correlation coefficients were small (0.00-0.03) suggesting only a small contribution of the hospital to the patients' decision to use Internet information. There was no clear indication of a decreased digital divide based on age and education. CONCLUSIONS: Use of the Internet for health information is on the rise among breast cancer patients. The strong age- and education-related differences raise the question of how relevant information can be adequately provided to all patients, especially to those with limited education, older age, and living without a partner.