scholarly journals ASSOCIATION OF WELL-BEING WITH ANXIETY, DEPRESSION, AND FUNCTIONAL IMPAIRMENT FOLLOWING REHABILITATION SERVICES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S272-S272
Author(s):  
Adam Simning ◽  
Christopher L Seplaki

Abstract Millions of older adults receive rehabilitation services yearly that aim to restore, sustain, or limit decline in functioning. Older adults who receive rehabilitation comprise a vulnerable population that is unfortunately at elevated risk for anxiety, depression, and functional impairment. We hypothesize that lower levels of wellbeing prior to rehabilitation services are associated with a greater risk of having clinically significant anxiety or depressive symptoms, or worsening impairments in self-care or household activities, following rehabilitation. This study uses data from 2015 and 2016 waves of the National Health and Aging Trends Study, and includes 853 participants with information on rehabilitation services, wellbeing, anxiety and depression, and functional impairment, as well as demographic characteristics, socioeconomic status, and health variables. In a series of multivariable logistic analyses with wellbeing serving as our primary independent variable, older adults in the lowest quartile of wellbeing (compared to those in the highest quartile of wellbeing) had greater odds for having anxiety symptoms (OR=3.04; 95% CI: 1.24-7.46), depressive symptoms (OR=6.54; 95% CI: 2.80-15.25), and worsening impairment in self-care (OR=2.15; 95% CI: 1.09-4.23), but not in household activities (OR=1.49; 95% CI: 0.67-3.32). This study’s findings suggest that older adults with low levels of wellbeing at baseline may be more susceptible for having mental illness and functional impairment at follow-up. Conversely, the findings suggest that perhaps those with high levels of wellbeing may be able to experience significant health events with fewer residual consequences. The mechanism by which wellbeing may affect these outcomes is unclear and warrants further investigation.

Author(s):  
Xiaoling Xiang ◽  
Yong Yang ◽  
Jianjia Cheng ◽  
Ruopeng An

Abstract Objectives This study examines the impact of a previously validated disability spectrum that accounts for compensatory strategies on depressive symptoms in older adults. Methods This study was a secondary data analysis of 2011 through 2018 surveys from the National Health and Aging Trends Study (N = 7,609). The disability spectrum was categorized using a 5-level hierarchical scheme: fully able, successful accommodation, reduced activity, difficulty, and assistance for 12 mobility, self-care, and household activities. The individual fixed-effects panel model was used to examine the impact of this disability spectrum on depressive symptoms. Results Depressive symptoms rose progressively with each successive category on the disability spectrum in descriptive analyses. In fixed-effects models, moving from “fully able” to “successful accommodation” was not associated with significant changes in depressive symptoms; this result held for all self-care and mobility activities. Moving from “fully able” to “reduced activity” was associated with a significant increase in depressive symptoms for 3 household activities (doing laundry, making hot meals, and shopping for groceries) but not for paying bills/banking or keeping track of medications. Going up 2 or more stages above “fully able” on the disability spectrum was associated with a significant increase in depressive symptoms across all 12 activities. Discussion While limitations in a range of daily activities have harmful effects on mental health, using compensatory strategies that do not erode one’s perception of autonomy can help older adults cope with the psychological detriments of late-life disability.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S671-S671
Author(s):  
Richard E Chunga ◽  
Haowei Wang ◽  
Deborah Carr

Abstract Health-related declines that affect physical functioning are a common stressor among older adults. Functional impairment can take a toll on older adults’ psychological well-being as it limits one’s capacities to independently carry out meaningful daily activities. The extent to which impairment affects mental health may vary based on the levels of support and strain in one’s personal relationships. Stress buffering perspectives suggest that support mitigates the detrimental psychological consequences of impairment, whereas stress amplification perspectives predict that strain will amplify these consequences. We use data from 2012 and 2016 waves of the Health and Retirement Study (N=3800) to explore: (a) the direct effects of functional limitation on depressive symptoms (CES-D); (b) the extent to which these associations are moderated by spouse, child, other relative, and friend support/strain; and (c) gender and marital status differences therein. Using lagged endogenous regression models, we find that impairment significantly increases depressive symptoms among men and women, and these effects are intensified by marital strain for both married men and women. However, buffering effects are found for women only, such that marital support mitigates against depressive symptoms in the face of current impairment. These results may reflect the gendered nature of marriage, where men with impairment uniformly benefit from marriage although women may experience protective effects of only in highly supportive unions. Results for other strain and support moderators also reveal gender differences, reflecting the distinctive ways that men and women interact with kin and friends over the life course.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 484-484
Author(s):  
Shinae Choi ◽  
Eun Ha Namkung

Abstract The growing prevalence of functional impairment is a serious concern due to its relation to decreased quality of life in later life. Guided by the social convoy model and the stress process model, the present study investigated whether psychological resilience, particularly optimism and mastery moderated an association between functional impairment and subsequent depressive symptoms in later life. This study used data derived from two population-based national studies in the United States: 2012 and 2016 waves of the Health and Retirement Study (N = 5,035) and 2004 and 2013 waves of the Midlife in the United States (N = 2,476). Ordinary least squares regression was used to estimate the impact of optimism and mastery, respectively, on the associations between functional impairment (baseline measure at wave(t-1), changes over the study period from wave(t-1) to wave(t)) on subsequent changes in depressive symptoms. Across both studies, we found that having and developing functional impairment are related to increased number of depressive symptoms. Optimism independently predicted decreased depressive symptoms over the study periods and buffered the negative effects of functional impairment on depressive symptoms across the two studies. Specifically, the mitigating effects of optimism on depressive symptoms were greater for those with more numbers of functional limitations. The findings suggest that psychological resilience plays a key role in decreasing depressive symptoms, especially for midlife and older adults with functional impairment. The results also demonstrate the importance of examining both optimism and mastery when investigating psychological resilience and emotional well-being in older adults.


2004 ◽  
Vol 20 (4) ◽  
pp. 262-274 ◽  
Author(s):  
Manuel de Gracia Blanco ◽  
Josep Garre Olmo ◽  
María Marcó Arbonès ◽  
Pilar Monreal Bosch

Summary: Self-concept is a construct consisting of a group of specific self-perceptions that are hierarchically organized. Age-associated changes of self-concept are related to the individual's perception of the changes occurring throughout the aging process. The authors examined external validity and internal consistency of an instrument that has been developed to assess self-concept in older adults and examined self-concept's characteristics in two different contexts. Results confirm the multidimensionality of the scale and show a satisfactory external validity, indicating good discriminatory capacity. Findings support the hypothesis that older people who live in a nursing home have a poor self-esteem, self-concept, and psychological well-being and have a greater presence of depressive symptoms than people who live in their own home.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 498-498
Author(s):  
Yooumi Lee ◽  
Janet Wilmoth

Abstract This study investigates whether intergenerational relationships and social support improve the psychological well-being of Korean older adults. We examine whether intergenerational relationships and social support directly influence psychological well-being and the extent to which they mediate the distressing consequences of life events such as declining health and recent widowhood. Using longitudinal data from the 2006 to 2016 Korean Longitudinal Study of Aging, we explore depression trajectories among individuals who are 60 or older with at least one living adult child at baseline. Specifically, we converted data from 5,383 older adults into a person-period file with 24,726 observations over a ten-year period. Then we estimated linear growth curve models of depression trajectories separately for men and women using the Center for Epidemiologic Studies Depression Scale (CES-D). Results from the hierarchical linear models indicate that declining health and recent widowhood are positively related to depressive symptoms. Satisfactory intergenerational relationships and social support in the form of personal interactions and proximate living arrangements with adult children decrease depressive symptoms of older parents, especially among women. We conclude that the psychological benefits of intergenerational relationships and social support are contingent upon the vulnerability of older adults and discuss the implications for public policy.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 480-481
Author(s):  
Eva Kahana ◽  
Tirth Bhatta ◽  
Boaz Kahana ◽  
Nirmala Lekhak

Abstract Existing scholarship in social gerontology has surprisingly paid little attention to broader loving emotions, such as compassionate and altruistic love, as potentially meaningful mechanisms for improving later life psychological well-being. This study examined the influence of feeling love toward other persons and experiencing love from others on later life psychological well-being. We conducted a 3-wave longitudinal study of a representative sample of 340 ethnically heterogeneous community dwelling older residents of Miami, Florida. The increase in feeling of being loved (β=-1.53, p<0.001) and love for others (β=-1.43, p<0.001) led to decline in odds of reporting greater level 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=1.16, p<0.001) and expressed love for other people (β=1.18, p<0.01). Older adults who felt loved had 0.92-point lower ordered log odds of reporting higher negative affect than those who reported lower level of love. The impact of compassionate love on depressive symptoms and negative affect remained statistically significant even after adjustment for altruistic attitudes and emotional support. The influence of loving emotions on positive affect was, however, explained by altruistic attitudes and emotional support. Our findings underscore the powerful influence of both receiving and giving love for the maintenance of later life psychological well-being. We offer support for the expectation that love is a significant force in the lives of older adults that transcends intimate relationships.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S880-S880
Author(s):  
Zhiyong Lin

Abstract As the processes of urbanization and globalization have intensified across the world, a burgeoning literature has documented the impact of emigration on the health of family members left behind in emigrant communities. Although the association between children’s migration and parental well-being is well documented, few have examined the health implications of children’s migration in the milieu of multiple children and further differentiated between children’s short-term and long-term migration. Therefore, I argue that it is not the geographic locality of a single child but the composition of all children’s location that matters. I further suggest that the impact of children’s migration on parental wellbeing is conditioned on the duration of children’s migration. Using a six waves longitudinal data (2001-2015) collected in rural China, this paper compares mental health (measured as depressive symptoms) trajectories of old adults (aged 60 and older) across different compositions of local and migrant children over a 14-year span. Results from growth curve models show that parents having more migrant children relative to local children experience a more rapid increase in depressive symptoms. In addition, older adults who have their most children migrate away for three or more waves of data have experienced the steepest rate of increase in depressive symptoms. These findings provide new evidence to support the life course processes of mental health disparities among older adults from the perspective of intergenerational proximity.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 251-251
Author(s):  
Kheng Siang Ted Ng ◽  
Shu Cheng Wong ◽  
Glenn Wong ◽  
Ee Heok Kua ◽  
Anis Larbi ◽  
...  

Abstract Despite increasing emphasis on assessing the mental health of older adults, there has been inconclusive evidence on whether depression and psychological well-being (PWB) are fundamentally distinct constructs or representations of the opposite ends of the mental health spectrum. To instantiate either hypothesis, investigation of the associations between mental health scales and biomarkers have been proposed. First, we assessed depressive symptoms and PWB in community-dwelling older adults (N=59, mean age=67) using the Self-Rating Depression Scale (SDS) and Ryff’s Scale of PWB (comprising six sub-scales). We measured a wide range of immune markers employing ELISA and flow cytometry. Subsequently, we used principal component analysis (PCA) to aggregate and derived biomarker factor scores. Lastly, multiple linear regressions were performed to examine the associations between the scales and the derived biomarker factor scores, controlling for covariates. PCA extracted six biomarker factors. Biomarker factor score 1 was significantly associated with PWB (β=-0.029, p=0.035) and the PWB sub-scale, self-acceptance (β=-0.089, p=0.047), while biomarker factor score 4 was significantly associated with the PWB sub-scale, purpose in life (β=-0.087, p=0.025). On the other hand, biomarker factor 6 was significantly associated with SDS (β=-0.070, p=0.008). There were mutually- exclusive associations between the scales with biomarker factor scores, supporting the hypothesis of distinct constructs. Our findings expanded the biomarkers of depression and PWB, deepening understanding of the biological underpinnings of depressive symptoms and PWB. These findings have implications in field work, since researchers could not infer one construct from the other, the examination of both constructs are essential.


2021 ◽  
pp. 1-14
Author(s):  
Nikki L. Hill ◽  
Sakshi Bhargava ◽  
Emily Bratlee-Whitaker ◽  
Jennifer R. Turner ◽  
Monique J. Brown ◽  
...  

Background: Subjective cognitive decline (SCD) may be an early indicator of cognitive impairment, but depressive symptoms can confound this relationship. Associations may be influenced by differences between individuals (i.e., between-persons) or how each individual changes in their experiences over time (i.e., within-persons). Objective: We examined depressive symptoms as a mediator of the between- and within-person associations of SCD and objective memory in older adults. Methods: Coordinated analyses were conducted across four datasets drawn from large longitudinal studies. Samples (range: n = 1,889 to n = 15,841) included participants 65 years of age or older with no dementia at baseline. We used multilevel structural equation modeling to examine the mediation of SCD and objective memory through depressive symptoms, as well as direct relationships among SCD, objective memory, and depressive symptoms. Results: Older adults who were more likely to report SCD had lower objective memory on average (between-person associations), and depressive symptoms partially mediated this relationship in three of four datasets. However, changes in depressive symptoms did not mediate the relationship between reports of SCD and declines in objective memory in three of four datasets (within-person associations). Conclusion: Individual differences in depressive symptoms, and not changes in an individual’s depressive symptoms over time, partially explain the link between SCD and objective memory. Older adults with SCD and depressive symptoms may be at greater risk for poor cognitive outcomes. Future research should explore how perceived changes in memory affect other aspects of psychological well-being, and how these relationships influence cognitive decline and Alzheimer’s disease risk.


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