Examination of the Problem Gambling Severity Index for Use with Older Adults: A Rasch Model Approach.

Research and prevalence studies commonly use the nine-item Problem Gambling Severity Index (PGSI; Ferris and Wynne in The Canadian Problem Gambling Index, 2001) to measure problem gambling severity in older adults. However, the appropriateness of the PGSI for use with older adults must be evaluated to ensure accurate interpretation of scores. This study evaluated the PGSI with older adults that gamble using a Rasch model approach, which has not yet been examined in the literature. Data from the Quinte Longitudinal Study (Wiiliams et al. in The Quinte Longitudinal Study of Gambling and Problem Gambling 2006-2011, Bay of Quinte region, Ontario [Canada] (V28), 2014) were utilized, accessed through the Gambling Research Exchange of Ontario (GREO). Using WINSTEPS.V5, a Rasch rating scale model was applied to an older adult sample from Ontario, Canada (n = 571, Mage = 66, range = 60-80 +) to assess: (1) the dimensionality and fit between individual PGSI items and the underlying latent construct of problem gambling; (2) utility of items and response options; and (3) potential differential item functioning (DIF) between genders. Using a larger sample (N = 3206, Mage = 45, range = 18-80 +), DIF was examined across three age subgroups. Results supported unidimensionality of the PGSI and item polarity (rpm range = 0.42-0.85). Infit and outfit statistics showed mixed model misfit for three items. The use of three response options were deemed productive for measurement, but almost always was not frequently endorsed. Model-person separation (1.00) and reliability (0.50) were poor, and model-item separation (6.12) and reliability (0.97) were excellent. There was no significant DIF between older adults by gender. Three items showed significant DIF between older and younger adults. Possible modifications to improve the PGSI for use with older adults are discussed.

A socially-engaged lifestyle moderates the association between gait velocity and cognitive impairment.

Objective: Cognitive status has been linked to impaired gait velocity, and diminished social and physical engagement. To date, the potential moderating influence of lifestyle engagement on gait-cognitive status associations has not been systematically explored. The present investigation examines whether a socially- or physically-engaged lifestyle moderates the association between diminished gait velocity and likelihood of amnestic mild cognitive impairment (a-MCI) classification.Methods: Participants (aged 65+, Mage=73 years) were classified as either healthy controls (n = 30) or a-MCI (n = 24), using neuropsychological test scores and clinical judgement. Gait velocity was indexed using a GAITRite computerized walkway, engaged lifestyle (social and physical subdomains) were measured using a well-validated self-report measure, the revised Activity Lifestyle Questionnaire.Results: Logistic regression, evaluating likelihood of a-MCI classification, yielded a significant interaction between a socially-engaged lifestyle and gait velocity (b=.01, SE=.003, p=.015). Follow-up simple effects were derived for two levels (+/-1SD) of social engagement; for individuals 1 SD below the mean, the association between gait velocity and increased likelihood of a-MCI classification was exacerbated (probability of a-MCI classification for those with slower gait velocity was 60% higher for individuals 1 SD below vs 1 SD above the mean of social engagement). Physically-engaged lifestyle did not significantly moderate the gait-cognitive status association.Conclusions: The significant moderating influence of social engagement has several implications, including the likelihood that distinct mechanisms underlie the relationships of social engagement and gait velocity to cognitive function, the value of social variables for well-being, and the potential utility of socially-based interventions that may prevent/delay a-MCI onset.

Exploring life-course patterns of substance abuse: a qualitative study.

OBJECTIVES: This research sought to examine how older adults with substance abuse issues understand the pattern of their use. Qualitative interviews explored: (1) Whether self-reported age of onset of substance abuse in fact aligned with the age when use became problematic; (2) Patterns of substance use over the life-course; (3) Precipitants of substance use throughout the lifespan; (4) Factors that prevented identification of problem use; (5) How participants came to recognize that their substance use was problematic. METHOD: Participants were 11 men and 9 women aged 62-78 years (M = 69.80, SD = 3.86) who were clients of an older adult substance abuse treatment program. Semi-structured interviews were conducted and transcribed for thematic analysis. RESULTS: Interview data revealed discrepancies between self-identified age of substance abuse onset and reported problematic use throughout the lifetime. Thematic analysis revealed factors that contributed to participants not recognizing problem use earlier in life, such as normalizing and minimizing the impact of use and lack of severe consequences earlier in life. Additionally, factors that led to increased use (i.e. retirement, grief), and to recognition of problem use and treatment-seeking were identified (i.e. social, financial, legal, and health problems). CONCLUSION: In general, self-reported age of substance abuse onset and patterns of substance abuse were highly variable across participants. These results have implications for assessment of substance use among older adults, as well as preventative efforts to decrease risk of substance abuse.

Social Isolation and Psychological Distress Among Older Adults Related to COVID-19: A Narrative Review of Remotely-Delivered Interventions and Recommendations.

The COVID-19 pandemic is associated with several short- and long-term negative impacts on the well-being of older adults. Physical distancing recommendations to reduce transmission of the SARS-CoV2-19 virus increase the risk of social isolation and loneliness, which are associated with negative outcomes including anxiety, depression, cognitive decline, and mortality. Taken together, social isolation and additional psychological impacts of the pandemic (e.g., worry, grief) underscore the importance of intervention efforts to older adults. This narrative review draws upon a wide range of evidence to provide a comprehensive overview of appropriate remotely-delivered interventions for older adults that target loneliness and psychological symptoms. These include interventions delivered by a range of individuals (i.e., community members to mental health professionals), and interventions that vary by implementation (e.g., self-guided therapy, remotely-delivered interventions via telephone or video call). Recommendations to overcome barriers to implementation and delivery are provided, with consideration given to the different living situations.

Does Caregiving Influence Planning for Future Aging?: A Mixed Methods Study Among Caregivers in Canada.

A mixed method design was used to examine how caregiving and transitioning a family member into long-term care (LTC) influence planning. Participants, aged 50+ from the community, completed self-report questionnaires. Quantitative data evaluated differences between three groups (non-caregivers, caregivers, caregivers with experience in assisting with a LTC transition); and predictive effects of caregiving, care expectations and social support to planning. Interviews among a subsample of caregivers examined how experiences of caregiving, including assisting in a transition to LTC, and social support influenced planning. Results indicated that: (1) caregivers with LTC transition experience planned significantly more than non-caregivers, (2) caregiving, care expectations, and social support significantly predicted of planning, and (3) future care expectation was an important mechanism in the relationship between caregiving and planning. These findings underscore the impact of caregiving experiences on expectations of future care needs and preparation for future care needs, and the importance of social support.