Predictors of Interleukin-6 Elevation in Older Adults

OBJECTIVES: To investigate the characteristics of older adults who develop high interleukin-6 (IL-6) levels at 3-year follow-up.
DESIGN: Population-based study of adults living in Tuscany, Italy.
SETTING: Community.
PARTICIPANTS: Adults aged 65 and older and were selected for this study. Of 1,155 baseline participants aged 65 and older, 741 had IL-6 measurements at baseline and 3-year follow-up.
MEASUREMENTS: The uppermost quartile of IL-6 was used as the threshold for defining high IL-6 (≥4.18 pg/mL). Serum IL-6 levels were assessed using enzyme immunoassay.
RESULTS: Of the 581 participants with IL-6 levels less than 4.18 pg/mL at baseline, 106 (18.2%) had developed high IL-6 at follow-up. Although women had lower IL-6 levels at baseline than men, the risk of developing high IL-6 did not differ according to sex. High adiposity, defined as a body mass index of 30.0 kg/m² or higher (odds ratio (OR)=2.63, 95% confidence interval (CI)=1.40–4.96), and large waist circumference, defined as 102 cm or greater for men and 88 cm or greater for women (OR=2.05, 95% CI=1.24–3.40), were significant predictors of developing high IL-6 at follow-up. Other significant predictors were presence of three or more chronic diseases (OR=3.66, 95% CI=1.54–8.70), higher baseline IL-6 (OR=1.82, 95% CI=1.39–2.38) and higher white blood cell count (OR=1.24, 95% CI=1.06–1.45). Faster walking speed associated with decreased risk of progressing to elevated IL-6 (OR=0.83, 95% CI=0.74–0.92).
CONCLUSION: Older age, greater adiposity, slower walking speed, higher disease burden, and higher white blood cell count were associated with greater risk of IL-6 elevation over a 3-year period. Future research should target older adults with these characteristics to prevent progression to a proinflammatory state.     

Predictors of Activity Involvement Among Older Adults

Abstract

The purpose of this study was to measure the impact of age and other predictors (gender, health status, education, region) on activity participation among older adults. A stratified probability sample of 601 subjects was surveyed with in-depth structured interviews. Data on the frequency of involvement in four types of activity and on potential predictor variables were analyzed. A major finding is that old age per secannot explain lower involvement in any of the four types of activity under study. A canonical correlation analysis confirms previous research findings indicating that health status and education are the primary impediment to leisure participation among older adults.     

Neuropsychological Predictors of Driving Errors in Older Adults

OBJECTIVES: To identify neuropsychological factors associated with driving errors in older adults. DESIGN: Cross‐sectional observational study. SETTING: Neuropsychological assessment laboratory and an instrumented vehicle on a 35‐mile route on urban and rural roads. PARTICIPANTS: One hundred eleven older adult drivers (aged 65–89; mean age 72.3) and 80 middle‐aged drivers (aged 40–64; mean age 57.2). MEASUREMENTS: Explanatory variables included age, neuropsychological measures (cognitive, visual, and motor), and a composite cognitive score (COGSTAT). The outcome variable was the safety error count, as classified according to video review using a standardized taxonomy. RESULTS: Older drivers committed an average of 35.8 ± 12.8 safety errors per drive, compared with an average of 27.8 ± 9.8 for middle‐aged drivers (P<.001). For older drivers, there was an increase of 2.6 errors per drive observed for each 5‐year age increase (P=.03). After adjustment for age, education, and sex, COGSTAT was a significant predictor of safety errors in older drivers (P=.005), with an approximately 10% increase in safety errors observed for a 10% decrease in cognitive function. Individual significant predictors of more safety errors in older drivers included poorer scores on the Complex Figure Test—Copy, the Complex Figure Test—Recall, Block Design, Near Visual Acuity, and the Grooved Pegboard task. CONCLUSION: Driving errors in older adults tend to increase, even in the absence of neurological diagnoses. Age‐related decline in cognitive abilities, vision, and motor skills can explain some of this increase. Changes in visuospatial and visuomotor abilities appear to be particularly associated with unsafe driving in old age.     

Loneliness in Older Adults Living with HIV

We conducted a cross-sectional study among HIV-positive adults age ≥ 50 in San Francisco to evaluate the frequency of loneliness, characteristics of those who reported loneliness, and the association of loneliness with functional impairment and health-related quality of life (HRQoL). Participants (N = 356) were predominately male (85%); 57% were white; median age was 56. 58% reported any loneliness symptoms with 24% reporting mild, 22% moderate and 12% severe loneliness. Lonely participants were more likely to report depression, alcohol and tobacco use, and have fewer relationships. In unadjusted models, loneliness was associated with functional impairment and poor HRQoL. In adjusted models, low income and depression remained associated with poor HRQoL, while low income, higher VACS index and depression were associated with functional impairment. A comprehensive care approach, incorporating mental health and psychosocial assessments with more traditional clinical assessments, will be needed to improve health outcomes for the aging HIV-positive population.     

Predictors of Working Memory Maintenance and Decline in Older Adults

The aging process is associated with the gradual decline of several cognitive functions, and working memory is particularly affected. Although the majority of older adults experience a deterioration of their working memory, some individuals maintain their working memory in older age, and some suffer an extreme deterioration of their working memory. The purpose of the present study was to identify, among a total of 120 potential predictors, those that significantly contributed to these two extreme outcomes in working memory. A sample of 588 healthy adults was examined with the n-back task in the spatial and verbal domains using a 2-back level of difficulty. Individuals were classified as working memory maintainers or decliners if their discrimination level in the two domains was superior to the 80th percentile or inferior to the 20th percentile, respectively. Logistic regression identified eight and six significant predictors of working memory maintenance and decline, respectively. High vocabulary scores and smoking more were significant predictors of working memory maintenance; however, in the opposite direction, these same variables predicted working memory decline. Several consumption habits that influenced cerebrovascular function were found in both models. Psychological traits and everyday activities were present in both models. We identified specific predictors that contribute to extremely high or low working memory performance in older age.     

Predictors of Interest in Working with Older Adults: A Survey of Postgraduate Trainee Psychologists

ABSTRACT

Despite the growing number of older adults that implies an increasing need for psychological services, few psychologists choose to specialize in working with older clients. The present cross-sectional research examined predictors of student interest in working with older clients in an effort to understand factors that may influence future psychologists to work in this area. The targeted sample consisted of Australian postgraduate psychology students whose course coordinators responded to a request to participate in this national survey. Four hundred and thirty-one postgraduate trainee psychology students completed the survey that examined training, contact, and attitudinal variables. This represents a 45.3% response rate from surveys being distributed by course coordinators. Having undergone or intending to do a placement within an aged care setting was the most powerful predictor of interest, with confidence in working with the elderly, and positively anticipating old age being attitudinal factors related to increased interest. Amount or quality of contact with older adults and formal education through aging-related coursework failed to predict interest, based on hierarchical regression analysis. Implications for future training of psychologists highlight the importance of quality clinical experiences with older clients during training as opposed to pure coursework.     

Medication and Behavioral Adherence Among HIV+ Older Adults

The purpose of this investigation was to explore HIV medication adherence among older adults. In Study 1, 44 HIV+ adults were recruited from the University of Pennsylvania Center for AIDS Research and interviewed about their health behaviors, including medication adherence. In Study 2, 40 HIV+ adults were surveyed about their communication with their physician and HIV medication and behavioral recommendations. Both studies found that a considerable percentage of participants were not completely adherent to their HIV medications. Furthermore, the majority of participants reported good communication with their physician. The findings of these studies have implications for intervention efforts aimed at increasing adherence to both medications and recommended behaviors among HIV+ older adults.     

Countertransference Reactions Toward Older Adults Facing HIV and AIDS

Abstract

This article will provide a technique designed to identify and explore areas of countertransference when working with older adults facing HIV/AIDS. It offers instructors and supervisors a way to teach about countertransference toward older adults facing HIV and AIDS. This technique can be utilized in a variety of gerontological settings such as mental health clinics, multipurpose centers for older adults, as well as classrooms and private practice.