Stress and Loneliness Among Family Caregivers of Older Persons With Cognitive Impairment: The Mediating Role of Social Isolation and the Moderating Role of Personal Mastery.

OBJECTIVES: Relatively little attention has been paid to the underlying processes and conditions leading to loneliness among caregivers of older persons with cognitive impairment (PCI). Drawing upon the caregiver stress-process model and the social relationship expectations framework, this study examined the mediating role of social isolation and the moderating role of caregiver personal mastery in the association between PCI memory and behavioral problems and caregiver loneliness. METHODS: Structural equation modeling was applied to cross-sectional data from 266 caregivers in Singapore. RESULTS: Caregiver-reported PCI memory and behavioral problems were associated with increased levels of caregiver loneliness. Caregiver social isolation partially mediated the association and caregiver personal mastery moderated the association. DISCUSSION: Caregivers with low mastery were more likely to experience loneliness due in part to social isolation resulting from their PCI's memory and behavioral problems. Tailored interventions should address caregiver social isolation and foster caregiver personal mastery.

Informal Caregiver Social Network Types and Mental Health: The Mediating Role of Psychological Resilience.

Little is known about whether and why social networks protect mental health among informal caregivers. This study examined the association between informal caregiver social network types and depressive symptoms and the mediatory mechanism of psychological resilience. Latent class analysis, applied to cross-sectional data on 278 Singaporean caregivers, identified four social network types: restricted (42%), friend (16%), family (21%), and diverse (21%). Path analysis showed that the diverse social network type, compared to the restricted social network type, was associated with a lower level of depressive symptoms, and psychological resilience fully mediated this association. Interventions should help caregivers to maintain social networks with their family and friends.

Informal caregiver social network typologies were explored using data from Singapore.Diverse, friend, family, and restricted social network types were identified.Diverse social network type was negatively associated with depressive symptoms.Psychological resilience fully mediated the association.

Feeling Alone Together: Loneliness in Older Adults with Cognitive Impairment and Their Family Caregivers with Low Mastery.

INTRODUCTION: Loneliness in older persons with cognitive impairment (PCI) may beget loneliness in their family caregivers, depending on buffering resources caregivers possess. This study examined the association between loneliness in older PCI and loneliness experienced by their family caregivers, and the moderating role of caregiver mastery in this association. METHODS: Dyadic data from 135 PCI and their family caregivers in Singapore were analyzed using multivariable regression. Loneliness was measured using a three-item UCLA loneliness scale. Mastery was assessed using a seven-item Pearlin instrument. RESULTS: Multivariable regression showed that PCI loneliness and caregiver loneliness were weakly associated, taking other covariates into account. Notably, a significant interaction between PCI loneliness and caregiver mastery was observed, indicating that PCI loneliness was associated with caregiver loneliness only when caregivers had low mastery. CONCLUSION: Lonely PCI may share their feelings of loneliness with their caregivers, and this can lead to loneliness among caregivers if they have low mastery. Promoting caregiver mastery may help reduce caregiver loneliness, directly and indirectly as a buffer against PCI loneliness.

Within-Family Differences in Intergenerational Contact: The Role of Gender Norms in a Patrilineal Society.

Intergenerational contact is important to older adults' quality of life, but less is known about within-family differences in older parents' contact between sons and daughters, especially in countries with patrilineal traditions. Applying latent profile analysis to data on 3,228 Korean older adults' frequency of meeting and communication with each of their children, this study identified within-family patterns of intergenerational contact. Nearly half of parents exhibited gender-balanced patterns of meeting across children, while 13% reported "more frequent contact with daughters" and 39% reported "more frequent contact with sons." On the other hand, "equally high contact" (77%) was the most common pattern for communication. Multinomial regression results showed that the derived patterns were differentiated by parents' education, marital status, region, economic satisfaction, health, and depressive symptoms. The results highlighted the enduring nature of patrilineal traditions as well as the differing patterns of contact that Korean older adults have with their children.

Health Profiles among Community-Dwelling Older Adults with Cognitive Impairment and Their Implications for Caregiving Experience.

INTRODUCTION: Identifying health conditions of persons with cognitive impairment (PCI) in the community and exploring their implications for caregiving experience are vital for effective allocation of healthcare resources. This study examined distinct PCI health profiles among community-dwelling PCI and their association with caregiving burden and benefits. METHODS: Latent profile analysis and multivariable regression were applied to dyadic data from 266 PCI and their caregivers in Singapore. RESULTS: Three PCI health profiles were identified: less impaired (40% of PCI), moderately impaired (30%), and severely impaired (30%). Caregivers for severely impaired PCI were more likely to report a higher level of caregiving burden, and caregivers for moderately impaired PCI were more likely to report a higher level of caregiving benefits, compared to caregivers for less impaired PCI. CONCLUSION: The findings captured heterogeneity in health status among PCI in the community. Tailored interventions, based on PCI health profiles, should be designed to reduce caregiving burden and increase caregiving benefits.

Social Participation Through the Retirement Transition: Differences by Gender and Employment Status.

This study examines how retirees' formal and informal social participation change over time and investigates gendered differences. Seven waves of the Korean Longitudinal Study of Ageing track the frequency of social participation. A comparison group of employed individuals, weighted with coarsened exact matching, controls for age and time trends, and mixed model regressions estimate changes over time. Retirees show a gradual decline in the frequency of meeting friends and an abrupt decrease in the frequency of attending a social gathering, compared to their working peers. These trends are much stronger for men than women, and compound pre-existing gender differences in social participation. The more severe decline in the social participation of men is of great concern and points to the persistence of gendered employment structures into the retirement transition, putting Korean retirees at risk of social isolation and related health deterioration.

Social Participation in Widowhood: Evidence From a 12-Year Panel.

OBJECTIVES: Social participation is important to the quality of life of older adults, especially widows. This is the first study to test whether older widows' formal and informal social participation rises or declines using multiple panel observations pre- and postbereavement. This article also tests the moderating effects of economic and marital satisfaction, depression, and husband's illness before death on these trends. METHODS: Seven waves of the Korean Longitudinal Study of Ageing are used to track changes in 4 measures of social participation-meeting and contacting a child, meeting friends, and attending a formal group. A comparison group of married individuals, weighted with coarsened exact matching, controls for age and time trends. Mixed model regressions estimate the effects of widowhood over time. RESULTS: Social participation shows little change before bereavement and rises significantly after bereavement for all measures. However, frequencies of meeting and contacting a child peak and decline early postbereavement, while meeting friends and attending a group show delayed but long-lasting effects. With regard to moderators, economic and marital satisfaction are positively associated with overall social participation levels but negatively associated with social participation postbereavement. DISCUSSION: Increased social participation after bereavement underscores the resilience of widows and the social support they receive. However, differences in timing suggest that contact with children is gradually substituted with extrafamilial relationships in the long run. The negative moderating roles of economic and marital satisfaction point to a paradox where seemingly well-off individuals may be more vulnerable to widowhood.

Ageism Linked to Culture, Not Demographics: Evidence From an 8-Billion-Word Corpus Across 20 Countries.

OBJECTIVES: Ageism has increased over 200 years and costs the U.S. health care system $63 billion a year. While scholars agree on the consequences of ageism, there are disagreements on whether it is related to the demographics of aging, or society's cultural values. We test both hypotheses across 20 countries. METHOD: To circumvent the sampling limitations of survey studies, we used an 8-billion-word corpus, identified 3 synonyms with the highest prevalence-aged, elderly, old people-and compiled the top 300 words (collocates) that were used most frequently with these synonyms for each of the 20 countries. The resulting 6,000 collocates were rated on an ageism scale by 2 raters to create an ageism score per country. Cultural dimension scores-Power Distance, Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation-were taken from Hofstede, and demographics-size and speed of population aging-came from the World Development Indicators. RESULTS: Of the 20 countries, UK topped the ageism table, while Sri Lanka had the lowest ageism score. Multiple regression models showed that higher levels of masculinity and long-term orientation are associated with ageism, controlling for other cultural dimensions, demographics (size and speed of aging), and economics (GDP-per-capita). DISCUSSION: Our findings blunt the deterministic nature of ageism at the societal level. Demographics is only one side of the ageism coin, and the cultural side is equally, if not more important. This study lays the groundwork to tackle societal ageism-one of our generation's most pernicious threats.