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.].

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.

Utilization and Perception of Peer-Support After Lower Limb Loss in the United States: Potential Benefits on Mobility Outcomes.

OBJECTIVE: To examine participants' experiences with peer-support after lower limb loss (LLL) and the associations between the peer-support experience (perceived benefits and barriers) and mobility outcomes. DESIGN: Quantitative and qualitative descriptive study with a cross-sectional design. SETTING: National survey (distributed to 169 peer-support groups in 44 states in the US). PARTICIPANTS: The survey was completed by 82 individuals with a major lower limb amputation (53% female, 54% over 55 years of age; N=82). MAIN OUTCOME MEASURES: A 32-item survey to examine respondents' experiences in peer-support activities. Prosthetic mobility was measured using the Prosthetic Limb Users Survey of Mobility (PLUS-M). RESULTS: Two out of 3 respondents received some forms of peer-support after amputation. Among them 75% reported peer-support having a positive effect on their outlook on life, and 78% reported that information gained from peer-support was helpful. Companionship, altruistic acts, and gaining information on how to cope with amputation were the top themes of why respondents enjoyed the peer-support experience. Nearly all (94%) respondents would recommend peer-support to other people with LLL. Individuals who received peer-support exhibited a trend of greater mobility (55th vs 36th percentile on PLUS-M; P=.055). CONCLUSION: Individuals with LLL reported generally positive experiences regarding their engagement in peer-support activities. Peer-support groups are viewed as a helpful source for both information and emotional support, potentially benefiting functional and psychological recovery after amputation. Individuals who have received peer-support also exhibited greater mobility.

Correction: The rural-urban divide in Tanzania: Residential context and socioeconomic inequalities in maternal health care utilization.

[This corrects the article DOI: 10.1371/journal.pone.0241746.].

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.

Urbanicity and cognitive functioning in later life.

Introduction: Prior research has shown disparities in cognitive functioning across the rural-urban continuum. We examine individual- and contextual-level factors to understand how and why urbanicity shapes cognitive functioning across older adulthood. Methods: Using a nationally representative sample from 1996 to 2016 waves of the Health and Retirement Study (HRS) and growth curve models, we assess urban-suburban-exurban differences in older adult cognitive functioning. Results: Results demonstrate that older adult men and women living in exurban areas, and older adult men in suburban areas, have lower cognitive functioning scores compared to their urban peers. Educational attainment and marital status contribute to but do not fully explain these differences. There were no differences in the trajectory over age, suggesting that urbanicity disparities in cognition occur earlier in life, with average differences remaining the same across older adulthood. Discussion: Differences in cognitive functioning across urbanicity are likely due to factors accumulating prior to older adulthood.

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.].

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.

Intersecting Early-Life Selection Mechanisms: Socio-Historical Changes in Racially Stratified Effects of Education on Functional Limitations in the United States.

OBJECTIVE: Scant research has focused on the role of sociohistorical changes in shaping intersecting early-life selection mechanisms and their impacts on racially stratified effects of education on health across cohorts. METHOD: Drawing from the Health and Retirement Survey, this study fitted negative binomial regression models to assess the impacts of childhood socioeconomic status (SES) on the relationship between education and functional limitations for Black and White adults across birth cohorts (n = 16,269, born 1931-1959). RESULTS: The disparities between Black adults and White adults in impacts of childhood SES on both education and functional limitations were more pronounced in recent cohorts. The racial stratification in the impacts of education on functional limitations was documented across cohorts. However, after adjusting for childhood SES, this stratification narrowed considerably in recent cohorts. DISCUSSION: This study underscores the role of a sociohistorical context in shaping the effects of education on health at the intersection of race and cohort.

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.

Exploring the relationships between resilience, mindfulness, and experiential avoidance after the use of a mindfulness- and acceptance-based mobile app for posttraumatic stress disorder.

PURPOSE: This study used a mindfulness- and acceptance-based mobile app to examine the relationships between resilience, mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptoms. DESIGN AND METHODS: A quasi-experimental pre-posttest, single-group study design was used. A total of 23 college student veterans used the app for 4 weeks. Outcomes of resilience, mindfulness, experiential avoidance, and PTSD were measured at three time-points (baseline, end of Week 2, and end of Week 4). FINDINGS: All outcomes significantly improved at postintervention. Improvements in resilience and PTSD significantly correlated with improvement in mindfulness. PRACTICE IMPLICATIONS: Mindfulness- and acceptance-based mobile apps can be safely used by individuals with PTSD as a complementary approach to enhance resilient coping with PTSD.

Altruistic Attitudes Among Older Adults: Examining Construct Validity and Measurement Invariance of a New Scale.

BACKGROUND AND OBJECTIVES: Scholarly research has established the role of altruism in facilitating human cooperation and prosocial behaviors and highlighted its contribution to psychological well-being. Given the health significance of altruistic attitudes and orientations, we developed a valid and reliable measure of this construct that is suitable for use with older adults. RESEARCH DESIGN AND METHODS: Based on data from a long-term panel study on adaptation to frailty among older adults (n = 366; mean age = 86 years), we used confirmatory factor analysis to perform construct validation of a five-item Elderly Care Research Center Altruism Scale among older adults (e.g., "Seeing others prosper makes me happy"). Moreover, we examined the invariance of the scale's factor structure across time and gender using nested models. RESULTS: Composite reliability (coefficient omega = 0.78), factor loadings (>0.45 with eigenvalue = 2.84) from exploratory factor analysis, and model fit indices (e.g., comparative fit index = 0.999) from confirmatory factor analysis suggest a single factor, supporting a unidimensional reliable construct of altruistic orientation at baseline. The results provided support for configural, metric, and scalar invariance across time. Findings pertaining to measurement invariance across gender confirmed full configural invariance but only offered support for partial metric, scalar, and residual invariance at baseline. Strong correlations among the altruism scale, salient personality traits, psychological well-being, religiosity, and meaning in life help establish construct validity. DISCUSSION AND IMPLICATIONS: The availability of a reliable and valid measure of altruistic attitudes enables a comprehensive evaluation of altruism's influence on later-life health and well-being.

Intercohort Variations in the Education-Health Gradient: Sociohistorical Changes in Early-Life Selection Mechanisms in the United States.

OBJECTIVES: Most prior studies on cohort-specific changes in the education gradient relative to health treat the distribution of education within a particular cohort as a "starting place" for understanding later-life health disparities. This premise has obfuscated the role that sociohistorical changes in early-life selection mechanisms play in the widening of education-based inequalities in functional limitations across birth cohorts. METHODS: Drawing from the Health and Retirement Survey (1992-2016; n = 20,920), this study employs inverse probability weight (IPW) to account for early-life selection mechanisms that are likely to affect both educational attainment and functional limitations. IPW-adjusted generalized linear mixed-effects models were used to estimate the total effect of education on functional limitations across birth cohorts (born 1924-1959). RESULTS: A significant linear decline in the negative effects of childhood socioeconomic disadvantage on education (ß = 0.005, p < .01) over the birth year was documented. By contrast, the same variable's negative effect on functional health increased significantly (ß = 0.006, p < .001) across cohorts. Adjustment for childhood socioeconomic status did yield narrower education-based inequalities in functional limitations, but the difference between IPW-adjusted and unadjusted results was not statistically significant. The pattern of significant widening of education-based inequalities (ß = -0.05, p < .001) in functional limitations across birth cohorts was maintained. DISCUSSION: This study underscores the role that sociohistorical changes in early-life selection mechanisms play in modifying patterns of education-based inequalities in health across cohorts.

Loving Others: The Impact of Compassionate Love on Later-Life Psychological Well-being.

OBJECTIVES: Existing scholarship in social gerontology has paid relatively little attention to broader loving emotions, such as compassionate and altruistic love, as potentially meaningful mechanisms for improving later-life psychological well-being outside a family framework. METHOD: Drawing from a 3-wave longitudinal survey of community-dwelling older residents (n = 334) of Miami, Florida, we utilized generalized estimating equation models to examine the influence of changes in compassionate love (i.e., feeling love toward other persons and experiencing love from others) on depressive symptoms over time. We also explored cross-sectional relationship between compassionate love and positive and negative affects. RESULTS: An increase in the feeling of being loved (ß = -0.77, p < .001) and feeling love for others (ß = -0.78, p < .001) led to a decline in odds of reporting greater levels of depressive symptoms over time. The odds of reporting higher level of positive affect were significantly greater for older adults who reported feeling loved by others (ß = .63, p < .001) and expressed love for other people (ß = 0.43, p < .05). Older adults who felt loved and expressed love for other people, respectively, had 0.71 and 0.54-point lower ordered log odds of reporting higher negative affect than those who reported lower levels of love. The statistically significant impact of feeling loved on all well-being outcomes was maintained even after adjustment for altruistic attitudes and emotional support. Except for depressive symptoms, such adjustments explained the positive influence of love for others on well-being outcomes. DISCUSSION: Our findings underscore the powerful influence of both receiving and giving loving emotions for the maintenance of later-life psychological well-being.

The rural-urban divide in Tanzania: Residential context and socioeconomic inequalities in maternal health care utilization.

BACKGROUND: Existing studies in Tanzania, based mostly on rural samples, have primarily focused on individual behaviors responsible for the lower utilization of maternal health care. Relatively less attention had been paid to inequalities in structural circumstances that contribute to reduced utilization of maternal health care. More importantly, scholarship concerning the impact of the rural-urban divide on socioeconomic disparities in the utilization of maternal health care is virtually nonexistent in Tanzania. METHODS: Drawing from the Demographic Health Survey (2015-2016) conducted in Tanzania, our study includes a total of 3,595 women aged between 15-49 years old, who had given birth in five years before the month of the interview and living in both rural and urban Tanzania. The maternal health care utilization was assessed by four variables (i.e., antenatal care, skilled delivery assistance, the before and after discharging postnatal care). The independent variables were wealth, education, residence, parity, occupation, age, and the head of the household's sex. We used bivariate statistics and logistic regression to examine the rural-urban differences in the influence of education and wealth on maternal health care utilization. RESULTS: Significantly lower use of maternal health care in rural than urban areas demonstrated a stark rural-urban divide in Tanzania. We documented socioeconomic inequalities in maternal health care utilization in the form of lower odds of the utilization of such services among women with lower levels of education and household wealth. The educational inequalities in the utilization of skilled delivery assistance (or = 0.37, 95% CI: 0.16, 0.86; p = 0.021) and (before discharge) postnatal care (or = 0.60, 95% CI: 0.38, 0.95; p = 0.030) were significantly wider in rural than urban areas. The differences in the odds of the utilization of skilled delivery assistance between women in poorer wealth quintile and women in richer household wealth quintile were also significantly wider in rural areas than in urban areas. However, the statistically significant rural-urban divides in the impacts of socioeconomic status on antenatal care and (after discharge) postnatal care were not observed. CONCLUSION: This study establishes the need for consideration of the rural-urban context in the formulation of policies to reduce disparities in maternal health care utilization in Tanzania.

Promoting Resilience Among College Student Veterans Through an Acceptance-and-Commitment-Therapy App: An Intervention Refinement Study.

Military veterans' stigmatized views on mental disorders and traditional mental health care considerably reduce veterans' access to mental health services. The present study aimed to refine a previously developed non-stigmatizing smartphone-app intervention based on the principles of acceptance and commitment therapy for college student veterans with posttraumatic stress disorder (PTSD). To this end, we tested the acceptability of the developed prototype using a mixed-method study design. A total of nine student veterans participated in the study by using the app intervention and completing pre-post study measures and a post-intervention qualitative interview. The results showed that the intervention was highly acceptable. The results of the qualitative data analysis highlighted relevant themes related to strategies for improving the content, delivery, and structure of the intervention. The results also showed that, despite a decrease in the participants' adherence as the intervention progressed, there was a consistent improvement in the participants' resilience, PTSD, and rumination. Based on the results, the intervention was revised for prospective feasibility and efficacy testing. Our results highlight the need to use a collaborative approach in the early stage of the development of self-management PTSD interventions.

Testing the acceptability and initial efficacy of a smartphone-app mindfulness intervention for college student veterans with PTSD.

This single-arm, pre-post feasibility study evaluated the acceptability and initial efficacy of a mindfulness smartphone-app intervention intended to promote resilience and improve posttraumatic stress disorder (PTSD) symptoms among college student military veterans. The app contained mindfulness exercises and meditations based on the acceptance and commitment therapy. Twenty-three student veterans used the app for four weeks. The results showed high levels of perceived satisfaction and usability of the app. Significant changes in resilience, mindfulness, PTSD, experiential avoidance, and rumination were observed. Future research is needed to test the intervention in a randomized controlled trial.

Intersectional Effects of Gender, Education, and Geographic Region on Functional Health Disparities Among Older Adults in India.

Objective: Research on social determinants of health in India has focused largely on the independent influence of education, gender, and region. Using an intersectionality framework in this study, we examine the combined effects of these three key social locators on the critical, yet underexamined outcome of later life functional health. Method: We use data from Wave 1 (2007-2010) of the Study of Global Ageing and Adult Health (SAGE) (N = 7,150) to examine whether the effects of education on functional limitations differ by gender in six highly heterogenous regions of India. Results: The effects of education on functional limitations were significantly greater (ß = .026, p < .001) for men than women. Consistent with established regional differences in economic development, cultural practices, and political context, this relationship varied across locales. Discussion: Our findings highlight the need to move beyond independent sources of heterogeneity in examining later life functional health in the global South.

Episodic Memory in Later Life: Benefits of Prayer and Meditation.

Purpose: To examine the effects of prayer and meditation on the episodic memory of older adults. Design: Secondary analysis of Health and Retirement Study (HRS). Method: Drawing from a subsample of HRS (n = 1,135), this study utilized generalized estimating equation regression models to examine the effects of meditation and prayer on changes in episodic memory of older adults over time. Findings: Findings show a statistically significant positive effect of the use of prayer (0.50, p < .05) on episodic memory score at baseline. We also observed a slight gain in episodic memory over time for older adults who used prayer (0.04, p = .05). Meditation was not found to have a statistically significant effect on changes in memory in later life. Conclusion: This study illustrates the benefits of prayer in preserving memory and provides much needed empirical basis for community-level interventions to enhance memory in later life.

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.