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.

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.

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.

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.

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.

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.

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.

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.

The mediating role of self-continuity on the link between childhood adversity and loneliness in later life.

Many factors may influence adaptation to critical life events such as divorce and bereavement in the second half of life, including having faced childhood adversity. However, pathways to reduced adaptation success are poorly understood. Self-continuity, an identity mechanism that incorporates life changes into a coherent life story, may contribute to better adaptation to adult critical life events, such as feeling less socially and emotionally lonely. We investigated the mediating role of self-continuity channeling the effects of childhood adversity on later life adaptation outcomes among individuals who had experienced divorce or bereavement. Data were derived from the longitudinal LIVES Intimate Partner Loss Study conducted in Switzerland from 2012 to 2016. The sample consisted of individuals who had experienced divorce (n = 416, Mage = 57.35) or bereavement (n = 339, Mage = 71.36) in later life, and a continuously married control group (n = 925, Mage = 67.04). Multilevel moderated mediations were used. Self-continuity mediated the effect of childhood adversity on emotional loneliness for all marital groups, but to a greater extent among divorcees. Self-continuity also mediated the effect of childhood adversity on social loneliness; however, this effect did not differ by marital group. In conclusion, childhood adversity was associated to greater loneliness in later life through self-continuity. Divorcees were the most impacted group regarding emotional loneliness, as they experienced lower levels of self-continuity. Interventions that aim to reinforce self-continuity may help overcome social and emotional loneliness, especially for individuals who have experienced the loss of their partner through divorce.

Social Isolation and Loneliness among Near-Centenarians and Centenarians: Results from the Fordham Centenarian Study.

Social isolation and loneliness have been recognized as problems older people face due to their adverse effects on health and mortality, but very few researchers have analyzed their co-occurrence, which might be particularly prevalent and critical among the very old. In this study, we investigated the prevalence of combinations of social isolation and loneliness among near-centenarians and centenarians. We used data collected from 94 individuals aged 95-107 from the Fordham Centenarian Study. We built a four-group typology and explored associations with individual characteristics in various domains (demographic, socioeconomics, social, health, care, and psychological) with multinomial logistic regression models. Considering their combinations, the most prevalent groups were "isolated and lonely" and "neither isolated nor lonely" (29.8% and 28.7%, respectively). The "lonely but not isolated" (20.2%) and "isolated but not lonely" (21.3%) groups were also notably large. The likelihood of belonging to each group varied according to various individual characteristics, such as education, health, and personality. Social isolation and loneliness are distinct phenomena among centenarians. The consideration of their varied combination can help better assess life conditions at very old ages. Taking into account the differences between groups can facilitate the design of tailored interventions to improve the lives of near-centenarians and centenarians.

Loneliness during COVID-19: Development and influencing factors.

In early pandemic waves, when vaccination against COVID-19 was not yet an option, distancing and reduced social contact were the most effective measures to slow down the pandemic. Changes in frequency and forms of social contact have reduced the spread of the COVID-19 virus and thus saved lives, yet there is increasing evidence for negative side effects such as mental health issues. In the present study, we investigate the development of loneliness and its predictors to examine the role of changes in social networks due to social distancing and other COVID-19-related life changes. A total of 737 participants (age range = 18-81 years) completed an online survey in three waves during the last quarter of 2020 at one-month intervals. Latent growth and multilevel modeling revealed that emotional loneliness increased over time, while social loneliness remained stable. Moreover, socially lonely individuals were likely to also develop emotional loneliness over time. Increased social distancing and sanitary measures were accompanied by decreased social interactions and loss of individuals considered SOS contacts and confidants. Changes in specific social network indicators were differentially associated with changes in emotional vs social loneliness: Loss of friends considered confidants was associated with increasing emotional loneliness, whereas loss of friends considered SOS contacts and reduced overall social interactions were related to increasing social loneliness. Lastly, individuals with more family-and-friend SOS contacts, more friends as confidants and an overall higher number of social interactions were more protected from feeling socially or emotionally lonely. Study findings enhance the understanding of underlying mechanisms differentially contributing to social and emotional loneliness and offer practical suggestions to reduce mental-health side effects of social distancing.

"I'm Getting Older Too": Challenges and Benefits Experienced by Very Old Parents and Their Children.

Very old parents and their "old" children are a growing group in industrialized countries worldwide. However, virtually nothing is known about the nature and implications of this relationship constellation. To fill this gap, this study explored the challenges and rewards of the very old parent-child relationship. In-depth interviews were conducted with 114 parent-child dyads (parent age ≥90; child age ≥65). While both challenges and rewards were present, the balance of challenges and rewards was notably less favorable for children with more challenges experienced overall. Challenges reported by children were often characterized by references to children's own advanced age and health problems, and the prolonged caregiving involvement due to their parents' longevity. Health care professionals, policymakers, and families should be made aware of this increasingly common phenomenon, and specific services and policies will be needed to adequately support very old adults and their families.

Support Exchanges Among Very Old Parents and Their Children: Findings From the Boston Aging Together Study.

BACKGROUND AND OBJECTIVES: Very old parents and their "old" children are a growing group in industrialized countries worldwide. Care needs of very old parents can be substantial, while children may also face their own age-related issues. Continued mutual support represents an important pathway to addressing emerging care needs. This study aimed to identify patterns of support exchanges occurring in very old parent-child dyads and to ascertain associated individual and relationship factors. RESEARCH DESIGN AND METHODS: Participants were 114 very old parents (aged ≥90) and their children (aged ≥65) from the Boston Aging Together Study. Data were collected using comprehensive, semistructured in-person interviews with both dyad members, including standardized assessments of support exchanges, relationship quality, health, and perceptions of family norms. Actor-Partner Interdependence Models were used to predict upward and downward support reported by children and parents. RESULTS: Both dyad members not only reported substantial upward support (child to parent) in all domains but also notable amounts of downward (parent to child) in the domains of emotional support, listening, and socializing. Findings showed significant associations of parent functional impairment, parent and child relationship quality, and child perceptions of family obligation with upward support and of relationship quality with downward support. DISCUSSION AND IMPLICATIONS: Continued support exchanges among very old parents and their children indicated that intergenerational theories still hold up in very late-life relationships. Health care professionals should be aware that attention to relationship quality and family norms might be vital to ensure that support needs are met.

Professional Support After Partner Loss: Likelihood and Correlates of Help-Seeking Behavior.

Intimate partner loss in later life can be one of the most stressful events in adulthood. Individuals who struggle to adapt to the new life conditions may need support from a mental health professional. However, less is known about the likelihood to seek professional help after separation, divorce, or bereavement in later life and associated factors. This study investigated professional help-seeking (PHS) for partner loss after a long-term marriage in separated, divorced, and bereaved individuals and examined the extent to which specific person and event-related variables, as well as depressive symptoms, increase its likelihood. The data were derived from the LIVES "Intimate Partner Loss Study." The self-administered questionnaires were completed by 388 adults. PHS was higher after separation (57%) and divorce (49%), compared to widowhood (18%). Higher likelihood of PHS was associated with separation and divorce, female gender, having someone to count on, loss unexpectedness, needing more time to overcome the loss, and more depressive symptoms. Informing individuals unlikely to seek help (e.g., males, bereaved, and individuals with no confidant) about PHS benefits may facilitate adaptation to partner loss.

Talking to the Dead in the Classroom: How a Supposedly Psychic Event Impacts Beliefs and Feelings.

Paranormal beliefs (PBs) are common in adults. There are numerous psychological correlates of PBs and associated theories, yet, we do not know whether such correlates reinforce or result from PBs. To understand causality, we developed an experimental design in which participants experience supposedly paranormal events. Thus, we can test an event's impact on PBs and PB-associated correlates. Here, 419 naïve students saw a performer making contact with a confederate's deceased kin. We tested participants' opinions and feelings about this performance, and whether these predicted how participants explain the performance. We assessed participants' PBs and repetition avoidance (PB related cognitive correlate) before and after the performance. Afterwards, participants rated explanations of the event and described their opinions and feelings (open-ended question). Overall, 65% of participants reported having witnessed a genuine paranormal event. The open-ended question revealed distinct opinion and affect groups, with reactions commonly characterized by doubt and mixed feelings. Importantly, paranormal explanations were more likely when participants reported their feelings than when not reported. Beyond these results, we replicated that 1) higher pre-existing PBs were associated with more psychic explanations (confirmation bias), and 2) PBs and repetition avoidance did not change from before to after the performance. Yet, PBs reminiscent of the actual performance (spiritualism) increased. Results showed that young adults easily endorse PBs and paranormal explanations for events, and that their affective reactions matter. Future studies should use participants' subjective experiences to target PBs in causal designs (e.g., adding control conditions).

Measurement Invariance and Developmental Trajectories of Multidimensional Self-Perceptions of Aging in Middle-Aged and Older Adults.

OBJECTIVES: This study examined the measurement invariance and longitudinal trajectories of multidimensional self-perceptions of aging (SPA) and factors that predict between-person variability in the level and change of SPA in middle-aged and older adults. METHOD: Data were drawn from the German Ageing Survey spanning four waves, covering a 15-year period. Multidimensional SPA was assessed with the Personal Experience of Aging Scale, consisting of three dimensions, physical decline, social loss, and continuous growth. RESULTS: The measurement invariance models across age groups (middle-aged versus older adults) and across time showed a good fit after allowing one item to vary at metric and/or scalar levels. Growth curve models showed only minor declining trajectories in two of the three dimensions of SPA, social loss and continuous growth dimensions, toward more negative views. Participants with poor resources in general were more likely to have negative SPA across all three dimensions. The protective effect of having a spouse was observed on only the social dimension of SPA, supporting a domain-specific effect of having a spouse. DISCUSSION: The study demonstrates the usefulness of a multidimensional understanding of SPA and recognizes the need for identifying different factors that may promote positive perceptions on aging in different dimensions of life.

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.

Thinking About the End of Life When It Is Near: A Comparison of German and Portuguese Centenarians.

This study examined how common thinking of and planning for the end of life (EOL) is among German and Portuguese centenarians, and whether patterns of EOL views are shaped by cultural and individual characteristics. A significant portion of centenarians in both countries reported not thinking about the EOL, not believing in the afterlife, and not having made EOL arrangements. Latent class analysis identified three EOL patterns: Class 1 (EOL thoughts with EOL arrangements and afterlife beliefs), Class 2 (EOL arrangements and afterlife beliefs without EOL thoughts), and Class 3 (Overall low endorsement of EOL items). The proportion of Portuguese centenarians was higher in Class 1 and of German centenarians higher in Classes 2 and 3. Centenarians' demographic, social, and health characteristics were significantly different across EOL patterns. As lack of EOL planning can result in poor EOL quality, enhancing communication among centenarians, family, and health-care professionals seems imperative.

Valuation of Life Among Old and Very Old Adults: Comparison Between Germany and Japan.

BACKGROUND AND OBJECTIVES: Valuation of life (VOL) represents a construct capturing individuals' active attachment to their life. The majority of studies on VOL were conducted in North America and Europe where personal autonomy and independence are highly valued, leaving open the question about the relevance of this construct in interdependence-oriented cultures. Using a framework of cross-cultural and life-span theories, the present study compared levels and predictors of VOL between the young-old and old-old individuals from Germany and Japan. RESEARCH DESIGN AND METHODS: Two hundred fifty-seven Germans and 248 Japanese, matched by age, gender, education, and IADL, answered a 5-item VOL scale and shared information on sociodemographic, social, and health resources. RESULTS: Germans' VOL levels were higher than in Japanese participants. Both culture- and age-moderated predictions of VOL: education was significant only in the young-old Japanese, and close social partners mattered in the old-old, not in the young-old. Health determined VOL irrespective of culture and age. DISCUSSION AND IMPLICATIONS: The findings suggest that cultural values and aging processes should be considered to better understand how individuals value their life and to help older adults to feel that his/her life is meaningful and worth living.