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Despite midlife adults accounting for a substantial and growing segment of the population, few large-scale studies have investigated factors which distinguish highly satisfying relationships from less satisfying ones in midlife. In a subsample of partnered 40-59-year-old Canadians (705 men, 743 women), relationship characteristics, sexual activity and communication, and health were investigated individually and simultaneously as predictors of high emotional and sexual satisfaction. Though the vast majority of participants reported being at least somewhat satisfied in their current relationship, less than half reported high satisfaction. For men and women, high emotional and sexual satisfactions were strongly linked. Logistic regressions indicated that longer relationships, dating relationships, and greater subjective overall health predicted high emotional satisfaction for men, whereas older age, married or cohabiting relationships, and frequent sexual communication predicted high emotional satisfaction for women. All types of sexual activities (minus penile-anal intercourse) were bivariately related to high emotional and sexual satisfaction. More frequent partnered sexual activity predicted high emotional and sexual satisfaction for men and women in regression analyses. More frequent sexual communication predicted high emotional satisfaction for women and high sexual satisfaction for both men and women. Newer relationships were more sexually satisfying for men. Postmenopausal women were less likely to be highly sexually satisfied. Findings suggest that physical health conditions are not generally related to high levels of satisfaction in midlife couples and that frequently discussing sex and engaging in (any) sexual activity with a partner are key components of highly satisfying relationships. [ABSTRACT FROM AUTHOR]

Research has long demonstrated that loneliness is a key risk factor for poor health. However, less is known about the development and predictors of loneliness across later adulthood. We examined these questions using two-wave data obtained 5 years apart in the population-based Norwegian NorLAG study (N = 5,555; age 40–80 years; 51% women). We considered direct measures of loneliness (asking directly about feeling lonely) and indirect measures (avoiding the term loneliness) and linked them to self-report data on personality and contact with friends, and to register data on socioeconomic (education, income, unemployment), physical health (sick leave, lifetime history of disability), and social factors (children, marriage/cohabitation, lifetime history of divorce and widowhood). Results indicated that levels of loneliness increased steadily for women, whereas men's levels followed a U -shaped curve, with highest loneliness at ages 40 and 80. At age 40, loneliness declined between the two data waves, but with increasing age the decrease abated and turned into increases when loneliness was measured indirectly. Disability, no spouse/cohabiting partner, widowhood, and little contact with friends were each associated with more loneliness. Similarly, people high in emotional stability and extraversion reported less loneliness and experienced steeper loneliness declines on one or both loneliness measures. We take our results to illustrate the utility of combining self-report and register data and conclude that the development of loneliness across the second half of life is associated with both individual difference characteristics and aspects of social embedding. We discuss possible mechanisms underlying our findings and consider practical implications. [ABSTRACT FROM AUTHOR]

Both reaction time and agility times increase with advancing age. However, it is not whether and to what extent regular practise of sport such as table tennis contributes to faster decision-making and movement speed in middle-aged and older adults. Objective: The aim of this study was to compare agility time in table tennis players and sedentary subjects of different ages and also to investigate the relationship between agility time and age in these groups. Methods: Forty four young, early middle-aged, late middle-aged and older table tennis players and forty eight sedentary subjects of matched age performed the agility test consisting of movement reactions to visual stimuli. Results: ANCOVA revealed a significant difference in agility time between table tennis players and sedentary subjects when the effect of age was controlled (F(1, 89) = 46.1, p < .001). Agility time was significantly shorter in early middle-aged (435.8 ± 35.6 ms and 483.8 ± 36.5 ms, respectively; p = .006), late middle-aged (481.0 ± 36.8 ms and 530.7 ± 31.8 ms, respectively; p = .004) and older (500.9 ± 24.4 ms and 564.5 ± 44.9 ms, respectively; p = .007) table tennis players than sedentary subjects. In addition, there was a significant relationship between agility time and age in sedentary subjects (rp = .73, p < .001) and table tennis players (rp = .53, p < .001). Conclusions: Agility time is shorter in early middle-aged, late middle-aged and older (= 60 years) table tennis players compared to age-matched sedentary subjects (9.9%, 9.4%, and 11.3%, respectively). [ABSTRACT FROM AUTHOR]

Work stress is a growing problem in Europe. Together, the negative physiological effect of stress on health, and increasing age increases the risk of developing cardiovascular disease in those aged over 50 years. Therefore, identifying older workers who may be at risk of work-related stress, and its physiological effects, is key to promoting their health and wellbeing in the workforce. The present study examined the relationship between perceived psychological resilience and work-related factors (work engagement and presenteeism) and the physiological response to acute psychological stress in older manual workers in the UK. Thirty-one participants, mean (SD) age 54.9 (3.78) years reported perceived levels of resilience, work engagement, and presenteeism using standardized questionnaires. Cardiovascular measurements (heart rate (HR) and blood pressure (BP) and salivary cortisol were used to assess their physiological response to an acute psychological stress task. Resilience was not associated with work-related factors or reactivity. However, workers with higher work engagement showed lower SBP ( p = 0.02) and HR ( p = 0.001) reactivity than those with lower work engagement. Further, those with higher sickness presenteeism also had higher HR reactivity ( p = 0.03). This suggests a potential pathway by which higher work stress might contribute to the risk of future cardiovascular disease. [ABSTRACT FROM AUTHOR]

Objectives To identify distinct latent groups of baseline levels and age-related decline in verbal episodic memory in middle-aged and older adults, and to identify factors associated with these trajectories. Design Longitudinal study of six data collections over a period of 10 years. Setting Population-based cohort in England. Participants 9,515 community-dwelling adults aged 50-79 years. Measurements Six repeated measurements of immediate and delayed recall of 10 words over 10-year follow-up. Group-based trajectory modeling was used to identify patterns of baseline levels and subsequent decline in memory in two age categories (50-64 and 65-79 years), and to investigate associations between trajectories and baseline predictors of group membership (gender, education, household wealth, marital status, smoking and physical activity) and time-varying covariates (depressive symptoms and number of chronic conditions). Results Four trajectories were identified and labelled according to baseline status and decline in memory: very low/decline (9.8%), low/stable (40.2%), average/stable (39.5%) and good/stable (10.5%) in the younger group, and very low/rapid decline (15.7%), low/decline (32.0%), average/stable (38.8%), and good/stable (13.5%) in older participants. In people with stable or declining trajectories, a higher number of depressive symptoms and the presence of cardiovascular diseases were associated with worse memory. Female sex, younger age, and higher education, wealth and physical activity were consistently associated with more favourable trajectories. Conclusions We identified four memory trajectories. Factors known to be associated with cognitive reserve (such as education, wealth and physical activity) were associated with better memory function while depressive symptoms and cardiovascular disease were associated with poorer memory. This suggests that interventions to reduce depressive symptoms and better manage cardiovascular risk factors and disease in midlife may help prevent or delay future memory decline. [ABSTRACT FROM AUTHOR]

Little is known about developmental outcomes in midlife of persons who were placed in out-of-home care (OHC) in childhood. Utilizing longitudinal Swedish data from a cohort of more than 14,000 individuals who we can follow from birth (1953) to the age of 55 (2008), this study examines midlife trajectories of social, economic, and health-related disadvantages with a specific focus on the complexity, timing, and duration of disadvantage in individuals with and without childhood experience of OHC. Roughly half of the OHC alumni did not have disadvantaged outcomes in midlife. However, experience of OHC was associated with a two-fold risk for various forms of permanent disadvantage, net of confounding factors. Implications for research, policy, and practice are discussed. [ABSTRACT FROM AUTHOR]

Studies reveal inconclusive evidence of the relationship between executive function and creativity. Further, there is a dearth of studies investigating creativity in older adults in the Indian context. Three tests—namely, Torrance Test of Creative Thinking (Figural), the Stroop Test, and Mental Balance (PGI memory scale)—were administered on a sample of 58 middle-aged and older adults (50–64 years). Analysis revealed a significant correlation between creativity and executive function (rs = −.35). Mann-Whitney U confirmed that individuals who were above average on creativity performed significantly better on executive function. However, there was an insignificant relationship between creativity and working memory, as well as between working memory and executive function. Further, no age decline nor gender differences were found except for speed of processing, which decreased with increase with age. These findings might aid in planning interventions and cognitive retraining exercises for individuals of the same age bracket by targeting their creative strengths. Academically, they can contribute to understanding the cognitive processes underlying creativity and can further help create norms in the Indian context. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between protective lifestyle behaviours (PLB) and depression in middle-aged Irish adults.Design: Secondary analysis of a cross-sectional study. PLB (non-smoker, moderate alcohol, physical activity, adequate fruit and vegetable intake) were assessed using a general health and lifestyle questionnaire and a validated FFQ. Depression was assessed using the Center for Epidemiologic Studies Depression Scale. A score of 15-21 indicates mild/moderate depression and a score of 22 or more indicates a possibility of major depression. Binary logistic regression was used to examine the association between PLB and depression.Setting: Livinghealth Clinic, Mitchelstown, North Cork, Republic of Ireland.Subjects: Men and women aged 50-69 years were selected at random from a list of patients registered at the clinic (n 2047, 67 % response rate).Results: Over 8 % of participants engaged in zero or one PLB, 24 % and 39 % had two and three PLB respectively, while 28 % had four PLB. Those who practised three/four PLB were significantly more likely to be female, have a higher level of education and were categorised as having no depressive symptoms. Engaging in zero or one PLB was significantly associated with an increased odds of depression compared with four PLB. Results remained significant after adjusting for several confounders, including age, gender, education and BMI (OR=2·2; 95 % CI 1·2, 4·0; P for trend=0·001).Conclusions: While causal inference cannot be established in a cross-sectional study, the findings suggest that healthy behaviours may play a vital role in the promotion of positive mental health or, at a minimum, are associated with lower levels of depression. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between a changes in social activity and cognitive function in Koreans aged 45 years or older.Methods: Data were obtained from 6076 participants aged 45 years and older included in the Korean Longitudinal Study of Aging (2006-2012). Cognitive function was measured using the mini-mental state examination-Korean version (MMSE-K). Participation in social activities was classified as "consistent participation," "consistent non-participation," "participation to non-participation," and "non-participation to participation." Linear mixed models were used to investigate the relationship between type of social activity (religious organizations, friendship organizations, leisure/culture/sports clubs, family or school reunion, volunteering work, and political organizations), and cognitive function.Results: Individuals who reported "no participation to participation" (b = 0.778, p < 0.0001) and "consistent participation" (b = 0.968, p < 0.0001) were more likely to show reduced cognitive decline than those who reported "consistent non-participation" (p < 0.0001 for trend). The positive association between cognitive function and consistent participation in religious activities, friendship organizations, and family/school reunions was particularly strong (b = 0.325, p < 0.0001; b = 0.570, p < 0.0001; b = 0.234, p = 0.0004; respectively, versus consistent non-participation).Conclusions: Promotion of participation in religious organizations, friendship organizations, and family/school reunions (only for older persons) may help preserve cognitive function in individuals aged 45 years or older in Korea. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Previous studies have reported that young participants typically date events that they remember, but no longer believe they experienced, to the period of childhood. The present study investigated whether participants aged between 40 and 79 years dated events related to relinquished memories to the period of childhood, as do younger people, or whether they dated such events to a period later in life. The study also compared believed and nonbelieved memories with respect to memory perspective (1st vs 3rd person perspective). Results indicated that the majority of middle-aged and older people dated nonbelieved memories to the period of childhood (median age = 8 years). No correlation was found between the participants’ current age and their age at the time the nonbelieved event occurred. In addition, results showed that believed memories were more likely to be retrieved from a 1st person perspective than were nonbelieved memories. [ABSTRACT FROM AUTHOR]

Age is associated with reductions in surface area and cortical thickness, particularly in prefrontal regions. There is also evidence of greater thickness in some regions at older ages. Non-linear age effects in some studies suggest that age may continue to impact brain structure in later decades of life, but relatively few studies have examined the impact of age on brain structure within middle-aged to older adults. We investigated age differences in prefrontal surface area and cortical thickness in healthy adults between the ages of 51 and 81 years. Participants received a structural 3-Tesla magnetic resonance imaging scan. Based on a priori hypotheses, primary analyses focused on surface area and cortical thickness in the dorsolateral prefrontal cortex, anterior cingulate cortex, and orbitofrontal cortex. We also performed exploratory vertex-wise analyses of surface area and cortical thickness across the entire cortex. We found that older age was associated with smaller surface area in the dorsolateral prefrontal and orbitofrontal cortices but greater cortical thickness in the dorsolateral prefrontal and anterior cingulate cortices. Vertex-wise analyses revealed smaller surface area in primarily frontal regions at older ages, but no age effects were found for cortical thickness. Results suggest age is associated with reduced surface area but greater cortical thickness in prefrontal regions during later decades of life, and highlight the differential effects age has on regional surface area and cortical thickness. [ABSTRACT FROM AUTHOR]

Objectives To investigate the association between random measured glucose levels in middle and old age and dementia-related death. Design Population-based cohort study. Setting Norwegian Counties Study (middle-aged individuals; 35-49) and Cohort of Norway participants (older individuals; 65-80). Participants Individuals without (n = 74,630) and with (n = 3,095) known diabetes mellitus (N = 77,725); 67,865 without and 2,341 with diabetes mellitus were included in the complete case analyses (nonmissing for all included covariates), of whom 1,580 without and 131 with diabetes mellitus died from dementia-related causes. Measurements Dementia-related death was ascertained according to the Norwegian Cause of Death Registry. Cox regression was used to assess the relationship between random glucose levels (nonfasting) in individuals without and with diabetes mellitus and dementia-related death. Education, smoking, cardiovascular disease, body mass index, cholesterol, blood pressure, and physical activity were adjusted for. Results Individuals without diabetes mellitus at midlife with glucose levels between 6.5 and 11.0 mmol/L had a significantly greater risk of dementia-related death than those with levels less than 5.1 mmol/L (hazard ratio = 1.32, 95% confidence interval = 1.04-1.67) in a fully adjusted model. A dose-response relationship ( P = .02) was observed. No significant association between high glucose levels in individuals aged 65 to 80 and dementia-related death was detected. Conclusion High random glucose levels measured in middle-aged but not older age persons without known diabetes mellitus were associated with greater risk of dementia-related death up to four decades later. [ABSTRACT FROM AUTHOR]

Guided by a life-span developmental systems approach, this study examined links between self-esteem assessed over 25 years and adaptive interaction and relationship risk at midlife using data from 341 Canadian adults surveyed (or followed) from ages 18 to 43. Results showed higher self-esteem at age 18 was associated with more adaptive interactions and lower perceived relationship risk at age 43. A more rapid increase in self-esteem through the transition to adulthood into midlife (ages 18-43) was also associated with more frequent adaptive interactions and less relationship risk at age 43. These results held after accounting for potential confounding variables. This study is the first to demonstrate self-esteem trajectories over a quarter century predict midlife intimate relationship functioning. [ABSTRACT FROM AUTHOR]

Background: Several studies have found depression and depressive feelings to be associated with subsequent dementia. As dementias typically have a long preclinical development phase, it has been difficult to determine whether depression and depressive feelings reflect a concurrent underlying dementia disease, rather than playing a causative role. Our aim was to investigate hopelessness, one dimension of depressive feelings, and evaluate the likelihood of a prodromal versus a causative role of hopelessness feelings in dementia development. Methods: We invited a random sample of 2000 survivors from a representative population in Eastern Finland, originally investigated in midlife between 1972 and 1987, for re-examination an average of 21 years later. The age of the 1449 persons who accepted the invitation was between 39 and 64 years (mean 50.4 years) in midlife and between 65 and 80 (mean 71.3) at follow-up. To measure feelings of hopelessness in midlife and at follow-up, the participants indicated their level of agreement to two statements about their own possible future. We used logistic regression to investigate the association between the combined scores from these two items and cognitive health at follow-up, while adjusting for several health and life-style variables from midlife and for apolipoprotein E4 (ApoE4) status, depression and hopelessness feelings at follow-up. We compared the associations with late-life cognitive health when feelings of hopelessness were either measured in midlife or at the follow-up. In addition we analyzed the changes in hopelessness scores from midlife to follow-up in participants who were either cognitively healthy or impaired at follow-up. Results: We found higher levels of hopelessness in midlife, but not at follow-up, to be associated with cognitive impairment at follow-up; the adjusted odds ratio for each step of the five-level hopelessness scale was 1.30 (95% confidence interval 1.11–1.51) for any cognitive impairment and 1.37 (1.05–1.78) for Alzheimer’s disease. These associations remained significant also after the final adjustments for depressive feelings and for hopelessness at follow-up. The individual changes in hopelessness scores between midlife and follow-up were not systematically related to cognitive health at the follow-up. Conclusion: Our results suggest that feelings of hopelessness already in midlife may have long-term implications for cognitive health and increase the risk of Alzheimer’s disease in later life. [ABSTRACT FROM AUTHOR]

The article presents a study conducted by the authors related to relationship between initial job status and psychological distress in middle aged-people in Japan. Topics discussed include an increase in distress due to unstable initial job status, effect mediated in men by marital status and household income and less distress among women due to initial job status as compared to men.

The main objective of the present study was to examine the potential buffering effect of regularity of the duration of time spent on daily activities in the association between perceived control and affect in community-dwelling adults. The sample for the current study was derived from the Midlife in the United States longitudinal follow-up study, MIDUS-II. Findings corroborated the association between a general sense of perceived control and positive and negative affect. Further, daily regularity was found to moderate the relationships of perceived control and both positive and negative affect. In each case, the findings suggest that individuals who scored lower on perceived control measures were more likely to have better affective outcomes when they demonstrated greater regularity in daily activities. The findings imply the relevance of regularity to affective experiences. [ABSTRACT FROM AUTHOR]

The current study developed regression-based normative adjustments for a bi-factor model of the The Brief Test of Adult Cognition by Telephone (BTACT). Archival data from the Midlife Development in the United States-II Cognitive Projectwere used to develop eight separate linear regression models that predicted bi-factor BTACT scores, accounting for age, education, gender, and occupation-alone and in various combinations. All regression models provided statistically significant fit to the data. A three-predictor regression model fit best and accounted for 32.8% of the variance in the global bi-factor BTACT score. The fit of the regression models was not improved by gender. Eight different regression models are presented to allow the user flexibility in applying demographic corrections to the bi-factor BTACT scores. Occupation corrections, while not widely used, mayprovide useful demographic adjustments for adult populations or for those individuals who have attained an occupational status not commensurate with expected educational attainment. [ABSTRACT FROM AUTHOR]

Personality theory and research typically focus on chronological age as a key indicator of personality development. This study examines whether the subjective experience of age is an alternative marker of the biomedical and psychosocial factors that contribute to individual differences in personality development. The present study uses data from the Midlife in the United States longitudinal survey ( N = 3,617) to examine how subjective age is associated with stability and change in personality and the dynamic associations between subjective age and personality traits over a 10-year period. Regression analyses indicated that a younger subjective age at baseline was associated with increases in Openness, Conscientiousness, and Agreeableness; correlated changes were also found. The rank-order stability of Extraversion and Openness and overall profile consistency were higher among those with a younger subjective age at baseline and were also associated with the rate of subjective aging over time. The present study reveals that beyond chronological age, the age an individual feels is related to changes in characteristic ways of thinking, feeling, and behaving over time. [ABSTRACT FROM AUTHOR]

Objectives This paper aims to examine the relationship between obesity and onset of depression among U.S. middle-aged and older adults. Methods Data came from 1994 to 2010 waves of the Health and Retirement Study. Study sample consisted of 6514 community-dwelling adults born between 1931 and 1941 who were free of clinically relevant depressive symptoms in 1994. Body mass index (BMI) was calculated from self-reported height/weight. Body weight status was classified into normal weight (18.5 kg/m 2 ≤ BMI < 25 kg/m 2 ), overweight (25 kg/m 2 ≤ BMI < 30 kg/m 2 ), and obesity (BMI ≥ 30 kg/m 2 ). A score of ≥ 3 on the 8-item Center for Epidemiologic Studies Depression Scale was used to define clinically relevant depressive symptoms. Kaplan–Meier estimator and time-dependent Cox proportional hazards model were performed to examine the association between body weight status and onset of clinically relevant depressive symptoms. Results Unhealthy body weight was associated future onset of depression. Compared with their normal weight counterparts, overweight and obese participants were 13% (hazard ratio [HR] = 1.13, 95% confidence interval [CI] = 1.04–1.23) and 9% (HR = 1.09, 95% CI = 1.01–1.18) more likely to have onset of clinically relevant depressive symptoms during the 16 years of follow-up, respectively. The relationship between obesity and depression onset appeared stronger among females and non-Hispanic whites than their male and racial/ethnic minority counterparts. Conclusions Health care providers should be aware of the potential risk for depression among obese older adults. [ABSTRACT FROM AUTHOR]

Objective A ginsenoside-rich extract of American ginseng ( Panax quinquefolius L.), CereboostTM, was previously shown to improve working memory and mood in healthy young individuals. The present study represented a partial replication investigating whether these effects extended to healthy middle-aged individuals. Methods Fifty-two healthy volunteers (40-60 years old, mean age 51.63) received 200 mg of P. quinquefolius or a matching placebo according to a double-blind, placebo-controlled, balanced, crossover design. The Cognitive Drug Research battery and the Computerised Mental Performance Assessment System were used to evaluate cognitive performance at baseline then 1, 3 and 6 h following treatment. Blood glucose and mood were co-monitored. Results Compared with placebo, P. quinquefolius improved cognitive performance on 'Working Memory' factor at 3 h. Similar effects were observed in one of the two tasks making up this factor, spatial working memory. There were no significant effects on mood or blood glucose levels. Conclusions These data confirm that P. quinquefolius can acutely benefit working memory and extend the age range of this effect to middle-aged individuals. These changes are unlikely to be underpinned by modulation of blood glucose in this population. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Suicidal ideation represents an important burden worldwide. However, little is known about it in low-/middle-income countries. We investigated this issue in a large cross-sectional of Brazilian civil servants (ELSA-Brasil, the Brazilian Health Longitudinal Study, n =15,105). Logistic univariate and multivariate analyses were performed to evaluate the strength of association (odds ratio, OR) between clinical and sociodemographic variables with acute life-weariness (tiredness of life) and suicidal thoughts. The presence of major depressive disorder (MDD), common mental disorders (CMDs), stressful life-events (SLEs) and poor self-perceived physical health was also collected. MDD and CMDs were strongly associated with suicidal ideation in univariate and multivariate analyses. For life-weariness thoughts, a modest, consistent association was found for female gender, being single, non-White ethnicity and poor education. SLEs and poor self-perceived physical health were also associated with suicidal ideation. Espiritism–Kardecism, but not other religions or Atheism/Agnosticism, was associated with lower rates of life-weariness and suicidal thoughts. To conclude, suicidal ideation does not differ in Brazil compared to developed countries, being primarily associated with psychiatric disorders and, to a lesser but significant extent, to social disadvantage, SLEs, poor self-perceived health and being single. [ABSTRACT FROM AUTHOR]

Background--Younger age and female sex are both associated with greater mental stress in the general population, but limited data exist on the status of perceived stress in young and middle-aged patients presenting with acute myocardial infarction. Methods and Results--We examined sex difference in stress, contributing factors to this difference, and whether this difference helps explain sex-based disparities in 1-month recovery using data from 3572 patients with acute myocardial infarction (2397 women and 1175 men) 18 to 55 years of age. The average score of the 14-item Perceived Stress Scale at baseline was 23.4 for men and 27.0 for women (P<0.001). Higher stress in women was explained largely by sex differences in comorbidities, physical and mental health status, intrafamily conflict, caregiving demands, and financial hardship. After adjustment for demographic and clinical characteristics, women had worse recovery than men at 1 month after acute myocardial infarction, with mean differences in improvement score between women and men ranging from -0.04 for EuroQol utility index to -3.96 for angina-related quality of life (P<0.05 for all). Further adjustment for baseline stress reduced these sex-based differences in recovery to -0.03 to -3.63, which, however, remained statistically significant (P<0.05 for all). High stress at baseline was associated with significantly worse recovery in angina-specific and overall quality of life, as well as mental health status. The effect of baseline stress on recovery did not vary between men and women. Conclusions--Among young and middle-aged patients, higher stress at baseline is associated with worse recovery in multiple health outcomes after acute myocardial infarction. Women perceive greater psychological stress than men at baseline, which partially explains women's worse recovery. [ABSTRACT FROM AUTHOR]

Though a complex behavior, online privacy regulation has been considered by social media researchers to be a function of making information available or in the enactment of privacy controls, resulting in a perceived contradiction between concern for privacy and actual behaviors. Using data from interviews of 23 midlife adults, this study explores privacy management within social media use by examining privacy behaviors and strategies through an ecological lens, which considers how an individual's behavior intersects with the technological, social and discursive dimensions of the social media environment. This perspective highlights that social strategies such as connection selectivity and discursive treatments related to the quality of communicated information factor significantly into privacy management, behaviors which may be overlooked because they leave scant evidence. These findings provide further insight in the reconciliation of the privacy paradox, and offer more nuance to the understanding of how privacy is perceived and accomplished by individuals as they use social media platforms. [ABSTRACT FROM PUBLISHER]

This study examined the relationships between daily negative financial events and positive and negative interpersonal events, as well as the moderating effects of life circumstances, for a sample of 182 adults between the age of 40 and 65 providing 30 days of diary data collected between 2008 and 2011. There was a significant and positive relationship between daily negative interpersonal events and daily levels of both negative interpersonal events and positive interpersonal events; these relationships varied by income, employment status, parenting roles, and the experience of major financial challenges over the previous year. The moderating effect of income was nonlinear but its effect disappeared when the interaction between major financial challenges over the previous year and daily negative financial events was entered into the model. The results were interpreted in the context of the stress proliferation and resource mobilization theoretical models and directions for future studies were delineated with respect to individual- and community-level factors that influence the role of financial events on the daily social worlds of middle-aged adults. [ABSTRACT FROM AUTHOR]

Objective: Depression is common in women with much research focusing on hormonal changes and menopausal symptoms but with little exploration of psychosocial problems in midlife. This study investigates the prevalence of clinically relevant depressive symptoms in midlife Chinese women and its association with psychosocial factors. Methods: A cross-sectional, community-based household survey of women aged 45 to 64 years of age was conducted in Hong Kong from September 2010 to March 2011. The structured questionnaire included demographic data, educational status, marital status and household income, as well as perceived current stressful events and significant life events in the past 12 months. Information on clinically relevant depressive symptoms was measured by the validated chinese Patient Health Questionnaire (PHQ-9). Results: A total of 402 participants were recruited in the study period. Of the 393 women who completed the questionnaire, the prevalence of clinically relevant depressive symptoms (PHQ-9 score≧10) was 11.0%. In multiple regression analysis, being single/divorced/separated/widowed, having an educational level of primary school level or below, having multiple chronic diseases, loss of hobby or loss of close social support in the past 12 months in midlife were associated with clinically relevant depressive symptoms. Conclusions: Correlates of clinically relevant depressive symptoms in midlife Chinese women can be used to identify those at increased risk and potentiate further studies to explore early psychosocial and community interventions. [ABSTRACT FROM AUTHOR]

Childhood experiences are thought to predispose a person to the development of health anxiety later in life. However, there is a lack of research investigating the influence of specific adverse experiences (e.g., childhood abuse, household dysfunction) on this condition. The current study examined the cumulative influence of multiple types of childhood adversities on health anxiety in adulthood. Adults 18–59 years of age (N =264) completed a battery of measures to assess adverse childhood experiences, health anxiety, and associated constructs (i.e., negative affect and trait anxiety). Significant associations were observed between adverse childhood experiences, health anxiety, and associated constructs. Hierarchical multiple regression analysis indicted that adverse childhood experiences were predictive of health anxiety in adulthood; however, the unique contribution of these experience were no longer significant following the inclusion of the other variables of interest. Subsequently, mediation analyses indicated that both negative affect and trait anxiety independently mediated the relationship between adverse childhood experiences and health anxiety in adulthood. Increased exposure to adverse childhood experiences is associated with higher levels of health anxiety in adulthood; this relationship is mediated through negative affect and trait anxiety. Findings support the long-term negative impact of cumulative adverse childhood experiences and emphasize the importance of addressing negative affect and trait anxiety in efforts to prevent and treat health anxiety. [Copyright &y& Elsevier]

The present study is aimed at exploring the difference between work as a stressor and work as a social resource between working middle aged married men and women in Karachi. Given the importance to middle aged working married men and women it was hypothesized that there would be a significant difference of work as a life stressor and social resource between working middle aged married men and women. A total of 150 participants including 75 working married men and 75 working married women from the middle socioeconomic status involved in various occupations from Karachi were included in the sample for the research. Their age range was 35 to 55 years and their education was at least at the graduation level. The Life Stressors and Social Resources Inventory - Adult Form (LISRES- A) by Moos and Moos (1994) was administered on an individual basis. The results provided partially significant support for the hypothesis. Work as a life stressor was found to be significantly different (t=3.207, p<.00) for middle aged working married men and women. However work as a social resource was not found to be significantly different (t=0.914, p>.05) for middle aged working married men and women. [ABSTRACT FROM AUTHOR]

Abstract: Background: Although bereavement is accompanied with depression and anxiety symptoms, it is usually not associated with increased rates of mental disorders in North American and European samples. Data from low- and middle-income countries are, however, scarce. We therefore explored the prevalence of mental disorders after bereavement in Brazil. Methods: The Clinical Interview Schedule-Revised (CIS-R) was used for psychiatric assessment of 15,105 participants from the Brazilian Health Longitudinal Study (ELSA-Brasil). We asked whether the participant suffered loss of a first-degree relative/spouse within 6 and 12 months prior to the interview. Results: The prevalence within 6 and 12 months after bereavement for major depressive disorder (MDD, 4.3% for 6 and 12 months) and anxiety disorders (17.4% and 15.9%, respectively) did not differ compared to non-bereaved participants, except for panic disorder. Sociodemographic and clinical data were also similar. Conversely, we found increased 12-month prevalence of bereaved-related (vs. non-related) mixed anxiety and depressive disorder (15.7% vs. 12.5%, respectively) and common mental disorder (30.7% vs. 26.2%); diagnoses that are solely based on the number and severity of depression and anxiety symptoms. Limitations: Although this was a cross-sectional study, the sample size was large. Conclusions: Bereavement was associated with greater psychopathological burden but not with increased prevalence of MDD and anxiety disorder diagnoses, therefore highlighting the need of carefully monitoring subjects whom recently experienced bereavement. Our findings also support and provide a “cultural validator” for excluding bereavement as an exclusionary criterion for MDD diagnosis. [Copyright &y& Elsevier]

Voluntary career change during the midlife stage of the lifespan can sometimes be attributed to self-actualization concerns. Midcareer adults realize the reasons that brought them into a career no longer apply. Those in midlife often seek meaning in life, and some can attain this meaning through inding a calling. Choosing to change careers in midlife is not always a rational decision, and emotions play a strong role. Career counselors are encouraged to employ creative approaches such as the Transtheoretical Model of Change, the Life-Span Life-Space approach, as well as narrative techniques to help middle-aged clients ind increased happiness in their work. [ABSTRACT FROM AUTHOR]

Older adults may be more vulnerable to negative health effects from alcohol as they age. Distress and adverse neighborhood conditions that provoke distress may influence drinking behavior. Using baseline data from the Baltimore Memory Study, a cohort study of adults aged 50-70 years living in 65 Baltimore City neighborhoods, we investigated the association between neighborhood psychosocial hazards (NPH) and the number of binge drinking days in the past month among non-abstainers ( N = 645). We used negative binomial regression with generalized estimating equations to estimate the relative number of binge drinking days per month associated with a one standard deviation increase in NPH score. Residing in neighborhoods with more psychosocial hazards was independently associated with more binge drinking for females, but not for males. For females, each one standard deviation increase in NPH score was associated with a 1.52 relative risk of binge drinking (95 % confidence interval, 1.10, 2. 10) in the adjusted model. The findings were robust to a sensitivity analysis in which we used the average number of drinks per drinking occasion as an alternative outcome. Our findings provide evidence linking adverse neighborhood conditions with alcohol consumption in non-abstaining late middle-aged women, and suggest that late middle-aged men and women may have different reactions to adverse residential neighborhoods. [ABSTRACT FROM AUTHOR]

Loss of cognitive functions, as apparent through self-awareness, is considered an important indicator of cognitive deficits and is therefore commonly used in clinical practice. However, little is known about self-awareness of cognitive performance, including its accuracy, its basis, and whether people can distinguish their performance across different cognitive domains. In the present study, 20 university students (Mage = 21.7 ± 2.2 years, 9 males) and 20 middle-aged participants (Mage = 52.8 ± 3.9 years, 10 males) gave estimations of their performances on executive functioning, memory, attention, and visuoperception before and after confrontation with their capacities. A repeated-measures analysis of variance with age group as a between-subjects factor was performed on the calculated estimation errors, before and after neuropsychological testing. Overall, the estimation errors were significantly higher before than after experience with test performance,ps < .01, partial η²s = .17. An overall effect of domain (four levels),ps < .001, partial η²s = .22 was found. These results suggest that self-awareness is domain-specific, and although it is adaptive to the experience of mental effort, it is most dependent on preexisting beliefs about one's own cognitive abilities. [ABSTRACT FROM PUBLISHER]

Using two waves of panel data from the National Survey of Midlife in the United States (MIDUS), we examine the relationship between volunteer work and three dimensions of well-being: hedonic (e.g., positive mood), eudemonic (e.g., purpose in life), and social (e.g., feeling of belonging to the community). We test for the effects of volunteering measured as a binary and a continuous variable. Results show that volunteering enhances eudemonic and social well-being (but not hedonic well-being) although the number of hours contributed makes no difference. Conversely, people who have greater hedonic, eudemonic, and social well-being are more likely to volunteer and, in the case of hedonic and eudemonic well-being, volunteer more hours. [ABSTRACT FROM AUTHOR]

Three studies explored how the traits that people ideally desire in a romantic partner, or ideal partner preferences, intersect with the process of romantic relationship initiation and maintenance. Two attraction experiments in the laboratory found that, when participants evaluated a potential romantic partner's written profile, they expressed more romantic interest in a partner whose traits were manipulated to match (vs. mismatch) their idiosyncratic ideals. However, after a live interaction with the partner, the match vs. mismatch manipulation was no longer associated with romantic interest. This pattern appeared to have emerged because participants reinterpreted the meaning of the traits as they applied to the partner, a context effect predicted by classic models of person perception (S. E. Asch, 1946). Finally, a longitudinal study of middle-aged adults demonstrated that participants evaluated a current romantic partner (but not a partner who was merely desired) more positively to the extent that the partner matched their overall pattern of ideals across several traits; the match in level of ideals (i.e., high vs. low ratings) was not relevant to participants' evaluations. In general, the match between ideals and a partner's traits may predict relational outcomes when participants are learning about a partner in the abstract and when they are actually in a relationship with the partner, but not when considering potential dating partners they have met in person. [ABSTRACT FROM AUTHOR]

Apathy and depression are the most common neuropsychiatric symptoms in mild cognitive impairment (MCI) and Alzheimer disease (AD). This study was the first to explore midlife motivational abilities as a predictor of the progression of apathy and depression in MCI and AD. It used a subsample of the Aging, Demographics, and Memory Study (N = 137). Participants, aged over 70, were categorized according to baseline clinical diagnosis (normal cognition, MCI, or AD). Assessments were conducted at an 18-month interval. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory. Midlife motivational abilities were estimated on the basis of the main occupation using the Occupational Information Network (O*NET) database, which provides detailed information on worker abilities. Repeated measures analysis of covariance was used. Apathy and depression were found to be particularly high in participants with AD and high motivational abilities. Apathy, but not depression, increased over time in those with AD and high motivational abilities. It would appear that holding on to unattainable goals with strong motivational efforts when faced with severe cognitive loss might lead to unproductive persistence, depressive reaction, and more apathetic behavior. [ABSTRACT FROM AUTHOR]

This study examined what variables best predict concerns about neighborhood safety among middle-aged and older adults. Eighty-five participants were selected from a Midwestern urban area. Participants completed a 22-item questionnaire that assessed their perceptions of neighborhood safety and vigilance. These items were clustered as: (a) community care and vigilance, (b) safety concerns, (c) physical incivilities, and (d) social incivilities. Police crime data were also used in the analyses. Our findings suggest that aspects of the broken window theory, collective efficacy, and place attachments play a role in affecting residents' perceptions of neighborhood safety. [ABSTRACT FROM AUTHOR]

This study examines the association of cognitive functioning with urban neighborhood socioeconomic disadvantage and racial/ethnic segregation for a U.S. national sample of persons in late middle age, a time in the life course when cognitive deficits begin to emerge. The key hypothesis is that effects of neighborhood on cognitive functioning are not uniform but are most pronounced among subgroups of the population defined by socioeconomic status and race/ethnicity. Data are from the third wave of the Health and Retirement Survey for the birth cohort of 1931 to 1941, which was 55 to 65 years of age in 1996 (analytic N = 4,525), and the 1990 U.S. Census. Neighborhood socioeconomic disadvantage has an especially large negative impact on cognitive functioning among persons who are themselves poor, an instance of compound disadvantage. These findings have policy implications supporting “upstream” interventions to enhance cognitive functioning, especially among those most adversely affected by neighborhood socioeconomic disadvantage. [ABSTRACT FROM PUBLISHER]

This study examined young ( n = 40) and middle-aged ( n = 30) adults' susceptibility to comparative optimism and comparative pessimism regarding disability in old age and their willingness to save for long-term care. Participants rated their risk of diverse levels of disability in old age, compared to another similar person, and indicated the amount of money they would be willing to save for future long-term care. While middle-aged participants showed the same level of comparative optimism for diverse disability levels, younger participants showed increasing levels of comparative optimism with increasing disability. Participants' comparative optimism levels and age both predicted their intentions to save. The findings are discussed in terms of theories of judgment and behavioral decision making. [ABSTRACT FROM AUTHOR]

Chen C-H, Suckling J, Lennox BR, Ooi C, Bullmore ET. A quantitative meta-analysis of fMRI studies in bipolar disorder. Bipolar Disord 2011: 13: 1-15. © 2011 The Authors. Journal compilation © 2011 John Wiley & Sons A/S. Functional magnetic resonance imaging (fMRI) has been widely used to identify state and trait markers of brain abnormalities associated with bipolar disorder (BD). However, the primary literature is composed of small-to-medium-sized studies, using diverse activation paradigms on variously characterized patient groups, which can be difficult to synthesize into a coherent account. This review aimed to synthesize current evidence from fMRI studies in midlife adults with BD and to investigate whether there is support for the theoretical models of the disorder. We used voxel-based quantitative meta-analytic methods to combine primary data on anatomical coordinates of activation from 65 fMRI studies comparing normal volunteers (n = 1,074) and patients with BD (n = 1,040). Compared to normal volunteers, patients with BD underactivated the inferior frontal cortex (IFG) and putamen and overactivated limbic areas, including medial temporal structures (parahippocampal gyrus, hippocampus, and amygdala) and basal ganglia. Dividing studies into those using emotional and cognitive paradigms demonstrated that the IFG abnormalities were manifest during both cognitive and emotional processing, while increased limbic activation was mainly related to emotional processing. In further separate comparisons between healthy volunteers and patient subgroups in each clinical state, the IFG was underactive in manic but not in euthymic and depressed states. Limbic structures were not overactive in association with mood states, with the exception of increased amygdala activation in euthymic states when including region-of-interest studies. In summary, our results showed abnormal frontal-limbic activation in BD. There was attenuated activation of the IFG or ventrolateral prefrontal cortex, which was consistent across emotional and cognitive tasks and particularly related to the state of mania, and enhanced limbic activation, which was elicited by emotional and not cognitive tasks, and not clearly related to mood states. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Suicidal ideation is an important phase in the suicidal process, preceding suicide attempts and completed suicide. Weak social ties and low support from friends or relatives have been significantly associated with suicidal ideation. This study investigated the relationship between social support and suicidal ideation among young and middle-aged adults in Korea. Methods: The Seoul Citizens Health and Social Indicators Survey conducted face-to-face interviews with 10,922 self-reporting adults. Questions were asked to assess suicidal ideation, and several questions focused on social support, social networks, health behaviors, and health status. Results: The strongest association in middle-aged adults was that between suicidal ideation and lack of social support. Poor emotional support significantly influenced suicidal ideation in middle-aged men, whereas lack of instrumental support significantly affected suicidal thoughts in middle-aged women, after controlling for sociodemographic factors, health behaviors, and health status. High alcohol use, functional limitations, and stress were related to suicidal thoughts in young adults, whereas depressive feelings had the strongest association with suicidal ideation in middle-aged women. Conclusions: Social support is a crucial independent correlate of suicidal ideation, especially in middle-aged adults in an urban community setting. This study shows that it is essential to provide gender-specific social support to prevent suicide. [Copyright &y& Elsevier]

Whereas theoreticians are interested in modeling how bereavement contributes to health, the bulk of research on spousal bereavement is conducted after a loss has occurred. Using prospective longitudinal data, this study examined the extent to which positive emotion following spousal loss varies on the basis of preloss characteristics of the bereaved spouse and the marital relationship prior to loss. Analyses are based on the National Survey of Midlife Development (MIDUS), a 2-wave panel survey of adults in the contiguous United States. Results indicate that compared with continuously married controls, widowed participants experienced a significant decline in positive emotion within 3 years following loss. Conversely, no significant declines in positive emotion were evident among widowed persons with greater preloss trait resilience or greater marital strain. Results provide support for the notion that adjustment to loss may be linked to factors that precede actual loss. [ABSTRACT FROM AUTHOR]

The present research examined stressful life events and personality development across middle adulthood. Participants (N = 533) related the most stressful event they had experienced within the last 10 years, indicated whether they considered the event to be a turning point and/or lesson learned, and twice completed a comprehensive measure of traits defined by the five-factor model of personality; the stressful event occurred between these two assessments. Descriptions were coded to classify events into broad Content domains based on the nature of the event. Prospectively, individuals high in Neuroticism perceived the event as a turning point; extraverts learned a lesson from it. Longitudinally, perceiving the event as a negative turning point was associated with increases in Neuroticism, whereas learning a lesson from the event was associated with increases in Extraversion and Conscientiousness. Characteristics of the events themselves were primarily unrelated to trait change. Across middle adulthood, personality trait change may be more strongly related to how individuals understand the stressful events in their lives rather than simply the occurrence of such events. [ABSTRACT FROM AUTHOR]

Summary: Background: Depression and anxiety have been linked to higher as well as lower reactivity to stressful circumstances. Large, population-based studies investigating the association between depression and anxiety, perceived and physiological stress responses are lacking. Methods: We studied 725 men and women, aged 55–60 years, from a population-based cohort, who filled out the Hospital Anxiety and Depression Scale (HADS). We performed a standardized interview on medical history and lifestyle. We measured continuous blood pressure (BP) and heart rate (HR) reactivity, saliva cortisol reactivity and perceived stress during a psychological stress protocol. Results: Albeit not statistically significant in all groups, systolic BP (SBP), diastolic BP (DBP), HR and cortisol reactivity to the psychological stress protocol were lower in those with mild-to-severe depression or anxiety symptoms and those ever clinically diagnosed with depression or anxiety, while perceived levels of stress were higher compared to those without depression or anxiety symptomatology. Maximum SBP, HR and cortisol stress responses significantly decreased and perceived stress scores significantly increased with increasing scores on the HADS depression subscale (HADS-D) and HADS anxiety subscale (HADS-A) (all P <0.05). The same held for stress responses in relation to the total HADS score (all P <0.05) and, in this case, the maximum DBP stress response was also significantly lower with an increasing HADS score (P =0.05). In addition, the maximum DBP stress response was significantly lower for those ever clinically diagnosed with depression (P =0.04). Adjusting for sex, use of anti-hypertensive medication, anti-depressant and anxiolytic medication, smoking, alcohol consumption, socio-economic status (SES) and body mass index (BMI) did not attenuate the results. Conclusion: The present study results suggest that the biological stress response of middle-aged men and women who experienced depressed and anxious feelings does not completely correspond with how stressed they feel at that moment. Although differences were not substantial in all cases, response to a psychological stress protocol seemed to be decreased in the groups with experience of depressed and anxious feelings, while the perception of stress seemed to be increased. [Copyright &y& Elsevier]

Abstract: Although changes in autonomic activity have been extensively examined as responses to cognitive challenges, relatively few studies have used individual differences in autonomic parameters to predict executive performance in healthy adults. Here we examined baseline and task-related changes in heart rate and heart rate variability (measured by respiratory sinus arrhythmia (RSA)) to predict performance of a pictorial Stroop task in a group of 81 healthy adults aged 17–55. Greater autonomic reactivity (increased heart rate and reduced RSA for task performance) was associated with faster colour naming of faces in the Stroop task. Dividing the group by median age revealed that middle-aged adults reduced RSA to a greater degree than their younger counterparts in the context of equivalent performance across groups. Findings suggest that performance of executive function tasks that evoke attentional control may depend in part on the responsiveness of autonomic control parameters via age-dependent mechanisms. [Copyright &y& Elsevier]

Does happiness vary with age? The evidence is inconclusive. Some studies show happiness to increase with age (Diener et al. ; Argyle ). Others hold that the association is U-shaped with either highest depression rates (Mroczek and Christian ; Blanchflower and Oswald ) or highest happiness levels occurring during middle age (Easterlin ). Current studies suffer from two shortcomings. Firstly, they do not control for three confounding time variables: age, period and cohort effects. Secondly, all empirical research lacks a theoretical explanation as to why age affects happiness. The purpose of our analysis is to contribute to closing both of these research gaps. A social investment model frames the dynamics of happiness across the life-span. The empirical test draws on West German panel data that followed individuals from 1984 to 2005. Descriptive analysis shows a cubic age function with the lowest level at middle age. However, hierarchical three-level variance component models (Rabe-Hesketh and Skrondal ), find significant differences across pre-war and post-war cohorts, baby boomers and offspring of the baby bust as well as deviations during reunification. Yet, cohort and period effects account for less than 10% of the variance. (Un)happiness in midlife is more strongly determined by gender-specific occasional influences and individual characteristics. Both define objective and subjective returns of professional and personal life investments. These social investment decisions date back to early adulthood and bear a high risk of failure during midlife. Unforeseen consequences and long-term private and professional commitments make it costly to adjust, but at the same time new investments may pay off in a pro-longed future. This dilemma turns many middle-aged people into “frustrated achievers”. [ABSTRACT FROM AUTHOR]

Many people are apprehensive about old age and their future years. This pilot study sought to improve participants' sense of possibility in, and expectations for, old age. Students and middle-aged volunteers completed a survey including the Expectations Regarding Aging 38-item questionnaire (ERA-38) and a possible-selves questionnaire before and after a positive-aging-intervention presentation. While there were no significant possible-selves changes, respondents demonstrated an improvement in expectations about aging. This study demonstrates the potential for a brief positive aging intervention to impact expectations for the future. Implications for decision making and health choices are discussed. [ABSTRACT FROM AUTHOR]

Background. Cognitive performance has been associated with mental and physical health, but it is unknown whether the strength of these associations changes with ageing and with age-related social transitions, such as retirement. We examined whether cognitive performance predicted mental and physical health from midlife to early old age. Method. Participants were 5414 men and 2278 women from the Whitehall II cohort study followed for 15 years between 1991 and 2006. The age range included over the follow-up was from 40 to 75 years. Mental health and physical functioning were measured six times using SF-36 subscales. Cognitive performance was assessed three times using five cognitive tests assessing verbal and numerical reasoning, verbal memory, and phonemic and semantic fluency. Socio-economic status (SES) and retirement were included as covariates. Results. High cognitive performance was associated with better mental health and physical functioning. Mental health differences associated with cognitive performance widened with age from 39 to 76 years of age, whereas physical functioning differences widened only between 39 and 60 years and not after 60 years of age. SES explained part of the widening differences in mental health and physical functioning before age 60. Cognitive performance was more strongly associated with mental health in retired than non-retired participants, which contributed to the widening differences after 60 years of age. Conclusions. The strength of cognitive performance in predicting mental and physical health may increase from midlife to early old age, and these changes may be related to SES and age-related transitions, such as retirement. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine whether middle-aged persons with depressive symptoms are at higher risk for developing activity of daily living (ADL) and mobility limitations as they advance into older age than those without. DESIGN: Prospective cohort study. SETTING: The Health and Retirement Study (HRS), a nationally representative sample of people aged 50 to 61. PARTICIPANTS: Seven thousand two hundred seven community living participants in the 1992 wave of the HRS. MEASUREMENTS: Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D 11), with scores of 9 or more (out of 33) classified as significant depressive symptoms. Difficulty with five ADLs and basic mobility tasks (walking several blocks or up one flight of stairs) was measured every 2 years through 2006. The primary outcome was persistent difficulty with ADLs or mobility, defined as difficulty in two consecutive waves. RESULTS: Eight hundred eighty-seven (12%) subjects scored 9 or higher on the CES-D 11 and were classified as having significant depressive symptoms. Over 12 years of follow-up, subjects with depressive symptoms were more likely to reach the primary outcome measure of persistent difficulty with mobility or difficulty with ADL function (45% vs 23%, Cox hazard ratio (HR)=2.33, 95% confidence interval (CI)=2.06–2.63). After adjusting for age, sex, measures of socioeconomic status, comorbid conditions, high body mass index, smoking, exercise, difficulty jogging 1 mile, and difficulty climbing several flights of stairs, the risk was attenuated but still statistically significant (Cox HR=1.44, 95% CI=1.25–1.66). CONCLUSION: Depressive symptoms independently predict the development of persistent limitations in ADLs and mobility as middle-aged persons advance into later life. Middle-aged persons with depressive symptoms may be at greater risk for losing their functional independence as they age. [ABSTRACT FROM AUTHOR]

Abstract: Associations between depression and impaired functioning are well known and have been documented in numerous clinical, primary care and epidemiological studies. Reviews of this research have focused on the elderly. Recent studies suggest that women become increasingly vulnerable during the menopausal transition to declines in physical and role function and increases in depressive symptoms. The purpose of the current research is to review the literature since 1966 for studies examining the association between depression and physical and psychosocial impairment in midlife women. We selected only longitudinal studies that had the potential to elucidate the nature of the complex relationship between depression and functioning. Results of the review indicate evidence for bi-directional associations between depression and functioning in middle-aged women. However, the studies are only broadly informative. Most adjusted for only a limited group of factors that could be associated with both depression and functioning. None of them directly examined potential moderators or mediators of the relationship between depression and impaired functioning. [Copyright &y& Elsevier]

This article develops a series of hypotheses about the long-term effects of one's history of marriage, divorce, and widowhood on health, and it tests those hypotheses using data from the Health and Retirement Study. We examine four dimensions of health at mid-life: chronic conditions, mobility limitations, self-rated health, and depressive symptoms. We find that the experience of marital disruption damages health, with the effects still evident years later; among the currently married, those who have ever been divorced show worse health on all dimensions. Both the divorced and widowed who do not remarry show worse health than the currently married on all dimensions. Dimensions of health that seem to develop slowly, such as chronic conditions and mobility limitations, show strong effects of past marital disruption, whereas others, such as depressive symptoms, seem more sensitive to current marital status. Those who spent more years divorced or widowed show more chronic conditions and mobility limitations. [ABSTRACT FROM AUTHOR]

Abstract: Cognitive deficits and hippocampal atrophy, features that are shared with aging and dementia, have been described in type 2 diabetes mellitus (T2DM). T2DM is associated with obesity, hypertension, dyslipidemia, hypothalamic pituitary adrenocortical (HPA) axis abnormalities and inflammation, all of which have been shown to negatively impact the brain. However, since most reports in T2DM focused on glycemic control, the relative contribution of these modifying factors to the impairments observed in T2DM remains unclear. We contrasted 41 middle-aged dementia-free volunteers with T2DM (on average 7 years since diagnosis) with 47 age-, education-, and gender-matched non-insulin resistant controls on cognition and brain volumes. HPA axis activity and other modifiers that accompany T2DM were assessed to determine their impact on brain and cognition. Individuals with T2DM had specific verbal declarative memory deficits, reduced hippocampal and prefrontal volumes, and impaired HPA axis feedback control. Diminished cortisol suppression after dexamethasone and dyslipidemia were associated with decreased cognitive performance, whereas obesity was negatively related to hippocampal volume. Moreover, prefrontal volume was influenced by worse glycemic control. Thus, obesity and altered cortisol levels may contribute to the impact of T2DM on the hippocampal formation, resulting in decreased verbal declarative memory performance. [Copyright &y& Elsevier]