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This observational cross-sectional study of 152 people with HIV (PWH) examined the effects of age and estimated duration of HIV infection (EDI) on depressive and anxiety symptoms. All participants were cisgender men and completed the Profile of Moods State (POMS), a self-report inventory of current (i.e., past week) mood states. Overall, study results confirmed higher levels of anxiety and depression in PWH compared to individuals without HIV. Age group (< 50 or ≥ 50 years) moderated the effect of EDI (< 3 or ≥ 3 years) on mood disturbance. Specifically, younger PWH with early diagnosed infection exhibited the highest levels of depression and anxiety, whereas depression and anxiety were attenuated in older PWH with early infection such that their POMS scores did not significantly differ from the HIV-negative and chronically HIV-infected groups. Despite the small sample size and other important limitations in our study design, our preliminary findings confirm previous observations that older people may have some adaptive ability to better handle the acute psychological stressors associated with recent HIV infection. [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]

Many factors can influence perceptions of successful aging (SA), including social isolation and poor physical health. We hypothesized that social support attenuates the negative effect of plasma D-dimer, a correlate of HIV and aging, on SA. Participants included 230 adults (134 people with HIV; PWH, 96 HIV−), ages 36–65, segregated into age cohorts with up to 5 yearly visits. Multilevel modeling examined longitudinal within-person associations between D-dimer, social support, and SA. Social support moderated the relationship between D-dimer and SA and was significant among PWH and older individuals (ages 56–65), but not HIV− or younger cohorts. This association was significant only at extreme levels of social support, with significant decreases in social support potentiating the negative impact of D-dimer on SA and significant increases in social support facilitating increased SA. Despite declining health, high social support may improve SA in PWH and older adults, and low support may be especially problematic for older adults. [ABSTRACT FROM AUTHOR]

Strategies to build a larger workforce of physicians dedicated to research on aging are needed. One method to address this shortage of physician scientists in geriatrics is short-term training in aging research for early-stage medical students. The authors examined the effects of two summer research training programs, funded by the National Institutes of Health, on medical students’ attitudes toward aging, using the Carolina Opinions on Care of Older Adults (COCOA). The programs combined mentored research, didactics, and some clinical exposure. In a sample of 134 participants, COCOA scores improved significantly after completion of the research training program. There was a significant interaction of gender, such that female students had higher baseline scores than males, but this gender difference in COCOA scores was attenuated following the program. Four of the six COCOA subscales showed significant improvement from baseline: early interest in geriatrics, empathy/compassion, attitudes toward geriatrics careers, and ageism. [ABSTRACT FROM AUTHOR]

Objectives: Develop an empirically grounded measure that can be used to assess family and individual resilience in a population of older adults (aged 50–99). Methods: Cross-sectional, self-report data from 1006 older adults were analyzed in two steps. The total sample was split into two subsamples and the first step identified the underlying latent structure through principal component exploratory factor analysis (EFA). The second step utilized the second half of the sample to validate the derived latent structure through confirmatory factor analysis (CFA). Results: EFA produced an eight-factor structure that appeared clinically relevant for measuring the multidimensional nature of resilience. Factors included self-efficacy, access to social support network, optimism, perceived economic and social resources, spirituality and religiosity, relational accord, emotional expression and communication, and emotional regulation. CFA confirmed the eight-factor structure previously achieved with covariance between each of the factors. Based on these analyses we developed the multidimensional individual and interpersonal resilience measure, a broad assessment of resilience for older adults. Conclusion: This study highlights the multidimensional nature of resilience and introduces an individual and interpersonal resilience measure developed for older adults which is grounded in the individual and family resilience literature. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "A Cross‑Sectional Study to Evaluate the Efects of Age and Duration of HIV Infection on Anxiety and Depression in Cisgender Men."

OBJECTIVES: To determine whether measures of successful aging are associated with sexual activity, satisfaction, and function in older postmenopausal women. DESIGN: Cross-sectional study using self-report surveys; analyses included chi-square and t-tests and multiple linear regression analyses. SETTING: Community-dwelling older postmenopausal women in the greater San Diego region. PARTICIPANTS: One thousand two hundred thirty-five community-dwelling women aged 60 to 89 participating at the San Diego site of the Women's Health Initiative. MEASUREMENTS: Demographic information and self-reported measures of sexual activity, function, and satisfaction and successful aging. RESULTS: Sexual activity and functioning (desire, arousal, vaginal tightness, use of lubricants, and ability to climax) were negatively associated with age, as were physical and mental health. In contrast, sexual satisfaction and self-rated successful aging and quality of life remained unchanged across age groups. Successful aging measures were positively associated with sexual measures, especially self-rated quality of life and sexual satisfaction. CONCLUSION: Self-rated successful aging, quality of life, and sexual satisfaction appear to be stable in the face of declines in physical health, some cognitive abilities, and sexual activity and function and positively associated with each other from age 60 to 89. [ABSTRACT FROM AUTHOR]

Abstract: Patients with schizophrenia demonstrate impaired verbal fluency, but no studies have examined the underlying cognitive mechanisms (e.g., clustering and switching) associated with impaired fluency among middle-aged and older, non-institutionalized patients. Using Troyer et al.''s [Troyer, A.K., Moscovitch, M., Winocur, G., 1997. Clustering and switching as two components of verbal fluency: evidence from younger and older healthy adults. Neuropsychology 11 (1), 138–146] conceptual model, we examined clustering and switching on verbal fluency tasks among 163 middle-aged and older outpatients with schizophrenia and 92 age comparable healthy comparison (HC) participants. The patients produced significantly fewer total words than HC participants on both the letter (“F”, “A”, “S”) and Animal fluency conditions. With regard to clustering, patients were similar to HC participants on both FAS and Animal fluency tasks. However, significantly fewer switches between lexical–semantic categories were observed among patients with schizophrenia on both conditions relative to HC participants. A small, but statistically significant association was found between number of switches on the Animal fluency task and severity of negative symptoms. The absence of a difference in mean cluster size between the patient and HC groups suggests intact lexical–semantic stores among middle-aged and older outpatients with schizophrenia. Differences in switching between patients and HC participants may be driven by several cognitive impairments associated with schizophrenia. Further delineation of the cognitive mechanisms of the observed lexical–semantic switching deficits in schizophrenia should be a focus of future research. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to evaluate the trajectory of neuropsychological performance among middle-aged and older patients with schizophrenia using hierarchical linear modeling (HLM). Using the Mattis Dementia Rating Scale (DRS), we assessed cognitive performance of 143 schizophrenia outpatients (Mean age=53.1 years, SD=8.8) and 66 healthy comparison subjects (Mean age=61.8 years, SD=8.8). All participants had DRS data from two or more testing sessions with average intervals between sessions being 15 months (range=6–55). Using HLM, we found cognitive performance to be stable over time in both schizophrenia patients and healthy comparison subjects. Age, gender, ethnicity, and education did not affect trajectories. We also analyzed the data using more traditional statistical approaches to longitudinal data and found similar results. In sum, we found cognitive impairment to be stable over time among outpatients with schizophrenia, regardless of the statistical methodology used to analyze longitudinal data. [Copyright &y& Elsevier]

Objective: Goldman-Rakic and Selemon (Schizophr. Bull. 23 (1997)) hypothesized that many of the symptoms of schizophrenia can be explained by deficits of working memory (WM) that are, in turn, caused by dysfunction of dorsolateral prefrontal cortex (DLPFC). We examined whether older patients with schizophrenia would show an aberrant neural response in the DLPFC or other brain sites when performing a spatial working memory (WM) task adapted from McCarthy et al. (Proc. Natl. Acad. Sci. U. S. A. 91 (1994)). Method: Middle-aged and older patients with schizophrenia or schizoaffective disorder and healthy volunteers performed a spatial WM task contrasted with two baselines, passive and active viewing (PV and AV, respectively), while blood oxygen level dependent (BOLD) images were acquired in a functional magnetic resonance study. Results: Patients did not perform significantly less well on the spatial tasks compared to the volunteers. Although we found no significant group effects in spatial WM activation of DLPFC, we did observe areas in medial frontal cortex including the left anterior cingulate gyrus, parietal areas of the both hemispheres, multiple sites within the basal ganglia of the left hemisphere, and the left superior temporal gyrus where healthy volunteers showed greater BOLD response to WM. In a second pattern, patients showed a greater BOLD response to WM in left fusiform gyrus [Brodmann's Area (BA) 19], peri-rolandic areas, medial frontal area; right anterior cerebellum (culmen), middle occipital lobe, and postcentral/supramarginal gyri (BA 2/40). Conclusions: Middle-aged and older patients with schizophrenia display normal or near-normal spatial WM activation of DLPFC when the processing demands of the WM task are within their performance capacity. Nonetheless, even when patients perform nearly normally, they demonstrate an aberrant pattern of brain response. [ABSTRACT FROM AUTHOR]

Schizophrenia and aging are both risk factors for deficits in independent functioning, yet relatively few studies have examined the level and predictors of functional status of older outpatients with schizophrenia. We compared employment history, current living situation, and driving status of 83 middle-aged and elderly outpatients with schizophrenia (mean age 59 years), and 46 demographically equivalent normal comparison subjects. We also examined the relationships of neuropsychological functioning and psychiatric symptoms to these aspects of everyday functioning. The schizophrenia patient group had consistently worse functional status than the normal comparison group, but 30% of the patients were employed at least 50% of the time during their post-schizophrenia-onset adult lives, 73% were living in a house or apartment and responsible for meeting most of their own daily needs, and 43% were current drivers. Severity of negative symptoms (but not that of positive symptoms) was inversely correlated with functional status. Worse performance on a neuropsychological battery was generally associated with worse functional status. These findings counter notions that functional impairment is inevitable in older schizophrenia patients, and highlight the importance of assessment of functional skills and possibly targeting them as a treatment focus. [Copyright &y& Elsevier]