Memory Interventions and Quality of Life for Older Adults with Dementia

ABSTRACT

In this article we focus on memory remediation activities for older adults with cognitive impairment. Memory interventions that promote retention of simple information, such as a caregiver name, may have important emotional consequences for affected individuals and their families. The inclusion of memory activities in long-term care facilities offers a new and creative direction for programming with potential benefits for clients, staff, and families. We describe recent studies that demonstrate the efficacy of the spaced retrieval technique for improving memory for simple associations in older adults with probable Alzheimer's disease (AD). We present data that address quality-of-life issues for persons who participate in a spaced retrieval memory training program. These data strongly suggest that memory remediation activities should be included as a component of current best practices for memory-impaired older adults in long-term care settings.     

Smoking and Drinking Behaviors among Older Adults: A Comparative Analysis of Three Southeast Asian Countries

Studies on the two major health-risk behaviors of smoking tobacco and drinking alcohol among older populations, particularly in Southeast Asia, are limited. This paper provides comparative analyses of the prevalences and correlates of smoking tobacco and drinking alcohol among older people in Myanmar, Vietnam, and Thailand, using data from the latest available national aging surveys in the three countries. The analyses were conducted within a multivariate framework. Gender-specific results show that smoking tobacco and drinking alcohol are more common among older men than women in all three countries. However, the prevalence of smoking and drinking among men declines at older ages. The multivariate analyses reveal that a higher level of education has a significant negative association with smoking and drinking in all three settings, but the magnitude and the direction of associations vary considerably between countries and genders. Area of residence is correlated with smoking among men in all three countries, whereas co-residential arrangements with spouse, children, or both significantly reduce alcohol consumption among men in Myanmar and among men and women in Thailand. In all three settings a significant complementary relationship between smoking and drinking is observed. From a policy perspective this implies that a successful reduction in smoking could be achieved through anti-drinking campaigns and vice versa.

     

Leisure-Related Predictors on a Sense of Purpose in Life among Older Adults with Cancer

The purpose of this study was to examine leisure-related factors as predictors of a sense of purpose in life for older adults with cancer. A final sample of 1,271 older adults with cancer experience was drawn from the Health and Retirement Survey. The results of the regression analysis indicated that leisure satisfaction was the strongest predictor of a greater sense of purpose in life. The three most significant predictors of a greater purpose in life were frequent participation in hobbies and indoor activities, physical activities, and religious activities. Implications for further research and practice are discussed.     

Successful Cognitive Aging and Health-Related Quality of Life in Younger and Older Adults Infected with HIV

Neurocognitive impairments commonly occur and adversely impact everyday functioning in older adults infected with HIV, but little is known about successful cognitive aging (SCA) and its health-related quality of life (HRQoL) correlates. Seventy younger (≤40 years) and 107 older (≥50 years) HIV+ adults, as well as age-matched seronegative comparison groups of younger (N = 48) and older (N = 77) subjects completed a comprehensive battery of neuropsychological, psychiatric, medical, and HRQoL assessments. SCA was operationalized as the absence of both performance-based neurocognitive deficits and self-reported symptoms (SCA-ANDS) as determined by published normative standards. A stair-step decline in SCA-ANDS was observed in accordance with increasing age and HIV serostatus, with the lowest rates of SCA-ANDS found in the older HIV+ group (19 %). In both younger and older HIV+ adults, SCA-ANDS was strongly related to better mental HRQoL. HIV infection has additive adverse effects on SCA, which may play a unique role in mental well-being among HIV-infected persons across the lifespan.     

Types of Learning Activities and Life Satisfaction among Older Adults in Urban Community-Based Lifelong Learning Programs

Education, lifelong learning activities, and well-being are positively associated. However, significantly less is known about types of learning activities such as participation in organized adult education programs and self-learning among older adults in the same context. Data from 420 older adults from the Osher Lifelong Learning Institute (OLLI) were analyzed. Results showed that additional participation in organized education programs was positively associated with life satisfaction among OLLI members. Given the beneficial effects of additional participation in organized adult education programs on life satisfaction, older learners are encouraged to be engaged in more learning activities.     

Characteristics and Impact of Life Turning Points for Older Adults

This research examines the characteristics of turning points, events considered as being significant in one’s life. One hundred and forty-nine turning points, as reported by 53 older adults were investigated. They were characterized according to: age at occurrence of turning point, domain, specific or thematic nature, and areas of functioning on which the turning point had an impact. Compared to men, women reported significantly more turning points related to the health domain. Turning points were distributed through the life span, with some concentration at midlife. Family was the sphere most influenced by turning points. The different domains of turning points corresponded to the specific spheres of impact. Turning points were more often related to discrete events than to a series of events clustered under a theme. Identity and social role processes appear most influential in leading older adults to identify particular life circumstances as turning points in their lives.

The Effect of Social Support on Quality of Life in Older Adults Receiving Cognitive Behavioral Therapy

The current study explores the role of social support in changes in quality of life resulting from home-delivered cognitive behavioral therapy (CBT). One hundred thirty-seven participants, characterized primarily as rural, low-resource, and frail, were randomly assigned to either CBT or a minimal support control condition. Hierarchical regression revealed that positive change in satisfaction with social support was associated with improvement in quality of life beyond the effects of the CBT treatment. In addition, pretreatment satisfaction with social support and change in satisfaction with social support moderated the effect of CBT on quality of life. These results suggest that bolstering social support concomitant to CBT may increase quality of life.     

Life Satisfaction of Older Chinese Adults Living in Rural Communities

Guided by the socio-environmental theoretical framework, this study examined factors associated with life satisfaction experienced by older Chinese adults living in rural communities. The data used in this study were extracted from the Sample Survey on Aged Population in Urban/Rural China conducted by the China Research Center on Aging in 2000. This study included 10,084 rural older adults in mainland China. In this study 60.2 % of rural older adults were satisfied with their lives. Results from a multinomial logistic regression analysis showed that life satisfaction reported by rural older Chinese adults was significantly related to education, financial resources, self-rated health, financial support from children, satisfaction with children’s support, house sitting for their children, visiting neighbors, and being invited to dinner by neighbors. Research and policy implications of these findings are also discussed.     

Use of Sleeping Medication and Quality of Life among Older Women who Report Sleeping Difficulty

Objective : To estimate the proportion of older women who report sleeping difficulties and/or use sleeping medication; and to identify associated factors. Method: Cross sectional survey of Australian women aged 70–75 years. These women were participants in the Australian Longitudinal Study on Women's Health (ALSWH) randomly selected from the Australian Medicare database. Results : Of the 12,624 women aged 70–75 years who provided data for this analysis (36% response rate), 50%{n‐6,042) reported sleeping difficulty “never/rarely”, 33% (n=3,979) “sometimes”, and 17% (n=2,011) “often”. Approximately 18% (n=2,287) of women reported using sleeping medication within the previous four weeks. Women reporting sleeping difficulty “sometimes ” were over five times more likely to be taking sleeping medications than women who reported “never/rarely” experiencing difficulties (p≤0.0001); while women reporting difficulty sleeping “often” were over 15 times more likely to be using sleeping medications (p≤0.0001). Mean scores for sub‐scales of the SF‐36 health‐related quality of life measure were significantly lower for women reporting sleeping difficulty and women using sleeping medication (p≤0.001). Similarly, there was an inverse relationship between the SF‐36 physical and mental health summary scores and difficulty sleeping or sleeping medication use. Conclusion : Self‐reported sleeping difficulty is significantly related to reduced quality of life, suggesting sleeping difficulty is not a benign complaint. After adjustment for other explanatory variables there were strong, clinically significant differences between the SF‐36 scores of women reporting sleeping difficulty. However, while this association is statistically and clinically significant, it is not clear whether sleeping difficulty reduces quality of life, or whether quality of life interferes with sleep, or whether both problems are a result of other associated conditions. Further longitudinal exploration of this relationship is necessary. Further, issues need to be explored with older women, with a view to identifying acceptable and effective alternatives to sleeping medication use.     

Sexual Risk Behaviors in Late Middle Age and Older HIV Seropositive Adults

Little is known about the sexual behaviors of older adults, although the prevalence of HIV/AIDS is rapidly increasing in this population. As part of a larger multi-site study examining secondary HIV prevention, we recruited from an HIV primary care clinic 210 sexually active HIV positive individuals aged 45 and over (125 men, 85 women) who had engaged in vaginal or anal sex within the past six months. Twenty percent of the participants reported inconsistent use of condoms and 33% had multiple sexual partners during the previous six months. Negative mood and perceived HIV stigma were associated with inconsistent condom use. In addition, multiple sex partners and higher level of education were related to inconsistent condom use during sex with partners of negative or unknown serostatus. These findings indicate that contrary to current beliefs, sexually active older adults, similar to younger ones, may be engaging in high risk transmission behaviors.     

Patterns and Associations of Body Weight Among Older Adults in Two Asian Societies

Body weight has important health implications across the lifespan. Most recent attention has focused on the obesity epidemic that is occurring in many parts of the world. However, underweight is also a concern, particularly in less developed countries. For most health outcomes there is a curvilinear association with body weight, with underweight and overweight (compared to normal weight) being associated with a higher prevalence of chronic debilitating and life-threatening conditions and ultimately mortality. This paper uses data from two nationally-representative surveys of older adults (aged 60 and older) in the Philippines (1996) and Taiwan (1999) to assess the prevalence of underweight and overweight and examine associations between body weight and demographic, socioeconomic, and health characteristics in these populations. Older Filipinos have a modest prevalence of underweight (29.9%) and low prevalence of overweight (12.2%), whereas the reverse is observed in Taiwan (6.4 and 29.3%, respectively). Results show generally expected associations between body weight and demographic characteristics, health conditions and behaviors. We find little evidence of socioeconomic differences in body weight, except in the Philippines where higher SES is associated with a lower risk of being underweight. Implications of the results are discussed in terms of healthy weight maintenance among critical subgroups to potentially reduce the prevalence of disease and improve quality of life.