Social support as a mediator in the relation between functional status and quality of life in older adults.

We explored possible paths from physical and mental health-related quality of life, self-efficacy, optimism, and social support to happiness in older adults, considering hedonic balance and life satisfaction as mediators. A total of 154 Spanish male and female (50%) older adults (65–96 years old, M = 77.44, SD = 8.03; 64% noninstitutionalized elderly) voluntarily participated in this correlational, cross-sectional study. The participants completed self-reports on their perceived health status, self-efficacy, social support, optimism, and global subjective well-being (SWB) as well as its dimensions. Path analysis was used to examine direct and indirect relationships. The final model had an excellent fit with the data (χ2(10) = 11.837, p = 0.296, χ2/df = 1.184; SRMR = 0.050, CFI = 0.994, RMSEA = 0.035), revealing the unique causal effects of all the included predictors on happiness. With the exception of self-efficacy, the psychosocial resources predicted older adults’ current happiness, and this relationship was fully mediated by hedonic balance and life satisfaction, which were found to be putative intermediary factors for SWB. Self-efficacy in turn predicted the remaining psychosocial resources. Our findings extend the existing evidence on the influences of health-related quality of life, self-efficacy, optimism, and social support on SWB. Furthermore, they support the proposal of hedonic balance and life satisfaction as dimensions of SWB, thus supporting the tripartite hierarchical model of happiness. These results may inform future interventions seeking to improve happiness in late adulthood.

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Quality of life in older adults receiving hemodialysis: a qualitative study

Quality of Life Research ◽

10.1007/s11136-019-02349-9 ◽

2019 ◽

Vol 29 (3) ◽

pp. 655-663 ◽

Cited By ~ 1

Author(s):

Rasheeda K. Hall ◽

Michael P. Cary ◽

Tiffany R. Washington ◽

Cathleen S. Colón-Emeric

Keyword(s):

Quality Of Life ◽

Social Support ◽

Older Adults ◽

Qualitative Study ◽

Symptom Control ◽

Well Being ◽

World Health ◽

World Health Organization Quality ◽

Frailty Status

Abstract Purpose Patient priorities for quality of life change with age. We conducted a qualitative study to identify quality of life themes of importance to older adults receiving dialysis and the extent to which these are represented in existing quality of life instruments. Methods We conducted semi-structured interviews with 12 adults aged ≥ 75 years receiving hemodialysis to elicit participant perspectives on what matters most to them in life. We used framework analysis methodology to process interview transcripts (coding, charting, and mapping), identify major themes, and compare these themes by participant frailty status. We examined for representation of our study’s subthemes in the Kidney Disease Quality of Life (KDQOL-36) and the World Health Organization Quality of Life for Older Adults (WHOQOL-OLD) instruments. Results Among the 12 participants, average age was 81 (4.2) years, 7 African-American, 6 women, and 6 met frailty criteria. We identified two major quality of life themes: (1) having physical well-being (subthemes: being able to do things independently, having symptom control, maintaining physical health, and being alive) and (2) having social support (subthemes: having practical social support, emotional social support, and socialization). Perspectives on the subthemes often varied by frailty status. For example, being alive meant surviving from day-to-day for frail participants, but included a desire for new life experiences for non-frail participants. The majority of the subthemes did not correspond with domains in the KDQOL-36 and WHOQOL-OLD instruments. Conclusion Novel instruments are likely needed to elicit the dominant themes of having physical well-being and having social support identified by older adults receiving dialysis.

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Predictors of change over time in subjective daytime sleepiness among older adult recipients of long-term services and supports

International Psychogeriatrics ◽

10.1017/s1041610220000782 ◽

2020 ◽

Vol 32 (7) ◽

pp. 849-861

Author(s):

Darina V. Petrovsky ◽

Karen B. Hirschman ◽

Miranda Varrasse McPhillips ◽

Justine S. Sefcik ◽

Alexandra L. Hanlon ◽

...

Keyword(s):

Quality Of Life ◽

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Daytime Sleepiness ◽

Daily Living ◽

Services And Supports ◽

Over Time

ABSTRACTObjectives:Daytime sleepiness is associated with multiple negative outcomes in older adults receiving long-term services and supports (LTSS) including reduced cognitive performance, need for greater assistance with activities of daily living and decreased social engagement. The purpose of this study was to identify predictors of change in subjective daytime sleepiness among older adults during their first 2 years of receiving LTSS.Design and Setting:Secondary analysis of data from a prospective longitudinal study of older adults who received LTSS in their homes, assisted living communities or nursing homes interviewed at baseline and every 3 months for 24 months.Participants:470 older adults (60 years and older) newly enrolled in LTSS (mean = 81, SD = 8.7; range 60–98; 71% women).Measurements:Subjective daytime sleepiness was assessed every 3 months through 2 years using the Epworth Sleepiness Scale. Multiple validated measures were used to capture health-related quality of life characteristics of enrollees and their environment, including symptom status (Symptom Bother Scale), cognition (Mini Mental Status Exam), physical function (Basic Activities of Daily Living), physical and mental general health, quality of life (Dementia Quality of Life, D-QoL), depressive symptoms (Geriatric Depression Scale) and social support (Medical Outcomes Survey-Social Support).Results:Longitudinal mixed effects modeling was used to examine the relationship between independent variables and continuous measure of daytime sleepiness. Increased feelings of belonging, subscale of the D-QoL (effect size = −0.006, 95% CI: −0.013 to −0.0001, p = 0.045) and higher number of depressive symptoms (effect size = −0.002, 95% CI: −0.004 to −0.001, p = 0.001) at baseline were associated with slower rates of increase in daytime sleepiness over time.Conclusions:Comprehensive baseline and longitudinal screening for changes in daytime sleepiness along with depression and perceived quality of life should be used to inform interventions aimed at reducing daytime sleepiness among older adults receiving LTSS.

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Association of social support, functional status, and psychological variables with changes in health-related quality of life outcomes in patients with colorectal cancer

Psycho-Oncology ◽

10.1002/pon.4022 ◽

2015 ◽

Vol 25 (8) ◽

pp. 891-897 ◽

Cited By ~ 20

Author(s):

M. Gonzalez-Saenz de Tejada ◽

A. Bilbao ◽

M. Baré ◽

E. Briones ◽

C. Sarasqueta ◽

...

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Social Support ◽

Functional Status ◽

Health Related Quality ◽

Life Outcomes ◽

Psychological Variables ◽

Related Quality ◽

Health Related

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The Influence of Social Support and Coping on Quality of Life Among Elderly With Age-Related Hearing Loss

American Journal of Audiology ◽

10.1044/2017_aja-16-0083 ◽

2017 ◽

Vol 26 (2) ◽

pp. 170-179 ◽

Cited By ~ 6

Author(s):

Sarah Moser ◽

Wolfgang Luxenberger ◽

Wolfgang Freidl

Keyword(s):

Quality Of Life ◽

Social Support ◽

Older Adults ◽

Hearing Loss ◽

Perceived Social Support ◽

World Health ◽

Age Related ◽

Health Organization ◽

Age Related Hearing Loss

Purpose The consequences of hearing loss hinder the everyday life of older adults and are associated with reduced well-being. The research aim was to explore the influence of hearing problems, various coping strategies, and perceived social support on quality of life. Method Sixty-five older adults with age-related hearing loss (≥55 years) in Austria participated and completed a paper–pencil survey with standardized questionnaires: Hearing Handicap Inventory for the Elderly (Ventry and Weinstein, 1982), Assessment for Coping and Stress (Laireiter, 1997), short form of the Social Support Questionnaire (Fydrich, Sommer, Tydecks, & Brähler, 2009), and World Health Organization Quality of Life Scale–Brief Version (World Health Organization, 1996). Results Quality of life was predicted by perceived social support and the number of comorbid diseases (i.e., the physical, psychological, environmental, and social quality of life was better the greater the extent of perceived social support and poorer the more diseases from which the participants suffered). Conclusions Perceived social support may be a relevant factor to focus on in auditory rehabilitation programs, in particular, for participants who communicate little support in hearing-related situations and are, hence, at a relative disadvantage. The involvement of significant others in counseling could facilitate the everyday life for older adults with age-related hearing loss and their significant others.

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The association of polypharmacy with functional status impairment, frailty, and health-related quality of life in older adults with gastrointestinal malignancy: Results from the Cancer and Aging Resilience Evaluation (CARE) registry.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.118 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 118-118

Author(s):

Darryl Alan Outlaw ◽

Chen Dai ◽

Mustafa Al-Obaidi ◽

Smith Giri ◽

Smita Bhatia ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Activities Of Daily Living ◽

Functional Status ◽

Daily Living ◽

Cancer Type ◽

Health Related Quality ◽

Related Quality ◽

Health Related

118 Background: The majority of new cancer diagnoses occur in adults greater than 65 years of age. Polypharmacy is a common and potentially devastating problem amongst older adults; however, its prevalence and impact in older adults with gastrointestinal (GI) malignancy is poorly understood. Our objective was to examine the prevalence of polypharmacy and its association with functional status impairments, frailty, and health-related quality of life (HRQoL) in older adults with GI malignancy. Methods: The Cancer and Aging Resilience Evaluation (CARE) registry at the University of Alabama at Birmingham (UAB) is an ongoing prospective cohort study that uses a brief geriatric assessment (CARE survey) in older adults with cancer. We evaluated older adults diagnosed with GI malignancy prior to starting cancer therapy. Our primary outcomes of interest were functional status impairments, including dependence in activities of daily living (ADL) and instrumental activities of daily living (IADL), frailty (as defined by a frailty index derived using the principles of deficit accumulation), and HRQoL (assessed via PROMIS 10 global that includes physical and mental scores). Patients were dichotomized into those taking ≥9 vs. < 9 medications. Multivariable analyses examined associations between polypharmacy and the above-listed outcomes, adjusted for age, sex, race, cancer type, cancer stage, and comorbidities. Results: Overall, 357 patients met eligibility criteria; mean age: 70.1 years; primary diagnoses: colorectal (33.6%), pancreatic (24.6%), hepatobiliary (16.2%), gastroesophageal (10.9%), other (14.6%). Patients reported taking a mean of 6.2 medications: 27.7% with 0-3 medications, 48.2% with 4-8 medications, and 24.1% with ≥ 9 medications. Patients taking ≥ 9 medications were more likely to report limitations in ADL (adjusted odds ratio [aOR] 3.29, 95% CI 1.72-6.29) and IADL (aOR 2.86, 95% CI 1.59-5.14). Polypharmacy was also associated with frailty (aOR 3.06, 95% CI 1.73-5.41) and lower physical (aOR 2.82, 95% CI 1.70-4.69) and mental (aOR 1.73, 95% CI 1.03-2.91) HRQoL. Conclusions: Independent of comorbid conditions, polypharmacy was associated with functional status limitations, frailty, and reduced HRQoL in older adults with GI malignancy. Further study of specific medications and interactions is warranted in order to reduce the negative consequences of polypharmacy in this growing and vulnerable population.

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