PTSD Symptoms, Daily Subjective Age, and Psychological Distress in Community-Dwelling Older Adults

GeroPsych ◽  
2021 ◽  
pp. 1-10
Author(s):  
Yaakov Hoffman ◽  
Amit Shrira ◽  
Ehud Bodner

Abstract. This study had three goals: (1) to address daily links between subjective age and the three psychological distress facets (depression/anxiety/somatization); (2) to examine whether such links would be stronger under higher posttraumatic stress disorder (PTSD) levels; (3) to assess which PTSD cluster is most relevant. The sample (168 community-dwelling-older-adults, mean age = 73.48, 46% female) completed an online, web-based questionnaire across 14 consecutive days. Results show that on the days participants felt older, they reported higher psychological distress, which was further exacerbated by higher PTSD levels. The PTSD cluster of intrusive thoughts was most relevant. The discussion addresses the “double-burden” view, two theories of subjective age (resource/stress vs. ageism), and finally interventions for daily psychological distress reduction amongst older adults.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 271-271
Author(s):  
Yuxiao Li ◽  
Minhui Liu ◽  
Christina Miyawaki ◽  
Xiaocao Sun ◽  
Tianxue Hou ◽  
...  

Abstract Frailty is a clinical syndrome that becomes increasingly common as people age. Subjective age refers to how young or old individuals experience themselves to be. It is associated with many risk factors of frailty, such as increased depression, worse cognitive function, and poorer psychological wellbeing. In this study, we examined the relationship between subjective age and frailty using the 2011-2015 waves of the National Health and Aging Trends Study. Participants were community-dwelling older adults without frailty in the initial wave (N=1,165). Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the Fried five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust=0, pre-frail=1 or 2; frail=3 or more criteria met. Participants were, on average, 74.1±6.5 years old, female (52%), and non-Hispanic White (81%). Eighty-five percent of the participants felt younger, and 3% felt older than their chronological age, but 41% of them were pre-frail/frail. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95%CI= 1.01, 1.01-1.02). In contrast, frailty predicted an “older” subjective age (OR, 95%CI= 2.97, 1.65-5.35) adjusting for demographics and health conditions. These findings suggest a bidirectional relationship between subjective age and frailty. Older people who feel younger than their chronological age are at reduced risk of becoming pre-frail/frail. Intervention programs to delay frailty progression should include strategies that may help older adults perceive a younger subjective age.


2017 ◽  
Vol 38 (5) ◽  
pp. 599-616 ◽  
Author(s):  
Szu-Hsuan Lin ◽  
Omolola E. Adepoju ◽  
Bita A. Kash ◽  
Bethany DeSalvo ◽  
Darcy K. McMaughan

In this study, we explored whether psychological distress plays a role in the use of recommended clinical preventive services among community-dwelling older adults. The sample is drawn from respondents 65 years and older who participated in the 2011 Medical Expenditure Panel Survey (MEPS). Logistic regressions with selected covariates were entered in the model to estimate odds ratios (OR) with 95% confidence interval (CI) for the independent effect of psychological distress on the utilization of each of five preventive services. With the exception of breast cancer screening where the uptake of preventive services was significantly lower for older adults with psychological distress (OR = 0.57, p < .001), uptake of other key preventive measures revealed no significant utilization differences between older adults with and without psychological distress. The results suggest that adherence to breast cancer screening guidelines may be increased by improving recognition and treatment of emotional health problems in older women.


2021 ◽  
Author(s):  
Lean L. Kramer ◽  
Lex van Velsen ◽  
Jenna L. Clark ◽  
Bob C. Mulder ◽  
Emely de Vet

BACKGROUND Embodied conversational agents (ECAs) have been proposed as a promising interaction modality for the delivery of programs focused on promoting lifestyle changes. However, it is not understood which factors influence use of an ECA and their health effects. OBJECTIVE We aim to (1) identify whether ECAs can persuade community-dwelling older adults to change their dietary behavior and whether ECAs use can decrease loneliness, (2) test these pathways to effects, and (3) understand the use of an ECA. METHODS The web-based eHealth app PACO is a fully automated 8-week intervention in which 2 ECAs engage older adults in dialogue to motivate them to change their dietary behavior and decrease their loneliness. PACO was developed via a human-centered and stakeholder-inclusive design approach and incorporates Self-determination Theory and various behavior change techniques For this study, an unblinded web-based randomized controlled trial was conducted. Participants were recruited via social media, an online panel, flyers and advertorials. The intervention group received access to the PACO service for eight weeks. The waitlist group received PACO after waiting for four weeks. The primary outcomes, eating behavior and loneliness, were assessed via self-assesed online questionnaires at intake, waitlist, after 4 weeks, and after eight weeks. In addition, the primary outcome—use—was assessed via data logs. Secondary outcomes were measured at the same times, via questionnaires or an optional interview. RESULTS In total, 32 participants completed the intervention. We found a significant correlation between use in minutes on the one hand, and perceived usefulness (r = .39, P =.030) and enjoyment on the other (r = .38, P = .032). However, these did not predict use in the full regression model (F(2,29) = 1.98, P = .16, R2 = .12). Additionally, PACO use did not lead to improvements in eating behavior (χ2(2) = .34, = .85) or a decrease in loneliness (χ2(2) = .02, = .99). CONCLUSIONS Our study did not provide any concluding evidence about factors that are linked to the use or health effects of ECAs. Future service design could benefit from either creating a functional design catered towards the predominant stage of the targeted population, or by personalizing the service based on an intake in which the end-user’s stage is determined. CLINICALTRIAL ClinicalTrials.gov NCT04510883; https://clinicaltrials.gov/ct2/show/NCT04510883 INTERNATIONAL REGISTERED REPORT RR2-10.2196/22186


2021 ◽  
Author(s):  
Claudia Pischke ◽  
Claudia Voelcker-Rehage ◽  
Tiara Ratz ◽  
Manuela Peters ◽  
Christoph Buck ◽  
...  

BACKGROUND Despite the crucial role of regular physical activity (PA) for preventing chronic non-communicable diseases, fewer than half of older adults in Germany engage in the recommended levels of endurance training. OBJECTIVE The aim of this study was to compare acceptance and effectiveness of two interventions (web- vs. print-based) for PA promotion among initially inactive community-dwelling older adults aged 60 years and above in a nine-month randomized trial with a cross-over design. METHODS Participants were recruited offline and randomized to one of the following interventions for self-monitoring PA: (a) a print-based intervention (PRINT n=113), (b) a web-based intervention (WEB, n=129). Thirty percent (n=38) of those in group (b) received a PA tracker in addition to WEB (WEB+, (c)). After randomization, participants and researchers were not blinded. Participants’ intervention preferences at baseline were assessed retrospectively. All intervention groups were offered ten weekly face-to-face group sessions led by trained assistants. Afterwards, participants could choose to stay in their group or cross over to one of the other groups and group sessions were continued monthly for another six months. Three-dimensional accelerometers to assess PA and sedentary behavior (SB) at baseline (T0), three-month (T1) and nine-month follow-ups (T2) were employed. Adherence to PA recommendations, attendance of group sessions, and acceptance of the interventions were assessed via self-administered paper-based questionnaires. Linear mixed models were used to calculate differences in moderate-to-vigorous PA (MVPA) and SB between time points and intervention groups. RESULTS One-hundred and ninety-five participants completed T1. Only n=1 changed from WEB to PRINT and n=15 moved from PRINT to WEB (WEB-WEB: n=103, PRINT-PRINT: n=76) when offered to cross over at T1. One-hundred and sixty participants completed T2. MVPA in min per day increased between baseline and T1, but these within-group changes in time disappeared after adjusting for covariates. MVPA decreased by 9 min per day between baseline and T2 (βtime = -9.37, 95% CI: [-18.58; -0.16]), regardless of intervention group (WEB vs. PRINT: βgroup*time = -3.76, 95% CI: [-13.33; 5.82], WEB+ vs. PRINT: βgroup*time = 1.40, 95% CI: [-11.04; 13.83]). Nineteen percent of the participants met PA recommendations at T0, 20% at T1, and 20% at T2. For SB, there were no significant group differences and group-by-time interactions, neither at T1 nor at T2. Intervention acceptance was generally high. Use of intervention material was high to moderate at T1 (e.g., the PA diary was used by over 65% at least once a week) and decreased by T2 (40-50% in PRINT and in WEB used the PA diary at least once a week, and 58% in WEB+). CONCLUSIONS Despite high levels of acceptance of web- and print-based interventions for PA promotion and little movement between groups at T1, when given the choice, participation was not associated with increases in PA or decreases in SB over time. CLINICALTRIAL German Clinical Trials Register DRKS00016073 (Date of registration 10–01-2019).


2002 ◽  
Vol 50 (3) ◽  
pp. 489-495 ◽  
Author(s):  
Hillary R. Bogner ◽  
Joseph J. Gallo ◽  
Mary D. Sammel ◽  
Daniel E. Ford ◽  
Haroutune K. Armenian ◽  
...  

10.2196/22186 ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. e22186
Author(s):  
Lean L Kramer ◽  
Bob C Mulder ◽  
Lex van Velsen ◽  
Emely de Vet

Background An unhealthy eating pattern and loneliness negatively influence quality of life in older age. Embodied conversational agents (ECAs) are a promising way to address these health behaviors in an engaging manner. Objective We aim to (1) identify whether ECAs can persuade community-dwelling older adults to change their dietary behavior and whether ECA use can decrease loneliness, (2) test these pathways to effects, and (3) understand the use of an ECA. Methods The web-based eHealth app PACO is a fully automated 8-week intervention in which 2 ECAs engage older adults in dialogue to motivate them to change their dietary behavior and decrease their loneliness. PACO was developed via a human-centered and stakeholder-inclusive design approach and incorporates Self-determination Theory and various behavior change techniques. For this study, an unblinded randomized controlled trial will be performed. There will be 2 cohorts, with 30 participants per cohort. Participants in the first cohort will immediately receive the PACO app for 8 weeks, while participants in the second cohort receive the PACO app after a waiting-list condition of 4 weeks. Participants will be recruited via social media, an online panel, flyers, and advertorials. To be eligible, participants must be at least 65 years of age, must not be in paid employment, and must live alone independently at home. Primary outcomes will be self-assessed via online questionnaires at intake, control, after 4 weeks, and after 8 weeks, and will include eating behavior and loneliness. In addition, the primary outcome—use—will be measured via data logs. Secondary outcomes will be measured at the same junctures, via either validated, self-assessed, online questionnaires or an optional interview. Results As of July 2020, we have begun recruiting participants. Conclusions By unraveling the mechanisms behind the use of a web-based intervention with ECAs, we hope to gain a fine-grained understanding of both the effectiveness and the use of ECAs in the health context. Trial Registration ClinicalTrials.gov NCT04510883; https://clinicaltrials.gov/ct2/show/NCT04510883 International Registered Report Identifier (IRRID) PRR1-10.2196/22186


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