Is death anxiety more closely linked with optimism or pessimism among older adults?

The purpose of this study was to investigate whether death anxiety is more closely linked with optimism or pessimism among older adults. Participants consisted of community-dwelling older adults (N = 253; 73.1% female) in the southern U.S. Both optimism and pessimism demonstrated a bivariate association with death anxiety; however, when considering optimism and pessimism together—and after controlling for age, gender, physical health, and mental health—optimism was not associated with death anxiety, while pessimism was associated with higher death anxiety. Post hoc analyses found a unique relationship between pessimism and greater fear of the unknown. Perhaps, given the inevitability of death, limiting negative expectancies is more salient to death anxiety than having positive expectancies, and pessimism may be particularly associated with existential and religious concerns.     

Safety perceptions of older adults on an urban greenway: Interplay of the social and built environment

BackgroundCreating neighbourhood places for older adults to be socially and physically active is a global health priority. Safety is integral to older adult mobility. In greenway research, perceived safety is often only partially or superficially explored. Our study comprehensively examines older adults’ experiences and perceived safety for walking on a new urban greenway in Vancouver, Canada—the Arbutus Greenway.MethodsWe integrated mixed methods: i) observational count data to describe the use and context of the greenway over 3 years (2017; 2018; 2019), and; ii) semi-structured interviews with older adults at two time points (2017, n = 27; 2019, n = 16).Resultsand discussion: We conducted thematic analysis to illuminate older adults' experiences across three safety domains: personal safety, traffic safety, and security. Built environment features such as benches, paving, road markings, and natural foliage buffers intersected with elements of the social environment to influence older adults’ perceived safety. While the greenway supported active transportation, leisure, and social engagement for many older adults, certain factors also provoked fears, especially for older adults with mobility limitations. We advocate for a multidimensional lens to better understand how urban interventions influence perceived safety, and identify practical solutions to encourage mobility for all ages and abilities.     

Mental well-being: A 16-year follow-up among older residents in Jyväskylä

This study investigated changes in perceived depression, anxiety and loneliness during a 16-year follow-up among elderly Jyväskylä residents born in 1914-1923. A further concern was with how perceived atmosphere in the formative environment was reflected in depression, anxiety and loneliness in old age. The first phase of the study took place in 1988 when interviews were conducted with 635 persons (241 men and 394 women). Depression and anxiety were assessed using the Finnish modified version of Beck's 13-item depression scale (RBDI), which was completed fully by 74% of the interviewees. Loneliness was assessed with a single four category item. In the second phase of the study in 1996, interviews were conducted with 410 persons, of whom 94% filled the RBDI questionnaire. In the third phase in 2004, the number of interviewees was 220 and the response rate 82%. There were no significant changes in the number of people with depressive symptomatology and anxiety, except in 1996 when the proportion of men with mild and moderate depression almost doubled. The number of men and women who felt lonely increased significantly during the 16-year follow-up. People who said they were lonely also had more depression and anxiety than others. People who had grown up in warm and safe environment were the most balanced mentally. The presence or absence of warmth and safety in the formative environment is reflected in mental well-being even at a very old age.     

Physical therapy in the emergency department: A new opportunity for collaborative care

Emergency department-initiated physical therapy (ED PT) is an emerging resource in the United States, with the number of ED PT programs in the United States growing rapidly over the last decade. In this collaborative model of care, physical therapists are consulted by the treating ED physician to assist in the evaluation and treatment of a number of movement and functional disorders, such as low back pain, peripheral vertigo, and various gait disturbances. Patients receiving ED PT benefit from the physical therapist's expertise in musculoskeletal and vestibular conditions and from the individualized attention provided in a typical bedside evaluation and treatment session, which includes education on expected symptom trajectory, recommendations for activity modulation, and facilitated outpatient follow-up. Early data suggest that both physicians and patients view ED PT services favorably, and that ED PT is associated with improvement of several important clinical and operational outcomes. Hospital systems interested in building their own ED PT program may benefit from the key steps outlined in this review, as well as a summary of the typical clinical volumes and practice patterns encountered at existing programs around the country.     

Developing the Intergenerational Community Survey for older adults: Assessing neighborhood environments,social and physical activities,and health

Many survey instruments have been developed to assess neighborhood environments for their impacts on people's health and daily activities. However, no instruments are available for capturing social interactions with different age groups among older populations. This study introduces a four-phase process of developing a comprehensive Intergenerational Community Survey (ICS) covering six domains: (1) physical activities, walking, and sedentary activities; (2) mental health and quality of life; (3) social activities (e.g. intergenerational and peer interactions) in and outside the neighborhood; (4) neighborhood environments (e.g. safety, streets and sidewalks); (5) supportive services or programs (e.g. intergenerational programs, transportation services); and (6) personal characteristics. Test-retest reliability assessments among 38 community-dwelling older adults (aged 65+) showed fair to good reliability results. ICS can serve as a useful tool to facilitate future research on intergenerational communities and interactions for older adults.     

Onset of loneliness in older adults: results of a 28?year prospective study

The goal of this research is to test whether often observed correlates of loneliness in older age are related to onset of loneliness longitudinally. Despite the increasing number of longitudinal studies, the investigation of factors that are related to onset of loneliness is still limited. Analyses are based on data of the TamELSA study, which is a population-based prospective study in Tampere, Finland and started in 1979. For the present study 469 older adults aged between 60 and 86 years at baseline, who were not lonely at baseline, were selected and followed-up in 1989, 1999 and 2006. During the 28 years of follow-up approximately one third (N = 178) of the study population developed feelings of loneliness. Logistic regression analyses indicated that losing a partner, reduced social activities, increased physical disabilities, increased feelings of low mood, uselessness and nervousness, rather than baseline characteristics, are related to enhanced feelings of loneliness at follow-up. The higher incidence of loneliness among women can be fully explained by the unequal distribution of risk factors among men and women (e.g., women more often become widowed). Our results are in line with the cognitive approach that conceptualizes loneliness as an unpleasant feeling due to a perceived discrepancy between the desired and the achieved level of social and personal resources.     

Evaluation of a Mindfulness-Based Intervention Program to Decrease Blood Pressure in Low-Income African-American Older Adults

Hypertension affects a large proportion of urban African-American older adults. While there have been great strides in drug development, many older adults do not have access to such medicines or do not take them. Mindfulness-based stress reduction (MBSR) has been shown to decrease blood pressure in some populations. This has not been tested in low-income, urban African-American older adults. Therefore, the primary purpose of this pilot study was to test the feasibility and acceptability of a mindfulness-based program for low income, minority older adults provided in residence. The secondary purpose was to learn if the mindfulness-based program produced differences in blood pressure between the intervention and control groups. Participants were at least 62 years old and residents of a low-income senior residence. All participants were African-American, and one was male. Twenty participants were randomized to the mindfulness-based intervention or a social support control group of the same duration and dose. Blood pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention. A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood pressure measurements, controlling for age, education, smoking status, and anti-hypertensive medication use. Effect sizes were calculated to quantify the magnitude of the relationship between participation in the mindfulness-based intervention and the outcome variable, blood pressure. Attendance remained >80% in all 8 weeks of both the intervention and the control groups. The average systolic blood pressure decreased for both groups post-intervention. Individuals in the intervention group exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group post-intervention and this value was statistically significant (p = 0.020). The average diastolic blood pressure decreased in the intervention group post-intervention, but increased in the social support group. Individuals in the intervention group exhibited a 16.70-mmHg lower diastolic blood pressure compared to the social support group post-intervention, and this value was statistically significant (p = 0.003). Older adults are at a time in life when a reflective, stationary intervention, delivered in residence, could be an appealing mechanism to improve blood pressure. Given our preliminary results, larger trials in this hypertensive study population are warranted.     

Relationships of proactive behaviour with job-related affective well-being and anticipated retirement age: an exploration among older employees in Belgium

Developed countries throughout the world are challenged with the ageing of their labour force. In these societal contexts, low employment rates and early labour market exits of older employees are at stake, as well as arrangements for retirement, financial household considerations and mutual obligations between generations. Although proactive behaviour has been extensively studied, no research has addressed the proactive behaviour of older employees themselves when facing (re)hiring and retention versus early retirement. For the first time, this study tests the relationships of proactive behaviour with job-related affective well-being and anticipated retirement age in a sample of employees aged 50+ (N = 89) in Belgium. The findings are obtained by using a self-report questionnaire. Statistical analysis includes correlation and regression analysis. Major findings are that (i) proactive older employees feel energetic, enthusiastic, inspired, at ease, relaxed and satisfied; and (ii) later retirement is anticipated when experiencing positive affective well-being at study.