Aging during COVID-19 in Germany: a longitudinal analysis of psychosocial adaptation

Existing theories of aging suggest that there may be similarities and differences in how COVID-19 impacts older people’s psychosocial adaptation compared to younger age groups, particularly middle-aged individuals. To assess the degree to which these impacts vary, we analyzed data from 3098 participants between the ages of 40 and 79 from an online survey in Germany. Data were collected at three measurement occasions between the start of the nationwide lockdown in mid-March 2020 and the end of the lockdown in early August 2020. The survey focused on everyday experiences during the COVID-19 crisis and collected various satisfaction ratings (e.g., general life satisfaction, satisfaction with family life, satisfaction with social contacts). At baseline, participants also provided retrospective ratings of satisfaction for the period before the COVID-19 crisis. In our analyses, we compared satisfaction ratings of middle-aged (40–64 years) and older individuals (65–79 years) and found that both middle-aged and older participants experienced the greatest decreases in satisfaction with social contacts, with more pronounced decreases seen in middle-aged participants. A similar pattern was observed for general life satisfaction, but the overall decreases were less pronounced in both groups compared to the decreases in satisfaction with social contacts. We also observed a partial recovery effect in all measures at the last measurement occasion, and this effect was more pronounced in older adults. Findings were also confirmed using age as a continuous variable and checking for linear and nonlinear effects of outcomes across the age range. Although ageism arose during the pandemic in the sense that older adults were labeled as a “risk group,” particularly at the start of the outbreak, we found consistently with other studies that middle-aged adults’ satisfaction decreased to a greater extent than that of older adults.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-021-00655-1.     

How do personality traits manifest in daily life of older adults?

The present study examined how personality traits manifest in daily life of older adults and distinguished between the manifestations of experiences and behaviors. We used data from an ambulatory assessment study over 10 days with assessments of trait-related experiences and behaviors obtained from 136 older adults aged between 60 and 91 years (41.2% male; M = 70.45 years). Multilevel models revealed that on average, 61.2% of variance in trait-related experiences and 39.6% of variance in behaviors were due to consistent differences between persons. Older adults were rather variable and diverse in their trait manifestations, while they also showed relative stability in trait manifestations. Across older age, some age effects for trait manifestations were found. Moreover, within-person variation of experiences and behaviors showed, with one exception, joint fluctuations in daily life. The findings portray a nuanced picture of trait manifestations in older adulthood. The findings complement the literature on within-person variability in older adulthood and might encourage further studies from a within-person perspective to better understand how older adults navigate through daily life.Supplementary InformationThe online version contains supplementary material available at (10.1007/s10433-020-00598-z).     

The association between supportive social ties and autonomic nervous system function—differences between family ties and friendship ties in a cohort of older adults

Supportive family and friendship ties can serve different functions and thus might show different associations with an individual’s health. Particularly, older adults might show varying health benefits of different types of supportive ties depending on their marital and retirement status. Our aim is to analyze relationships between different types of supportive social ties and autonomic nervous system (ANS) function, a physiological indicator of health that can help to establish the biological plausibility of the association—measured by heart rate variability (HRV). We present cross-sectional linear regression analyses of a German cohort of community-dwelling older adults (2008–2010; n = 1,548; mean age = 68.7 years). Our findings indicate that supportive friendship ties show significant positive associations (i.e., higher HRV) in individuals that are either not married or above retirement age. Supportive family ties show significant positive associations in individuals below retirement age. Significant results vanish or are reduced after accounting for behavioral/physical and psychological/cognitive indicators. We conclude that programs supporting the development or maintenance of friendship ties might be especially beneficial in unmarried older adults and adults above retirement age.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-021-00638-2.     

Impact of Early Life Socioeconomic Status on Decision Making in Older Adults Without Dementia

ObjectivesA growing body of evidence points to the negative impact of early life socioeconomic status (SES) on health and cognitive outcomes in later life. However, the effect of early life SES on decision making in old age is not well understood. This study investigated the association of early life SES with decision making in a large community-based cohort of older adults without dementia from the Rush Memory and Aging Project.Materials and MethodsCross-sectional data from the Rush Alzheimer's Disease Center Memory and Aging Project was analyzed. Participants were 1044 community-dwelling older adults without dementia (M age = 81.15, SD = 7.49; 75.8% female; 5.4% non-White). Measures of financial and healthcare decision making and early life SES were collected, along with demographics, global cognition, and financial and health literacy.ResultsEarly life SES was positively associated with decision making (estimate = 0.218, p = 0.027), after adjustments for demographic covariates and global cognition, such that a one-unit increase in early life SES was equivalent to the effect of being four years younger in age as it pertains to decision making. A subsequent model demonstrated that the relationship was strongest in those with low literacy, and weakest for those with high literacy (estimate = -0.013, p = 0.029).ConclusionsFindings from this study suggest that early life SES is associated with late life decision making and that improving literacy, a modifiable target for intervention, may buffer the negative impact of low early life SES on decision making in older adulthood.     

Disclosure of New Type 2 Diabetes Diagnoses to Younger Adults: a Qualitative Study

BackgroundAdults diagnosed with type 2 diabetes at a younger age are at increased risk for poor outcomes. Yet, little is known about the early experiences of these individuals, starting with communication of the diagnosis. Addressing this knowledge gap is important as this initial interaction may shape subsequent disease-related perceptions and self-management.ObjectiveWe examined diagnosis disclosure experiences and initial reactions among younger adults with newly diagnosed type 2 diabetes.ParticipantsPurposive sample of adult members of Kaiser Permanente Northern California, an integrated healthcare delivery system, diagnosed with type 2 diabetes before age 45 years.ApproachWe conducted six focus groups between November 2017 and May 2018. Transcribed audio recordings were coded by two coders using thematic analysis.Key ResultsParticipants (n = 41) were 38.4 (± 5.8) years of age; 10 self-identified as Latinx, 12 as Black, 12 as White, and 7 as multiple or other races. We identified variation in diagnosis disclosure experiences, centered on four key domains: (1) participants’ sense of preparedness for diagnosis (ranging from expectant to surprised); (2) disclosure setting (including in-person, via phone, via secure message, or via review of results online); (3) perceived provider tone (from nonchalant, to overly fear-centered, to supportive); and (4) participants’ emotional reactions to receiving the diagnosis (including acceptance, denial, guilt, and/or fear, rooted in personal and family experience).ConclusionsFor younger adults, the experience of receiving a diabetes diagnosis varies greatly. Given the long-term consequences of inadequately managed diabetes and the need for early disease control, effective initial disclosure represents an opportunity to optimize initial care. Our results suggest several opportunities to improve the type 2 diabetes disclosure experience: (1) providing pre-test counseling, (2) identifying patient-preferred settings for receiving the news, and (3) developing initial care strategies that acknowledge and address the emotional distress triggered by this life-altering, chronic disease diagnosis.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-020-06481-y.KEY WORDS: type 2 diabetes, diagnosis, patient-provider communication     

Education,wealth, and duration of life expected in various degrees of frailty

Multistate life tables are used to estimate life expected in three frailty states: frailty free, mild/moderate frailty, severe frailty. Estimates are provided for the combination of education and wealth by age, stratified by sex. Data consider 17,115 cases from the Health and Retirement Study, 2000–2014. Frailty is measured using a 59 item frailty index based on deficit accumulation. Estimates are derived using stochastic population analysis for complex events. Population-based and status-based results are reported. Findings confirm a hypothesis that the combination of higher education and wealth results in longer lives in more favorable degrees of frailty. Also, as hypothesized, wealth generally affords a greater advantage than does education among those with severe frailty at baseline. For instance, high wealth provides a 70-year-old woman with severe frailty at baseline 0.70 more total years and 0.81 more frailty free years then her counterpart with low wealth, compared to gains of 0.39 and 0.54, respectively, for those with high education. Unexpectedly, wealth also has a greater role among those frailty free at baseline. A 70-year-old woman frailty free at baseline with high wealth lives 3.19 more net years and 4.13 more years frailty free than her counterpart with low wealth, while the same comparison for high versus low education indicates advantages of 2.00 total and 1.96 frailty free years. Relative change ratios also indicate more robust results for wealth versus education. In sum, there is evidence that inequality in duration of life in degrees of frailty is socially patterned.Electronic supplementary materialThe online version of this article (10.1007/s10433-020-00587-2) contains supplementary material, which is available to authorized users.     

Continuity of leisure participation from middle age to old age

OBJECTIVE: Continuity in habits, activities, and roles is important upon entering old age according to the continuity theory of aging. Few studies have investigated patterns of leisure participation over an extended period of time among older adults. This study examines changes in nine different leisure activities in a nationally representative sample of individuals followed over a 34-year period in Sweden. METHODS: We used longitudinal data from three waves of an interview survey that followed 495 individuals from 1968 to 2002. Individuals were aged 43-65 in 1968 and 77-99 in 2002. We conducted logistic regression analyses on each of the leisure activities. RESULT: For the panel followed, a decline in participation rates was the most common pattern over time. Analyses at the individual level showed that late-life participation was generally preceded by participation earlier in life. Previous participation, both 10 and 34 years earlier, predicted late-life participation. The modifying effect of functional status in late life was small. DISCUSSION: In accordance with the continuity theory of aging, leisure participation in old age is often a continuation of previous participation. However, there is considerable variation among both activities and individuals.     

Ten-year patterns of alcohol consumption and drinking problems among older women and men

AIMS: This study focused on changes in 10-year patterns of alcohol consumption among older women and men, late-life and life history predictors of drinking problems, and gender differences in these predictors. DESIGN, SETTING, PARTICIPANTS: A sample of late-middle-aged community residents (N = 1291) who had consumed alcohol in the past year or shortly before was surveyed at baseline and 1 year, 4 years and 10 years later. MEASUREMENTS: At each contact point, participants completed an inventory that assessed their alcohol consumption, drinking problems and health-related and life context factors. Participants also provided information about their life history of drinking. RESULTS: Over the 10 years, the proportion of individuals who consumed alcohol declined. Among individuals who continued to drink, women and men showed comparable declines in alcohol consumption, minor concomitants of alcohol consumption and drinking problems. In addition to the amount of alcohol consumption, smoking, friends' approval of drinking and avoidance coping consistently predicted late-life drinking problems. With respect to life history factors, heavy drinking, drinking problems and increased drinking in response to life events were related to a higher likelihood of late-life drinking problems; obtaining help from family members and friends and, among men, participation in Alcoholics Anonymous, were related to a lower likelihood of problems. CONCLUSION: Older women and men show comparable declines in alcohol consumption and drinking problems. Specific late-life social context and coping variables, and life history indices, are risk factors for late-life drinking problems among both women and men.     

Coping: Impact of Gender and Stressful Life Events in Middle and in Old Age

ABSTRACT

Objectives: This study seeks to identify different life events that participants considered stressful and to study the joint effect of gender, age group, and main stressful life events on the use of different coping strategies.Methods: The sample comprised 243 men and women, 55 to 99 years old, who attended senior activity centers. Analyses were conducted using multivariate analysis of variance (MANOVA).Results: Three main categories of stressful life events were identified: health problems, family problems, and other problems. Significant main effects of gender and stressful life events, and marginal effects of age group on coping strategies were found. Furthermore, an interaction between gender and age group, and also between gender and stressful life events emerged in some of the coping strategies analyzed.Conclusions: Age, gender or type of stressful situation impact on the coping strategies used by older people. Older men and women were found to use different strategies depending upon the situation they are facing and upon their age group. The results may prove useful to practitioners and clinicians who directly work with older people and may help clinicians provide effective coping strategies to address the specific life events that older adults find stressful.     

Living longer,working longer: analysing time trends in working life expectancy in Germany from a health perspective between 2002 and 2018

Population ageing poses growing challenges to social security systems, in particular to public pension funds. The study analyses how Working Life Expectancy (WLE) and Healthy Working Life Expectancy (HWLE) in terms of three health indicators developed in Germany. Based on the German Socio-Economic Panel (GSOEP) from 2002 to 2018 (n = 211,141), time trends in labour force rates, mental and physical Health-Related Quality of Life (HRQoL), self-rated health (SRH) and the respective combinations (health indicator*labour force) were analysed for all respondents aged 18–74. WLE and HWLE were calculated using the Sullivan method. WLE and HWLE in men and women at age 18 and 50 clearly increased over time. These increases in HWLE were found in terms of all three health indicators. This development was mainly driven by the clear increase of the labour force rates, since the shares of individuals with good and satisfactory SRH or average and good HRQoL remained largely stable over time. The results show that from a health perspective there have been potentials for increases in WLE during the past two decades and that increasingly more healthy life years are spent economically active. However, life years in the labour force but in poor health have increased, too. The absence of clear improvements in health emphasises the importance of current and future preventive measures to maintain health, especially among the middle-aged and older labour force.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10433-022-00707-0.     

Delay of gratification in old age: assessment, age-related effects, and clinical implications

Delay of gratification (DoG), the ability to reject immediately available smaller rewards in favor of later larger rewards, has been a topic of continuous research interest for almost 60 years. Although numerous studies have explored this construct and its effects on wellbeing, social behavior, cognitive abilities, and academic success in children, DoG studies in adulthood and old age are scarce. Instead, delay discounting (DD), that is, the degree to which individuals devalue delayed rewards, has been used in samples of adults and older individuals, and is of particular interest in clinical studies. Findings from DD research suggest that the preference for delayed rewards increases from childhood to early adulthood, and then decreases from middle age to old age. The main aim of this review is to elucidate the importance of DoG in adulthood and old age. First, the review explores the theoretical status of DoG by specifying the relationships and distinctions between DoG and related constructs. Second, it provides an overview of DoG measurements, from traditional to novel. Third, the effects of DoG on development and wellbeing are explored. Fourth, age-related differences in DoG are summarized. Lastly, the review closes with conclusions, clinical implications, and the outlook for possible further research directions.     

The relationship between age and depressive symptoms: a test of competing explanatory and suppression influences

OBJECTIVE. The objective is to examine competing explanatory and suppression influences on a negative, linear association between age and depressive symptoms. METHODS. Two samples were used: a community sample of physically disabled individuals and a comparison sample matched on age, sex, and area of residence. RESULTS. Fewer economic hardships and fewer experiences of negative interpersonal exchanges among older disabled and nondisabled respondents account for the negative relationship between age and depressive symptoms. Higher scores on a composite measure of religiosity among older disabled adults also account for part of the negative age effect. Conversely, a lower sense of mastery among older respondents in both samples suppresses the size of the negative age slope. DISCUSSION. Findings are discussed in terms of stress process and socioemotional selectivity theories, which predict that personal and social arrangements influence the experience of emotions differentially across the life course.     

Dietary patterns explaining variations in blood biomarkers in young adults are associated with the 30-year predicted cardiovascular disease risks in midlife: A follow-up study

Background and aimsTo examine a combined effect of dietary intakes, blood lipid and insulin resistance in young adulthood on the risk of predicted CVD through midlife.Methods and resultsData of young adults from a birth cohort study in Australia were used. Reduced rank regression (RRR) and partial least squares (PLS) methods identified dietary patterns rich in meats, refined grains, processed and fried foods, and high-fat dairy and low in whole grains and low-fat dairy from dietary intakes obtained at 21-years, and blood lipids and measures of insulin resistance measured at 30-years of age. Using standard CVD risk factors measured at 30-years of age, the Framingham Heart Study risk-prediction algorithms were used to calculate the 30-year predicted Framingham CVD risk scores. The scores represent Hard CVD events; coronary death, myocardial infarction and stroke and Full CVD events; Hard CVD plus coronary insufficiency and angina pectoris, transient ischaemic attack, intermittent claudication, and congestive heart failure in midlife. Sex-specific upper quartiles of CVD risk scores were used to define high-risk groups. Modified Poisson regression models were used to estimate relative risks (RRs) with 95% CI. Greater adherence to the diet identified applying RRR in young adulthood was associated with higher risks of predicted Hard CVD (RR: 1.60; 1.14, 2.25) and Full CVD (RR: 1.46; 1.04, 2.05) events in midlife. The diet from PLS showed similar trend of association for the risk of predicted Hard CVD events (RR: 1.49; 1.03, 2.16) in adjusted models.ConclusionDietary patterns associated with variations in blood lipids and insulin resistance in young adulthood are associated with increased risks of predicted CVD events in midlife. The findings suggest that diet induced altered blood lipids and insulin resistance in the life course of young adulthood could increase the risks of CVD events in later life.     

Childhood adversity: A gateway to multimorbidity in older age?

BackgroundMultimorbidity, or co-occurrence of several chronic diseases, has major consequences in terms of function, quality of life and mortality. Recent advances suggest that the aetiology of multimorbidity includes a life-long process. The purpose of this study was to determine the association between childhood adversity and multimorbidity in community-dwelling older adults, and to investigate variation in participants born immediately before, during and at the end of the Second World War.MethodsParticipants were 4731 community-dwelling older adults who enrolled in the Lausanne cohort 65+ study (Switzerland) at age 65–70 years in 2004/2009/2014. A baseline questionnaire provided several indicators of childhood adversity including premature birth, food restrictions, child labour, family economic environment, serious illness/accident, and stressful life events. Multimorbidity at age 67–72 years was defined as ≥2 active chronic diseases at the 2-year follow-up questionnaire.ResultsAll childhood adversity indicators except premature birth were significantly associated with multimorbidity. Odds ratio (OR) ranged from 1.23 (P = 0.034) for poor family economic environment to 1.74 (P < 0.001) for stressful life events. In a multivariable model adjusted for socioeconomic status, health behaviours and stressful life events in adulthood (>16 years), a history of serious illness/accident (OR = 1.45; P < 0.001) and stressful life events (OR = 1.42; P = 0.001) in childhood remained significantly associated with multimorbidity. Comparisons between cohorts indicated substantial variations in the prevalence of childhood adversity indicators but similar associations with multimorbidity.ConclusionThere was an independent association between childhood adversity and multimorbidity after age 65. This study encourages a comprehensive life-course perspective to better understand and potentially prevent multimorbidity.     

Older Women's Perceptions of Successful Aging

ABSTRACT

Little is known about the ways in which older adults view or define successful aging. This qualitative study, therefore, examined older women's perceptions of the characteristics and components of successful aging. Transitions are complex person–environment interactions that include the disruption of the individual's life and their responses to the disruption. Older adults experience many life transitions or changes in life situations, such as relocation or loss of spouse, that result in new life patterns and perhaps even changes in well-being. Because transition is theoretically a time of change that involves introspection and self-examination, older adults who are experiencing transition, such as the study sample, are expected to be able to express their views on successful aging. Acceptance of change, engagement, and comportment emerged as key components of successful aging. Findings from this study can contribute to the development of interventions for older women, in particular, and their families to promote and reinforce personal, social, and behavioral factors that lead to successful aging.     

Age differences in meaning in life: Exploring the mediating role of social support

ObjectivesThree sets of analyses are performed in our study. First, following Erikson (1959), we hypothesized that the relationship between age and meaning becomes progressively stronger at successively older ages (i.e., the relationship is nonlinear). Second, following Carstensen (1992), we predicted that the relationship between age and social support (received support and satisfaction with support) becomes progressively stronger at successively older ages (i.e., these relationships are nonlinear, as well). Third, we proposed that the nonlinear relationship between age and meaning is mediated by the nonlinear social support constructs (i.e., received support and satisfaction with support).MethodsOur data were obtained from online interviews with a nationwide sample of adults of all ages (N = 2, 245).ResultsOur findings suggest there is a nonlinear relationship between age and meaning in life as well as a nonlinear relationship between age and each social support measure. Our data also indicate that the nonlinear effects of the social support measures mediate the nonlinear relationship between age and meaning in life.DiscussionFinding a sense of meaning may be facilitated by the supportive social networks that older people maintain.     

Age differences in dispositional optimism: a cross-cultural study

Testing the hypothesis that individuals develop their personal characteristics according to what their cultures emphasize, this cross-sectional study aimed at investigating how dispositional optimism varied with age among Americans and Hong Kong Chinese. The sample included 84 younger adults and 55 older adults that were equally distributed across the two cultures. Results revealed that older Americans displayed a higher level of dispositional optimism than did younger Americans; whereas older Chinese showed a lower level of dispositional optimism than did their younger counterparts. Findings shed light on the mixed findings on age-related dispositional optimism in the literature.     

Live longer,retire later? Developments of healthy life expectancies and working life expectancies between age 50–59 and age 60–69 in Europe

Europe’s population is ageing. Statutory retirement ages are commonly raised to account for continuous increases in life expectancy. In order to estimate the potential to increase statutory and consequently effective retirement ages further, in this study, we investigate the relationship between partial working life expectancy (WLE) and three health expectancies that represent health aspects important for work ability and employability between ages 50 and 59 as well as 60 and 69 for women and men in Europe. We also explore the association between these four indicators and the highest level of educational attainment. We apply Sullivan’s method to estimate WLE and three selected measures that capture general, physical, and cognitive health status of older adults for 26 European countries since 2004. Over time, WLEs increased significantly in the younger age group for women and in the older age group for both sexes. The expected number of years in good physical health have continuously been higher than any of the other three indicators, while the expected number of years in good cognitive health have shown a noticeable increase over time. The investigation of the relationship between education and each life expectancy confirms the well-established positive correlation between education and economic activity as well as good health. Our results indicate potential to extend working lives beyond current levels. However, significant differences in the expected number of years in good health between persons with different levels of education require policies that account for this heterogeneity.Electronic supplementary materialThe online version of this article (10.1007/s10433-020-00592-5) contains supplementary material, which is available to authorized users.     

Older adults with asthma: does age of asthma onset make a difference?

Abstract

Objective: Older adults with asthma can develop symptoms early in life or during adulthood. Differences between these groups may have diagnostic and therapeutic implications. Our goal was to identify differences in demographics, control, quality of life and healthcare utilization between those with long-standing asthma (LSA) and late-onset asthma (LOA). Methods: Data from a cross-sectional study of asthma patients over age 65 were analyzed. LSA or LOA was based on age of diagnosis (before or after age 40). Demographic and asthma specific information were analyzed, and allergy prick tests and lung function testing (spirometry and FENO) were performed. Results: After regression analysis, LSA subjects were more likely to demonstrate positive prick tests (92 versus 71%, p?=?0.04), with both groups demonstrating higher levels of atopy than previously reported. LSA subjects were also more likely to have received a peak flow meter (p?=?0.07). LOA subjects were more likely to have moderate or severe asthma (OR?=?3.1, p?=?0.05), and had higher FENO readings (p?=?0.02). They also had more hospitalizations (p?=?0.04), though significance was lost after regression analysis. No differences were noted in demographic information, medical comorbidities, spirometry, compliance, asthma control, or asthma quality of life between LSA and LOA subjects. Conclusion: LSA subjects are more atopic and more likely to be given a peak flow meter, while LOA subjects have higher FENO levels and more severe asthma. Defining age of asthma onset may help improve treatment recommendations and outcomes for older adults.     

Low birth size and final height predict high sympathetic nerve activity in adulthood

OBJECTIVE: Being born small for gestational age (SGA) is associated with insulin resistance, hypertension and increased cardiovascular morbidity/mortality in adulthood. Sympathetic nerve hyperactivity is a well-known risk factor for cardiovascular disease mortality and is proposed to link insulin resistance with hypertension. The objective of this study was to test the hypothesis that sympathetic nerve activity is altered in individuals born SGA. DESIGN: A cross-sectional, comparative study of 20 healthy adults (21-25 years old) born SGA (birth weight < -2SD score for healthy newborns) with normal and short stature, and 12 age, gender and body mass index matched individuals, born appropriate for gestational age (AGA) with normal stature. METHODS: Direct recordings of resting sympathetic nerve activity to the muscle vascular bed (MSA) were obtained from the peroneal nerve posterior to the fibular head. Heart rate, respiration and blood pressure were recorded during the microneurographic session. RESULTS: MSA was increased in both groups of young adults born SGA as compared to those born AGA (P < 0.05 and P < 0.005, respectively). In the combined study group MSA was inversely correlated to birth weight, length (r = -0.59, P < 0.001 and r = -0.69, P < 0.0005, respectively) and final adult height (r = -0.58; P < 0.001). CONCLUSIONS: Being born SGA and achieving a short final height is associated with increased sympathetic nerve traffic. We suggest that the increase in sympathetic nerve traffic in young adults born SGA with normal and short stature may be the link between low birth size, hypertension and cardiovascular morbidity later in life.