Testing the Impact of Variations in Administration on the Kessler Psychological Distress Scale (K10).

Self-report measures are useful in psychological research and practice, but scores may be impacted by administration methods. This study investigated whether changing the recall period (from 30 to 7 days) and response option order (from ascending to descending) alters the score distribution of the Kessler Psychological Distress Scale (K10). Participants were presented with the K10 with either different recall periods or different response option orders. There was weak evidence of lower mean K10 scores when using a 7-day recall period than when using the 30-day recall period (B = 1.96, 95% CI [0.04-3.90]) but no evidence of a change in the estimated prevalence of very high psychological distress. Presenting the response options in ascending order did not affect mean scores, but there was weak evidence of reduced prevalence of very high distress relative to the descending order (incidence rate ratio [IRR] = 0.60, 95% CI [0.36-0.98]). These findings suggest that varying the administration method may result in minor differences in population estimates of very high psychological distress when using the K10.

Neural correlates of the revised reinforcement sensitivity theory: A cross-sectional structural neuroimaging study in middle-aged adults.

The revised reinforcement sensitivity theory (RST) proposes that neurobiological systems control behavior: the fight-flight-freeze (FFFS) for avoidance of threat; behavioral approach/activation (BAS) for approach to rewards; and behavioral inhibition (BIS) for conflict resolution when avoidance and approach are possible. Neuroimaging studies have confirmed some theoretical associations between brain structures and the BAS and BIS; however, little representative population data are available for the FFFS. We investigated the neural correlates of the revised RST in a sample of 404 middle-aged adults (Mage = 47.18 (SD = 1.38); 54.5% female). Participants underwent structural magnetic resonance imaging and completed health questionnaires and the BIS/BAS/FFFS scales. We used multiple regression analyses to investigate the association between scale scores and volumes of a priori theoretically linked regions of interest while controlling for sex, age, intracranial volume, and cardio-metabolic variables; and conducted exploratory analyses on cortical thickness. The BIS was negatively associated with hippocampus laterality. At standard significance levels, the fear component of the FFFS was positively associated with anterior cingulate cortex; the BAS was positively associated with bilateral caudate; and the BIS was positively associated with posterior cingulate cortex volume. Furthermore, these neurobiological systems showed distinct patterns of association with cortical thickness though future work is needed. Our results showed that the neurobiological systems of the revised RST characterized in rodents can also be identified in the human brain.

Comparing estimates of psychological distress using 7-day and 30-day recall periods: Does it make a difference?

Self-report measures are widely used in mental health research and may use different recall periods depending on the purpose of the assessment. A range of studies aiming to monitor changes in mental health over the course of the COVID-19 pandemic opted to shorten recall periods to increase sensitivity to change over time compared to standard, longer recall periods. However, many of these studies lack pre-pandemic data using the same recall period and may rely on pre-existing data using standard recall periods as a reference point for assessing the impact of the pandemic on mental health. The aim of this study was to assess whether comparing scores on the same questionnaire with a different recall period is valid. A nationally representative sample of 327 participants in Australia completed a 7-day and 30-day version of the six-item Kessler Psychological Distress Scale (K6) and a single-item measure of psychological distress (TTPN item) developed for the Taking the Pulse of the Nation survey. Linear mixed models and mixed logistic regression models were used to assess whether altering the recall period systematically changed response patterns within subjects. No substantive recall period effects were found for the K6 or the TTPN, although there was a trend towards higher K6 scores when asked about the past 30 days compared to the past 7 days (b = 1.00, 95% CI: -0.18, 2.17). This may have been driven by the "feeling nervous" item which was rated higher using the 30-day compared to the 7-day recall period. Neither the K6 nor the TTPN item were significantly affected by the recall period when reduced to a binary variable of likely severe mental illness. The results indicate that altering the recall period of psychological distress measures does not substantively alter the score distribution in the general population of Australian adults.

Psychometric validation of the Emerging Adult Stress Inventory (EASI).

Emerging adulthood is characterized by a prolonged transition from adolescence into adult roles and responsibilities. During this time, changes across multiple life domains can elicit stress, and while the impact of this has received substantial attention, measurement across different domains has been inconsistent. The ability to assess both the global stress experience and specific stressor domains (such as in family, peer and romantic relationships, study, work, finances, competing priorities and the future) would be valuable in understanding and addressing the impact of stress on well-being during this period. Informed by the Adolescent Stress Questionnaire, this study sought to design and evaluate the psychometric properties of a multidimensional self-report stress scale for use in emerging adults. The factor structure and validity of the self-report instrument was examined in two large community samples of emerging adults (Nsample1 = 760, Nsample2 = 546) aged 18 to 25 years. A series of exploratory factor analyses yielded eight internally reliable dimensions of emerging adult stress which were then validated with confirmatory factor analysis against univariate and hierarchical models. The derived scale scores related positively to established measures of general stress, anxiety and depression, and negatively to self-esteem, supporting their validity as measures of emerging adult stress. Associations across the domains with age and gender are also reported. The resultant 39-item Emerging Adult Stress Inventory offers a multidimensional self-report stress measure for emerging adults which enables investigation of specificity in the relationship between stress and well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Short Barriers Questionnaire (SBQ): Validity, factor structure and correlates in an out-of-treatment sample of people dependent on methamphetamine.

INTRODUCTION AND AIMS: We validate a brief questionnaire to assess barriers to help-seeking for illicit substance use, and explore the factor structure and correlates of scale scores, among people dependent on methamphetamine. DESIGN AND METHODS: We administered a modified version of 27 items from the Barriers Questionnaire to 145 adults who had used methamphetamine in the past month and who screened positive for methamphetamine dependence on the Mini International Neuropsychiatric Interview. We used an exploratory factor analysis to identify the scale's dimensions. We examined correlates of the scale scores, their internal consistency, and their concurrent validity against help-seeking intentions on the General Help Seeking Questionnaire (GHSQ). RESULTS: A three factor model (χ2 = 308.6 df=168; RMSEA 0.08 [95% CI 0.06-0.09]; comparative fit index = 0.92) identified low perceived need for treatment (9 items), stigma (6 items), and apprehension about treatment (7 items) with Eigenvalues of 5.7, 3.8 and 2.3 respectively. The final 22-item scale had good internal consistency (Cronbach's alpha 0.83) and correlated negatively with help-seeking intentions on the GHSQ (rs = -0.24 p < .001) and positively with the GHSQ item, "I would not seek help from anyone" (rs = 0.38 p < .001). The scale dimensions of low perceived need, stigma, and apprehension had adequate to good internal consistency (Cronbach's alpha of 0.83, 0.79 and 0.69 respectively) but only low perceived need for treatment correlated significantly with the GHSQ scores. Low perceived need was also related to less severe methamphetamine dependence, not having children, and not having received professional help for methamphetamine use. Stigma was associated with specific demographics (being employed, having children), polysubstance use, and having attended sessions with a counselor or psychologist. Apprehension was associated with poor mental health, more severe substance use, being a woman, and having received help from an ambulance. DISCUSSION AND CONCLUSIONS: This short version of the Barriers Questionnaire (the Short Barriers Questionnaire; SBQ) is an internally consistent and valid scale for assessing low perceived need for treatment among people who use methamphetamine. Further work is needed to capture and validate other barriers to help-seeking for this population.

Re-examining the reciprocal effects model of self-concept, self-efficacy, and academic achievement in a comparison of the Cross-Lagged Panel and Random-Intercept Cross-Lagged Panel frameworks.

BACKGROUND: The cross-lagged panel (regression) model (CLPM) is the usual framework of choice to test the longitudinal reciprocal effects between self-concept and achievement. Criticisms of the CLPM are that causal paths are over-estimated as they fail to discriminate between- and within-person variation. The random-intercept cross-lagged panel model (RI-CLPM) is one alternative that extends the CLPM by partialling out between-person variance. AIMS: We compare analyses from a CLPM and a RI-CLPM which examine the reciprocal relationships between self-concept, self-efficacy, and achievement and determine the extent CLPM estimates are inflated by between-person variance. SAMPLE(S): Participants (n = 314) were first-year undergraduate psychology students recruited as part of the STudent Engagement with Education and Learning (STEEL) project. METHODS: Participants completed measures of self-efficacy and self-concept prior to completing fortnightly quiz assessments. RESULTS: Cross-Lagged Panel (regression) Model estimates are likely over-estimated in comparison with RI-CLPM estimates. Cross-Lagged Panel (regression) Model analyses identified a reciprocal effects relationship between self-concept and achievement, confirming established literature. In RI-CLPM analyses, these effects were attenuated and a skill development association between achievement and self-concept was supported. A reciprocal relationship between self-efficacy and achievement was supported. Better model fit was reported for the RI-CLPM analyses. CONCLUSIONS: Prior findings relating to the reciprocal effects of self-concept and achievement need to be reconsidered. Whilst such a relationship was supported in a CLPM analysis in this study, within an RI-CLPM framework, only achievement predicted self-concept. However, in both CLPM and RI-CLPM models a reciprocal effects model of self-efficacy and achievement was supported.

Age, sex and period estimates of Australia's mental health over the last 17 years.

OBJECTIVE: Describing the long-term mental health of Australians is limited as many reports rely on cross-sectional studies which fail to account for within-person changes and age-related developmental processes which may bias estimates which ignore these phenomena. We examined the 17-year trajectories of mental health in 27,519 Australian adults. METHODS: Household panel data of 27,519 participants aged 18 years and over from the Household, Income and Labour Dynamics in Australia Survey provided at least one observation of mental health over a 17-year period from 2001. On average, participants reported 7.6 observations. Mental Health was assessed annually using the Short-Form Health Survey-36 mental health scale. RESULTS: Over time, there were only very small changes in mental health and only for the youngest and oldest adults. Over time, there was consistent evidence for better metal health with increasing age, although for the very old, there appear to be substantial declines. These patterns were consistent between sex. In line with an existing literature, males reported better mental health over life span, although the declines of mental health in very-late-life are particularly pronounced for males. CONCLUSION: Decline in mental health was only reported by the youngest and oldest respondents, and was notable only in the last 4-5 years. However, the magnitude of the decline was small and further follow-up will be needed to determine whether this is a trend of substantive declining mental health for these specific age cohorts. In contrast, the more consistent finding is that there has been no substantive change in the level of mental health in Australia over the last 17 years. Analysis of the mental health trajectories of baseline age-cohorts confirmed that age differences are consistent over time.

The long-term mental health of Australia's tertiary students.

PURPOSE: The objective of the current study was to quantify the extent to which Australia's tertiary students have reported poorer mental health in comparison with the general community between 2001 and 2017. METHODS: Data were derived from the Household, Income and Labour Dynamics in Australia Survey, a longitudinal household-based panel study. There were 29,124 participants who provided at least one observation over the study period. On average, participants provided 7.4 observations. Mental Health was assessed with the SF-36 mental health and vitality subscales. RESULTS: There was little evidence for differences in mental health and vitality between those studying at tertiary levels and those not in tertiary education. Age-stratified analyses revealed that any differences were reported by older students. Interactions between education level and time revealed that the association between tertiary study and mental health outcomes has been consistent over time. CONCLUSION: There were very few differences between those in and those not in tertiary education. The magnitude of any differences was very small and does not necessarily reflect substantial poor mental health outcome. Overall, the most consistent finding was that there was little risk for poor mental health outcomes attributed to tertiary study.

BMI trajectories and risk factors among 2-11-year-old children by their immigrant status: evidence from the Longitudinal Study of Australian Children.

OBJECTIVE: This study aimed to identify body mass index (BMI) trajectories and their predictors in Australian children by their maternal immigrant status. METHODS: Data on 4142 children aged 2-3 years were drawn from the birth cohort of the Longitudinal Study of Australian Children. BMI was calculated according to the International Obesity Task Force cut-off points. Immigrant status was determined by the Australian Bureau of Statistics and the United Nations Development Programme, Human Development Index criteria. Latent class growth analysis estimated distinct BMI trajectories, and multinomial logistic regression analysis examined factors associated with these BMI trajectories. RESULTS: Two BMI groups and six BMI trajectories were identified. The stable trajectories group included high-risk (10%, n=375), moderate-risk (5%, n=215) and low-risk (68%, n=2861) BMI trajectories. The changing trajectories group included delayed-risk (6%, n=234), gradual-risk (8%, n=314) and declining-risk (3%, n=143) BMI trajectories. We found some evidence that children of immigrants from low-and middle-income countries were more likely to have moderate-risk and high-risk BMI trajectories compared with low-risk BMI trajectory. However, these associations were insignificant in fully adjusted models. The explanatory risk factors for moderate-risk and high-risk BMI trajectory were birth weight, family socioeconomic position, and organised sports participation. Our results also suggest that 4-7 years of age may be important for the prevention of overweight/obesity in children. DISCUSSION: A better understanding of the risk factors associated with distinct BMI trajectories in immigrant children will inform effective preventive strategies. Some of these risk factors such as non-participation in organised sports, and high screen time, may also impede the integration of immigrant children into the host culture. Obesity prevention strategies aimed at increasing physical activities in immigrant children could help deliver a social and health benefit by increasing social integration among children of immigrants and Australians.

Heterogeneity in the Health and Functional Capacity of Adults Aged 85+ as Risk for Mortality.

OBJECTIVES: To examine whether older adults aged 85+, with different health and functional capacities, cluster in different ways and to demonstrate whether individuals within particular clusters report differential mortality risk. DESIGN: Retrospective cohort study. SETTING: The Dynamic Analyses to Optimize Aging (DYNOPTA) project is a harmonization project of nine Australian longitudinal surveys of health and well-being in adults aged 50+ between 1991 and 2006. PARTICIPANTS: Participants were 685 older adults (female = 52%) living in the community and aged 85 to 103 at baseline who were followed until death or December 31, 2006, for survivors. MEASUREMENT: Latent class analysis (LCA) analyzed self-reported information on physical health, mental health, and functional capacity to define homogeneous classes based on probable cognitive impairment and depression status, medical conditions, and number of activities of daily living and instrumental activities of daily living. RESULTS: LCA discriminated four classes reflecting two main survival patterns. Two classes reported half the median survival days; differences between these classes were related to high vs moderate depression and extent of functional limitations. Two classes reported better survival; differences between these classes were related to functional limitations, but both had low proportions with depression and dementia. The classes with shorter survival were associated with substantively higher rates of depression and dementia. CONCLUSION: Higher rates of baseline depression and dementia were unique characteristics of those individuals in the clusters that reported shorter survival. However, a substantial proportion of very old adults experience good mental health with better survival outcomes. J Am Geriatr Soc 67:1036-1042, 2019.

Living well with chronic disease for those older adults living in the community.

BACKGROUND: Definitions of successful aging that incorporate dimensions of physical capacity and medical conditions are limited owing to the normative nature of experiencing medical conditions with age. We examine the capacity for older adults living in the community to live well with or without chronic disease as they age. METHOD: Participants (n = 1,001) were from the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) study who were aged 65+ years at baseline, were living in the community and followed for 16 years. RESULTS: Aging was associated with not living well (OR = 1.21; p < 0.001) and having a chronic disease (OR = 1.09; p < 0.001). There was increasing proportion of older adults not living well with chronic disease as they aged. Those not living well were at a substantial risk of death with (OR = 3.63; p < 0.001) or without (OR = 3.59; p < 0.001) chronic disease. DISCUSSION: The defining normative experience for older adults is that they are more likely to have a chronic disease and importantly not be living well with chronic disease as they age. However, it was the state of not living well that reflected the most substantial vulnerability for mortality, not chronic disease.

Sex and age trends in Australia's suicide rate over the last decade: Something is still seriously wrong with men in middle and late life.

Despite significant investment in mental health and suicide intervention strategies in Australia, the extent of change in suicide rates over the last decade is unclear. This paper analyses sex and age trajectories in suicide rates over the last decade in Australia. Age Standardized Suicide Rates from 2004 to 2013 were obtained from the Australian Bureau of Statistics and reflect rates of suicide per 100,000 within age and sex cohorts. Age-related suicide rates were consistent over the last decade. For both males and females, there were increases in mid-life suicide rates before declining around 55-65 years of age. However, rates of suicide in men increased in late-life with rates for those aged 70-79 comparable with those in mid-life. Rates amongst men aged 85+ were consistently the highest rates over the decade. Positively, there was decline in suicide rates among younger men aged 20-34 years. However, more consistently, for both sexes across most age cohorts, there were either increases or no change in suicide rate. Apart from declines in younger-adult males, analysis of age-standardized suicide rates indicate no improvement in suicide rates. High suicide rates amongst middle-aged and older males remain a significant public health issue that needs to be addressed.

The profile of psychiatric symptoms exacerbated by methamphetamine use.

BACKGROUND: Methamphetamine use can produce symptoms almost indistinguishable from schizophrenia. Distinguishing between the two conditions has been hampered by the lack of a validated symptom profile for methamphetamine-induced psychiatric symptoms. We use data from a longitudinal cohort study to examine the profile of psychiatric symptoms that are acutely exacerbated by methamphetamine use. METHODS: 164 methamphetamine users, who did not meet DSM-IV criteria for a lifetime primary psychotic disorder, were followed monthly for one year to assess the relationship between days of methamphetamine use and symptom severity on the 24-item Brief Psychiatric Rating Scale. Exacerbation of psychiatric symptoms with methamphetamine use was quantified using random coefficient models. The dimensions of symptom exacerbation were examined using principal axis factoring and a latent profile analysis. RESULTS: Symptoms exacerbated by methamphetamine loaded on three factors: positive psychotic symptoms (suspiciousness, unusual thought content, hallucinations, bizarre behavior); affective symptoms (depression, suicidality, guilt, hostility, somatic concern, self-neglect); and psychomotor symptoms (tension, excitement, distractibility, motor hyperactivity). Methamphetamine use did not significantly increase negative symptoms. Vulnerability to positive psychotic and affective symptom exacerbation was shared by 28% of participants, and this vulnerability aligned with a past year DSM-IV diagnosis of substance-induced psychosis (38% vs. 22%, χ(2)(df1)=3.66, p=0.056). CONCLUSION: Methamphetamine use produced a symptom profile comprised of positive psychotic and affective symptoms, which aligned with a diagnosis of substance-induced psychosis, with no evidence of a negative syndrome.

An examination of the long-term impact of job strain on mental health and wellbeing over a 12-year period.

OBJECTIVES: Job strain has been implicated in a range of employee health outcomes including psychiatric health. Much of the literature is drawn from studies that utilise cross-sectional designs, whilst the long-term follow-up of participants is limited. We examine the short and long-term risks of job strain for depression and wellbeing over a 12-year period. In particular, we utilise measures of wellbeing to emphasise the importance of discriminating between indices of subjective and psychological wellbeing that complement measures of mental health. METHODS: Participants (n = 2530) were aged between 40 and 44 years at baseline and were drawn from the Personality and Total Health (PATH) Through Life Project. Participants were observed once every 4 years for 12 years. RESULTS: A high strain job was associated with an increased risk of reporting sub-syndromal [RRR = 1.66 (95 % CI 1.23; 2.25), p < 0.001], minor [RRR = 1.92 (95 % CI 1.19; 3.10), p < 0.001] and major depression [RRR = 2.19 (95 % CI 1.30; 3.67), p < 0.001], but strain was not a long-term risk for depression 4 years later. In contrast, strain was a risk for both cross-sectional and longitudinal wellbeing outcomes. Moving into a high strain job was a risk for developing depression [RRR = 1.81 (95 % CI 1.26; 2.59), p < 0.001], but the cumulative exposure to a high strain job was not associated with poorer outcomes in adjusted models. CONCLUSIONS: Overall, our results emphasise the importance of current job strain, and the risk of moving into a high strain job, on adverse mental health and wellbeing outcomes. Effects were not consistent between indices of mental health, subjective or psychological wellbeing, supporting the need to dedifferentiate between wellbeing and mental health.

Examination of the association between mental health, morbidity, and mortality in late life: findings from longitudinal community surveys.

BACKGROUND: Physical health has been demonstrated to mediate the mental health and mortality risk association. The current study examines an alternative hypothesis that mental health mediates the effect of physical health on mortality risk. METHODS: Participants (N = 14,019; women = 91%), including eventual decedents (n = 3,752), were aged 70 years and older, and drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Participants were observed on two to four occasions, over a 10-year period. Mediation analysis compared the converse mediation of physical and mental health on mortality risk. RESULTS: For men, neither physical nor mental health was associated with mortality risk. For women, poor mental health reported only a small effect on mortality risk (Hazard Risk (HR) = 1.01; p < 0.001); more substantive was the risk of low physical health (HR = 1.04; p < 0.001). No mediation effects were observed. CONCLUSIONS: Mental health effects on mortality were fully attenuated by physical health in men, and partially so in women. Neither mental nor physical health mediated the effect of each other on mortality risk for either gender. We conclude that physical health is a stronger predictor of mortality risk than mental health.

An examination of the effects of intra and inter-individual changes in wellbeing and mental health on self-rated health in a population study of middle and older-aged adults.

PURPOSE: Self-rated health is frequently used as an indicator of health and quality of life in epidemiological studies. While the association between self-rated health and negative mental health is well established, associations with indictors of positive wellbeing are less clear. Data from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project were used to compare the effects of vitality and mental health on self-rated health. METHODS: Participants (n = 40,712) provided information on vitality, mental health and self-rated health, were aged 45-95 years at baseline, and were followed between 1 and 10 years (M = 5.6; SD = 2.9). RESULTS: In comparison with mental health, multi-level modelling indicated between- and within-person change in vitality was more strongly associated with self-rated health. Bivariate dual change score modelling of the cross-lagged associations between vitality and self-rated health indicated vitality to be a stronger predictor of change in self-rated health. Self-rated health was unrelated to change in vitality. CONCLUSION: Vitality accounted for most of the mental health effect on self-rated health and was identified as a significant predictor of change in self-rated health over a 10-year period. Promoting wellbeing and psychological functioning may have significant protective effects on negative health outcomes throughout the adult lifespan and into late life.

Trajectories of terminal decline in the well-being of older women: the DYNOPTA project.

Terminal decline in well-being is well established. However, the examination of covarying physical health and functioning on mortality-related well-being decline is limited. This study tested the effect of physical health changes on mortality-related well-being decline and examined the extent to which mortality-related trajectories of different well-being dimensions are similar. Participants comprised 1,862 decedent Australian females (aged M = 69.59 years; SD = 8.08 years at baseline) from the Dynamic Analyses to Optimize Ageing (DYNOPTA) Study who were observed on up to 4 occasions for up to 16 years (M = 6.04 years; SD = 2.14 years) prior to death, and who provided data on 2 well-being indices, vitality and mental health. Although between and within-person change in physical health fully accounted for mortality-related well-being decline, further analysis indicated that prior level of physical health reported only small effects on subsequent level of well-being and was wholly unrelated to well-being change. Conversely, only prior vitality reported significant effects on the level of, and change in, physical health. In conclusion, terminal decline in vitality and mental health appears to be an artifact of within-person physical health change and not prior level of physical health. Future areas of research should focus on identifying other significant predictors of physical health change which subsequently impact on well-being decline. There is also a need to discriminate between different indices of well-being as mortality-related changes and associations with physical function are not consistent.

Prevalence of physical activity behaviour in older people: findings from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project and Australian national survey data.

AIM: Many older people lead sedentary lives. National Health Survey physical activity prevalence data provide limited coverage of the 'old old' (≥75 years). METHOD: The Dynamic Analyses to Optimise Ageing (DYNOPTA) project's dataset provided physical activity data for 13,420 participants. Physical activity (walking, moderate- and vigorous-intensity activities in the previous week) was measured. Data were weighted and prevalence was calculated. RESULTS: The frequency of walking in DYNOPTA was similar to that in the national sample. Walking remained relatively stable until a decline among persons aged 80 years and over; moderate and vigorous activity declined in all but a minority of persons aged 70 years and over. Although DYNOPTA participants reported more physical activity than those in the contemporary national survey, the rates of sedentary behaviour were high. CONCLUSION: We require more information about the 'oldest old' (85+ years). There is great scope for increasing physical activity, even walking, among older people.

Measuring anxiety about aging across the adult lifespan.

BACKGROUND: The development of instruments to measure aging attitudes is an essential part of research into the role of individual differences in the aging process, giving clarification to the relationship between attitudes and behavior across the lifespan. Here we test the structural validity of Lasher and Faulkender's (1993) Anxiety about Aging Scale (AAS), and explore measurement invariance across age and gender. METHODS: A sample of 783 adults (42% females) age ranging from 20 to 97 years (M = 57.3, SD = 13.66) participated. RESULTS: The first-order four-factor AAS model reflecting the original Lasher and Faulkender (1993) structure showed a better fit to the data than the second-order model. Measurement invariance for both gender and age groups (young adults 20-44 years; mid-aged adults 45-64 years, older adults 65+ years old) was found for three of the factors, but not for all items in the Fear of Losses factor. Structural covariance inequality between the Fear of Losses and Physical Appearance factors was shown between males and females. CONCLUSIONS: Findings indicate that the original AAS measures four distinct dimensions of anxiety about aging. These dimensions were shown to be generally comparable across age and gender, indicating that the AAS is a suitable measure for providing meaningful comparison of anxiety about aging across the lifespan. The exception is the Fear of Losses factor, where items may have differential meanings across groups based on cultural and social attitudes regarding aging and gender.

Alcohol, hospital admissions, and falls in older adults: a longitudinal evaluation.

BACKGROUND: There are limited data on the impacts of alcohol use in older adults. We aimed to evaluate self-reported hospital admissions and falls against current Australian alcohol consumption guidelines. METHODS: We conducted a longitudinal analysis of data from five Australian cohort studies. The study comprised 16,785 people aged 65 years or older at baseline. Alcohol consumption was categorized using Australian guidelines in standard (10 g) drinks per day as "abstinent," "low-risk" (>0 ≤2), "long-term risk" (>2 ≤4), or "short-term risk" (>4). Separate generalized estimating equations for men and women, controlling for key demographic, and health variables (depression, diabetes, circulatory and musculoskeletal conditions) were used to examine the relationship of alcohol consumption with hospitalization and falls against a reference category of low-risk consumption. RESULTS: Most participants were in the low (10,369, 62%) or abstinent (5,488, 33%) categories. Among women, all alcohol groups had greater odds of admission than low-risk users; among men, only the abstinent group had increased odds. For both genders, depression, diabetes, circulatory and musculoskeletal conditions all increased the odds of admission. For both genders, the unadjusted model showed that abstainers had increased odds of falling, with depression, diabetes, and for women, musculoskeletal conditions also associated with falls in the adjusted model. CONCLUSION: These outcomes suggest that older women in particular could benefit from targeted alcohol consumption messages or interventions. In relation to falls, other health conditions appear better targets for intervention than alcohol use.