Self-care among older adults: an analysis of the objective and subjective illness contexts.

OBJECTIVES: The authors hypothesize that older adults diagnosed with arthritis show a greater reliance on objective factors in their self-care behaviors, whereas those diagnosed with heart problems or hypertension demonstrate a greater reliance on more general belief-laden factors. METHODS: A total of 794 older adults (mean age = 69.3) who were professionally diagnosed with arthritis, heart problems, or hypertension completed a telephone survey about a number of aspects of their illness condition and their general well-being. RESULTS: The results from the hierarchical regression analyses indicate that objective factors and illness-specific beliefs are better predictors of self-care behavior in the arthritis group, whereas general beliefs (e.g., self-efficacy and general well-being) are better predictors of such behavior in the heart problems and hypertension groups. DISCUSSION: The analyses support the authors' hypothesis. The results are discussed in the context of expanding the Health Belief Model of self-care.

Self-reported medication adherence and health status in late adulthood: the role of beliefs.

In this study, we explore the role of subjective beliefs in determining self-reports of medication adherence and health status in 90 older adults (M age = 71.7 years, SD = 7.44). Self-reported adherence was predicted by personal health locus of control beliefs, but not by medical factors nor beliefs regarding one's own health care professionals. Self-reported health was predicted by medical factors, perceptions of one's health care professional, and health locus of control. These results suggest that self-reported adherence is primarily a belief-laden construct whereas self-reported health consists of both an objective assessment of health and a subjective belief-laden component. Exploratory analyses conducted on younger-old and older-old age groups indicated that medical factors may be less important to older-old adults' perceived health status than the younger-old adults.

Metacognition and medication adherence: how do older adults remember?

Fifty-one older adults (M age = 75.9 years, SD = 6.9) reported their use of memory strategies for taking of medication using the Prospective Memory for Medication Questionnaire. Older adults used internal strategies more often when the domain was restricted to medication taking but used external strategies more often when queried across a variety of everyday situations. Surprisingly, the hypothesis that medical factors would be the primary determinants of older adults' reports of memory strategy use and perceived adherence was not supported. Metamemorial variables of non-domain-specific memory self-efficacy and memory anxiety in everyday life were significant predictors of strategy use and perceived adherence over and above variables related to the domain of health.

Age differences in recall and predicting recall of action events and words.

Age differences in recall and prediction of recall were examined with different memory tasks. We asked 36 younger (19-28 yrs) and 36 older (60-81 yrs) women to provide both global and item-by-item predictions of their recall, and then to recall either (a) Subject Performance Tasks (SPTs), (b) verb-noun word-pairs memorized in list-like fashion (Word-Pairs), or (c) nonsense verb-noun word-pairs (Nonsense-Pairs) over three experimental trials. Based on previous research, we hypothesized that these tasks would vary in relative difficulty and flexibility of encoding. The results indicated that (a) age differences in global predictions (task specific self-efficacy) and recall performance across trials were minimized with SPT as compared with verbal materials, (b) global predictions were higher and more accurate for SPT as compared to verbal materials, and (c) item-by-item predictions were most accurate for materials encoded with the most flexibility (Nonsense Pairs). The results suggest that SPTs may provide some level of environmental support to reduce age differences in performance and task-specific self-efficacy, but that memory monitoring may depend on specific characteristics of the stimuli (i.e., flexibility of encoding) rather than their verbal or nonverbal nature.

Stability and accuracy of metamemory in adulthood and aging: a longitudinal analysis.

The stability and accuracy of memory perceptions in 2 longitudinal samples was examined. Sample 1 consisted of 231 adults (22-78 years) tested twice over 2 years. Sample 2 consisted of 234 adults (55-86 years) tested 3 times over 6 years. Measures of perceived and actual memory change were obtained. A primary focus was whether perceptions of memory change stem from application of an implicit theory about aging and memory or from accurate monitoring of actual changes in performance. Individual differences in metamemory were highly stable over time. Results suggested at least some accurate monitoring of memory in Sample 2, in which actual change was greatest. However the overall pattern of results is largely consistent with predictions derived from an implicit theory hypothesis.

Adult age differences in predicting memory performance: the effects of normative information and task experience.

Two experiments addressed the effects of task information and experience on younger and older adults' ability to predict their memory for words. The first study examined the effects of normative task information on subjects' predictions for 30-word lists across three trials. The second study looked at the effects of making predictions and recalling either an easy (15) or a difficult (45) word list prior to making predictions and recalling a moderately difficult (30) word list. The results from both studies showed that task information and experience affected subjects' predictions and that elderly adults predicted their performance more accurately than younger adults.

Short-term longitudinal change in cognitive performance in later life.

Changes in mean performance on memory, information processing, and intellectual ability tasks over a 3-year period were examined. The sample consisted of 328 community-dwelling men and women (from an original sample of 484 individuals) aged 55-86 years. Ss completed tasks yielding measures of verbal processing time, working memory, implicit memory, vocabulary, verbal fluency, world knowledge, reading comprehension, word recall, and text recall. The results showed significant average decline on working memory, verbal fluency, and world knowledge. There were also interactions for 2 processing time measures and working memory, showing greater decline in the earlier-born cohort group than in the later-born cohort group. A step-down analysis revealed that covarying declines in other variables, including processing time, did not eliminate significant declines in working memory, verbal fluency, and world knowledge.