Correlates of subjective health in older adults: A meta-analysis.

Age-associated changes of subjective health and associations of subjective health with physical health, functional health, and mental health were meta-analyzed in older adults (mean age > 60 yrs). An age-associated decline of subjective health, which was stronger in old-old samples than in young-old samples, was found. Subjective health was correlated with the indicators of objective health, but the association with physical health was stronger than with functional health. Correlations of subjective health with physical health and functional health were lower in the old-old than in the young-old samples, whereas associations of subjective health with mental health were stronger in older samples. Furthermore, the size of the association between subjective and objective health varied by the method of assessment of objective health, showing highest associations with symptom checklists and results of medical examinations due to strict protocols. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of disability and bereavement on the mental health and recovery of older adults.

We investigated the role of two major stressors, recent disability and conjugal bereavement, in older adults' self-reports of mental health and recovery from stress. A sample of 246 older adults between the ages of 60–80 was interviewed monthly for 3 months by trained elderly interviewers; Month-10 interview data were also analyzed. Control subjects, who were not experiencing the stressors, were carefully selected from a sample of adults matched on age, sex, and socioeconomic status. Dependent variables were psychological distress and psychological well-being, each with component subscales. The disabled group evidenced significantly lower positive well-being and significantly greater distress than did the other groups. Bereaved subjects demonstrated high levels of depression compared with the disabled subjects, but showed less anxiety. Bereaved subjects showed recovery on several indicators of mental health, but disabled subjects continued to show considerable psychological upset in comparison with the other groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neighborhood effects on physical and mental health: A study of Korean American older adults.

This study explored how the physical and mental health of Korean American older adults were influenced by neighborhood characteristics (i.e., proportion of individuals living below the poverty level, proportion of individuals 65 years of age and older, and proportion of racial/ethnic minorities in the census block groups where each respondent lived). Health perceptions (i.e., the subjective appraisal of one's own health) and depressive symptoms were used as indicators of physical and mental health. Multilevel analyses were performed with 567 individuals (at Level 1) nested within 233 census block groups (at Level 2). After controlling for individual demographic and health characteristics, we found that neighborhood poverty predicted health perceptions. The results add to the growing literature on the influence of the social environment and suggest that neighborhood characteristics should be taken into consideration in developing community-based policies for racially/ethnically diverse populations. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Supplemental group discussions in memory training for older adults.

Memory training was compared in adults aged 60–80. Groups 1 and 2 studied a self-instructional memory training manual; Group 2 also attended supplementary group discussions of typical problems of later life, related coping methods, and the techniques in the self-instructional manuals. Group 3 was a wait–list control group. Memory performance on 2 word lists significantly improved in the supplemental discussion group but not in the group that only studied the self-instructional manual. Enhanced performances were maintained at a 1-month follow-up. Bibliotherapy alone may be inferior to treatment involving a group component, although the mechanisms of such enhancement remain unexplored with respect to memory training. Neither treated group improved their digit span or recall of names and a brief prose passage; teaching older adults the strategies of chunking and use of imagery may not be beneficial. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes toward older and younger adults: A meta-analysis.

Attitudes toward the elderly have been examined in a number of empirical studies, yet the question of whether the elderly are viewed more negatively than younger persons has not been resolved. A meta-analysis of the literature was conducted to examine this question; results demonstrated that attitudes toward the elderly are more negative than attitudes toward younger people. However, smaller differences between the evaluations of elderly and younger targets were found when (a) the study used measures of personality traits (compared with measures of competence), (b) there were a larger number of dependent measures included in the effect size, (c) specific information was provided about the target person (compared with when a general target such as old person was used), and (d) a between-subjects design (compared with a within-subjects design) was used. These results support Lutsky's (1981) conclusion that age, in and of itself, seems to be less important in determining attitudes toward the elderly than other types of information. The methodological limitations within the literature and a need to consider multiple components of attitudes toward older individuals are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working memory training in older adults: Evidence of transfer and maintenance effects.

Few studies have examined working memory (WM) training-related gains and their transfer and maintenance effects in older adults. This present research investigates the efficacy of a verbal WM training program in adults aged 65–75 years, considering specific training gains on a verbal WM (criterion) task as well as transfer effects on measures of visuospatial WM, short-term memory, inhibition, processing speed, and fluid intelligence. Maintenance of training benefits was evaluated at 8-month follow-up. Trained older adults showed higher performance than did controls on the criterion task and maintained this benefit after 8 months. Substantial general transfer effects were found for the trained group, but not for the control one. Transfer maintenance gains were found at follow-up, but only for fluid intelligence and processing speed tasks. The results are discussed in terms of cognitive plasticity in older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure of mental health measures for older adults.

This article examines the factor structure of mental health self-reports among 246 older adults, ages 60 to 80 years, who were either recently physically disabled (n?=?62), recently bereaved (n?=?61), or matched control subjects (n?=?123). Confirmatory factor analyses were carried out on the Mental Health Inventory and the Psychiatric Epidemiology Research Interview (PERI) Demoralization Composite to test whether factor structures obtained in previous studies would fit the data for this older adult sample and whether those structures would be equivalent among groups that differ in degree of life stress. The structure of these two inventories was reorganized as a result of these analyses, resulting in 9 subscales that varied somewhat from the original subscale structure. The Bradburn Positive Affect Scale was added, and a second order confirmatory factor analysis was performed on these 10 scales. Two highly correlated superordinate factors emerged: Psychological Distress and Psychological Well-Being. Although the factor structure was generally similar across groups, there were some notable exceptions that could be attributed to between-groups differences in exposure to life stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preferences for emotional information in older and younger adults: A meta-analysis of memory and attention tasks.

The authors conducted a meta-analysis to determine the magnitude of older and younger adults' preferences for emotional stimuli in studies of attention and memory. Analyses involved 1,085 older adults from 37 independent samples and 3,150 younger adults from 86 independent samples. Both age groups exhibited small to medium emotion salience effects (i.e., preference for emotionally valenced stimuli over neutral stimuli) as well as positivity preferences (i.e., preference for positively valenced stimuli over neutral stimuli) and negativity preferences (i.e., preference for negatively valenced stimuli to neutral stimuli). There were few age differences overall. Type of measurement appeared to influence the magnitude of effects; recognition studies indicated significant age effects, where older adults showed smaller effects for emotion salience and negativity preferences than younger adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The mental health system and older adults in the 1990s.

Trends in mental health services for older adults during the past decade were used to predict salient issues for the current decade. These include overreliance on inpatient treatment, increased use of general hospitals as treatment sites, inadequate integration with the nursing-home industry, and insufficient mental health referrals from general medical providers. In the decade ahead, the mental health needs of older adults are unlikely to be an identified focus; rather, the issues will overlap with other priorities (e.g., biomedical research on brain functioning, alternative treatment programs for the chronically mentally ill, and containing health care costs). Advocates for the elderly will be successful to the extent that they cast aging services within the context of these other concerns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of depressive symptomatology on episodic memory functioning among clinically nondepressed older adults.

The authors examined a community-based sample of 303 clinically nondepressed individuals aged 75 through 96 years on 4 recall tasks: free recall of rapidly presented random words, free recall of slowly presented random words, free recall of organizable words, and cued recall of organizable words. Using a classification taxonomy that identified mood- and motivation-related symptoms of depression, it was found that motivation-related symptoms had a negative effect on performance across all tasks, whereas mood-related symptoms had no effects. In addition, motivation-related symptoms negatively influenced the ability to benefit from more study time but had no effect on the ability to make use of item organization or category cues. An analysis of the specific motivation-related symptoms suggested that symptoms that may affect the ability to focus and sustain attention (e.g., concentration difficulties, lack of interest ) were most strongly associated with performance deficits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Local Medicare policies: A pathway for providing mental health services to older adults.

Inconsistent local Medicare service coverage policies constitute one of the most prominent barriers encountered by mental health professionals who provide services to older adults. In this study, the authors analyzed the scope and delineation of local Medicare policies for 19 types of psychiatric and psychological services in 2003 and again in 2006. Results indicated policies now exist for all Medicare services in all the states, and many of the local policies provide definitive statements to guide practice. However, some policies lacked delineation and variability persists from one region to the next. While researchers ascertain how local policies can impact service outcomes, providers should form issue networks and resolve current problems such as the inequities surrounding service documentation requirements and the lack of guidance in providing mental health care to older persons with dementia. Given that the Medicare administrative structure will undergo substantive changes in the next five years, there is an exceptional opportunity for providers to address these problems successfully and pave a pathway for providing specialty mental health services to older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community mental health service use by older adults with dementia.

We considered the role of community-based public mental health services in providing care to older persons with Alzheimer's disease and other forms of dementia, and examined service outcomes within California's county-based public mental health system over a 3-year period. Treated prevalence rates, repeat service use rates, and service mix patterns were regressed onto individual, market, and contextual variables across 25 counties over 12 observation periods. The number of older adults with dementia who used community mental health services increased slightly over the observation periods, and service use was associated with age and Medicaid status. Service outcomes also were affected by complementary mental health and aging service systems within each county, as well as the poverty rate and location of the county. Future research is needed to clarify how administrative policies and service management practices contribute to increasing community mental health service use by persons with dementia. In the meantime, these findings can help program administrators and service providers understand the role of community-based mental health services in providing care to persons with dementia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religiosity and mental health: A critical reevaluation and meta-analysis.

A meta-analysis of 24 studies on the relationship between religiosity and personality revealed no support for the preconception that religiousness is necessarily correlated with psychopathology; but it also showed only slightly positive correlates of religion. Better specification of concepts and methods of measuring religiosity are alleviating the problem of ambiguity in research results and suggest that religion reflects a multidimensional phenomenon that has positive and negative aspects. Clinical education, practice, and research need revision so that professionals will be better informed of the evidence, more open to the study of such variables, and more efficacious in their work with individuals who approach life from a religious perspective. (73 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Providing mental health care to older adults: Unraveling the maze of Medicare and managed care.

This article reviews fundamental information about mental health benefits for older adults. Major systems, including Medicare, Medicaid, and managed care, are described. Regulations and policies that influence mental health care for older adults are distinct from those for the general population. In addition, Medicare has adopted managed-care options more recently than the private insurance industry. This relationship between Medicare and managed care is chronicled and future directions are postulated. Finally, we examine several empirical questions that have been raised due to the recent changes in the delivery of mental health care to older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Utilization of specialty mental health organizations by older adults: U.S. national profile

Data from the four most recent biennial inventories of mental health organizations and general hospital mental health services conducted by the U.S. Department of Health and Human Services (1988 through 1994) were used to examine utilization of specialty mental health organizations by older adults. The data show steady inverse trends in utilization rates for inpatient and ambulatory care. The oldest clients (age 75 and older) had both the highest percentage decrease in use of inpatient services and the highest percentage increase in use of ambulatory services. The expected growth of the older adult population will challenge the ability of systems of care to maintain or increase the rate of ambulatory mental health care.     

Overcoming obstacles in providing mental health treatment to older adults: Getting in the door.

Older adults significantly underutilize mental health services relative to their numbers in the population. Barriers that impede their access include physical, financial, cognitive, emotional, and attitudinal issues. This article discuss strategies for overcoming these barriers including physical adaptations such as in-home psychotherapy and telephone sessions, use of support groups, strong community outreach, and liaisons with other professionals. Adaptations that help to increase older adults' use of mental health services are discussed, including education about treatment, nontraditional "pursuit" of clients, and use of alternative terminology. Informed consent is discussed as a special issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability and stability of executive functioning in older adults.

A number of methodological questions have been raised about the reliability and validity of measuring executive functioning (EF) across multiple time points. In this study, correlational and latent-variable analyses were used to examine test-retest reliability of 5 common measures of EF and the stability of a latent EF construct. One hundred eighteen nondemented older adults were tested twice over a 4- to 8-week period. Findings demonstrated modest reliability of individual EF measures but very high stability of a latent EF construct. Relative contributions of each measure to the latent EF factor did not change across measurement trials. In addition, age-related effects on EF were similar at the 2 time points and were within the expected range. Implications for future studies of EF are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health and mental health in older adults: First steps in the study of a pedestrian complaint.

Investigated the relationship of self-reported foot problems to health, mental health, and functional mobility in 111 50–87 yr olds living in a multiethnic urban area. One-third of the respondents reported having problems with their feet. Analyses supported the prediction that foot complaints were significantly related to greater psychological distress and that for most individuals, this relationship was mediated by limited mobility. Specific psychological correlates were congruent with a picture of diminished sense of self-efficacy among those with foot problems. Results have implications for prevention and rehabilitation. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective memory and self-reports of memory abilities in older adults.

Investigated age differences in prospective memory, and the relations among metamemory, reported use of memory aids, and actual performance on prospective memory tasks. Ss were 83 males and 145 females, aged 30–99 yrs, (with approximately equal numbers in each of the age ranges of 30–39, 40–49, 50–59, 60–69 and 70+ yrs) who completed a metamemory questionnaire and 2 prospective memory tests. Findings of the metamemory task show an age-related increase in reported memory problems. The pattern of correlations revealed that metamemory scores and prospective remembering performance were often negatively correlated (especially for the 30-yr-old people). The correlations indicated either that people have poor knowledge about their own memory abilities or that their concept of memory is different from that of the psychologist. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Plasticity of executive functioning in young and older adults: Immediate training gains, transfer, and long-term maintenance.

The authors investigated immediate training gains, transfer effects, and 18-month maintenance after 5 weeks of computer-based training in updating of information in working memory in young and older subjects. Trained young and older adults improved significantly more than controls on the criterion task (letter memory), and these gains were maintained 18 months later. Transfer effects were in general limited and restricted to the young participants, who showed transfer to an untrained task that required updating (3-back). The findings demonstrate substantial and durable plasticity of executive functioning across adulthood and old age, although there appear to be age-related constraints in the ability to generalize the acquired updating skill. (PsycINFO Database Record (c) 2010 APA, all rights reserved)