scholarly journals A Network Perspective on Successful Aging and Resilience in Later Life: A Protocol Paper

2021 ◽  
Author(s):  
Lotte Brinkhof ◽  
K. Richard Ridderinkhof ◽  
sanne de wit ◽  
Harm Krugers ◽  
Jaap M. J. Murre

Aging inevitably gives rise to many late-life challenges and transitions that impose threats for one’s physical and mental health, which can greatly impact our well-being and quality of life. Hence, the key to successful aging may not be the absence of these challenges and transitions, but the ability to demonstrate resilience to them. We recently started a large-scale study (N > 10.000) among older adults (55 years or older) in the Netherlands, with the aim to understand resilience as an emergent property that arises through the interplay between various (risk and protective) factors from different domains. Participants are asked to complete online questionnaires and tests that cover a multitude of relevant factors from multiple domains (e.g., physical, psychological, cognitive, social, environmental). Relationships between those factors will be analysed through network analysis, in which conditional dependencies between factors are depicted in a network of nodes. In this way, critical resilience (protective) and risk factors can be identified. This study offers a unique possibility to obtain insights into the factors that characterize and contribute to resilience in old age and thereby assist in generating hypotheses for follow up work. The contribution of this study in the growing field of resilience research, as well as the limitations, are discussed accordingly.

2011 ◽  
Vol 26 (S2) ◽  
pp. 569-569 ◽  
Author(s):  
A.S. Ferreira ◽  
E.M.S. Barbosa ◽  
N.R.B. Raposo ◽  
W.F. Gattaz

IntroductionHealth life expectation could be defined in many ways. The notion of health life can considered, for example, physical, mental or social well-being; disease consequences; functional impairment; successful aging. Functional independence in daily activities is a key aspect on frailty elderly quality of life. This independence is related with elderly social and leisure activities, which improves their physical and mental health and brings sense to their life.ObjectivesData obtained in other countries could not represent the national population; the objective was to describe a Brazilian frailty elderly sample.AimsDetermine functional impairment prevalence in Brazilian frailty elderly.Methods8769 frailty elderly were examined. Social data, tobacco and alcohol consumption were verified and the functional activities questionnaire was applied from May, 2009 to August, 2010.ResultsFemale elderly was predominant (68.1%). They were almost married (47.3%), followed by widow (37.9%), single (9%), divorced (5.9%). White people were predominant (69.9%); black (14.9%) and brown (15.2%) were presented at the same proportion. Only 13.1% were smokers and 4.3% drank alcohol. The majority (78.7%) were younger than 80 years-old. Functional impairment prevalence was 9.5% in the 60–69 years old group; 18.9% in 70–79 years old group; 36.8% in 80–89 years old group and 61.3% in 90–99 years old group.ConclusionsThe prevalence of functional impairment increased with aging and we presented data obtained in a Brazilian sample. These data can be used to compare functional impairment in different countries and to stimulate elderly independence during their aging.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Melody Ding ◽  
Jo-Anne Gale ◽  
Adrian Bauman ◽  
Philayrath Phongsavan ◽  
Binh Nguyen

Abstract Background Marital dissolution, such as divorce and widowhood, are common life events with potentially important implications on health. Previous research has found that those who have divorced or widowed tended to have a higher risk of mortality, however, the mechanisms for the observed associations are not well understood. We aimed to examine the association of divorce and widowhood with subsequent changes in health-related lifestyles, psychological outcomes, and overall health and wellbeing within both immediate and longer terms. Methods We used data from the 45 and Up study collected at baseline (T1, 2006-09), first (T2, 2010) and second follow-up (T3, 2012-16). Martial status and health-related outcomes were self-reported at all three time-points using validated questionnaires. Nine outcomes were examined, including lifestyles (smoking, drinking, diet and physical activity), psychological outcomes (distress, anxiety and depression) and overall health/well-being (self-rated health and quality of life). Logistic regression and generalised estimating equations were conducted adjusted for sociodemographic characteristics. Results Of the 33184 participants who were married/co-habiting at T1, after 3.4 years, 2.9% became divorced and 2.4% widowed. Those who divorced had much higher odds of smoking, having poor quality of life, high psychological distress, anxiety and depression at T2. Similar but weaker associations were observed for those who became widowed. After another 5 years of follow-up, however, the associations were much attenuated towards the null. Conclusions We found strong adverse short-term effects of marital dissolution on health outcomes, particularly within the psychological health domain. The effects, however, seemed to attenuate in the longer terms.


2016 ◽  
pp. 1-6
Author(s):  
J. LAUSSEN ◽  
C. KOWALESKI ◽  
K. MARTIN ◽  
C. HICKEY ◽  
R.A. FIELDING ◽  
...  

Background: As the population of older adults continues to increase, the dissemination of strategies to maintain independence of older persons is of critical public health importance. Recent large-scale clinical trial evidence has definitively shown intervention of moderate-intensity physical activity (PA) reduces major mobility disability in at-risk older adults. However, it remains unknown whether structured PA interventions, with demonstrated efficacy in controlled, clinical environments, can be successfully disseminated into community settings to benefit wider populations of older adults. Objective: To assess the dissemination of an evidence-based PA program for older adults by evaluating program participation and its impact on mobility, strength and quality of life. Setting: An urban senior center. Participants: Fifty older adults (71.2 ± 8 years aged; BMI: 30.1 ± 7 kg/m2). Intervention: Average of 8.0 ± 1.8 months of participation in the Fit-4-Life Program, a community-based PA and nutrition counseling intervention. Measurements: Mobility (Short Physical Performance Battery (SPPB)), self-reported physical activity (CHAMPS questionnaire), leg strength, grip strength, and quality of life (Quality of Well-Being Self-Administered (QWB-SA) scale) were assessed at baseline and follow-up. Results: Mean attendance was 55.8%. Fourteen participants were lost to follow-up. Those who dropped-out engaged in less PA at baseline (78 ± 108 mins/wk) compared to those who completed follow-up (203 ± 177 mins/wk, P=0.01). Participants exhibited sustained increases of PA (65 ± 153 mins/wk, P= 0.08), and there were meaningful improvements in SPPB (0.5 ± 0.2, P< 0.01), knee extensor strength (2.6 ± 4.4 kg, P< 0.01) and QWB-SA (0.04 ± 0.09, P= 0.05). Conclusion: The dissemination of a clinically efficacious PA intervention into a community-based setting can improve mobility, strength and quality of life for older adults. This knowledge may be helpful for the design and implementation of larger-scale PA intervention studies designed to preserve mobility in older adults within community-based settings.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S341-S341
Author(s):  
Alexandra P Harris ◽  
Alexandria Nuccio ◽  
Ashely M Stripling

Abstract Factors like physiology, mental health, personal resources, and social support have been identified to contribute to perceived successful aging (Cosco, Prina, Perales, Stephan & Brayne, 2015); however, sense of control’s role in these relationships remains underexplored. Studying the impact of sense of control is crucial, given that many factors associated with well-being are correlated with later life success. The current study investigates associations among sense of control and constructs known to define successful aging. The data was derived from the Survey of Midlife in the US database (MIDUS3). Participants were primarily Caucasian (88.7%) and female (54.9%) with a mean age of 63.64 years (SD=11.35). A series of hierarchical multiple regressions revealed that sense of control impacts physical health (F = 87.734, p&lt;0.001), depression (F =43.944, p&lt;0.001), anxiety (F =24.680, p&lt;0.001), social actualization (F = 66.450, p&lt;0.001), and instrumental activities of daily living (IADL) (F = 135.963, p&lt;0.001) over demographic correlates (i.e., age, sex, and race). The present findings suggest that higher levels of control results in increased comfort in social atmospheres, absence of mood symptoms, good health, and limited issues with IADL. Implications of the current findings include a deeper understanding of how psychological factors, such as sense of control, can impact physical and mental health in order to improve care and promote wellbeing in late life.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Salzwedel ◽  
I Koran ◽  
E Langheim ◽  
A Schlitt ◽  
J Nothroff ◽  
...  

Abstract Introduction Comprehensive cardiac rehabilitation (CR) programs based on the bio-psycho-social approach of the international classification of functioning and disease are carried out to achieve improved prognosis, superior health-related quality of life (HRQL) and social integration. We aimed to identify predictors of returning to work (RTW) and HRQL among cardiovascular risk factors and physical performance as well as patient-reported outcome measures (PROMs) modifiable during CR. Methods We designed a prospective observational multi-center study and enrolled 1,586 patients (2017/18) in 12 German rehabilitation centers regardless of their primary allocation diagnoses (e.g. acute myocardial infarction (AMI), coronary artery bypass grafting (CABG), coronary artery disease (CAD), valvular disease). Besides general data (e.g. age, gender, diagnoses), parameters of risk factor management (e.g. smoking, lipid profile, hypertension, lifestyle change motivation), physical performance (e.g. maximum exercise capacity, endurance training load, 6-min walking distance), and PROMs (e.g. depression, heart-focused anxiety, HRQL, subjective well-being, somatic and mental health, pain, general self-efficacy, pension desire as well as self-assessment of occupational prognosis using several questionnaires) were documented at CR admission and discharge. 6 months after discharge, status of RTW and HRQL (SF-12) were captured by a follow-up (FU) survey and analyzed in multivariable regression models with multiple imputation of missing values. Results Out of the study participants, 1,262 patients (54±7 years, 77% men) responded to the follow-up survey and could be analyzed regarding the outcome parameters. Most of them were assigned to CR primarily due to AMI (40%) or CAD without myocardial infarction (18%), followed by heart valve diseases in 12% of patients and CABG (8%). 864 patients (69%) returned to work within the follow-up period. Pension desire, negative self-assessed occupational prognosis, heart-focussed anxiety, major life events, smoking and heart failure were negatively associated with RTW, while higher endurance training load, HRQL and work stress were positively associated (Figure 1). HRQL after 6 months was determined more by PROMs (e.g. pension desire, heart-focused anxiety, physical/mental HRQL in SF-12, physical/mental health in indicators of rehab-status questionnaire (IRES-24), stress, well-being in the World Health Organization well-being index and self-efficacy expectations) than by clinical parameters or physical performance. Conclusions Patient-reported outcome measures predominantly influenced RTW and HRQL in heart-disease patients, whereas patients' pension desire and heart-focussed anxiety had a dominant impact on all investigated endpoints. Therefore, the multi-component CR approach focussing on psychosocial support is crucial for subjective health prognosis and occupational resumption. Figure 1. Predictors of returning to work Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): German pension insurance


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23557-e23557
Author(s):  
Jonathan R. Day ◽  
Benjamin Miller ◽  
Sarah L. Mott ◽  
Bradley T. Loeffler ◽  
Munir Tanas ◽  
...  

e23557 Background: Sarcomas are a diverse group of neoplasms that vary greatly in clinical presentation and responsiveness to treatment. Given the differences in the sites of involvement, rarity, and treatment modality, a multidisciplinary approach is required. Previous literature suggests patients with sarcoma suffer from poorer quality of life (QoL) especially physical and functional well-being. This study aims to understand if there is an association between treatment at a tertiary sarcoma center and a difference in QoL. Methods: De-identified data was obtained from the Sarcoma Tissue Repository at University of Iowa. Mixed effects regression models were utilized to evaluate the association between disease and treatment characteristics and QoL. QoL was assessed using the self-report FACT-G questionnaire at 12-, 24-, and 36-months post-diagnosis; overall scores and the 4 well-being subscales (Physical, Emotional, Social, Functional) were calculated. Results: 443 patients were identified. Soft tissue sarcomas were more prevalent (87.6%) than bone (12.4%). 53% of patients received chemotherapy and 38.6% got radiation therapy. Sarcomas were most frequently located in the lower extremities(ext.) (33.1%), followed by abdomen (20.9%), pelvic (13.6%), upper ext. (13.1%), thorax (11.3%), head & neck (7.8%). For ext. sarcoma; lower ext: 144 (71.3%), Upper ext: 58 (28.7%). Patients with extremity sarcoma; 133 had limb sparing and 48 had amputations. FACT-G Scores did not appreciably vary between 12, 24-, and 36-month for any QoL responses. Overall well-being had a mean score reported of 87.7 (sd = 15.7). Social well-being sores averaged 23.5 (5.0). Emotional well-being (EWB) 19.2 (4.1) and functional well-being (FWB) 21.3 (6.1), and physical well-being (PWB) 23.7 (4.6). There was no association between overall, PWB, EWB, or FWB with the histological subtype, radiation treatment, type of limb surgery, or any location in the same patients over time. Chemotherapy treatments were associated with lower well-being in multiple domains; PWB scores being 2.01 points lower, (p < 0.01), EWB scores being 1.27 points lower (p = 0.01) and FWB scores being 1.72 (p = 0.03), and 4.44 points lower overall (p = 0.03), on average, after adjusting for overall changes across time. Patients with ext. sarcoma only overall FACT-G scores differed 6.72 points higher for upper ext. than lower ext (p = 0.04). Conclusions: Overall QoL areas were similar to normative FACT-G scores both overall and specific areas. Having received chemotherapy was associated with lower well-being scores physically, emotionally, functionally, and overall. There were no clinically relevant differences reported in QoL scores between 12-,24-, and 36-months in the same patients. Further work is needed to describe QoL differences among patients with sarcoma at tertiary centers and examine what protective factors may influence patient well-being.


2018 ◽  
Vol 60 (3) ◽  
pp. 385-395 ◽  
Author(s):  
Pariya L Fazeli ◽  
Jessica L Montoya ◽  
Chastity N McDavid ◽  
David J Moore

Abstract Background and Objective As HIV-infected (HIV+) individuals age, there is a need to understand successful aging (SA) from the patient perspective. This study compared SA definitions between HIV+ and HIV-uninfected (HIV−) older adults and then examined correlates of SA categories. Research Design and Methods Ninety-three HIV+ and 46 HIV− older (aged 50+) adults provided brief definitions of SA, which was examined using content analysis. We then compared the frequency of SA categories by serostatus and examined the correlates of SA categories within both groups. Results Seven SA categories emerged: General Health, Cognitive Health & Ability, Physical/Biological Health & Ability, Social Relationships, Attitudes, Psychological, & Emotional Well-Being, Proactive & Engaged Lifestyle, and Independence. While no significant differences emerged, HIV− older adults were more likely to report General Health and the subcategory of Longevity/Survival, while HIV+ older adults were more likely to report subcategories of Enjoying Life & Fulfillment and Maintaining Balance. Few demographic correlates of SA categories emerged. Mood and HIV characteristics were not associated with SA categories. In both groups, those without neurocognitive impairment were significantly more likely to endorse General Health than those with neurocognitive impairment. Discussion and Implications HIV+ and HIV− older individuals may generally perceive SA similarly, and their definitions parallel with existing models of SA. Yet, living with a chronic illness may cause HIV+ older adults to place greater value on quality of life and life satisfaction than physical health and chronological age. Observational and intervention studies may use similar approaches in evaluating and maximizing SA.


2021 ◽  
Author(s):  
Yuanhui Luo ◽  
Wei Xia ◽  
Ankie Tan Cheung ◽  
Laurie Long Kwan Ho ◽  
Jingping Zhang ◽  
...  

BACKGROUND Caring for children with cancer can be a stressful experience for parents and may have negative effects on their physical and psychological well-being. Although evidence has shown that resilience is associated with positive psychological well-being, few interventions have been specifically designed to enhance the resilience of parents of children with cancer. OBJECTIVE The aim of this study is to examine the effectiveness of a mobile device–based resilience training program in reducing depressive symptoms and enhancing resilience and quality of life (QoL) in parents of children with cancer. METHODS Parents of children diagnosed with cancer were recruited from the pediatric oncology wards of 3 tertiary hospitals in China. The participants were randomly assigned to either the experimental group (52/103, 50.5%) to undergo an 8-week mobile device–based resilience training program or to the control group (51/103, 49.5%) to receive an 8-week program of placebo information. The study outcomes included resilience, depressive symptoms, and QoL, as measured by the Connor–Davidson Resilience Scale, the Self-Rating Depression Scale, and the Short Form of the 6-Dimension Health Survey, respectively. All data were collected at baseline and at 2 and 6 months of follow-up. The data analysis followed the intention-to-treat principle. A generalized estimating equation was used to examine the effects of the intervention. RESULTS The participants were mostly female (72/103, 69.9%), and their mean age was 33.6 (SD 5.2) years. The participants in the experimental group showed significantly higher levels of resilience (mean 67.96, SD 15.8 vs mean 58.27, SD 19.0; <i>P</i><.001) and lower levels of depressive symptoms (mean 40.17, SD 9.9 vs mean 46.04, SD 10.9; <i>P</i><.001) than those in the control group at 6 months of follow-up. The intervention showed statistically significant effects in improving resilience (<i>β</i>=6.082; <i>P</i>=.01) and decreasing depressive symptoms (<i>β</i>=−2.772; <i>P</i>=.04) relative to the control group. The QoL score in the experimental group was higher than that in the control group at 6 months of follow-up (mean 0.79, SD 0.2 vs mean 0.76, SD 0.3; <i>P</i>=.07); however, no statistically significant intervention effect was detected (<i>β</i>=.020; <i>P</i>=.38). CONCLUSIONS The mobile device–based resilience training program effectively enhanced resilience and alleviated depressive symptoms in parents of children with cancer. It is highly recommended that health care professionals incorporate this resilience training program when providing psychological care to parents of children with cancer. CLINICALTRIAL Clinical.Trials.gov NCT04038242; http://clinicaltrials.gov/ct2/show/NCT04038242


10.2196/27639 ◽  
2021 ◽  
Vol 23 (11) ◽  
pp. e27639
Author(s):  
Yuanhui Luo ◽  
Wei Xia ◽  
Ankie Tan Cheung ◽  
Laurie Long Kwan Ho ◽  
Jingping Zhang ◽  
...  

Background Caring for children with cancer can be a stressful experience for parents and may have negative effects on their physical and psychological well-being. Although evidence has shown that resilience is associated with positive psychological well-being, few interventions have been specifically designed to enhance the resilience of parents of children with cancer. Objective The aim of this study is to examine the effectiveness of a mobile device–based resilience training program in reducing depressive symptoms and enhancing resilience and quality of life (QoL) in parents of children with cancer. Methods Parents of children diagnosed with cancer were recruited from the pediatric oncology wards of 3 tertiary hospitals in China. The participants were randomly assigned to either the experimental group (52/103, 50.5%) to undergo an 8-week mobile device–based resilience training program or to the control group (51/103, 49.5%) to receive an 8-week program of placebo information. The study outcomes included resilience, depressive symptoms, and QoL, as measured by the Connor–Davidson Resilience Scale, the Self-Rating Depression Scale, and the Short Form of the 6-Dimension Health Survey, respectively. All data were collected at baseline and at 2 and 6 months of follow-up. The data analysis followed the intention-to-treat principle. A generalized estimating equation was used to examine the effects of the intervention. Results The participants were mostly female (72/103, 69.9%), and their mean age was 33.6 (SD 5.2) years. The participants in the experimental group showed significantly higher levels of resilience (mean 67.96, SD 15.8 vs mean 58.27, SD 19.0; P<.001) and lower levels of depressive symptoms (mean 40.17, SD 9.9 vs mean 46.04, SD 10.9; P<.001) than those in the control group at 6 months of follow-up. The intervention showed statistically significant effects in improving resilience (β=6.082; P=.01) and decreasing depressive symptoms (β=−2.772; P=.04) relative to the control group. The QoL score in the experimental group was higher than that in the control group at 6 months of follow-up (mean 0.79, SD 0.2 vs mean 0.76, SD 0.3; P=.07); however, no statistically significant intervention effect was detected (β=.020; P=.38). Conclusions The mobile device–based resilience training program effectively enhanced resilience and alleviated depressive symptoms in parents of children with cancer. It is highly recommended that health care professionals incorporate this resilience training program when providing psychological care to parents of children with cancer. Trial Registration Clinical.Trials.gov NCT04038242; http://clinicaltrials.gov/ct2/show/NCT04038242


Author(s):  
Ilona Stolpner ◽  
Jörg Heil ◽  
Fabian Riedel ◽  
Markus Wallwiener ◽  
Benedikt Schäfgen ◽  
...  

Abstract Background Poor patient-reported satisfaction after breast-conserving therapy (BCT) has been associated with impaired health-related quality of life (HRQOL) and subsequent depression in retrospective analysis. This prospective cohort study aimed to assess the HRQOL of patients who have undergone BCT using the BREAST-Q, and to identify clinical risk factors for lower patient satisfaction. Methods Patients with primary breast cancer undergoing BCT were asked to complete the BREAST-Q preoperatively (T1) for baseline evaluation, then 3 to 4 weeks postoperatively (T2), and finally 1 year after surgery (T3). Clinicopathologic data were extracted from the patients’ charts. Repeated measures analysis of variance (ANOVA) was used to determine significant differences in mean satisfaction and well-being levels among the test intervals. Multiple linear regression was used to evaluate risk factors for lower satisfaction. Results The study enrolled 250 patients. The lowest baseline BREAST-Q score was reported for “satisfaction with breast” (mean, 61 ± 19), but this increased postoperatively (mean, 66 ± 18) and was maintained at the 1 year follow-up evaluation (mean, 67 ± 21). “Physical well-being” decreased from T1 (mean, 82 ± 17) to T2 (mean, 28 ± 13) and did not recover much by T3 (mean, 33 ± 13), being the lowest BREAST-Q score postoperatively and in the 1-year follow-up evaluation. In multiple regression, baseline psychosocial well-being, body mass index (BMI), and type of incision were risk factors for lower “satisfaction with breasts.” Conclusion Both the aesthetic/surgery-related and psychological aspects are equally important with regard to “satisfaction with breasts” after BCT. The data could serve as the benchmark for future studies.


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