Temporal and Racial/Ethnic Patterns of Social Engagement among Older Adults: Evidence from American Time Use Survey 2019 to 2022.

This study examines temporal and racial/ethnic patterns in social engagement among older adults from 2019 to 2022, using data from the American Time Use Survey (ATUS) for adults aged 60 and older (n = 13,605). Social engagement was operationalized as time spent on five activities in in-home and out-of-home settings. Descriptive analysis was used to characterize temporal trends of social engagement, and zero-inflated negative binomial regression was utilized to estimate year-specific racial/ethnic differences. Results indicate an initial decline in out-of-home social engagement, followed by a gradual recovery. Racial differences in social engagement became salient during the pandemic period. The evolving racial and ethnic patterns in social engagement underscore the challenges that Black and Hispanic older adults faced during the public health crisis. Understanding activity patterns specific to racial/ethnic groups has implications for targeted interventions, informing strategies to support Black, Hispanic, and other minoritized older adults in public health emergencies.

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.

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.

Following Physician's Advice in Late Life: The Roles of Health Beliefs and Health Status.

Objective: This study aims to explore the influence of health-related locus of control beliefs such as belief in the role of health professionals in influencing patient health, cognitive functioning, and multimorbidity on adherence to physician's recommendations among older adults. Methods: A cross-sectional study involving older adults (N=684, age range = 71-100 years) living in Clearwater, Florida, reported their adherence to physician's recommendations, cognitive functioning, physical health, and health-related locus of control beliefs. Ordered Logistic regression was used. Results: Older adults who believed that health professionals influence health and a person is likely to recover from illness because other people take good care of him/her had higher adherence to physician's recommendations. Older adults who believed that their own action affects their health had lower odds of reporting adherence by 27%. Additionally, those with cognitive impairment had lower odds of reporting adherence by 38%. Functional limitations, multimorbidity, and self-image of health were not associated with adherence. Conclusion: This is one of the first studies to consider the influence of locus of control beliefs on adherence of physician's recommendations among community dwelling older adults. With the exception of one item "My good health is largely a matter of good fortune", generally individuals with external locus of control had higher adherence. Our findings also underscore the policy and clinical significance of different health-related beliefs held by older adults.

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.

Beyond the treatment: The role of race, sex, and education in health trajectories between cancer survivors and noncancer older adults.

INTRODUCTION: The number of older, long-term cancer survivors is increasing. However, little is known about how cancer and aging affect the health trajectories of older adults differently. In addition, the impact of race, sex, and education on the processes of aging and the cancer experience needs further investigation. The current study aims to address this knowledge gap by combining two National Cancer Institute (NIC)-funded longitudinal studies conducted in Cleveland from 1998 to 2010. MATERIALS AND METHODS: The unique cross-sequential design facilitates a comparison between the health changes in long-term (five years +) older cancer survivors (breast, prostate, and colorectal cancer) and demographically matched older adults without a history of cancer in the same geographic area within the same period. The study also captured comprehensive information on how socioeconomic status interacts with cancer and aging over time. General linear models were employed in the data analysis. RESULTS: The findings showed that early cancer experience did not affect long-term cancer survivors' health status in later life. Conversely, comorbidities, being an African American, being female, and having education less than a college degree significantly decreased the health trajectory in later life for all older adults. Moreover, compared to other groups, older African American cancer survivors reported a dramatic decrease in self-reported health after controlling for other conditions. DISCUSSION: Study findings can inform public policy and social services to offer comprehensive treatment plans and help individuals overcome their diseases and lead longer and healthier lives.

Racial, ethnic and neighborhood socioeconomic differences in incidence of dementia: A regional retrospective cohort study.

BACKGROUND: Evidence on the effects of neighborhood socioeconomic disadvantage on dementia risk in racially and ethically diverse populations is limited. Our objective was to evaluate the relative extent to which neighborhood disadvantage accounts for racial/ethnic variation in dementia incidence rates. Secondarily, we evaluated the spatial relationship between neighborhood disadvantage and dementia risk. METHODS: In this retrospective study using electronic health records (EHR) at two regional health systems in Northeast Ohio, participants included 253,421 patients aged >60 years who had an outpatient primary care visit between January 1, 2005 and December 31, 2015. The date of the first qualifying visit served as the study baseline. Cumulative incidence of composite dementia outcome, defined as EHR-documented dementia diagnosis or dementia-related death, stratified by neighborhood socioeconomic deprivation (as measured by Area Deprivation Index) was determined by competing-risk regression analysis, with non-dementia-related death as the competing risk. Fine-Gray sub-distribution hazard ratios were determined for neighborhood socioeconomic deprivation, race/ethnicity, and clinical risk factors. The degree to which neighborhood socioeconomic position accounted for racial/ethnic disparities in the incidence of composite dementia outcome was evaluated via mediation analysis with Poisson rate models. RESULTS: Increasing neighborhood disadvantage was associated with increased risk of EHR-documented dementia diagnosis or dementia-related death (most vs. least disadvantaged ADI quintile HR = 1.76, 95% confidence interval = 1.69-1.84) after adjusting for age and sex. The effect of neighborhood disadvantage on this composite dementia outcome remained after accounting for known medical risk factors of dementia. Mediation analysis indicated that neighborhood disadvantage accounted for 34% and 29% of the elevated risk for composite dementia outcome in Hispanic and Black patients compared to White patients, respectively. CONCLUSION: Neighborhood disadvantage is related to the risk of EHR-documented dementia diagnosis or dementia-related death and accounts for a portion of racial/ethnic differences in dementia burden, even after adjustment for clinically important confounders.

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.].

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 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.

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.

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.

A Comprehensive Digital Self-care Support System for Older Adults With Multiple Chronic Conditions: Development, Feasibility, and Usability Testing of myHESTIA.

The objective of this mixed methods study is to evaluate the need for a comprehensive digital self-care support system (CDSSS) for older adults with multiple chronic conditions (MCC) and to examine whether such a system can be developed to enable daily capture of self-care data. The 3-phase study involved Phase-1: user needs assessment and prototype development; Phase-2: preliminary user evaluation of the prototype; and Phase-3: 4-week small group usability and feasibility testing of the tracking component of the prototype. Results of Phase-1 show the need for a CDSSS. Phase-2 results demonstrate interest among older adults in using such a CDSSS and Phase-3 findings show that older adults found the tracking component of the system easy to use for capturing daily inputs. Overall, the findings show that it is feasible to design a CDSSS for older adults with MCC in a way that is usable and functional for them.

Modeling the impact of financial hardship and age on self-rated health and depressive symptoms pre/post the great recession.

Stressful life events such as a recession, could be devastating on a macro and micro level. Although there have been a number of articles written examining the health effects of the recession, little is known about age differences in the relationship between financial stressors and health pre and post the 2008 recession. Using the Health and Retirement study, we investigated the relationship between two forms of financial hardships, mental and physical health among middle aged (N = 4403) and older adults) (N = 2709). Our findings indicate that with regard to financial hardships experienced pre/post recessionary periods there are differences by age. Specifically, older adults tend to report having less financial hardship than their younger counterparts. Additionally, reduced medication use due to costs was a significant predictor of poor self-rated health among middle aged participants compared to older adults. These results highlight the selective impact of recessions on certain age groups. They also suggests that economic recessions may also produce short-term procyclical health effects. Future research should focus on the relationship between other sources of financial hardship among middle-aged and older adults pre/post-recession at shorter time intervals.

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.

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.

Investigating Factors of Active Aging Among Chinese Older Adults: A Machine Learning Approach.

BACKGROUND AND OBJECTIVES: With the extension of healthy life expectancy, promoting active aging has become a policy response to rapid population aging in China. Yet, it has been inconclusive about the relative importance of the determinants of active aging. By applying a machine learning approach, this study aims to identify the most important determinants of active aging in 3 domains, i.e., paid/unpaid work, caregiving, and social activities, among Chinese older adults. RESEARCH DESIGN AND METHODS: Data were drawn from the first wave of the China Health and Retirement Longitudinal Study, which surveys a nationally representative sample of adults aged 60 years and older (N = 7,503). We estimated Random Forest and the least absolute shrinkage and selection operator regression models (LASSO) to determine the most important factors related to active aging. RESULTS: Health has a generic effect on all outcomes of active aging. Our findings also identified the domain-specific determinants of active aging. Urban/rural residency is among the most important factors determining the likelihood of engaging in paid/unpaid work. Living in a multigenerational household is especially important in predicting caregiving activities. Neighborhood infrastructure and facilities have the strongest influence on older adults' participation in social activities. DISCUSSION AND IMPLICATIONS: The application of feature selection models provides a fruitful first step in identifying the most important determinants of active aging among Chinese older adults. These results provide evidence-based recommendations for policies and practices promoting active aging.

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.

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.