Discordant Chronic Conditions and Depressive Symptoms: Longitudinal Associations Among Middle-Aged and Older Couples

Abstract Objectives Individuals often manage chronic conditions in middle and later life that may diminish well-being. Little is known, however, about discordant conditions (i.e., two or more conditions with competing self-management requirements) among older couples and their links to depressive symptoms. We considered discordant conditions at both the individual level and the couple level (i.e., between spouses), along with their long-term implications for depressive symptoms. Methods The U.S. sample included 1,116 middle-aged and older couples drawn from five waves (2006–2014) of the Health and Retirement Study. Longitudinal actor-partner interdependence models evaluated whether individual-level and couple-level discordant chronic health conditions were concurrently linked to depressive symptoms, and whether these associations became stronger over time. Models controlled for age, minority status, education, prior wave depressive symptoms, and each partner’s baseline report of negative marital quality and number of chronic conditions in each wave. Results Wives and husbands reported significantly greater depressive symptoms when they had individual-level discordant conditions about 2 years after baseline, and these links intensified over time. Beyond this association, husbands had significantly greater depressive symptoms when there were couple-level discordant conditions. Discussion Individual-level and couple-level discordant conditions may have lasting implications for depressive symptoms during midlife and older adulthood.

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DISCORDANT CHRONIC CONDITIONS AND DEPRESSIVE SYMPTOMS AMONG MIDDLE-AGED AND OLDER COUPLES

Innovation in Aging ◽

10.1093/geroni/igz038.226 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S58-S58

Author(s):

Courtney A Polenick ◽

Kira S Birditt ◽

Angela Turkelson ◽

Benjamin Bugajski ◽

Helen C Kales

Keyword(s):

Depressive Symptoms ◽

Marital Quality ◽

Chronic Conditions ◽

Later Life ◽

Well Being ◽

Minority Status ◽

Middle Aged ◽

Older Couples ◽

Individual Level ◽

Retirement Study

Abstract Discordant chronic conditions (i.e., those with competing management requirements) have adverse consequences for well-being, yet little is known about their implications among couples. We evaluated how depressive symptoms are linked to discordant conditions within individuals and between spouses across an 8-year period. The U.S. sample included 1,116 middle-aged and older couples from five waves (2006 – 2014) of the Health and Retirement Study. Longitudinal actor-partner interdependence models controlled for age, minority status, education, depressive symptoms in the previous wave, and each partner’s report of baseline marital quality and number of chronic conditions in each wave. Wives and husbands with their own discordant conditions reported higher depressive symptoms, and this association intensified over time. Over and above this link, husbands had higher depressive symptoms when there were discordant conditions between spouses. Both individual-level and couple-level discordant chronic conditions appear to have enduring implications for depressive symptoms in middle and later life.

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Individual-Level and Couple-Level Discordant Chronic Conditions: Longitudinal Links to Functional Disability

Annals of Behavioral Medicine ◽

10.1093/abm/kaz061 ◽

2019 ◽

Vol 54 (7) ◽

pp. 455-469

Author(s):

Courtney A Polenick ◽

Kira S Birditt ◽

Angela Turkelson ◽

Helen C Kales

Keyword(s):

Depressive Symptoms ◽

Chronic Conditions ◽

Functional Disability ◽

Well Being ◽

Multiple Chronic Conditions ◽

Individual Level ◽

Growth Curve Models ◽

Rate Of Increase ◽

The Individual ◽

Retirement Study

Abstract Background Multiple chronic conditions may erode physical functioning, particularly in the context of complex self-management demands and depressive symptoms. Yet, little is known about how discordant conditions (i.e., those with management requirements that are not directly related and increase care complexity) among couples are linked to functional disability. Purpose We evaluated own and partner individual-level discordant conditions (i.e., discordant conditions within individuals) and couple-level discordant conditions (i.e., discordant conditions between spouses), and their links to levels of and change in functional disability. Methods The U.S. sample included 3,991 couples drawn from nine waves (1998–2014) of the Health and Retirement Study. Dyadic growth curve models determined how individual-level and couple-level discordant conditions were linked to functional disability over time, and whether depressive symptoms moderated these links. Models controlled for age, minority status, education, each partner’s baseline depressive symptoms, and each partner’s number of chronic conditions across waves. Results Wives and husbands had higher initial disability when they had their own discordant conditions and when there were couple-level discordant conditions. Husbands also reported higher initial disability when wives had discordant conditions. Wives had a slower rate of increase in disability when there were couple-level discordant conditions. Depressive symptoms moderated links between disability and discordant conditions at the individual and couple levels. Conclusions Discordant chronic conditions within couples have enduring links to disability that partly vary by gender and depressive symptoms. These findings generate valuable information for interventions to maintain the well-being of couples managing complex health challenges.

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Marital strain trajectories over a quarter century and spouses’ loneliness: Couple-level and individual pathways

Journal of Social and Personal Relationships ◽

10.1177/0265407519879512 ◽

2019 ◽

Vol 37 (3) ◽

pp. 821-842 ◽

Cited By ~ 2

Author(s):

Kandauda A. S. Wickrama ◽

Tae Kyoung Lee ◽

Catherine Walker O’Neal

Keyword(s):

Extended Period ◽

Married Couples ◽

Later Life ◽

Well Being ◽

Quarter Century ◽

Individual Level ◽

The Individual ◽

Marital Strain ◽

Over 40 Years

Although research suggests that stressful marital experiences may lead to feelings of loneliness in later life, little is known about the influence of marital strain over an extended period of time on loneliness in later years. Thus, in the present study, drawing from family systems and cognitive theories along with common fate and actor–partner interdependence modeling approaches, we hypothesized a hybrid model comprised of two multilevel pathways explaining the persistent influence of marital strain on loneliness, including: (a) a couple-level pathway and (b) an individual pathway involving within-spouse and between-spouse effects. Specifically, we investigated the influences of individual- and couple-level trajectories of marital strain over a period of 25 years (from 1991 to 2015) on loneliness outcomes in later years with a sample of 257 couples in enduring, long-term (over 40 years) marriages. The results mostly supported both hypothesized pathways. Consistent with the pathway involving a couple-level process, couple-level trajectories of marital strain predicted couples’ later-life loneliness as reflected by both spouses’ reports of loneliness (shared perceptions). In addition, at the individual level, each spouses’ unexplained variances (unique perception) in marital strain trajectories predicted his/her own later-life loneliness outcomes (within-spouse effect or actor effect). Findings are discussed as they relate to intervention and prevention programs focusing on the well-being of married couples in later life.

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Frequency effects over the lifespan: a case study of Attenborough’s r’s

Linguistics Vanguard ◽

10.1515/lingvan-2017-0005 ◽

2017 ◽

Vol 3 (1) ◽

Cited By ~ 5

Author(s):

Laurel MacKenzie

Keyword(s):

High Frequency ◽

Mental Representations ◽

Later Life ◽

Community Change ◽

Small Scale ◽

Individual Level ◽

Show Evidence ◽

The Individual ◽

Over Time

AbstractThis paper uses a small-scale case study of the speech of a single speaker at two points in time to investigate the question of whether and how speakers’ mental representations change over their lives. Specifically, I test two predictions of usage-based models of phonological representation: that individuals surrounded by a changing community will show the community change in their own production, and that this individual-level change will show an effect of item frequency. The community change under study is the loss in English Received Pronunciation of [ɾ] as a realization of /ɹ/; the speaker studied is Sir David Attenborough, a well-known British nature documentary narrator. I find that Attenborough’s narrations do not show evidence of him participating in the community change away from [ɾ] over time; however, he does show a different sort of change, by which he increases his rate of [ɾ] in high-frequency collocations in later life. I propose that this result may be attributable to Attenborough’s mental representation of high-frequency collocations becoming more word-like over time. The results speak to questions about the malleability of mental representations and the role of the individual language user in cases of community change.

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Loving Others: The Impact of Compassionate Love on Later-Life Psychological Well-being

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa188 ◽

2020 ◽

Author(s):

Eva Kahana ◽

Tirth R Bhatta ◽

Boaz Kahana ◽

Nirmala Lekhak

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Later Life ◽

Well Being ◽

Community Dwelling ◽

Cross Sectional ◽

Psychological Well Being ◽

Compassionate Love ◽

The Impact ◽

Over Time

Abstract Objectives Existing scholarship in social gerontology has paid relatively little attention to broader loving emotions, such as compassionate and altruistic love, as potentially meaningful mechanisms for improving later-life psychological well-being outside a family framework. Method Drawing from a 3-wave longitudinal survey of community-dwelling older residents (n = 334) of Miami, Florida, we utilized generalized estimating equation models to examine the influence of changes in compassionate love (i.e., feeling love toward other persons and experiencing love from others) on depressive symptoms over time. We also explored cross-sectional relationship between compassionate love and positive and negative affects. Results An increase in the feeling of being loved (β = −0.77, p < .001) and feeling love for others (β = −0.78, p < .001) led to a decline in odds of reporting greater levels of depressive symptoms over time. The odds of reporting higher level of positive affect were significantly greater for older adults who reported feeling loved by others (β = .63, p < .001) and expressed love for other people (β = 0.43, p < .05). Older adults who felt loved and expressed love for other people, respectively, had 0.71 and 0.54-point lower ordered log odds of reporting higher negative affect than those who reported lower levels of love. The statistically significant impact of feeling loved on all well-being outcomes was maintained even after adjustment for altruistic attitudes and emotional support. Except for depressive symptoms, such adjustments explained the positive influence of love for others on well-being outcomes. Discussion Our findings underscore the powerful influence of both receiving and giving loving emotions for the maintenance of later-life psychological well-being.

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CORRELATES OF LONELINESS AMONG OLDER ASIAN IMMIGRANTS: A SYSTEMATIC REVIEW

Innovation in Aging ◽

10.1093/geroni/igz038.2345 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S629-S629

Author(s):

Yihan Wang ◽

Bongki Woo ◽

Nan Jiang

Keyword(s):

Systematic Review ◽

Older Adults ◽

Later Life ◽

Well Being ◽

Community Level ◽

Korean Immigrants ◽

Asian Immigrants ◽

Household Level ◽

Individual Level ◽

The Individual

Abstract Loneliness is a prevalent social concern among older adults, which calls for attention as a condition itself and its influence on mental and physical conditions. However, limited efforts have been made to understand loneliness, particularly among immigrant older adults. Guided by the ecological perspective, the present study contributes to the literature by providing a systematic review of the prevalence and individual-, household-, and community-level correlates of loneliness among Asian older immigrants, one of the fast-growing immigrant population. Following the PRISMA guideline, we systematically searched eight electronic databases to identify relevant empirical research articles. Of the 828 articles identified, ten articles met the inclusion criteria. Majority of these articles focused on older Chinese and Korean immigrants. On the individual level, migration grief, longer length of residence, and weaker ethnic attachment were linked to higher level of loneliness, indicating that immigration can be a challenging experience for later life well-being of Asian older adults. Other identified correlates include mental and functional impairment and worsening health changes. On the household level, while living alone was a commonly identified correlate of loneliness, those who live with family also reported loneliness when they have fewer interactions with their family members. On the community-level, smaller social network and lack of social support and interactions were correlates of loneliness. The findings of the present study are helpful for identifying older Asian immigrants who may be at risk of loneliness and implicates that the efforts to mitigate the loneliness need to be made at various ecological levels.

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Chronic Condition Discordance and Physical Activity: Longitudinal Associations Among Older Couples

Innovation in Aging ◽

10.1093/geroni/igaa057.2044 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 605-605

Author(s):

Courtney Polenick ◽

Kira Birditt ◽

Angela Turkelson ◽

Helen Kales

Keyword(s):

Physical Activity ◽

Chronic Condition ◽

Later Life ◽

Functional Health ◽

Older Couples ◽

Individual Level ◽

Growth Curve Models ◽

Lower Baseline ◽

The Individual ◽

Retirement Study

Abstract Chronic condition discordance (i.e., the extent that two or more conditions have non-overlapping self-management requirements) is detrimental for functional health but little is known about mechanisms accounting for these associations. We examined links between chronic condition discordance at both the individual level and the couple level (i.e., between spouses) and physical activity over time. Participants included 1,095 couples from five waves (2006-2014) of the Health and Retirement Study. Dyadic growth curve models showed that greater individual-level discordance was associated with lower baseline physical activity among individuals and their partners. When husbands had greater individual-level discordance, wives and husbands had faster declines in physical activity. The findings highlight the importance of considering both members of a couple when examining the implications of chronic illness for physical activity in middle and later life.

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Sleep and Loneliness as Mechanisms Through Which Marital Quality Predicts Depression Among Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.127 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 34-35

Author(s):

Christina Marini ◽

Lynn Martire ◽

Orfeu Buxton

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Sleep Quality ◽

Marital Quality ◽

Social Life ◽

Latent Variable ◽

Structural Equation ◽

Structural Equation Models ◽

Later Life ◽

Well Being

Abstract Pathways through which spousal support and strain influence older adults’ well-being are poorly understood. We examined sleep quality and loneliness as mechanisms through which support and strain predict depressive symptoms across ten years utilizing National Social Life, Health, and Aging Project data. Our sample included partnered participants at waves 1 and 2 (N = 1,293; 39% female, M age = 66, SD = 6.93). Support (e.g., rely on spouse) and strain (e.g., spouse criticizes you) were measured at W1, loneliness (UCLA) and sleep quality (restless sleep) were measured at W2, and depression (CES-D) was measured at W3. We estimated latent-variable structural equation models, controlling for age, gender, and W1 depression. Indirect effects of support and strain on depressive symptoms through loneliness were significant. There was an additional trend-level indirect effect of spousal strain on depressive symptoms through restless sleep. Findings highlight multiple pathways through which marital quality predicts later-life well-being.

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ESPO/BEHAVIORAL AND SOCIAL SCIENCES: SOCIAL RELATIONSHIPS, ISOLATION, AND WELL-BEING

Innovation in Aging ◽

10.1093/geroni/igz038.224 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S58-S58

Author(s):

Jeffrey E Stokes ◽

Elliane Irani ◽

Patricia A Thomas

Keyword(s):

Social Sciences ◽

Older Adults ◽

Social Relationships ◽

Chronic Conditions ◽

Healthy Aging ◽

Later Life ◽

Well Being ◽

Older Couples ◽

Depressive Symptomology ◽

Subjective Side

Abstract The purpose of this symposium is twofold: (1) To present innovative research linking social relationships, isolation, and well-being among older adults, and (2) To highlight new and emerging scholars in the Behavioral and Social Sciences section of GSA. The papers in this symposium examine the repercussions of numerous relationships for well-being in later life. Huo and colleagues examine the impacts of contact with close and not-close social partners on physical activity, highlighting differences by gender. Polenick and colleagues focus on perhaps the closest of relationships in later life: marriage, analyzing longitudinal associations between discordant chronic conditions and depressive symptoms among older couples. Upenieks takes an intergenerational perspective, examining the embeddedness of adult children in older adults’ networks in the context of both depression onset and chronically high depressive symptomology. This paper also highlights the consequences of well-being for older adults’ social isolation, and not merely the reverse. Hladek and colleagues explore the subjective side of isolation among older adults with chronic disease, noting links between loneliness and self-efficacy that may have clinical and interventional significance. Lastly, Meinertz and Gilligan explore potential gaps in service provision that may increase rural older adults’ risk of isolation and abuse. Taken together, these five papers underscore the importance of various social relationships for older adults’ well-being, and suggest implications for how best to promote healthy aging. As discussant, Thomas will assess the strengths and limitations of these papers, and consider the contributions these studies – and new scholars – can make to the field.

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Negative Marital Quality, Purpose in Life, and Depressive Symptoms Among Middle-Aged and Older Couples

Innovation in Aging ◽

10.1093/geroni/igaa057.1609 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 498-498

Author(s):

Elliane Irani ◽

Sumin Park ◽

Ronald Hickman

Keyword(s):

Depressive Symptoms ◽

Psychological Health ◽

Marital Quality ◽

Negative Relationship ◽

Purpose In Life ◽

Equation Modeling ◽

Heterosexual Couples ◽

Middle Aged ◽

Older Couples ◽

Sense Of Purpose

Abstract Negative marital quality is associated with poor health outcomes. Purpose in life can serve as a psychological resource to buffer the stressors experienced from a negative marital relationship. Yet, the associations among negative martial quality, a person’s level of purpose in life, and depressive symptoms have not been fully explored in a dyadic context. We examined the actor (intra-individual) and partner (cross-spousal) effects of negative marital quality on depressive symptoms in couples and the potential mediating role of purpose in life. Structural equation modeling was used to analyze cross-sectional data on middle-aged and older married, heterosexual couples (N=1,235) who participated in the 2016 wave of the Health and Retirement Study. The final model had an acceptable fit to the data (TLI=.963, RMSEA=.040, SRMR=.038). At the actor level, negative relationship quality was positively associated with depressive symptom severity, and purpose in life mediated the relationship in wives and husbands. At the partner level, wives had more depressive symptoms when husbands reported higher negative marital quality. Comparatively, husbands had less depressive symptoms when their wives indicated a greater sense of purpose. Husbands also had a lower purpose in life when their wives had higher states of negative marital quality. This study highlights the psychological benefits of allaying negative perceptions of marital quality and enhancing the sense of purpose in middle-aged and older couples. The results support a focus on dyadic approaches to improve the psychological health, and potentially, the physical health status of middle-aged and older couples.

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