Predictors of cognitive change in older persons: MacArthur studies of successful aging.

This study used a linear structural relations modeling technique (LISREL) to examine longitudinal data for 1,192 persons from a community-based population. The goal was to test the ability of an a priori model to predict cognitive change over a 2.0- to 2.5-year period in older adults aged 70–79 at the initial evaluation. The model included 22 demographic, physical, and psychosocial variables as predictors of cognitive function and cognitive change. The study used an exploratory-confirmatory design, enabling cross-validation of the model developed in the exploratory set in the confirmatory sample. Structural equation modeling analyses identified 4 endogenous model variables (education, strenuous activity, peak pulmonary expiratory flow rate, and self-efficacy) as direct predictors of cognitive change over the study period. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intraindividual variability in perceived control in a older sample: The MacArthur successful aging studies.

Two aspects of perceived control, locus of control (LOC) and perceived competence (COM), command significant attention in personality and aging research. Mainly, these concepts are regarded as stable variables of considerable promise for predicting a range of outcomes. The authors concentrate on week-to-week within-person variability in self-reported LOC and COM. Using data collected over 7 months, the authors first demonstrate that the responses of a panel of older participants are structurally consistent with dominant conceptions of perceived control and that the responses maintain an underlying structure over the frequently repeated protocol. They next show that the within-person variation over weekly measurements is coherent information rather than "noise" and that individual differences in magnitude of week-to-week variability are a relatively stable attribute that predicts mortality status 5 years later. Implications of the findings for both methodological and substantive concerns are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social self-efficacy and short-term variability in social relationships: the MacArthur successful aging studies

Dealing with others entails both stability and short-term variability of the functions and outcomes of social relationships. The authors argue that patterns of short-term intraindividual variability in social relationships and self-efficacy beliefs contribute interpretable information about social adaptation. On the basis of 23 repeated weekly measurements of a sample of 32 participants ages 56 to 88 years, the authors examined the extent to which fluctuations in perceived relational outcomes are related to fluctuations of social self-efficacy. Results showed that individuals differ systematically in respect to the extent to which they experience and display fluctuations in self-efficacy and availability of social relationships. Moreover, when individuals perceive others to be available across time, social self-efficacy beliefs are stronger and fluctuate less across time.     

Exploring the within-person coupling of sleep and cognition in older African Americans.

This study examined the within-person relationship between sleep and cognitive functioning. Fifty community-dwelling African Americans (age range = 50–80 years) were asked to report their sleep duration and quality the previous evening and to complete cognitive measures over 8 occasions within a 2–3 week period. A within-person daily change in sleep duration was significantly associated with worse global cognitive performance. The greater an individual deviated away from his or her average sleep duration on a particular day, the more likely his or her performance would decline. These results demonstrate that the sleep-cognition relationship can be observed at a within-person level of analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Balance and muscle strength as predictors of frailty among older adults

The term frailty is increasingly used in gerontological literature and in practice. However, indicators differentiating frail from nonfrail are not well delineated. Identifying factors discriminating between frail and nonfrail older community-residing adults may lead to more comprehensive clinical assessments and targeted interventions to minimize or prevent frailty. Eighty-four adults, ages 60 to 88 (mean = 74) living independently in the community completed a functional performance questionnaire and a perceived health questionnaire that were combined as measures of frailty. Predictor variables of frailty included four measures of balance and three measures of lower leg strength. Discriminant analysis revealed that one balance score and dorsiflexion correctly classified 65% of group membership, with better prediction of the nonfrail than frail group. This study clarifies that the predictors of frailty include the combination of dorsiflexion strength and balance, specifically the contribution of vision to balance when the support surface is compliant. Recommendations are proposed for conceptualizing and operationalizing frailty and adding variables to enhance discrimination between frailty and nonfrailty. Nursing implications include adding clinical assessments of specific components of balance and ankle strength to develop a more comprehensive evaluation of frailty.     

Thriving older African American women: aging after Jim Crow

Success of glaucoma filtration surgery is influenced by the wound healing response. Attention has been focused on pharmacological agents to control a process that leads to excessive scarring and eventual failure of glaucoma filtration surgery. Several agents, including 5-fluorouracil and mitomycin C, as well as other antiproliferative drugs will be discussed. Newer antifibrotic agents and novel drug delivery systems are under development in tissue culture and animal models in an effort to improve efficacy and safety. This article summarizes current treatment modalities and future prospects to prevent excessive wound healing and improve the success of glaucoma filtration surgery.     

Measures of fluency as predictors of incidental memory among older adults.

This study investigated fluency performance as a mediator of age-related declines in incidental memory performance as both are thought to rely on strategic retrieval processes. A large sample of community dwelling older adults completed a battery of tests assessing fluency, verbal knowledge, speed of information processing, and incidental recall. Fluency measures included initial and excluded letter fluency and the Uses for Objects Test, and they were assumed to reflect increasing reliance on strategic retrieval search. Speed emerged as the best mediator of age-related variance in incidental recall, and Uses for Objects Test performance added to the variance after controlling for verbal knowledge and speed. The results suggest that age-related decline in incidental recall is largely due to speed and the strategic search of memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric symptomatology among alcoholics: Comparisons between African Americans and Caucasians.

Using data collected on 190 patients in a hospital-based substance abuse treatment center in a large midwestern city, this study compared psychiatric symptomatology between 39 African-American and 151 Caucasian adults. Although the groups were equivalent in consumption and frequency of usage, African-American alcoholics used significantly more substances (beyond alcohol) than did Caucasians. With regard to psychiatric symptomatology, African Americans reported higher levels of somatization, obsessive–compulsive behavior, depression, hostility, paranoid ideation, and psychoticism, and an overall higher degree of stress. Although the overall level of alcoholic self-reported severity did not distinguish the 2 groups, African Americans exhibited lower levels of global functioning as assessed by trained clinical staff. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Profiles of successful aging in middle-aged and older adult married couples.

The study identified coupled profiles of successful aging in middle-aged (n = 139; wives, M = 43.8 years old; husbands, M = 45.6 years old) and older adult married couples (n = 148; wives, M = 62.0 years old; husbands, M = 64.4 years old). Latent profile analysis was applied to variables reflecting the domains of cognition, physical health, personality, and social support. A 2-profile solution and a 4-profile solution were interpreted. Both solutions indicated that a large group of couples scored favorably across domains of successful aging. A small group of largely middle-aged couples who were experiencing extreme marital distress was identified. Unevenness across domains was identified, in that some groups involved a disassociation between marital satisfaction and health outcomes. Spouses were substantially similar in the pattern of their profile of aging. Older adults were not always associated with less favorable profiles. Profiles of successful aging did discriminate on external measures of well-being. The results point to the value of a multidimensional notion of successful aging in couples across the life span. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Racism as a stressor for African Americans: A biopsychosocial model.

Various authors have noted that interethnic group and intraethnic group racism are significant stressors for many African Americans. As such, intergroup and intragroup racism may play a role in the high rates of morbidity and mortality in this population. Yet, although scientific examinations of the effects of stress have proliferated, few researchers have explored the psychological, social, and physiological effects of perceived racism among African Americans. The purpose of this article was to outline a biopsychosocial model for perceived racism as a guide for future research. The first section of this article provides a brief overview of how racism has been conceptualized in the scientific literature. The second section reviews research exploring the existence of intergroup and intragroup racism. A contextual model for systematic studies of the biopsychosocial effects of perceived racism is then presented, along with recommendations for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accounting for changes in social support among married older adults: Insights from the MacArthur Studies of Successful Aging.

Using longitudinal, community-based data from the MacArthur Studies of Successful Aging, the authors examined determinants of changes in social support receipt among 439 married older adults. In general, social support increased over time, especially for those with many preexisting social ties, but those experiencing more psychological distress and cognitive dysfunction reported more negative encounters with others. Gender affected social support receipt: Men received emotional support primarily from their spouses, whereas women drew more heavily on their friends and relatives and children for emotional support. Discussion centers on the importance of social support provision to those with the greatest needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceiving pervasive discrimination among African Americans: Implications for group identification and well-being.

The processes involved in well-being maintenance among African Americans who differed in their attributions to prejudice were examined. A rejection–identification model was proposed where stable attributions to prejudice represent rejection by the dominant group. This results in a direct and negative effect on well-being. The model also predicts a positive effect on well-being that is mediated by minority group identification. In other words, the generally negative consequences of perceiving oneself as a victim of racial prejudice can be somewhat alleviated by identification with the minority group. Structural equation analyses provided support for the model and ruled out alternative theoretical possibilities. Perceiving prejudice as pervasive produces effects on well-being that are fundamentally different from those that may arise from an unstable attribution to prejudice for a single negative outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur Studies of Successful Aging.

This study examines the relationship of social ties and support to patterns of cognitive aging in the MacArthur Studies of Successful Aging (see L. F. Berkman et al., 1993), a cohort study of 1,189 initially high-functioning older adults. Baseline and longitudinal data provide information on initial levels as well as changes in cognitive performance over a 7.5-year period. Linear regression analyses revealed that participants receiving more emotional support had better baseline performance, as did those who were unmarried and those reporting greater conflict with network members. Greater baseline emotional support was also a significant predictor of better cognitive function at the 7.5-year follow-up, controlling for baseline cognitive function and known sociodemographic, behavioral, psychological, and health status predictors of cognitive aging. The findings suggest the potential value of further research on the role of the social environment in protecting against cognitive declines at older ages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived self-efficacy domains as predictors of fear of the unknown and fear of dying among older adults.

Using a sample of 167 women and 121 men, aged 65-87, this study tested the hypothesis that self-efficacy beliefs of older persons are significantly stronger predictors of death fears than are demographics, social support, and physical health variables used in earlier predictor models. Standard self-report measures were used to assess all predictor variables, including perceived self-efficacy in 8 different domains. Findings from a series of hierarchical regression analyses that were conducted separately for men and women supported the hypothesis concerning the superiority of self-efficacy variables as predictors of fear of the unknown after death and fear of dying, with spiritual health efficacy and instrumental efficacy being the most potent predictors of death fears for women and men. respectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individualism-collectivism, social-network orientation, and acculturation as predictors of attitudes toward seeking professional psychological help among Chinese Americans.

Several culturally based variables were used to predict the patterns of help-seeking attitudes among a sample of 219 Chinese-American students in a large midwestern university. Cultural values operationalized by the H. C. Triandis et al (see record 1988-13667-001) Individualism-Collectivism Scale, social support attitudes operationalized by A. Vaux's (see record 1987-09232-001) Network Orientation Scale, and the continuous variable of acculturation operationalized by the Suinn-Lew Asian Self-ldentity Acculturation Scale (R. M. Suinn et al; see record 1987-30187-001) were selected as predictors of attitudes as measured by E. H. Fischer and J. L. Turner's (1970) Attitudes Toward Seeking Professional Psychological Help Scale. Each of the 4 independent variables were found to be significant predictors of attitudes toward seeking professional psychological help. The counseling and research implications of the results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal predictors of attitudes toward aging among women with multiple sclerosis.

The purpose of the study was to explore the impact of change in functional limitation (FL), controlling for social support (SS), on attitudes toward aging using longitudinal survey data collected over a 7-year period. The 503 women with multiple sclerosis (MS; age, M = 57 years, SD = 10.25) were mostly Anglo (93%) and married (69%). First, the authors identified a quadratic growth model as the best for describing change in FL. Next, they considered SS as a time-varying covariate of FL to assess both within- and between-individual effects of SS on FL over time. Within individuals, higher FL levels were associated with lower SS levels. Between individuals, level of but not change in FL was associated with average SS level. Finally, average SS and response level and change in FL were studied as predictors of attitudes toward aging, accounting for 38% of the variance. Women with higher FL and lower SS scores had more negative views of aging. Negative views of aging among women with MS may have long-term consequences for their health outcomes as well as for the quality of their later years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adult social behavioral effects of heavy adolescent marijuana use among African Americans.

The authors examined the effects of heavy adolescent marijuana use on employment, marriage, and family formation and tested both dropping out of high school and adult marijuana use as potential mediators of these associations among a community sample of African Americans followed longitudinally from age 6 to age 32-33. They used propensity score matching to reduce selection bias when estimating the effects of heavy adolescent marijuana use. Logistic regression results on the sample matched on sex, and early demographic and behavioral variables showed that adolescent marijuana use has adult social behavioral consequences: Use of marijuana 20 times or more during adolescence was associated with being unemployed and unmarried in young adulthood and having children outside of marriage for both males and females. Dropping out of high school and more frequent adult marijuana use seem to be important parts of the pathway from adolescent marijuana use to negative life outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence and impact of risk factors for lower body difficulty among Mexican Americans, African Americans, and whites

BACKGROUND: The purpose of the study was to estimate the prevalence of sociodemographic, health behavior, chronic disease, and impairment factors and their impact on difficulty in lower body function among two age-cohorts (51-61 and 71-81 years) of Mexican Americans, African Americans, and Whites. METHODS: Reports from 8,727 and 4,510 self-respondents of the 1992 baseline Health and Retirement Survey and the 1993 baseline Assets and Health Dynamics Study, respectively, were used to estimate prevalence. Multiple linear regression of the 4-item lower body difficulty scale (alpha = .80) was used to estimate the direct effects of the risk factors within the age-cohort and ethnicity groups. RESULTS: Overall, the risk factors are more prevalent among both minority groups and the older age-cohort. Lower body deficits are particularly high among Mexican Americans and the younger age-cohort of African Americans. The impact of risk factors does not vary much by ethnicity or age-cohort. Female gender, pain, arthritis, and heart and lung disease are the major risk factors, and they account for about one-third of the variance in lower body difficulty for each group. CONCLUSIONS: Efforts to prevent or reduce lower body difficulty should pay particular attention to pain, arthritis, and heart and lung disease. The central role of sociodemographic and behavioral factors in chronic disease argues for their continued inclusion in disability modeling and prevention.     

Utility of parameters measured during pneumatic dilation as predictors of successful dilation

OBJECTIVES: The ability to immediately predict the long term outcome of a pneumatic dilation in achalasia has not been well studied. This study prospectively compared immediate postpneumatic dilation parameters with long term efficacy to determine if any factors predicted a favorable long term outcome. METHODS: Twenty-nine previously undilated achalasia patients underwent graduated pneumatic dilation with Hurst-Tucker dilators (diameters 2.7, 3.3, 3.7, and 4.1 cm). Dilations began with the smallest dilator followed by an observation period of at least 6 wk to determine clinical response. If no clinical improvement was noted, the next size dilator was used. Immediate postdilation parameters studies included: 1) severity of pain during dilation, 2) amount of blood on the dilator, 3) insufflation pressures during dilation, 4) esophageal emptying of gastrograffin (30 ml), and 5) esophageal emptying of barium sulfate (90 ml). RESULTS: None of the postdilation parameters studied predicted which patients would have good long term results. Pain during dilation increased with increasing dilator size. CONCLUSIONS: The degree of pain associated with a pneumatic dilation, the amount of blood noted on the dilator, the difference in pressure required to inflate the dilator at the beginning versus the end of dilation, and the amount of esophageal emptying immediately postdilation did not predict long term outcome.