Executive functioning independently predicts self-rated health and improvement in self-rated health over time among community-dwelling older adults.

OBJECTIVES: Self-rated health, as distinct from objective measures of health, is a clinically informative metric among older adults. The purpose of our study was to examine the cognitive and psychosocial factors associated with self-rated health. METHODS: 624 participants over the age of 60 were assessed at baseline, and of these, 510 were contacted for a follow-up two years later. Measures of executive function and self-rated health were assessed at baseline, and self-rated health was assessed at follow-up. We employed multiple linear regression analyses to investigate the relationship between executive functioning and self-rated health, while controlling for demographic, psychosocial and biological variables. RESULTS: Controlling for other relevant variables, executive functioning independently and solely predicted self-rated health, both at a cross-sectional level, and also over time. Loneliness was also found to cross-sectionally predict self-rated health, although this relationship was not present at a longitudinal level. CONCLUSION: Older adults' self-rated health may be related to their executive functioning and to their loneliness. Self-rated health appeared to improve over time, and the extent of this improvement was also related to executive functioning at baseline. Self-rated health may be a judgement made of one's functioning, especially executive functioning, which changes with age and therefore may be particularly salient in the reflections of older adults.

A shared mealtime approach to improving social and nutritional functioning among older adults living alone: study protocol for a randomized controlled trial.

BACKGROUND: Older adults living alone are at increased risk of malnutrition as well as social isolation. Previous research has evaluated psychosocial interventions aimed at improving social support for older adults living alone. One meta-analysis in particular has suggested that multimodal psychosocial interventions are more effective than unimodal interventions. As such, it may be more effective to deliver an intervention which combines nutritional and social support together. Consequently, we designed the RelAte intervention, which focuses on shared mealtimes as a source of combined social and nutritional support for older adults living alone who are at risk of social isolation. OBJECTIVE: The objective of the RelAte trial was to evaluate the impact of such an intervention on energy intake, anthropometric measurements, and nutritional social cognitive variables among older adults living alone in the community. METHODS: There are 100 participants that will be recruited and randomized to either the treatment (n=50) or the control group. The treatment group will receive a visit from a trained peer volunteer once weekly for a period of 8 weeks. Outcomes of interest include: energy intake, social cognitive factors related to diet, abdominal circumference, body mass index, psychosocial well-being, frailty, nutritional status, and health utilities. Outcomes will be obtained at baseline, immediately postintervention (8 weeks after baseline), 12-week follow-up, and 26-week follow-up by assessors blinded to participants' randomized assignment. RESULTS: The Relate trial is currently active. We are currently at data analysis stage. The study started in June 2013 and will run until June 2015. CONCLUSIONS: Results from this study will primarily describe the effectiveness of a shared mealtime intervention for older adults living alone in terms of their dietary well-being, physical health, and psychosocial well-being. TRIAL REGISTRATION: Clinicaltrials.gov NCT02007551; http://clinicaltrials.gov/ct2/show/NCT00102401 (Archived by WebCite at http://www.webcitation/6WptuVTtz).

Perceived stress mediates the relationship between emotional loneliness and sleep quality over time in older adults.

OBJECTIVE: Both loneliness and poor sleep quality are common occurrences in late life and both are detrimental to physical and mental health. While loneliness may be difficult to intervene upon, there may be correlated factors, which, if alleviated, could mitigate the effects of loneliness and sleep quality on health in late life. DESIGN: A longitudinal, observational study whereby we gathered predictive variables at baseline and dependent variable (sleep) at follow-up. METHOD: We investigated the relationship between loneliness at baseline and sleep quality at follow-up in a group of 447 older adults attending the clinic for research participation. Loneliness, stress and sleep quality were all measured using self-report validated psychometric tools. RESULTS: We found that loneliness, specifically emotional loneliness, predicted sleep quality at follow-up, controlling for demographic factors and for sleep quality at baseline. Upon applying mediation methods to the data, we then found that this relationship was mediated in part by perceived stress. CONCLUSION: We conclude that the impact of emotional loneliness on sleep quality in older adults is partly because of the stress experienced as a result of feeling lonely.

Perceived health status is associated with hours of exercise per week in older adults independent of physical health.

BACKGROUND: Perceived health status does not always reflect actual health status. We investigated the association between objective and self-rated measures of health status and hours of exercise per week in older adults. METHOD: As part of the TRIL clinic assessment, we gathered information from 473 community dwelling adults over the age of 65, regarding hours spent per week exercising, depression, personality, perceived health status, and objective health status (in the form of a comorbidity count). Regression analyses were performed on these data to investigate whether perceived health status, objective health status, personality and mood are associated with hours of exercise per week. RESULTS: Perceived and objective health status were significantly but weakly correlated. Both perceived and objective health status, as well as depression, were independently associated with hours of exercise per week. CONCLUSIONS: We conclude that exercise uptake in older adults is contingent on both perceived and objective health status, as well as depression. Perceived health status has a stronger association with exercise uptake in older adults with lower depression levels. The current findings have implications for designing exercise interventions for older adults.

Teleconferencing as a source of social support for older spousal caregivers: initial explorations and recommendations for future research.

Teleconferencing is increasingly being used as a medium of delivering social support for dementia caregivers. Further direction is required from pilot studies before the optimal clinical service can be delivered. Following a 6-week pilot support group for spousal caregivers, delivered via teleconferencing software, we interviewed 8 participants for their feedback. Semi-structured interviews were conducted and analyzed using grounded theory analysis. Themes of "group processes" and "barriers," containing subcategories of "functions of the group," "responsibilities of facilitators," and "barriers to communication" were discussed. According to caregivers, successful teleconferencing support groups should acknowledge the caregiver as the dementia expert, allow participants to meet before the deployment of the support group, provide active facilitation and leadership via the researcher, employ user-friendly technologies, and facilitate for the group to self-maintain following the pilot deployment period. These issues should be taken into consideration when designing future teleconferencing applications for caregivers.

Orthostatic hypotension and subjective sleep quality in older people.

Poor sleep quality and orthostatic hypotension are common complaints in an older population, and both are related to factors such as polypharmacy and depression. However, it is not known whether there is a direct association between the two. Our objective is to investigate a potential association between orthostatic blood pressure response and subjective sleep quality in older people. A within-subjects, cross-sectional design embedded in a larger longitudinal study design. Participants were recruited from the community to visit the TRIL clinic at St James's Hospital, where they underwent a structured medical and psychosocial assessment. A total of 505 community dwelling adults aged 60+ (321 females, mean age 72.44) were participated in this study. Orthostatic blood pressure responses were recorded during an active stand using Finometer equipment, and health-related factors such as pain ratings, co-morbidities, polypharmacy, timed up and go, Mini-Mental State Examination score, body mass index, as well as depression, anxiety, age and gender, were also recorded. Self-reported sleep quality was also assessed using the Pittsburgh Sleep Quality Index. The results showed that timed up and go, polypharmacy, depression, anxiety, gender and delayed recovery of blood pressure at orthostasis were associated with subjective poor sleep quality. There is an association between subjective sleep quality and delayed recovery of blood pressure at orthostasis, independent of mental health or polypharmacy effects, in older adults. This link may have implications for the management of sleep disorders in older people.

Exercise and social support are associated with psychological distress outcomes in a population of community-dwelling older adults.

Exercise reduces the likelihood of psychological distress, but this may be due to incidental socializing. We gathered information on exercise, social support and three aspects of psychological distress from 583 community-dwelling older adults. Exercise and social support from friends were both associated with lower scores of depression, anxiety and perceived stress. For infrequent exercisers, having a low level of social support indicated higher levels of depression, whereas for frequent exercisers, having a low level of social support did not affect depression levels. Both exercise and social support have roles in regulating psychological well-being in older populations and exercisers are less susceptible to effects of low social support on depression.

Psychological distress as a key component of psychosocial functioning in community-dwelling older people.

OBJECTIVES: To explore the key components representative of measures of psychosocial functioning with a focus on identifying the constituents of psychological distress in an Irish sample of community-dwelling older adults and to examine the relationship between these components and health outcomes such as frailty. METHOD: Cross-sectional observational study at the Technology Research for Independent Living (TRIL) Clinic, a comprehensive geriatric assessment facility in St. James's Hospital, Dublin. In this study, 579 participants were given eight primary assessments (Centre for Epidemiological Studies of Depression, Geriatric Adverse Life Events Scale, Pittsburgh Sleep Quality Index, De Jong-Gierveld Scale, Practitioner Assessment of Network Type, Eysenck Personality Inventory, Hospital Anxiety and Depression Scale, Lubben Social Network Scale) and a broad range of health and demographic secondary assessments. Principal factor analysis identified the core components relating to psychosocial functioning. Following this, the regression factors of these components were correlated with health outcomes. RESULTS: The first of three components identified accounted for 9.08% of the variance and related to a core internal component of psychological distress. The two other components related to external and physiological functioning, specifically social support networks and sleep. Spearman's Rho correlations indicated significant associations of walking speed, age, Berg Balance Scale and living alone with all three components. Additionally, the core component of psychological distress significantly correlated with the Fried Frailty Index, illness co-morbidity, ADL, IADL and nutrition. CONCLUSION: These results characterise the variation in psychosocial functioning in older adults and identifies psychological distress as a core facet of psychosocial functioning which has associations with frailty.

The sound of the crowd: auditory information modulates the perceived emotion of a crowd based on bodily expressions.

Although both auditory and visual information can influence the perceived emotion of an individual, how these modalities contribute to the perceived emotion of a crowd of characters was hitherto unknown. Here, we manipulated the ambiguity of the emotion of either a visual or auditory crowd of characters by varying the proportions of characters expressing one of two emotional states. Using an intersensory bias paradigm, unambiguous emotional information from an unattended modality was presented while participants determined the emotion of a crowd in an attended, but different, modality. We found that emotional information in an unattended modality can disambiguate the perceived emotion of a crowd. Moreover, the size of the crowd had little effect on these crossmodal influences. The role of audiovisual information appears to be similar in perceiving emotion from individuals or crowds. Our findings provide novel insights into the role of multisensory influences on the perception of social information from crowds of individuals.

Perceiving emotion in crowds: the role of dynamic body postures on the perception of emotion in crowded scenes.

Although the perception of emotion in individuals is an important social skill, very little is known about how emotion is determined from a crowd of individuals. We investigated the perception of emotion in scenes of crowds populated by dynamic characters each expressing an emotion. Facial expressions were masked in these characters and emotion was conveyed using body motion and posture only. We systematically varied the proportion of characters in each scene depicting one of two emotions and participants were required to categorise the overall emotion of the crowd. In Experiment 1, we found that the perception of emotions in a crowd is efficient even with relatively brief exposures of the crowd stimuli. Furthermore, the emotion of a crowd was generally determined by the relative proportions of characters conveying it, although we also found that some emotions dominated perception. In Experiment 2, we found that an increase in crowd size was not associated with a relative decrease in the efficiency with which the emotion was categorised. Our findings suggest that body motion is an important social cue in perceiving the emotion of crowds and have implications for our understanding of how we perceive social information from groups.