Self-Compassion, Stressor Exposure, and Negative Affect: A Daily Diary Study of Older Adults.

OBJECTIVES: Self-compassion has been identified as a psychological resource for aging well. To date, self-compassion among older adults has typically been conceptualized as a trait variable. This study examined whether day-to-day (state) variability in self-compassion was associated with negative affective reactivity to daily stressors. METHODS: Daily diary assessment methods were used to examine the potential moderating role of between- and within-person self-compassion on the relationship between daily stressors and negative affect. A community-based sample of 107 older adults aged 65+ completed questionnaires once daily over 14 days. RESULTS: Multilevel modeling revealed that 37% of the variance in self-compassion occurred within persons. Daily self-compassion moderated the relationship between daily stressor exposure and daily negative affect. On days with greater stressor exposure than usual, older adults showed less negative affective reactivity on days when self-compassion was higher, compared with days when self-compassion was lower. No moderating effects were observed for between-person (trait) self-compassion. DISCUSSION: These findings suggest that self-compassion in older adults should be conceptualized as both state and trait variables and that state self-compassion may be protective in the stress-reactivity pathway. Future research should investigate whether brief self-compassion interventions might help older adults to avoid or downregulate negative emotions in response to stressors.

Engage! a pilot study of a brief behavioural activation program to promote engagement and well-being in older adults.

Previous research has indicated the suitability of behavioural activation (BA) as an intervention for reducing depression in older adults. However, little research has investigated the potential of BA to increase active engagement and well-being in older adults. The current pilot study sought to investigate the usefulness and acceptability of BA to promote well-being in a group of non-clinical older adults. Participants (N = 18) aged between 65 and 86 (M = 77.82, SD = 5.59) who were retired and living independently in the community were provided a 6-week BA program predominantly delivered online. Treatment retention, self-ratings, and participants' compliance to treatment principles indicate preliminary feasibility for the use of BA as an approach for increasing active engagement in older adult populations. Participants also provided feedback on their experiences with the program post-intervention via individual structured interviews. Thematic analysis of these data revealed that participants found the program to be beneficial in terms of increased self-awareness and social engagement, and provided several recommendations for improving acceptability of the program and workbook. The unexpected events relating to the first wave of the novel coronavirus (COVID-19) led to necessary adaptations to delivery modalities, and provided the researchers with an opportunity to investigate the use of a structured well-being program on a high-risk population during a pandemic. Our findings support the proposition that BA is a suitable intervention for increasing engagement and well-being in older adults, provide insight into adapting programs for older adults, and suggest next steps for testing intervention efficacy.

Barriers to activity engagement in older adulthood: Results of a community survey.

OBJECTIVES: Losses that occur with age can create barriers to meaningful activity engagement, a crucial aspect of ageing well. Research on this topic is frequently qualitative, with few studies accessing large community samples. This study (a) assessed the frequency specific personal and environmental barriers (such as poor health and limited transport access), identified by older adults in previous research, were endorsed; (b) used latent class analysis (LCA) to identify population subgroups based on combinations of these barriers, and (c) examined associations of subgroups with purpose in life and quality of life. METHODS: Four hundred and thirty-two randomly selected Australian adults aged 65+ years (average age 76.7, 58% female) completed a telephone survey. They were asked whether certain barriers affected engagement and provided data on sense of purpose and quality of life. RESULTS: Physical health/mobility were the most frequently reported barriers, followed by sensory difficulties, financial limitations, and caring responsibilities. The LCA revealed up to three subgroups/classes of participants according to the barriers endorsed. Class 1 had low endorsement of all barriers, including physical health. The majority of Class 2 endorsed physical health barriers and other barriers more frequently than Class 1. Class 3 were comparable to Class 2, but also frequently endorsed community access barriers. Class 1 were younger and reported a greater sense of purpose and higher quality of life. CONCLUSIONS: Physical health/mobility barriers to engagement are those most frequently endorsed by older adults. These barriers may increase vulnerability to, or exacerbate the impact of additional barriers, such as sensory difficulties, access to transport and lack of finances.

A behavioural activation intervention to increase engagement with life and wellbeing in older adults: Study protocol for a randomised controlled trial.

BACKGROUND: Meaningful activity engagement is a critical element of ageing well. Interventions designed to increase activity engagement tend to be activity-specific and do not always meet the needs of older adults with diverse interests and capacities. Behavioural activation (BA) provides a promising person-centred framework for promoting engagement in valued activities. This study will examine the effectiveness of a behavioural activation-based intervention for promoting engagement with life and wellbeing among older adults. METHOD: Participants will be randomly allocated to one of two conditions (BA intervention, Active Control) and take part in a six-week intervention that consists of one-on-one weekly sessions of up to one hour to be administered either via telephone or online video conferencing with a trained facilitator. This study will recruit 120 + participants aged 65 + who score at or below the median on a test of life engagement. Participants will complete questionnaires of primary and secondary measures both pre-program, one-week and three months post-program. Participants will also complete a daily diary questionnaire during the fourth and fifth weeks of the intervention. The primary outcome measure is the Life Engagement Test, and secondary outcome measures include assessments of subjective wellbeing, psychological wellbeing, mental health, self-reported health, social engagement, loneliness and life satisfaction. DISCUSSION: The outcomes from this study will provide evidence as to whether a BA based approach represents an effective method for promoting engagement with life and wellbeing among older community-dwelling adults. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (Reg no. ACTRN 12621001192875). Trial retrospectively registered 6th September, 2021.

Conscientiousness, Activity Engagement, and Momentary Affect in Oldest-Old Adulthood.

OBJECTIVES: Remaining engaged with life is a hallmark of aging well and pursuing personally meaningful activities is presumably important for late-life affect. We examined how moment-to-moment variability in meaning and degree of challenge ascribed to daily activities relate to positive and negative affect in very old adults. Possible moderating effects of between-person differences in conscientiousness on meaning-affect associations were also examined. METHODS: Participants were 73 adults aged 89 years on average from the Australian Daily Life Time-Sampling module of the Australian Longitudinal Study of Aging. Participants provided self-report data on activity engagement (meaning and challenge associated with activities) and affect, on 5 occasions per day for a period of 7 consecutive days. RESULTS: Within-person associations of activity meaning with affect varied as a function of within-person challenge ratings. Specifically, gains in positive affect associated with meaningful activity were more strongly evident when activities were regarded as more challenging. In contrast, meaningful activity was associated with higher negative affect when activities were regarded as more challenging and lower negative affect when activities were regarded as less challenging. Conscientiousness did not moderate associations of activity meaning with affect. DISCUSSION: Our findings shed light on the intricate interplay between maintaining meaningful engagement and daily emotional experiences in very old age. We discuss theoretical and practical implications and consider the role of late-life conscientiousness for self- and emotion regulation.

Pragmatic randomised controlled trial of a personalised intervention for carers of people requiring home oxygen therapy.

We used a pragmatic randomised controlled trial to evaluate a behavioural change strategy targeting carers of chronically hypoxaemic patients using long-term home oxygen therapy. Intervention group carers participated in personalised educational sessions focusing on motivating carers to take actions to assist patients. All patients received usual care. Effectiveness was measured through a composite event of patient survival to hospitalisation, residential care admission or death to 12 months. Secondary outcomes at baseline, 3, 6 and 12 months included carer and patient emotional and physical well-being. No difference between intervention (n = 100) and control (n = 97) patients was found for the composite outcome (hazard ratio (HR) 1.22, 95% confidence interval (CI) = 0.89, 1.68; p = 0.22). Improved fatigue, mastery, vitality and general health occurred in intervention group patients (all p values < 0.05). No benefits were seen in carer outcomes. Mortality was significantly higher in intervention patients (HR = 2.01, 95% CI = 1.00, 4.14; p = 0.05; adjusted for Australia-modified Karnofsky Performance Status), with a significant diagnosis-intervention interaction (p = 0.028) showing higher mortality in patients with COPD (HR 4.26; 95% CI = 1.60, 11.35) but not those with interstitial lung disease (HR 0.83; 95% CI = 0.28, 2.46). No difference was detected in the primary outcome, but patient mortality was higher when carers had received the intervention, especially in the most disabled patients. Trials examining behavioural change interventions in severe disease should stratify for functionality, and both risks and benefits should be independently monitored. Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12607000177459).

First-Time Grandparents' Role Satisfaction and Its Determinants.

This article focuses on satisfaction with the grandparent role at 1 and 2 years after the transition to grandparenthood. Three hundred and eighteen grandparents (male and female) were initially recruited and required to complete a well-validated self-report measure of grandparent satisfaction, together with self-report questionnaires assessing a range of characteristics which might predict role satisfaction. The main finding was that grandparent-grandchild attachment (bonding) was the most powerful predictor. Some predictors (e.g., generativity) appeared to have a direct effect on satisfaction, whereas the effect of others (e.g., grandchild temperament) appeared to be mediated via the grandparent-grandchild attachment relationship. Role satisfaction, aside from its probable relevance to grandparent wellbeing, is also likely to be of relevance to grandparents' willingness to provide childcare. The latter, besides impacting on well-being of both grandparents and parents, also powerfully influences workforce economics.

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.

Breathlessness and sexual activity in older adults: the Australian Longitudinal Study of Ageing.

Sexual activity is important to older adults (65 + ). Breathlessness affects about 25% of older adults but impact on sexual activity is unknown. We evaluated the relationships between breathlessness and sexual inactivity and self-reported health among older community-dwelling adults in the Australian Longitudinal Study of Ageing. Associations between self-reported breathlessness (hurrying on level ground or walking up a slight hill) at baseline, self-reported sexual activity, overall health and health compared to people of the same age were explored using logistic regression at baseline and 2 years, adjusted for potential confounders (age, sex, marital status, smoking status and co-morbidities). Of 798 participants (mean age 76.4 years [SD, 5.8] 65 to 103; 53% men, 73% married), 688 (86.2%) had 2-year follow-up data. People with breathlessness had higher prevalence and duration of sexual inactivity (77.7% vs. 65.6%; p < 0.001; 12 [IQR, 5-17] vs. 9.5 [IQR, 5-16] years; p = 0.043). Breathlessness was associated with more sexual inactivity, (adjusted OR 1.75; [95% CI] 1.24-2.45), worse health (adjusted OR 2.02; 1.53-2.67) and worse health compared to peers (adjusted OR 1.72; 1.25-2.38). Baseline breathlessness did not predict more sexual inactivity at 2 years. In conclusion, breathlessness contributes to sexual inactivity and worse perceived health in older adults, which calls for improved assessment and management.

The transition to grandparenthood: a prospective study of mental health implications.

OBJECTIVES: This study investigated the mental health of a cohort of 262 female and 168 male grandparents across the first two years of their transition to grandparenthood, with particular focus on the impact of providing childcare for the grandchild. METHOD: Baseline assessments were made during the pregnancy with the first grandchild, and subsequent assessments were at one and two years after the birth. The influence of demographic and psychosocial variables which could be expected to influence change in mental health from baseline was explored. RESULTS: The lack of change in mental health measures in this cohort was more prominent than change. Specifically, there was a small significant decrease in anxiety over the first year for females, and a small significant increase in depression for males. Other variables, not unique to the transition to grandparenthood such as physical health and adverse life events, were strongly associated with changes in mental health. Notably, more time spent babysitting the grandchild was associated with improvement in mental health. CONCLUSION: The transition to grandparenthood did not have any substantial adverse impact on five well-validated measures of mental health, in contrast to earlier American findings of adverse effects which implied that childcare was burdensome.

Is Occupational Complexity Associated with Cognitive Performance or Decline? Results from the Australian Longitudinal Study of Ageing.

BACKGROUND: Long-term protective associations proposed between previous complex occupational tasks and cognitive functioning in later life point to work roles contributing to cognitive reserve. OBJECTIVE: To examine occupational complexity involving data, people, and things in relation to the level of, and rate of change in, cognitive functioning. METHODS: Participants were 1,290 members of the Australian Longitudinal Study of Ageing and initially aged 65-102 years (mean = 79). Information about main lifetime occupation was collected retrospectively. Cognition was assessed 4 times over a 13-year interval. RESULTS: In multilevel models adjusted for demographics, medical conditions, and depressive symptoms, higher complexity involving data was associated with faster speed (ß = 0.73, p < 0.001), better memory (ß = 0.32, p < 0.05), and mental status (ß = 0.40, p < 0.001) at baseline. These associations remained statistically reliable after adjusting for complexity with people and things, sedentary and heavy physical work, retirement age, and leisure activity. Complexity with things was associated with slower speed (ß = -0.50, p < 0.001) and poorer mental status (ß = -0.26, p < 0.01) and was not explained by other variables. There were no associations of occupational complexity with rates of cognitive decline over time. CONCLUSION: Older individuals retired from occupations characterized by higher complexity with data maintain their cognitive advantage over those with lower complexity into older adulthood, although without additional moderation of this advantage in terms of less postretirement cognitive decline. Complexity of work with things confers a negative relation to cognition whilst also not affecting postretirement cognitive change. Although the relative contributions of occupation or other early life influences for cognition remain to be established, it nevertheless may be beneficial to promote workplace design strategies and interventions that incorporate complex activities, particularly tasks involving data.

Perceived Control Moderates the Effects of Functional Limitation on Older Adults' Social Activity: Findings From the Australian Longitudinal Study of Ageing.

OBJECTIVES: Research has shown that functional limitation is related to reduced social activity in older adults; however, individuals with high perceived control have greater confidence in their ability to achieve outcomes and are more likely to show persistence and employ strategies to overcome challenges. The aim of this study was to examine whether perceived control protects against the negative effects of functional limitation on older adults' social activity. METHOD: Participants were 835 older adults aged 69 to 103 years at baseline from the Australian Longitudinal Study of Ageing. Multilevel modeling was used to examine baseline and within-person change in functional limitation and perceived control as predictors of 18-year trajectories of social activity. RESULTS: An interaction between baseline functional limitation and perceived control indicated that having greater functional limitation was associated with less social activity and greater decline over time for those with lower perceived control, but not for those with higher control. Within-person change in functional limitation was not reliably associated with social activity. DISCUSSION: This study highlights the importance of perceived control as a protective psychological resource and may have implications for developing interventions aimed at enabling older adults to maintain their social activity as they experience functional decline.

An Examination of Resilience and Coping in the Oldest Old Using Life Narrative Method.

We aimed to identify aspects of late-life resilience and sense of self-identity and locate them within a life narrative to provide insights into methods of coping with the challenges of aging. To do this, in-depth interviews were conducted with 20 oldest-old adults (aged 88-98 years) recruited from the Australian Longitudinal Study of Ageing. Design, analysis, and interpretation of the study were informed by McAdams' life narrative theory, using concepts of redemption and contamination. Participants discussed their autobiographies and recounted significant life events. Interviews drew on McAdams' approach to elicit positive, negative, vivid, and turning point experiences. Analysis involved coding transcripts of the emergent personal narratives specifically to understand a "resilience story." This included data immersion and review of interview transcripts. Emergent codes were identified and discussed among the researchers. Although no contamination events were narrated, we identified the following themes: Adapting to aging-related physical challenges; Changing social networks; Continuity in sense of identity to maintain unity and life's purpose; and Redemptive capacity to cope positively with life challenges. This study fills a gap in knowledge on resilience from a personal perspective by the oldest old. Older people may benefit from interventions that harness positive coping strategies and foster social connections and meaningful activities, especially at times of loss or grief.

Does one size fit all? Assessing the preferences of older and younger people for attributes of quality of life.

PURPOSE: To systematically compare, via ranking and best worst tasks, the relative importance of key dimensions of quality of life for younger and older people. METHODS: A web-based survey was developed for administration to two Australia-wide community-based samples comprising younger people aged 18-64 years and older people aged 65 years and above. Respondents were asked to rank 12 quality of life dimensions. Respondents also completed a successive best worst task using the same 12 quality of life dimensions. RESULTS: The relative importance of the quality of life dimensions differed for younger and older person samples. For older people, the ability to be independent and to have control over their daily lives were particularly important for their overall quality of life whereas for younger people, mental health was considered most important. CONCLUSIONS: Many interventions accessed by older people in geriatric medicine and aged care sectors have a broader impact upon quality of life beyond health status. The findings from this study indicate that a focus on broader aspects of quality of life may also be consistent with the preferences of older people themselves as to what constitutes quality of life from their perspective.

Estimating the Years Lived With and Without Age-Related Sensory Impairment.

BACKGROUND: The aim of this study was to estimate the expected years lived with hearing impairment, vision impairment, and dual sensory impairment among older adults. METHODS: A total of 4,160 adults (45.1% men) from two Australian community based studies were followed for up to 16 years (average 8.9 years). Hearing impairment was defined by a pure-tone average (500-4000 Hz) greater than 25 dB in the better ear. Vision impairment was defined by presenting distance visual acuity worse than 6/12 (20/40). Postliminary analyses were also conducted for moderate levels of sensory impairment. Dual sensory impairment was defined by concurrent hearing and vision impairment. Multistate Markov models were used to calculate sensory life expectancies based on transition probabilities between health states (no sensory impairment, sensory impairment, and death). RESULTS: Based on thresholds for mild impairment, men aged 65 had a total life expectancy of 19.4 years, and were estimated to live for 10.4 years (95% confidence interval [CI]: 9.1, 11.7) with hearing impairment, 2.8 years (95% CI: 2.4, 3.2) with vision impairment, and 2.2 years (95% CI: 1.8, 2.6) with dual sensory impairment. Women aged 65 had a total life expectancy of 23.2 years, and were estimated to live for 12.9 years (95% CI: 11.9, 13.9) with hearing impairment, 3.9 years (95% CI: 3.4, 4.4) with vision impairment, and 3.2 years (95% CI: 2.7, 3.7) with dual sensory impairment. CONCLUSIONS: In addition to being highly prevalent, hearing and vision impairment affect older adults for substantial periods of their remaining life. Given their broad ranging impacts on health and well-being, sensory impairments are ideal targets for strategies to compress morbidity in late life.

Hypertension, antihypertensive treatment and cancer incidence and mortality: a pooled collaborative analysis of 12 Australian and New Zealand cohorts.

BACKGROUND: Observational studies examining associations between hypertension and cancer are inconsistent. We explored the association of hypertension, graded hypertension and antihypertensive treatment with cancer incidence and mortality. METHOD: Eighty-six thousand five hundred and ninety-three participants from the Australian and New Zealand Diabetes and Cancer Collaboration were linked to the National Death Index and Australian Cancer Database. Cox proportional hazards models estimated hazard ratios and 95% confidence intervals (95% CI) for the association of treated and untreated hypertension with cancer incidence and mortality. RESULTS: Over a median follow-up of 15.1 years, 12 070 incident and 4350 fatal cancers were identified. Untreated and treated hypertension, compared with normotension, were associated with an increased risk for cancer incidence [hazard ratio 1.06, 95% CI (1.00-1.11) and 1.09 (1.02-1.16) respectively], and cancer mortality (1.07, 0.98-1.18) and (1.15, 1.03-1.28), respectively. When compared with untreated hypertension, treated hypertension did not have a significantly greater risk for cancer incidence (1.03, 0.97-1.10) or mortality (1.07, 0.97-1.19). A significant dose-response relationship was observed between graded hypertension and cancer incidence and mortality; Ptrend = 0.053 and Ptrend = 0.001, respectively. When stratified by treatment status, these relationships remained significant in untreated, but not in treated, hypertension. CONCLUSION: Hypertension, both treated and untreated, is associated with a modest increased risk for cancer incidence and mortality. Similar risks in treated and untreated hypertension suggest that the increased cancer risk is not explained by the use of antihypertensive treatment.

Cohort Profile: The Australian Longitudinal Study of Ageing (ALSA).

In response to the expressed need for more sophisticated and multidisciplinary data concerning ageing of the Australian population, the Australian Longitudinal Study of Ageing (ALSA) was established some two decades ago in Adelaide, South Australia. At Baseline in 1992, 2087 participants living in the community or in residential care (ranging in age from 65 to 103 years) were interviewed in their place of residence (1031 or 49% women), including 565 couples. By 2013, 12 Waves had been completed; both face-to-face and telephone personal interviews were conducted. Data collected included self-reports of demographic details, health, depression, morbid conditions, hospitalization, gross mobility, physical performance, activities of daily living, lifestyle activities, social resources, exercise, education and income. Objective performance data for physical and cognitive function were also collected. The ALSA data are held at the Flinders Centre for Ageing Studies, Flinders University. Procedures for data access, information on collaborations, publications and other details can be found at [http://flinders.edu.au/sabs/fcas/].

Do dietary patterns in older age influence the development of cancer and cardiovascular disease: A longitudinal study of ageing.

BACKGROUND: The association between diet and cancer, and diet and cardiovascular disease (CVD) is well established in younger adults, however limited evidence exists to demonstrate that these associations persist for older adults, particularly in the context of dietary patterns. AIMS: To investigate whether the dominant dietary patterns identified in a cohort of older adults are predictive of cancer or CVD development. METHODS: This study was a secondary analysis of data from the Australian Longitudinal Study of Ageing (ALSA). The ALSA is a multi-dimensional population based study of human ageing which commenced in 1992 with 2087 participants aged 65 years or more. Data from a 170-item food frequency questionnaire administered at baseline in 1992 to 1034 older adults free from cancer and CVD was explored using factor analysis to identify dominant dietary patterns, being those patterns which comprise foods commonly consumed by the sample. Pooled logistic regression from data available at baseline, 2 and 8 years of follow-up was used to determine whether any associations existed between dietary patterns and development of or death from cancer or CVD. RESULTS: Five dominant dietary patterns were identified and labelled 'discretionary choices and breads and cereals', 'vegetable and fruit', 'white meat and milk products', 'breads and cereals, sweet bakery goods and milk products' and 'red meat and protein alternatives'. None of the dominant dietary patterns demonstrated a significant overall trend for the development of or death from cancer or CVD with the exception of the 'red meat and protein alternatives' pattern where an increased risk of cancer development or death was observed with adjustment for age, gender, smoking, overweight and obesity and total number of comorbidities (tertile 2: OR 1.46, 95% CI 1.03-2.07; tertile 3: OR 1.28, 95% CI 0.87-1.90). CONCLUSIONS: These results suggest that the development of or death from cancer and CVD may be independent of most dietary patterns in those who are free of either condition at age 70 years or older. Importantly, there was an association observed between the 'red meat and protein alternatives' pattern and cancer development and death. If these findings are confirmed then dietary guidelines for older adults may require further revision.

Trajectories of depressive symptoms in old age: Integrating age-, pathology-, and mortality-related changes.

Late life involves a variety of different challenges to well-being. This study extends and qualifies propositions drawn from the paradox of well-being in aging using 15-year longitudinal data on depressive symptoms from old and very old participants in the Australian Longitudinal Study of Ageing (Baseline N = 2,087; Mage = 78.69 years; range: 65-103 years; 49.40% women). We first examined age-related trajectories in depressive symptoms from young-old to oldest-old, taking into account (changes in) relevant correlates, pathology, and mortality; and, second, we investigated gender differences in these trajectories. Results revealed that age-related trajectories of depressive symptoms were predictive of mortality hazards. The unique predictive effects of both level of, and change in, depressive symptoms were independent of one another and held after taking into account education as well as changes in marital status, living arrangements, cognitive function, and illness burden. In addition, results indicated that depressive symptoms were elevated among participants suffering from arthritis, and increased with age more markedly in men than in women. In particular, the significant Age × Gender interaction indicated that the gender gap in depressive symptoms reduced from young-old to old-old and reversed in very old age when men showed more depressive symptoms than women. Qualifying the paradox of well-being in aging, findings demonstrated that depressive symptoms increased from young-old to oldest-old and suggest that age-, pathology-, and mortality-related changes should be examined in concert to advance our understanding of individual differences in depressive symptom trajectories in late life.

Sense of purpose as a psychological resource for aging well.

Having a sense of purpose is recognized as an important resource for maintaining health and well-being over the life span. We examined associations of individual differences in sense of purpose with levels and rates of change in indices of aging well (health, cognition, and depressive symptoms) in a sample of 1,475 older adults (Mage = 77.06 years, SD = 6.27; 50% female) assessed on up to 6 occasions over 18 years. We also conducted survival analysis to examine associations of purpose with longevity. We hypothesized that a higher sense of purpose would be associated with better performance on the aging well measures, and that those with a higher sense of purpose would show shallower declines in aging well over time. Results indicated that participants who scored higher on sense of purpose reported lower levels of functional disability, performed better on cognitive tests (episodic memory and speed of processing), and reported better self-rated health and fewer depressive symptoms. Sense of purpose was not associated with individual differences in rates of change in the aging well indices with the exception of speed of processing, for which a higher sense of purpose was associated with marginally shallower rates of decline. Higher sense of purpose was also associated with increased probability of survival, although this association became weaker over time. The findings support the notion that purposeful living contributes to health and well-being. At the same time, higher sense of purpose may not buffer against more pervasive losses in health that become more common in oldest-old adulthood.