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Lower awareness of age-related gains (AARC-gains) and higher awareness of age-related losses (AARC-losses) may be risk factors for depressive and anxiety symptoms. We explored whether: (1) Baseline AARC-gains and AARC-losses predict depressive and anxiety symptoms at one-year follow-up; (2) age and rumination moderate these associations; (3) levels of AARC-gains and AARC-losses differ among individuals with different combinations of current and past depression and/or with different combinations of current and past anxiety. In this one-year longitudinal cohort study participants (N = 3386; mean age = 66.0; SD = 6.93) completed measures of AARC-gains, AARC-losses, rumination, depression, anxiety, and lifetime diagnosis of depression and anxiety in 2019 and 2020. Regression models with tests of interaction were used. Higher AARC-losses, but not lower AARC-gains, predicted more depressive and anxiety symptoms. Age did not moderate these associations. Associations of lower AARC-gains and higher AARC-losses with more depressive symptoms and of higher AARC-losses with more anxiety symptoms were stronger in those with higher rumination. Individuals with both current and past depression reported highest AARC-losses and lowest AARC-gains. Those with current, but not past anxiety, reported highest AARC-losses. Perceiving many age-related losses may place individuals at risk of depressive and anxiety symptoms, especially those who frequently ruminate. [ABSTRACT FROM AUTHOR]

This study examined whether cumulative exposure to poor housing conditions is negatively associated with psychological well-being, and whether this association varies by age. Using fifteen waves of the Korean Welfare Panel Study between 2005 and 2019 (118,500 person-observations), this study employed fixed-effects regression models to account for unobserved individual-level heterogeneity. Exposure to poor housing conditions ranged from 1 to more than 5 annual waves. To formally test for age heterogeneity, interactive models were estimated. The trajectories of change in psychological well-being associated with cumulative exposure to poor housing conditions were different between young and middle-aged adults and older adults. Among young and middle-aged adults, the levels of depressive symptoms increased in the first year of exposure but remained at a similar level since then. In contrast, with the persistence of poor housing conditions, older adults continued to develop greater depressive symptoms over time. Similar age differences were found for life satisfaction. As exposure to poor housing conditions accumulated, life satisfaction persistently declined among older adults, but not young and middle-aged adults. This study suggests that cumulative exposure to poor housing conditions has more adverse psychological consequences for older adults than young and middle-aged adults. [ABSTRACT FROM AUTHOR]

Objectives: Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU. Methods: We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent–child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week). Results: Overall, past week alcohol consumption was 5.0 units (±7.8), prevalence of HAU was 25.4% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent–child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender. Conclusions: HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders. [ABSTRACT FROM AUTHOR]

Theory of mind (ToM), the ability to reason about mental states, declines in later life. While anxiety symptoms may predict ToM abilities, the nature of associations requires more elucidation. Further, it is unknown whether age group moderates associational patterns. We examined associations between anxiety symptoms (linear and curvilinear) and cognitive ToM (C-ToM) and affective ToM (A-ToM); and moderation by age group (older vs. younger adults). In a sample of healthy younger (n = 90, Mage = 20.17 years) and older adults (n = 87, Mage = 71.52), we used hierarchical regressions with polynomial and interaction terms to assess the association between anxiety symptoms and ToM in younger and older adults. Anxiety symptoms were associated with C-ToM but not A-ToM. Age group interacted linearly with anxiety (β = −1.64, p =.02), and with anxiety's quadratic polynomial (β =.84, p =.04). The inverted-U shaped association in younger adults (highest C-ToM at moderate anxiety) contrasted with older adults' linear decline in C-ToM with increasing anxiety. We highlight the importance of anxiety symptoms for predicting ToM, and clarify that associations vary by age. Elucidating associations may be critical to developing interventions that improve social wellbeing. [ABSTRACT FROM AUTHOR]

This study analyzed the conspiracy mentality of informal caregivers for older persons compared to non-caregivers and whether this association was dependent on age. The sample was collected randomly from a population-based online panel (forsa.omninet) and represents individuals aged ≥40 years from Germany. In total, 3022 participants were questioned about conspiracy mentality (Conspiracy Mentality Questionnaire), informal care provision (N = 489 informal caregivers of older adults), and sociodemographic background. Data assessment took place between 4th and 19th March 2021 and the questions referred to the time between December 2020 and March 2021. No significant differences were found between informal caregivers and non-caregivers. A significant interaction effect was found, indicating a decrease of conspiracy mentality among non-caregivers and an increase among informal caregivers with higher age. After stratifying by gender, this effect was found only among female informal caregivers. Middle-aged informal caregivers had a lower, and older-aged a higher, susceptibility to conspiracy theories during the COVID-19 pandemic compared to non-caregivers. The results indicate that providing care could be protective among middle-aged individuals, whereas older informal caregivers may benefit from interventions to reduce susceptibility to conspiracy theories and the associated risks for health and wellbeing. [ABSTRACT FROM AUTHOR]

To compare the effectiveness of 12 weeks of community-based, in-person, group Tai Chi (TC) and Health Education (HAP-E) in improving health and wellbeing in older adults with hypertension and in promoting psychological resilience during COVID-19. A 12-week randomized controlled trial (RCT) in San Diego County, USA. Self-reported depressive symptoms, anxiety, sleep disturbances, gratitude, resilience, mental and physical health were assessed in-person pre- and post-intervention, and by long-term follow-up surveys during COVID-19. Linear mixed-effects models were used to assess study arm differences over time and logistic regression to identify predictors of positive intervention response. Of 182 randomized participants (72.6 ± 7.9 yrs; 72% female), 131 completed the intervention. Modest improvements in health and wellbeing occurred post-intervention in both arms (Cohen's d: TC = 0.38, 95% CI: 0.25–0.51; HAP-E = 0.24, 0.11–0.37), though positive intervention responses were more than twice as likely in TC (OR = 2.29, 1.07–4.57). Younger age, higher anxiety, and poorer mental health at baseline predicted greater odds of response. Small declines in health and wellbeing were reported at the first COVID-19 follow-up, with smaller declines in the TC arm (Cohen's d: TC = −0.15, −0.31–0.00; HAP-E = −0.34, −0.49 to −0.19). Health and wellbeing stabilized at the second COVID-19 follow-up. Most participants (>70%) reported that the interventions benefitted their health and wellbeing during COVID-19. TC and HAP-E improved health and wellbeing, though TC conferred greater odds of an improved mental health response. Declines in health and wellbeing were observed at pandemic follow-up, with smaller declines in the TC arm, suggesting increased resilience. [ABSTRACT FROM AUTHOR]

Although life satisfaction (LS) could reduce mortality risk of older adults, whether the LS-mortality link is consistent in older adults with different marital status is largely unknown. In this study, we examine (1) how the LS-mortality association at older ages varies by marital status and marital quality, and (2) whether the role of marriage in the LS-mortality link differs between young-old (ages 65–79) and oldest-old (ages 80+) ages and between men and women in mainland China. We used five waves of data from a nationally representative survey in mainland China and applied the multilevel random effect of survival analysis to examine the LS-mortality association in Chinese older adults by marital status, controlling for a wide set of covariates. First, the protective effect of LS on mortality was valid in older men regardless of their marital status, whereas the protective effect was only valid in currently-not-married older women. Second, for a good marriage, LS significantly reduced mortality risk irrespective of gender and age, while for a poor marriage, LS had no significant association with mortality of older adults. Third, the LS-mortality association seemed to be stronger in the oldest-old than in the young-old irrespective of their marital status. Given the pivotal role of spouse in daily life, the society should create an age-friendly social environment for re-marriage among older adults who wish to get re-married, while highlighting and advocating the importance of good marriage in determining healthy aging, and design various policies to improve the LS of older people to reduce their mortality risk. Supplemental data for this article is available online at. [ABSTRACT FROM AUTHOR]

This study explored the age trajectories of depressive symptoms across multiple cohort groups who were in middle and late adulthood; examined sociodemographic differences in these trajectories; and investigated how relevant factors contributed to depressive symptoms trends of different cohorts. Drawing on data from the 1994–2016 Health and Retirement Study (HRS), we used growth curve models to examine the age patterns of depressive symptoms, changes in sociodemographic gaps in depressive symptoms trajectories, and predictors of changes in depressive symptoms. In general, adults' depressive symptoms started high in middle-adulthood, declined in young-old life, increased moderately in mid-old life, and peaked in old-old life; In detail, more nuanced cohort-specific age trajectories of depressive symptoms were observed, challenging the prevailing assumption of a common age trajectory of depressive symptoms. Later-born cohorts displayed higher levels of depressive symptoms than earlier-born cohorts at observed ages. Second, we found intra-cohort sociodemographic differences in levels of depressive symptoms, but these differences' growth rates varied by specific factors. Regardless of the cohort group, as people age, the gender gap in depressive symptoms persisted but the partnership gap reduced. A widening educational gap across cohorts was observed, but it declined with age in some cohorts. Results suggest more evidence for the persistent inequality and age-as-leveler hypotheses rather than the cumulative (dis-)advantage hypothesis. Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2021.2010182. [ABSTRACT FROM AUTHOR]

Objectives: The current study investigates the differential coping strategies and mental health consequences of food insecurity in relation to period of the lifespan (middle vs. late adulthood) and household composition (living with vs. without children). Method: Using a cross-sectional design, food-related coping strategies, anxiety (GAD-7), and depression (WHO-5) were compared among the following groups: middle adults with vs. without children, and middle adults without children vs. late adults without children. Predictive models using hierarchical linear regression examined the main effects of age and household composition with food insecurity predicting mental health; additionally, the interaction of food insecurity with age and household composition was tested in a separate model. Results: Middle-adults with and without children share similar frequencies in levels of food insecurity and coping strategies, which were significantly higher than late adults. Conclusion: The link between food insecurity and depression was stronger for middle-adults without children than late adults. Food insecurity was a stronger predictor of anxiety for middle-adults with children than those without. [ABSTRACT FROM AUTHOR]

Objectives: Despite initial concerns about older adult's emotional well-being during the COVID-19 pandemic, reports from the first months of the pandemic suggested that older adults were faring better than younger adults, reporting lower stress, negative affect, depression, and anxiety. In this study, we examined whether this pattern would persist as the pandemic progressed. Method: A convenience sample of 1,171 community-dwelling adults in the United States, ages 18–90, filled out surveys on various metrics of emotional well-being starting in March 2020 and at various time points through April 2021. We created time bins to account for the occurrence of significant national events, allowing us to determine how age would relate to affective outcomes when additional national-level emotional events were overlaid upon the stress of the pandemic. Results: Older age was associated with lower stress, negative affect, and depressive symptomatology, and with higher positive affect, and this effect was consistent across time points measured from March, 2020 through April, 2021. Age was less associated with measures of worry and social isolation, but older adults were more worried about their personal health throughout the pandemic. Conclusion: These results are consistent with literature suggesting that older age is associated with increased resilience in the face of stressful life experiences and show that this pattern may extend to resilience in the face of a prolonged real-world stressor. Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2021.2010183. [ABSTRACT FROM AUTHOR]

Objective:Tackling modifiable risk factors such as physical inactivity currently represents the only way to reduce the increasing prevalence of dementia worldwide. This study aimed to investigate attitudes to increasing physical activity to reduce risk of dementia in people over 50. Attitudes to increasing physical activity to reduce risk of dementia were assessed in a national online survey promoted via online forums and public adverts. The Motivation to Change Behaviour for Dementia Risk Reduction (MOCHAD-10) scale examined motivation for lifestyle change. Multivariable logistic regression was used to identify the predictors of willingness and motivation to increase physical activity. Data from 3,948 individuals showed most people were moderately/very physically active (80%). People more likely to be physically active had better health and education, were older, male, and had a partner. People willing to increase physical activity (73%) were more likely to be younger, non-White, underweight, had better health and lifestyles, and had experience caring for someone with dementia. People with higher levels of motivation to change lifestyle (MOCHAD-10 subscales) were more likely to be female, younger, in poorer physical/mental health, had lower perceived mental activity, and were a carer for someone with dementia. Men and those with better health status were more physically active. Those who exercised less and those who were more motivated to increase physical activity were not necessarily able to be physically active. Multisectoral public health strategies should seek to use the high motivation levels among this group to mitigate the barriers related to physical activity for dementia risk reduction. [ABSTRACT FROM AUTHOR]

The Male Depression Risk Scale (MDRS-22) is a self-report scale that assesses externalising and male-typical depression symptoms with promising psychometric properties reported in young-to-middle aged men. However, studies are yet to consider the psychometric properties of the MDRS-22 in older men. This study examined the psychometric properties of the MDRS-22 in both younger and older males and its relationship to prototypic depression symptoms and self-reported depression history. A community sample of younger (n = 510; 18–64 years) and older (n = 439; 65–93 years) males completed the original 82 MDRS items from which the MDRS-22 was derived, the Patient Health Questionnaire (PHQ-9), and provided information regarding previous depression diagnoses. Exploratory and confirmatory factor analyses were used to examine factor structure. Generalised linear models examined the relationship between externalised and male-typical symptoms with prototypic depression symptoms in younger and older men. Model fit indices demonstrated that the MDRS-22 performs well in older males. Results also revealed that the MDRS-22 is associated with prototypic depression symptoms and a previous depression diagnosis in both age groups. Results support the psychometric validity of the MDRS-22 as a measure of externalising and male-typical depression symptoms in older men. Use of scales such as the MDRS-22 may help to improve the detection of depression in men across the lifespan and may also identify factors that put men at risk of poor physical and mental health outcomes. [ABSTRACT FROM AUTHOR]

Social isolation is a critical public health issue that affects multiple domains of well-being among older adults, but little is known about social isolation among older military veterans. As such, the purpose of this study was to estimate the prevalence of social isolation among older veterans and to examine risk factors for social isolation among older veterans. Data were derived from Round 1 of the National Health and Aging Trends Study, which is an annual, longitudinal panel survey of Medicare beneficiaries aged 65 and older. The sample included 1,683 veterans, who were primarily White and male. Weighted logistic regression models were used to predict severe social isolation (having no social participation) and social isolation (having only one source of social participation) among older veterans, while controlling for age, sex, race, marital status, education, income, and metropolitan residency. After accounting for other predictors, results show that veterans who are 85 and older, male, White, unmarried or unpartnered, with lower educational attainment and lower income are greatly at risk of both severe social isolation and social isolation. The results of this study support past research showing that veterans with limited social and economic capital are at great risk of experiencing adverse outcomes in older adulthood, including social isolation. Interventions should therefore aim to improve social connectedness among this population and should address the risk-factors that contribute to social isolation among older veterans. [ABSTRACT FROM AUTHOR]

There is a large body of research indicating that substance use disorder treatment completion leads to higher rates of sustained recovery. However, not much is known about how age and opioid treatment programs (OTPs) OTPinteract to affect treatment completion. The purpose of this article is to better understand the pathway between age, OTP, and treatment completion. Data from the US 2017 Treatment Episodes Data Set was analyzed. Seemingly unrelated bivariate probit regression was used to determine whether OTP access mediates the relationship between age and treatment completion. We used propensity score matching to simulate the effects of a randomized control trial and to attenuate the likelihood of a Type 1 error. Older adults have a higher likelihood than their younger counterparts of completing treatment regardless of OTP status in inpatient and outpatient settings. Those who received OTP in inpatient treatment had a 45% increased probability of completing treatment in detox settings and a 41% increased probability of completing treatment in inpatient settings. Older adults (age 50+) were more likely to receive OTP than their younger counterparts. There is a small but significant indirect effect of age on treatment completion in inpatient settings. Older adults are more likely to receive OTP in both inpatient and outpatient settings. However, age does not appear to affect the probability of treatment completion when individuals receive OTP, except in inpatient settings. Implications are discussed. [ABSTRACT FROM AUTHOR]

Objective: Prolonged experiences of discrimination can be a major source of physical and health-related stress, particularly in older Black Americans. However, there is limited information on the relation between discrimination and anxiety, particularly within the context of other constructs that influence the manifestation of anxiety symptoms. For example, several studies have suggested that ethnic identification may provide psychological and social resources to deal with the effects of discrimination. This study aims to further understand these processes. Method: This study utilized structural equation modeling (SEM) to examine predictors of anxiety symptom severity in a sample of African American and Afro-Caribbean adults aged 55 and older from the National Survey of American Life (N = 1,032). Results: The final structural regression model revealed acceptable fit indices, and was successful in measuring latent anxiety symptom severity, showing that more experienced discrimination was related to higher anxiety and anxiety was directly related to mental health rating. While higher experience of discrimination was associated with higher anxiety, it was not directly related to mental health rating. However, contrary to expectation, ethnic identification did not serve as a protective factor between experienced discrimination and anxiety. As individuals aged, they experienced less discrimination and reported poorer self-rated mental health. Conclusions: While age served as a protective factor for perceived discrimination and anxiety symptom severity, ethnic identification did not. Implications for those working to reduce anxiety symptoms among Black Americans are discussed. [ABSTRACT FROM AUTHOR]

Objectives: We evaluated whether the effects of recent stressful life events (SLEs) and early childhood adversities (ECAs) on depressive symptoms are consistent between men and women and across older age, and whether there was evidence for the following: stress sensitization, whereby the psychological impact of SLEs is greater for individuals with ECAs compared with those without; or stress proliferation effect, whereby those with ECAs are more likely to report more SLEs than those without ECAs to effect depressive symptoms. Method: ECAs, SLEs in the past two years, and current depressive symptoms through a modified CES-D were obtained from 11,873 individuals participating in a population representative study of older adults, yielding 82,764 observations. Mixed-effects regression models on depressive symptoms were constructed to control for multiple observations per participant and evaluate within-person effects over time, thereby reducing bias from reverse causation. Results: Results suggest a stress proliferation effect and do not support stress sensitization. ECAs contribute to vulnerability for depressive symptoms, with a dosage effect for each additional ECA. Recent SLEs result in greater depressive symptom risk, with stable effects over age and dosage effects for each additional SLE that were smaller than the effects of ECAs among men, but not women. Belonging to an ethnic minority group, having less education, and less household income at baseline were associated with greater depressive symptom risk. Conclusions: Findings suggest the importance of addressing early childhood adversity and sociodemographic factors, among at-risk older adults to mitigate life-course stress proliferative processes and thereby reduce disparate risk for depression in older age. [ABSTRACT FROM AUTHOR]

To investigate the relationship between cognitive performance and cognitive health appraisals across non-Hispanic White, non-Hispanic Black, and Hispanic older adults in the United States and to explore within-group variations by examining interactions between cognitive performance and background and health variables. The sample (N = 3,099) included 2,260 non-Hispanic White, 498 non-Hispanic Black, and 341 Hispanic adults aged 65 or older, from the 2016–2017 Harmonized Cognitive Assessment Protocol. Regression models of cognitive health appraisals, indicated by self-rated cognitive health, were examined in the entire sample and in racial and ethnic subgroups to test direct and interactive effects of cognitive performance, indicated by the Mini-Mental State Examination (MMSE). The regression model for the entire sample showed direct effects of cognitive performance and race/ethnicity on cognitive health appraisals, as well as a significant interaction between cognitive performance and being non-Hispanic Black. Cognitive performance and cognitive health appraisals were positively associated in non-Hispanic Whites but not significantly associated in non-Hispanic Blacks. Our subsequent analysis within each racial/ethnic group showed that the effect of cognitive performance in non-Hispanic Blacks and Hispanics became either reversed or nonsignificant when background and health variables were considered. Modification by age or chronic medical conditions in each racial and ethnic group was also observed. Overall, these findings suggest that perceptions and appraisals of cognitive health vary by race and ethnicity and hold implications for how these differences should be considered in research and practice with diverse groups of older adults. [ABSTRACT FROM AUTHOR]

The Black-White mental health epidemiological paradox (i.e. Black Americans' lower or similar rates of mental disorder relative to Whites) characterizes the literature on race and mental health. Yet, research has generally paid less attention to how such findings may vary across other social statuses that shape mental health. This study assessed whether the Black-White paradox is consistent across gender, age groups, and psychiatric disorders, including lifetime mood, anxiety, and substance use disorders. We used data from the National Comorbidity Survey-Replication (NCS-R) and National Survey of American Life (NSAL), 2001–2003 (N = 4,591 African Americans; 6,668 non-Hispanic Whites). Psychiatric disorders were measured with the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview (WMH-CIDI). Binary logistic regression models were conducted to assess racial patterns of lifetime mental disorders across age and gender. Wald tests were performed to assess age and gender group differences in Black-White patterns of mental disorder. The Black-White mental health paradox generally extends across lifetime mood, anxiety, and substance use disorders and is consistent across age and gender groups. One exception is middle-aged (45–64 years) Black men, who had higher odds of lifetime substance use disorder relative to their White male middle-aged peers. This difference is no longer statistically significant after accounting for education and employment. We also found more similarity in mental disorders between older Blacks and Whites relative to their younger counterparts, suggesting that Black-White mental health differences are most pronounced among younger age groups. Our findings contribute to the broader literature on the Black-White mental health paradox by demonstrating that this epidemiological pattern persists across various mental disorder types and, at times, depends on age group and gender. Given that Black-Whte differences are less pronounced among older adults, future research should consider the ways life course theory might inform our understanding of the paradox. Findings also suggest that substance use services are critical to address the needs of middle-aged Black men of lower socioeconomic status who are disproportionately affected by substance use disorder, yet have relatively lower mental health care utilization rates. [ABSTRACT FROM AUTHOR]

Subjective age has been implicated in a range of health outcomes but its associations with Fear of Falling (FoF) are unknown. The present study examined the relation between subjective age and FoF in large national sample. Participants were drawn from the National Health and Aging Trends Study (NHATS, 2011–2017). 1,679 participants provided data on FoF, subjective age, demographic factors, depressive symptoms, prior falls, self-rated health and measures of the Short Physical Performance Battery. FoF was assessed again 7 years later. Regression analyses revealed that an older subjective age was related to a 24% higher likelihood to develop FoF 7 years later. This association was independent of age, sex, educational attainment, race and prior falls. In addition, depressive symptoms, self-rated health, and physical inactivity mediated the associations between subjective age and FoF. The present study showed that an older subjective age is related to the development of FoF over time, and further identified psychological and functional pathways that may explain this association. These results confirm the role of subjective age on one of the markers of frailty in the aging population. [ABSTRACT FROM AUTHOR]

Conceptualizations of emotions might evolve over the course of adult development as motivations shift, but there are gaps in knowledge regarding these changes. This mixed-methods study tested theoretical predictions pertaining to age group differences in conceptualizations of emotions. University students (N = 210, M age = 20.1 years) and community-dwelling older adults (N = 90, M age = 72.5 years) participated in three survey studies (2016-2018) conducted in person, online, or via mail and provided written narrative definitions for 11 emotion words. Responses were coded for valence, arousal, time frame, reference to self, reference to social contacts, and nature of response (i.e. example or definition). Code frequencies were compared for younger and older adults via odds ratio and logistic regression analyses. Younger and older adults used many of the same words in definitions of emotion terms. Older participants more often referenced situational examples in their definitions than younger participants. As expected, older adults used more low arousal language, referenced the 'self,' and included other persons more in their emotion descriptions than younger persons. Unexpectedly, younger participants used more positive language in descriptions of some positive emotions. Descriptions of emotion terms might serve a self-regulatory function, such as to facilitate low arousal emotion experiences for older adults or to illustrate important values, such as the greater importance of other persons to emotion experiences for older than younger adults. [ABSTRACT FROM AUTHOR]

To systematically review published evidence on self-neglect (SN) and its risk factors among community-dwelling older adults. A comprehensive literature search was conducted in PubMed, Embase, CINAHL Plus, PsycINFO, and Scopus for studies that were published in English from inception to 8 April 2020. Grey database was also included to ensure a thorough search. The study quality was assessed by two reviewers independently using the Newcastle-Ottawa Scale or the checklist suggested by the Agency for Healthcare Research and Quality. A total of 19 studies was included in this review. Various tools were used to assess SN among the available studies. The prevalence rates of SN among community-dwelling older adults ranged from 18.4% to 29.1%. The risk factors of SN identified by these studies involved sociodemographic characteristics (male gender, older age, low economic status, ethnicity, lower educational level, marital status, and lower number of children), health-related characteristics (cognitive impairment, lower level of physical function, nutritional status, higher number of medical comorbidities, and pain), psychological characteristics (depression), and social context characteristics (living alone, lower social networks and social engagement, lower neighborhood cohesion, and neighborhood disorder). SN is a common and under-recognized phenomenon among community-dwelling older adults. Our review provides healthcare professionals with an insight into SN and its risk factors. More studies are required to test the potency of each independent risk factor to deepen our understanding of this particular phenomenon. [ABSTRACT FROM AUTHOR]

There has been growing research interest in loneliness and wisdom in recent decades, but no cross-cultural comparisons of these constructs using standardized rating measures in older adults, especially the oldest-old. This was a cross-sectional study of loneliness and wisdom comparing middle-aged and oldest-old adults in Cilento, Italy and San Diego, United States. We examined loneliness and wisdom, using the UCLA Loneliness Scale Version 3 (UCLA-3) and San Diego Wisdom Scale (SD-WISE), respectively, in four subject groups: adults aged 50-65 and those ≥90 years from Cilento, Italy (N = 212 and 47, respectively) and San Diego, California, USA (N = 138 and 85, respectively). After controlling for education, there were no significant group differences in levels of loneliness, while on SD-WISE the Cilento ≥90 group had lower scores compared to the other three groups. There was a strong inverse correlation between loneliness and wisdom in each of the four subject groups. Loneliness was negatively associated while wisdom was positively associated with general health, sleep quality, and happiness in most groups, with varying levels of significance. These results largely support cross-cultural validity of the constructs of loneliness and wisdom, and extend previous findings of strong inverse correlations between these two entities. Loneliness has become a growing public health problem, and the results of our study suggest that wisdom could be a protective factor against loneliness, although alternative explanations are also possible. Research on interventions to reduce loneliness by enhancing wisdom in older adults is needed. [ABSTRACT FROM AUTHOR]

Overeating and obesity are major public health issues in the United States. Caregivers are at greater risk of engaging in poor health behaviors, such as emotional eating, to cope with the demands of caregiving. Using Heatherton and Baumeister (1991) Escape Theory, this study examines the associations between caregiver characteristics (i.e. age, gender, and BMI) and emotional eating, including the extent to which family strain mediates these associations. Data are from the MIDUS 3 dataset (N = 326) and include family caregivers of older adults and children with special health care needs (Mage = 62.88 years, SD = 10.28; 69.6% female). Female caregivers were more likely than male caregivers to engage in emotional eating. Age was significantly associated with emotional eating, where increased age was associated with less emotional eating. ANCOVA results indicated that obese caregivers were the most likely to engage in emotional eating. Results also indicated that family strain significantly mediated the association between caregiver age and emotional eating. Linear regression analyses indicated that female gender predicted emotional eating, although family strain did not mediate the association between gender and emotional eating. Similarly, after controlling for family strain as a mediator, higher BMI was still significantly associated with emotional eating, suggesting that BMI is a strong predictor of emotional eating among family caregivers regardless of present family strain. Interventions targeted at managing family strain, particularly for younger, female caregivers, could improve coping and decrease poor health behaviors. [ABSTRACT FROM AUTHOR]

Health policy in many countries is underpinned by a commitment to support dependent older people to remain in their own home for as long as possible and practicable. This study explores factors affecting both admission to long-stay residential care (LSRC) and mortality among people with and without dementia who are currently living at home with intensive formal care support. This is a cross-sectional study based on administrative data collected on 429 dependent older people in Ireland, 269 of whom were people with dementia. A cause-specific hazard model was used to investigate the hazard of admission to LSRC, while accounting for mortality as a competing risk and vice versa. Admission to LSRC was higher for people with dementia relative to people without and for those receiving lower amounts of informal care. The hazard of mortality was significantly higher for older people aged 85+, whereas it was lower for individuals with a medium level of dependency relative to those with high levels of dependency. The hazard of mortality was also influenced by the amount of informal care provision. People with dementia are more likely to be admitted to LSRC than people without. Care for people with dementia needs to be more specialised and personal, and intensity of provision should not be equated to the number of care hours on offer. Informal care provision may help to prevent admission to LSRC. Advanced age, physical dependency and informal care provision affect mortality, raising interesting issues in relation to resource allocation. [ABSTRACT FROM AUTHOR]