A healthy aging program for older adults: effects on self-efficacy and morale.

CONTEXT: As of 2012, 810 million people worldwide were older than 60 y, accounting for 11% of the population. That number is expected to rise to 2 billion by 2050 or to 22% of the overall population. As a result, a growing need exists to understand the factors that promote mental and physical health in older populations. OBJECTIVES: The purpose of this study was to develop a healthy aging program for older adults and to measure the changes from baseline to the end of the program in participants' relevant psychosocial outcomes (ie, self-efficacy and morale). DESIGN: The study's healthy aging mind-body intervention (MBI) was adapted from the Relaxation Response Resiliency Program (3RP) at the Benson-Henry Institute for Mind Body Medicine, which incorporates elements from the fields of stress management, cognitive behavioral therapy, and positive psychology. That program was modified with examples and exercises targeted to an older population and evaluated in the current single-arm pilot study. SETTING: The program took place at the Massachusetts General Hospital (MGH). PARTICIPANTS: The 9-wk healthy aging MBI was developed for participants aged 65 y and older. Fifty-one older adults from the surrounding community participated in the study's groups. INTERVENTION: A new intervention group began the program every 3 mo, with a maximum of 12 individuals per group. For each group, the MBI consisted of weekly 90-min sessions for 9 consecutive wk, directed by a psychologist. The program included sessions that taught participants (1) a variety of methods to elicit the relaxation response (RR), (2) the practice of adaptive coping and cognitions, (3) behaviors necessary to create a healthy lifestyle, and (4) methods of building social support. OUTCOME MEASURES: The research team chose to focus on 2 psychological variables of interest for aging populations: morale and self-efficacy. The study used 2 questionnaires to measure those outcomes, the Philadelphia Geriatric Center Morale Scale (PGCMS), a multidimensional measure of the psychological state of older people, and the Coping Self-efficacy Scale (CSES), a measure that addresses the multiple dimensions of self-efficacy. RESULTS: Data from 5 intervention groups were combined for the current analysis. Forty-six participants enrolled and completed questionnaires. Of those participants, 41 attended at least 7 of the 9 sessions. Significant increases in self-efficacy and morale were observed for program completers. After a highly conservative sensitivity analysis, the change for the measure of self-efficacy remained significant, and the change for the measure of morale trended toward significance. CONCLUSIONS: The study's healthy aging program appears to be a feasible intervention for older adults, with the potential to increase levels of self-efficacy and morale in participants. Further research is warranted to determine its effects on other psychosocial outcomes and health care utilization in aging populations.

Erythrocyte binding protein PfRH5 polymorphisms determine species-specific pathways of Plasmodium falciparum invasion.

Some human malaria Plasmodium falciparum parasites, but not others, also cause disease in Aotus monkeys. To identify the basis for this variation, we crossed two clones that differ in Aotus nancymaae virulence and mapped inherited traits of infectivity to erythrocyte invasion by linkage analysis. A major pathway of invasion was linked to polymorphisms in a putative erythrocyte binding protein, PfRH5, found in the apical region of merozoites. Polymorphisms of PfRH5 from the A. nancymaae-virulent parent transformed the nonvirulent parent to a virulent parasite. Conversely, replacements that removed these polymorphisms from PfRH5 converted a virulent progeny clone to a nonvirulent parasite. Further, a proteolytic fragment of PfRH5 from the infective parasites bound to A. nancymaae erythrocytes. Our results also suggest that PfRH5 is a parasite ligand for human infection, and that amino acid substitutions can cause its binding domain to recognize different human erythrocyte surface receptors.