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This study examined whether a reciprocal relationship exists between measures of self-assessed global health and depressive symptoms, net of covariates that included chronic illness, functional disability, education, income, gender, race, and age. Analyses of five waves of data from the Rand version of the Health and Retirement Survey (N = 7,475), using an autoregressive, cross-lagged panel design, indicated that self-assessed overall health had a modest but statistically significant and consistent effect on depressive symptoms. In contrast, the level of depressive symptoms had a statistically nonsignificant effect on self-assessed health. There has been growing interest in identifying the factors that inform self-assessments of overall health. The present findings indicate that self-assessed global health is not simply a manifestation of depressed affect.

The concept of physical health is central to the notion of aging well. In addition to being a core outcome or predictor variable in field of health and aging, physical [...]

Employment status of middle-aged women who tend to older relatives adds to their physical stress and is not beneficial either to the caregiver or the care receiver. Presence of children in the caregiver's household exerts positive effects on the caregiver, reduces depression and smoothens the relationship between the caregiver and the care recipient. Practitioners can work toward the well-being of these women by understanding the demands and the multiple roles thrust upon them.

Most caregivers consider their job a burden since they offer caregiving services indiscriminately, immaterial of the well-being of the patients. Caregiver well-being and caregiving burden are two variable used in caregiving research. Caregiver burden is a more viable variable for analysis than caregiver well-being, although burden is more subjective than generic well-being.

Abstract Introduction Common symptoms for children with Anderson-Fabry Disease (FD) such as acroparaesthesia and gastrointestinal manifestations can only be objectively assessed in patients using a valid instrument. To date, no such instrument exists. Methods A preliminary 40-item measure of symptoms and experience with FD, the Fabry-specific Paediatric Health and Pain Questionnaire (FPHPQ) was developed, but lacked a formal assessment of its measurement properties. The FPHPQ was used in the Fabry Outcome Survey (FOS), a registry for all patients with a confirmed diagnosis of FD who are receiving agalsidase alfa, or are treatment naïve and who are managed by physicians participating in FOS. After an item analysis to explore how items performed and combined into domains, a battery of psychometric analyses was performed to assess the measurement properties of this new instrument. Results Eighty-seven children (ages 4-18 years) completed the questionnaire. Twenty-three items in three subscales of the questionnaire emerged: pain associated with heat or exertion, pain associated with cold, and abdominal pain and fatigue symptoms. Internal consistency reliability for all three subscales was good (Cronbach alpha ≥ 0.84). Reliability was equally high for all age groups (4-7, 8-12, and 13-18). Test-retest reliability was high for all three subscales (intraclass correlation coefficient ≥ 0.74). Construct validity was demonstrated by moderate correlation with brief pain inventory (BPI), KINDL, and EQ-5D. Known group validity showed all subscales were able to discriminate between Fabry disease severity groups as classified by above or below median of the FOS MSSI (Mainz Severity Score Index) grade. The heat or exertion subscale was responsive to change in symptoms between responders and non-responders as defined by change in EQ-5D index scores between the first and second visit. Conclusions Preliminary results indicate that the measurement properties of FPHPQ are valid and reliable for assessing patient-reported symptoms of FD. The questionnaire could be a useful tool for clinicians to understand the progression of disease and monitor treatment effects. FPHPQ will be further validated and refined as the FOS registry is continuously adding more patients.

Abstract Background To estimate utility values for different levels of migraine pain severity from a United Kingdom (UK) sample of migraineurs. Methods One hundred and six migraineurs completed the EQ-5D to evaluate their health status for mild, moderate and severe levels of migraine pain severity for a recent migraine attack, and for current health defined as health status within seven days post-migraine attack. Statistical tests were used to evaluate differences in mean utility scores by migraine severity. Results Utility scores for each health state were significantly different from 1.0 (no problems on any EQ-5D dimension) (p Conclusions Results indicate that all levels of migraine pain are associated with significantly reduced utility values. As severity worsened, utility decreased and severe migraine pain was considered a health state worse than death. Results can be used in cost-utility models examining the relative economic value of therapeutic strategies for migraine in the UK.

Researchers are beginning to look more closely at the lives of never-married elderly. As yet, there is no clear consensus regarding the lives and social support networks of the never-married elderly. In particular, are never-married elderly at greater risk for institutionalization than other marital groups? Findings from past research are mixed. Part of the difficulty lies in grouping never-married elderly with other unmarried elderly, or focusing on the presence or absence of a spouse. This article reexamines the life situation of never-married elderly in terms of health, social interaction, and household and family structure. The never married are compared with married, widowed, and divorced/separated elderly persons on these three dimensions. The findings suggest that never-married elderly are socially active, are not socially isolated, and may not be at high risk for institutionalization compared to other marital groups.