Perceptions of intergenerational communication by young, middle-aged, and older Canadians.

Young, middle-aged, and older Canadians (N = 240) evaluated their past communicative experiences with older and younger adults who were not family as well as undertaking an age-stereotyping task. The latter showed that ratings of attributed benevolence increased with target age but personal vitality declined; young raters attributed older people with the least personal vitality. Communication with older targets was rated more negatively in terms of their being more nonaccommodating and avoided. Although these (and other) differences were more evident for young respondents, older adults, too, indicated problems communicating with same-aged peers. Middle-aged respondents rated communication experiences similarly to their older counterparts. The study also examined whether the communication variables predicted older people's psychological functioning. In contrast to the intergenerational focus of the communication predicament model of aging, perceived accommodation from other older adults predicted life satisfaction and age group esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical health impairment and depression among older adults

We studied the effect of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1), and interferon-gamma (IFN-gamma) on the function of thyroid cells and pituitary thyrotrophs. In FRTL-5 rat thyroid cells, both human and murine TNF-alpha inhibited basal and TSH-stimulated [125I]iodide transport. IL-1 shared this action with TNF-alpha, but was less potent. IL-1 and IFN-gamma did not cause a further reduction of TNF-alpha-induced inhibition of [125I]iodide transport. TNF-alpha, phorbol ester 12-myristate 13-acetate (PMA), and calcium ionophore (CI) A23817 all inhibited [125I]iodide transport, but high doses of PMA and CI also blocked the inhibitory action of TNF-alpha on [125I]iodide transport. Inhibition of protein kinase A and protein kinase C by H7 or HA inhibited TSH-stimulated iodide transport, but did not block the TNF-alpha action, suggesting that the mechanism of TNF-alpha action on thyroid cells is independent of protein kinase A and C. In pituitary cells, both human and murine TNF-alpha did not affect basal TSH secretion, but TNF-alpha reduced TRH-stimulated TSH secretion. This study provides further in vitro evidence that TNF-alpha inhibits the function of the hypothalamus-pituitary-thyroid axis acting directly on both the pituitary and thyroid glands.     

AIDS caregiving and health among midlife and older women

OBJECTIVES: This study investigated changes in finger circulation after different durations of exposure to hand-transmitted vibration. METHODS: Finger skin temperature (FST), finger blood flow (FBF), and finger systolic blood pressure (FSBP) were measured in the middle fingers of both hands of 10 healthy men. Finger vascular resistance was also estimated. The right hand was exposed for 7.5, 15, and 30 minutes (static load 10 N) to 125-Hz vibration (root-mean-square acceleration 87 m/s2). Static load only was used as a control. Finger circulation was measured before the vibration and static load exposure and at fixed intervals during exposure and a 45-minute recovery period. RESULTS: No significant changes were found with the static load. The FST and FSBP did not change significantly during vibration exposure, whereas vibration produced significant reductions in FBF and increases in vascular resistance at each duration when compared with preexposure and contralateral (non-vibrated) finger values. Temporary vasodilation occurred in the vibrated finger immediately after each vibration exposure. Recovery was complete for FBF and vascular resistance after the 7.5-minute vibration, whereas a progressive FBF reduction occurred in both the vibrated and the nonvibrated fingers after 15- and 30-minute exposure. The longer the duration of vibration exposure, the stronger the vasoconstriction in the vibrated finger during recovery. CONCLUSIONS: Vasoregulatory mechanisms mediated by both intrinsic (local) and extrinsic (neural or endocrine) control systems seem to be related to digital circulatory changes during 125-Hz vibration. It is concluded that, not only the frequency and magnitude of vibration, but also its duration contributes to the reaction of the digital vessels to acute vibration.     

Private health insurance coverage and disability among older Americans

OBJECTIVES: This study examines the relationship between the lack of private supplemental health insurance coverage and the development of disability among adults aged 65 and older. METHODS: Data are from the baseline and six follow-up waves of the Duke Established Populations for Epidemiologic Studies of the Elderly survey (N = 4,000). Discrete-time hazard models were used to estimate the impact of insurance coverage and other risk factors on the incidence of disability among those unimpaired at baseline. RESULTS: Controlling for education, income, and other potential confounders, the odds of developing disability were 35-49% higher among those without private coverage. Insurance coverage also statistically explained part of the increased risk of disability among low-income persons. DISCUSSION: The results indicate that changes in health insurance coverage as well as in individual behaviors may be needed to reduce disability generally and disability among the socioeconomically disadvantaged, in particular.     

Impact of psychological and physical health, stressful events, and social support on subsequent mental health help seeking among older adults.

Factors that influence mental health help seeking among adults 55+ yrs were examined prospectively. A discriminant analysis significantly differentiated between 120 older adults needing and seeking services and a comparison group of 120 older adults not needing services. Prior to having sought help, help seekers demonstrated poorer psychological well-being, reported more physical health problems, reported a higher level of unpleasant stressful events, and perceived greater deficits in the amount of social support available to them in time of need. The vast majority of these older help seekers sought help for their mental health problems from a medical doctor rather than from a mental health center or clinic or from a minister. Significantly more help seekers than nonseekers experienced stressful events involving bereavement, social and economic loss, and new physical illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trends in health and ability to work among the older working-age population

OBJECTIVES: Because of recent changes in Social Security regulations that will soon begin to raise the age of eligibility for full retirement benefits, it is important to determine whether health and ability to work at older ages have improved in recent years. METHODS: Individual-level data from the National Health Interview Survey from 1982 through 1993 are used in this analysis. Trends in self-reported ability to work, presence of disease, and causes of actual work limitation are examined. RESULTS: Men and women in their 60s, that is those in the older working ages and younger retirement ages, report significant improvement in their ability to work. The change in work ability is large enough so the percentage unable to work at age 67 in 1993 is lower than the percentage unable to work at age 65 in 1982. This improvement appears to have been similar for racial and ethnic groups and across educational subgroups of the population, although African Americans and those with lower educational attainment are less healthy to begin with. The improvement in health is due to the changing educational composition of the population, which is linked to better life-long health, different occupational circumstances, and better health behaviors. In addition, the improvement in work ability is explained by decline in the prevalence of cerebro/cardiovascular diseases and arthritis. DISCUSSION: The level of observed improvement in work ability means that the legislated rise in age of full eligibility for Social Security benefits should be more than compensated for by the improved ability to work.     

Social class differences in health and functional disability among older men and women

The aims of the study were to describe the health of older men and women and to investigate the social patterning of health and functional disability among older men and women, with special reference to social class differences. The data were derived from the 1994 nationwide Finnish Survey on Living Conditions (N = 1,448). Functional disability, limiting long-standing illness, and self-assessed health were used as health measures. Sociodemographic measures were social class, marital status, and urbanization. The age-adjusted social class differences were clear. Farmers and workers reported more functional disability and poorer health than did the white-collar class. Differences were somewhat smaller among women than among men. Social class was a stronger determinant than urbanization and marital status of functional disability and health.     

Factorial structure of two health belief measures among older adults.

Confirmatory factor analysis of K. A. Wallston's Multidimensional Health Locus of Control Scale and D. S. Krantz's Health Opinion Survey was conducted using 197 nondiabetic and 171 diabetic older adults. Qualified support was found for the 3-factor structure of the Wallston measure when applied to older adults. The Krantz model provided a less-than-adequate representation of the older sample's data. When the items from these 2 measures were combined, a 4-factor structure was found. Multisample simultaneous factor analyses using LISREL revealed that the factor structures of the Wallston and the Krantz measures fit the diabetic and the nondiabetic samples fairly equivalently. Despite the similarities in factor structures, diabetic individuals reported greater belief in powerful others and less desire for behavioral involvement in the health-care process than did nondiabetics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generativity among young, midlife, and older adults.

Generativity is conceived as a configuration of psychosocial features constellated around the goal of providing for the next generation. This study used a stratified random sampling of young (ages 22–27 yrs), midlife (ages 37–42 yrs), and older (ages 67–72 yrs) adults to examine age–cohort differences in 4 generativity features: generative concern, commitments, actions, and narration. Although prevailing views on generativity (e.g., E. H. Erikson, 1963) predict a peak in midlife and decline thereafter, support for this developmental hypothesis was mixed. Midlife Ss scored higher than young and older Ss on concern and actions in a second administration of measures, but not in the first. Generative commitments and narration showed high scores for both midlife and older Ss and relatively low scores for young Ss. Generative concern, assessed with the Loyola Generativity Scale, was positively associated with life satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective study of stressful circumstances, illness symptoms, and depressed mood among adolescents.

This study assessed the relationship of stressful life circumstances to illness symptoms and depressed mood among adolescent girls (in the 7th through the 11th grades). At two times, respondents indicated whether each of 20 commonly experienced circumstances had occurred to them and whether they rated its occurrence as positive or negative. Additionally, they completed an illness symptoms checklist and a standard measure of depressed mood. Cross-sectional analyses showed that circumstances rated negatively were associated with poor physical and mental health. Perspective analyses, controlling for initial physical or mental health status, revealed that negative circumstances led to reports of greater illness symptoms or depressed mood only when positive circumstances were low. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body size and physique among Canadians of First Nation and European ancestry

The purpose of this study was to compare body size and physique among Canadians of Aboriginal (First Nation [FN]) and European ancestry (EA) from the northern Ontario communities of Temagami and Bear Island. The sample consisted of 130 FN and 494 EA participants including adults (20-75 years: 214 men, 234 women) and youth (5-19 years: 97 boys, 79 girls). Indicators of body size and physique included stature, the sitting height-to-stature ratio (SSR), body mass, BMI, estimated upper-arm muscle area, biacromial, bicristal, biepicondylar, and bicondylar breadths, and the Heath-Carter anthropometric somatotype (endomorphy, mesomorphy, and ectomorphy). There were few differences in body size between FN and EA, with the exception of adult females. Adult FN females were significantly heavier and had greater bone breadths than EA women (P < 0.001). On the other hand, somatotype differed significantly between EA and FN by age and sex, except for 5-19-year-old females. Among boys and men, FN had greater endomorphy (P < 0.03), whereas FN men also had lower ectomorphy (P < 0.01). Among women, FN were significantly more endomorphic and mesomorphic and less ectomorphic (P < 0.001). Although results for 5-19-year-old females were not significant, they were in the same direction as the other groups (greater endomorphy). Forward stepwise discriminant function analyses indicated that endomorphy was the most important discriminator between FN and EA by age and sex.     

Deficient health knowledge, diet, and other lifestyles in smokers: is a multifactorial approach required?

BACKGROUND: Data from the Scottish Heart Health Study, a random cross-sectional sample of middle-aged men and women, are used to compare health knowledge, behavior, and lifestyles between 4896 smokers and 4595 nonsmokers. METHODS: Smokers are identified from self-reports with biochemical validation. They are compared with nonsmokers using analysis of covariance and logistic regression, adjusting for age and social class. RESULTS: Smokers are found to have poorer dietary knowledge than nonsmokers, although both groups are well-informed on some aspects of diet. Knowledge of personal risk modifiers for coronary heart disease and recent intention to improve lifestyle are both worse among smokers. Smokers have lower intakes of the antioxidant vitamins and fiber, but higher intakes of dietary cholesterol and alcohol than nonsmokers. They also tend to have higher salt intake and eat a greater proportion of saturated fat, butter, or hard margarine, and full-fat milk. High-density lipoprotein cholesterol levels are lower, but triglycerides, fibrinogen, and, for women only, total serum cholesterol levels are higher among smokers. On the other hand, body mass index and diastolic blood pressure are lower among smokers. CONCLUSIONS: In addition to advice to give up smoking, smokers should be counseled to improve their diet. The positive message to eat more fresh fruit and vegetables would be particularly helpful.     

Prediction of psychological symptoms under high-risk psychosocial circumstances: Life events, social support, and symptom specificity.

Examined life events, perceived dimensions of events, and social support in predicting different types of psychological symptoms (e.g., depressive and anxiety symptoms), all within the context of a specific high-risk situation for psychological distress: the final-examination period for university students (N?=?167). Ss were administered a battery of tests that included the State-Trait Anxiety Inventory and the Beck Depression Inventory. Results indicate that (a) certain dimensions of events and particular aspects of social support are directly related to symptoms manifested during final-examination stress, (b) perceived dimensions of events and social support interactively predict symptoms, and (c) depressive symptoms—in contrast to general distress or anxiety symptoms—are relatively specifically a function of events and support. Findings are discussed within the context of existing research; the implications for extending similar strategies employing other high-risk psychosocial circumstances are advanced. (59 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of attrition in health intervention research among older subjects with osteoarthritis.

Attrition in an experimental osteoarthritis intervention was studied among 364 (130 male) volunteers (aged 60–87 yrs). Ss were randomly assigned to control, social support, education, or combined treatment groups. A series of discriminant function analyses showed that the final intervention groups were more homogeneous than the original samples. The most robust predictor of attrition was having either high or very low depression scores. Social support variables were predictors of poor attendance in the social support group, indicating possible attrition bias in evaluating this treatment. The results indicate that psychosocial variables may be the best predictors of attrition in health intervention research among older Ss and that variables related to attrition can be related to the content of the intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life circumstances and personal resources as predictors of the ten-year course of depression

A 10-year naturalistic study of 313 patients who entered treatment for unipolar depression and a community comparison group of 284 nondepressed adults was conducted. We compared life stressors, social resources, personal resources, and coping among patients who were remitted (N = 76), partially remitted (N = 146), or nonremitted (N = 91). Compared with the controls and the remitted patients, the partially remitted and nonremitted patients consistently experienced more life stressors and fewer social resources, were less easygoing, and relied more on avoidance coping. A less easygoing disposition, fewer close relationships, and more reliance on avoidance coping were associated with higher odds of experiencing a course of partial remission or nonremission. In addition, more depressive symptoms and medical conditions predicted nonremission.     

Use of formal and informal sources of mental health care among older African-American public-housing residents

BACKGROUND: Elderly residents of public housing have high rates of psychiatric disorders, but most of those in need of care do not use any mental health service. This study examines the use of formal and alternative informal sources of mental health care in a sample of elderly African-American public-housing residents. METHOD: Data from an epidemiological survey of six Baltimore public-housing developments for the elderly (weighted N = 818) were analysed to examine the utilization of mental health services by older African-American residents. Logistic regression analyses were used to determine correlates of using formal and informal sources by those needing mental health care. RESULTS: Thirty-five per cent of subjects needed mental health care. Less than half (47%) of those in need received any mental health care in the previous 6 months. Residents in need were more likely to use formal (38.5%) than informal sources (18.6%) for care. The strongest correlates of using formal providers were substance use disorder (OR = 15.62), Medicare insurance (OR = 10.31) and psychological distress (OR = 10.27). The strongest correlates of using informal sources were perceiving little or no support from religious/spiritual beliefs (OR = 21.65), cognitive disorder (OR = 19.71) and having a confidant (OR = 15.07). CONCLUSIONS: Contrary to elderly African-Americans in general, those in public housing rely more on formal than informal sources for mental health problems. Nevertheless, both sources fail to fill the gap between need and met need. Interventions to increase identification, referral and treatment of elderly public-housing residents in need should target general medical providers and clergy and include assertive outreach by mental health specialists.     

Using subjective oral health status indicators to screen for dental care needs in older adults

A study was undertaken to assess the ability of a number of subjective oral health status indicators to identify community-dwelling older adults who need dental treatment. The indicators consisted of a single-item self-rating of treatment need, a 15-item psychosocial impact index and the 49-item Oral Health Impact Profile (OHIP). Data for the study were collected as part of an oral health survey of Canadians aged 50 years and over. The associations between these subjective indicators and clinically defined dental treatment needs were assessed using statistics for determining the predictive power of a diagnostic test. Although there were statistically significant associations between the subjective and clinical measures, values for statistics such as sensitivity, positive predictive values and positive likelihood ratios were low. Although the measures did not perform well as screening tests, they did identify a sub-group of individuals whose clinical conditions impacted significantly on daily life and who would probably benefit the most from dental treatment. In this respect, the subjective measures assessed here can themselves be interpreted as indicators of need which complement conventional clinical measures of needs for dental care.     

Experience of non-fatal overdose among heroin users in Adelaide, Australia: circumstances and risk perceptions

AIMS: To ascertain the prevalence and risk factors for non-fatal overdose among heroin users to assist in the development of an effective intervention. DESIGN: Cross-sectional design. SETTING: Community setting, principally metropolitan Adelaide. PARTICIPANTS: Current heroin users (used heroin in the previous six months). MEASUREMENTS: A structured questionnaire including the Severity of Dependence Scale. FINDING: Of 218 current South Australian heroin users interviewed in 1996, 48% had experienced at least one non-fatal overdose their life-time (median: two overdoses), and 11% had overdosed in the previous 6 months. At some time, 70% had been present at someone else's overdose (median: three overdoses). At the time of their own most recent overdose, 52% had been using central nervous system depressants in addition to heroin, principally benzodiazepines (33%) and/or alcohol (22%). The majority of overdoses occurred in a private home (81%) and in the presence of other people (88%). Unrealistic optimism regarding the risk of overdose was evident across the sample. Despite almost half the sample reporting having had an overdose, and the belief expressed by respondents that on average about 50% of regular heroin users would overdose during their life-time 73% had, during the previous 6 months, "rarely" or "never" worried about possibly overdosing. Optimism regarding the possibility of future overdose was reduced in those with recent experience of overdose in comparison to the rest of the sample. A targeted intervention aimed at the reduction of overdose among heroin users is outlined.