Differential item responses on CES-D inventory: A comparison of elderly Hispanics and non-Hispanic Whites in the United States and item usage by elderly Hispanics across time

Objectives: This study examines the differential item functioning (DIF) on both the standard 20-item scale and 10-item and 12-item subsets of the Center for Epidemiological Studies Depression (CES-D) inventory.

Method: Two elderly groups in the United States are compared: one composed of Hispanics and the other of non-Hispanic Whites. We also compare item use among the elderly Hispanics over time. Survey data was analyzed from participants (N = 4499) in the Established Populations for Epidemiologic Studies of the Elderly (EPESE) with complete data on the CES-D. Partial correlation analysis was applied to test hypotheses regarding the DIF on the basis of ethnic background and among the elderly Hispanics across time points.

Results: Hispanics appear to express positive affect differently than non-Hispanic Whites. On the 20-item scale, Hispanics under responded to items measuring positive affect. Item bias was also found for one positive affect question in the 10-item subset. Among the Hispanic sub-population, we also observed item response bias for the positive affect items across time. A 12-item subset tested for DIF displays an acceptable amount of item bias across ethnic groups and across time for the Hispanic sample.

Conclusions: Attempts to make substantive comparisons about the relative prevalence of depression symptoms in elderly Hispanic and non-Hispanic sub-populations appears to be limited by the lack of measurement invariance in the full CES-D. Comparisons across time for elderly Hispanics also appear problematic.     

Race differences in the association of spiritual experiences and life satisfaction in older age

Objectives: The primary objective of this study was to examine an African American ‘faith advantage’ in life satisfaction. Specifically, we sought to test the hypothesis that the positive relationship between spiritual experiences and life satisfaction is stronger among older African Americans than among older Whites.

Method: The data came from 6864 community-dwelling persons aged 65+ (66% African American) who participated in the Chicago Health and Aging Project. Life satisfaction was measured using a five-item composite and we used a five-item version of the Daily Spiritual Experiences scale.

Results: In a regression model adjusting for age, sex, marital status, education, income and worship attendance, we found that African American race was associated with lower life satisfaction. We also found a positive association between spiritual experiences and life satisfaction. In an additional model, a significant race by spiritual experiences interaction term indicates that spiritual experiences are more positively associated with life satisfaction among African Americans.

Conclusion: The data suggest that at higher levels of spiritual experiences, racial differences in life satisfaction are virtually non-existent. However, at lower levels of spiritual experiences, older African Americans show modestly lower levels of life satisfaction than do older Whites. This pattern suggests that spiritual experiences are a positive resource – distinct from worship attendance – that enable older African Americans to overcome decrements in life satisfaction and, in fact, that lower spiritual experiences may be especially harmful for older African American's life satisfaction.     

Spirituality attenuates the association between depression symptom severity and meaning in life

Objectives: This cross-sectional study examined whether spirituality moderates the association between depression symptom severity and meaning in life among treatment-seeking adults.

Method: Participants were 55 adults (≥60 years of age) newly seeking outpatient mental health treatment for mood, anxiety, or adjustment disorders. Self-report questionnaires measured depression symptom severity (Patient Health Questionnaire-9), spirituality (Spirituality Transcendence Index), and meaning in life (Geriatric Suicide Ideation Scale-Meaning in Life subscale).

Results: Results indicated a significant interaction between spirituality and depression symptom severity on meaning in life scores (β = .26, p = .02). A significant negative association between depression symptom severity and meaning in life was observed at lower but not the highest levels of spirituality.

Conclusion: In the presence of elevated depressive symptomatology, those participants who reported high levels of spirituality reported comparable levels of meaning in life to those without elevated depressive symptomatology. Assessment of older adult patients’ spirituality can reveal ways that spiritual beliefs and practices can be can be incorporated into therapy to enhance meaning in life.     

Urban and rural factors associated with life satisfaction among older Chinese adults

Objective: This study compared urban and rural factors associated with life satisfaction among older adults in mainland China.

Method: Study data were extracted at random from 10% of the Sample Survey on Aged Population in urban/rural China in 2006 for 1980 participants aged 60 and older, including 997 from urban cities and 983 from rural villages.

Results: In this study, 54.6% of urban older adults and 44.1% of rural older adults reported satisfaction with their lives. Binary logistic regression analysis showed that financial strain, depressive symptoms, filial piety, and accessibility of health services were significantly associated with life satisfaction for both urban and rural participants, but age and financial exchange with children were only associated with life satisfaction among urban older adults.

Conclusion: Findings are consistent with some previous studies that indicated the importance of financial strain, depressive symptoms, filial piety, and accessibility of health services to life satisfaction among the older adults in both urban and rural areas. This study also demonstrated the importance of age and family financial exchange to the life satisfaction of urban older adults.     

Subjective health and memory self-efficacy as mediators in the relation between subjective age and life satisfaction among older adults

Objective: Perceiving oneself as younger than one's actual age functions as a self-enhancing positive illusion that promotes life satisfaction. However, no research has yet focused on the mechanisms through which a youthful subjective age could be related to higher life satisfaction. The purpose of this study was to identify the mediating role of resources, such as subjective health and memory self-efficacy, in the relation between subjective age and life satisfaction among older adults.

Method: A cross-sectional study was conducted with 250 older individuals aged from 60 to 77 years who completed measures of subjective age, subjective health, memory self-efficacy, and life satisfaction.

Results: Path analysis revealed that subjective age was positively related to both subjective health and memory self-efficacy, and that subjective health and memory self-efficacy were both positively related to life satisfaction. Bootstrap procedures further indicated that subjective age has significant total and specific indirect contribution to life satisfaction through subjective health and memory self-efficacy.

Discussion: This study fills a gap in existing literature and suggests that a youthful subjective age is associated with higher life satisfaction because it is related to higher evaluation of health and memory self-efficacy. It provides an initial support for a resource-based explanation of the relation between subjective age and life satisfaction.     

Personal growth,grandmother engagement and satisfaction among non-custodial grandmothers

Objectives: We investigated grandmothers’ personal growth, their engagement with grandchildren, their satisfaction with this role and how personal growth was related to engagement and satisfaction.

Method: One thousand two hundred and five grandmothers completed a survey containing questions about: personal resources (age, education, whether partnered or not, health); engagement with grandchildren (number of grandchildren, hours spent per week, frequency of activities, satisfaction with being a grandmother); and personal growth (life satisfaction, generativity).

Results: Participants had a positive sense of living productive and worthwhile lives with most reporting high scores on life satisfaction and generativity. Most were actively engaged with their grandchildren, participating in a wide range of activities. Active engagement was positively related to grandmother satisfaction. Hierarchical regressions showed that both life satisfaction and generativity were significantly predicted by grandmother resources and grandmother engagement.

Conclusion: This group of grandmothers did not fit ageist stereotypes of disengagement and loss of function. Our study shows that grandmothering is a rewarding role, and women who engage with it have a positive sense of personal growth.     

Social ties and psychological well-being in late life: the mediating role of relationship satisfaction

Objective: The current paper examines whether quantitative aspects of social support (i.e., support network characteristics) indirectly influence psychological well-being via older adults' qualitative perceptions of support (i.e., satisfaction with social relationships).

Methods: A sample of 416 adults aged ≥60 was drawn from the Social Integration and Aging Study, a community-based survey conducted in a small US (Midwestern) city. The survey assessed social networks, social support, and physical and mental health among older adults.

Results: Bootstrapping was used to examine mediation models. Greater support network size predicted lower perceived stress, fewer depressive symptoms, and better life satisfaction, yet this association was fully mediated by relationship satisfaction. For support network composition, greater proportion kin was associated with lower stress and better life satisfaction, though not depressive symptoms, however, relationship satisfaction did not mediate this link.

Discussion: Findings highlight the complex interplay of support network characteristics and satisfaction, and suggest the greater import of support satisfaction for older adults' psychological well-being.     

The impacts of community social capital on the life satisfaction of older adults in Hong Kong: the moderator role of intergenerational family capital

Objective: This study examined the moderator role of intergenerational family capital on the relationship between community social capital and life satisfaction of older Chinese adults.

Method: The data were derived from a quota sampling of 372 older adults aged 60 and above, who were interviewed at four districts in Hong Kong in 2011. Multiple group analysis was employed to examine the proposed model.

Results: For the low family capital group, community social capital was found to be a significant predictor of life satisfaction, even when the well-known covariates were controlled. However, the association between community social capital and life satisfaction was statistically non-significant among the high family capital group.

Discussion: The findings highlighted the interplay between community social capital and intergenerational family capital, which supported community social capital replacement theory in understanding the mechanism linking social capital to life satisfaction in older age in a Chinese context. Community social capital can play a compensatory role in maintaining the mental health of older people. It is particularly important for older adults who lack family support and/or suffer from social isolation and loneliness in local communities.     

Perceived health status and life satisfaction in old age,and the moderating role of social support

Objectives: The aim of this study was on one hand to examine the associations between health impairment and life satisfaction, as well as social support and life satisfaction, and on the other, to analyze the moderating effect of social support with regard to health impairment and life satisfaction in a sample of community-dwelling older adults from urban areas of Granada, southern Spain.

Method: This was a cross-sectional survey in which a sample of 406 older adults with ages between 65 and 99 years old (M_age = 74.88, SD = 6.75) was selected. Multiple stepwise regression analysis was used to assess the impact of health impairment and perceived social support on life satisfaction. Moderation analysis was performed using the bias-corrected and accelerated bootstrapping approach.

Results: Significant differences in life satisfaction scores were found by number and type of disease, restrictions in daily life activities and subjective health. Perceived health and perceived social support predicted life satisfaction. Besides global social support, emotional and affectionate support moderated the link between perceived health and life satisfaction.

Conclusions: Older people who do not rate their health status positively and indicate low levels of social support have a higher risk of being dissatisfied with their lives and due to this they should receive special attention from gerontologists.     

Consumer satisfaction with antipsychotic medication-monitoring appointments: the role of consumer–prescriber communication patterns

Objective: The study was designed to explore patterns of prescriber communication behaviors as they relate to consumer satisfaction among a serious mental illness sample.

Methods: Recordings from 175 antipsychotic medication-monitoring appointments between veterans with psychiatric disorders and their prescribers were coded using the Roter Interaction Analysis System (RIAS) for communication behavioral patterns.

Results: The frequency of prescriber communication behaviors (i.e., facilitation, rapport, procedural, psychosocial, biomedical, and total utterances) did not reliably predict consumer satisfaction. The ratio of prescriber to consumer utterances did predict consumer satisfaction.

Conclusions: Consistent with client-centered care theory, antipsychotic medication consumers were more satisfied with their encounters when their prescriber did not dominate the conversation.

Practice implications: Therefore, one potential recommendation from these findings could be for medication prescribers to spend more of their time listening to, rather than speaking with, their SMI consumers.     

It's all in how you view it: Pessimism,social relations,and life satisfaction in older adults with osteoarthritis

Objectives: Current treatments for osteoarthritis (OA) continue to leave those burdened by the condition with pain and disability which affects physical and psychological well-being. The present study examines other psychosocial factors, such as dispositional personality and social relationships, in order to investigate their influence on the well-being of 160 older adults with OA (80% women).

Method: Older adults were recruited for self-reported knee or hip OA. Participants completed self-report measures of optimism and pessimism, social support, social strain, and life satisfaction using the computer program MediaLab. Measures were taken twice 9–12 months apart.

Results: Results showed that, both cross-sectionally and longitudinally, pessimism was related to lower social support and higher social strain. In addition, pessimism was mediated by social support in its relationship to life satisfaction.

Discussion: Our models support the combined roles of pessimism and social support influencing life satisfaction over time. Future interventions may want to concentrate on improving the social relationships of people with OA to enhance psychological well-being.     

Dispositional characteristics,relational well-being and perceived life satisfaction and empowerment of elders

Objectives: The broad purpose of this research is to identify the key modifiable variables most related to elders’ life satisfaction and empowerment in order to improve the efficacy of interventions projects. Our study aims to integrate the theoretical perspectives of personality and community psychology focusing both on dispositional characteristics and relational well-being of elders, investigating triads, composed by an elder, a paid caregiver and the most involved relative. This study explores the impact of (1) some socio-demographic characteristics of elders, (2) some modifiable dispositional variables of elders and (3) elders’ relational well-being on elders’ empowerment and life satisfaction.

Method: The study involved 429 people in 143 triads. Semi-structured interviews with elders, paid caregiver and close relatives were used to construct a new pilot measure of elders’ relational well-being. Life Satisfaction, Empowerment, Loneliness, Positivity, Humor and Emotions self-efficacy scales were also administered. Hierarchical multiple regressions were performed.

Results: Elders’ positivity, relational well-being of elders and living alone were significantly related to empowerment. Elders’ relational well-being and positivity significantly contributed to life satisfaction.

Discussion: Interventions to increase empowerment and life satisfaction should focus primarily on augmenting positivity and relational well-being integrating the theoretical premises of both personality and community psychology.     

Psychometric properties of the Valued Living Questionnaire Adapted to Dementia Caregiving

Objectives: Caring for a relative with dementia is associated with physical and emotional health problems in caregivers. There are no studies analysing the role of personal values in the caregiver stress process.

This study aims to analyse the psychometric properties of the Valued Living Questionnaire Adapted to Caregiving (VLQAC), and to explore the relationship between personal values and stressors, coping strategies and caregiver distress.

Method: A total of 253 individual interviews with caregivers of relatives with dementia were conducted, and the following variables were assessed: personal values, stressors, cognitive fusion, emotional acceptance, depression, anxiety, and satisfaction with life. An exploratory factor analysis and hierarchical regression analyses were carried out.

Results: Two factors were obtained, Commitment to Own Values and Commitment to Family Values which explain 43.42% of variance, with reliability coefficients (Cronbach's alpha) of .76 and .61, respectively. Personal values had a significant effect on emotional distress (depression and anxiety) and satisfaction with life, even when controlling for socio-demographic variables, stressors and coping strategies.

Conclusion: Results suggest that the personal values construct of dementia caregivers is two-dimensional. The personal values of the caregivers play an important role in accounting for distress and satisfaction with life in this population.     

Internet use and well-being in later life: a functional approach

Objectives: This study aimed at exploring the Internet's role in supporting subjective well-being in later life by applying a functional approach, namely, simultaneously but separately examining each of the principal online functions common among older adults (interpersonal communication, information, task performance and leisure).

Methods: Data were collected online from 306 Internet users aged 50 years and over. Subjective well-being was measured according to indicators of depression and life satisfaction.

Results: Interpersonal communication and information seeking were the most commonly used Internet functions, followed by task performance; use for leisure and recreation was significantly less prevalent. All four online functions were positively correlated with life satisfaction, and task performance and leisure were negatively correlated with depression. After controlling for sociodemographic variables, only leisure associated significantly with the well-being measures.

Discussion: These findings revealed a paradoxical situation in which the most beneficial use of the Internet is the least popular.     

A creative reminiscence program for older adults with severe mental disorders: Results of a pilot evaluation

Objective: Older adults with severe mental disorders experience major dissatisfaction with conditions of life that are connected with aging. To assist them in developing a coherent, meaningful life-story and to improve their life satisfaction, we conducted a pilot evaluation of a creative reminiscence program called Searching for meaning in life.

Methods: One week before and one week after the intervention 36 participants from three psychiatric hospitals and one sheltered housing program were interviewed. Life satisfaction was measured with the Manchester Short Assessment of Quality of Life (MANSA) and the Philadelphia Geriatric Center Moral Scale (PGCMS). At follow-up questions were also asked about the intervention.

Results: About 78% of the participants completed the course. Most of them were satisfied with the course (74%). The overall sample showed significantly more life satisfaction after the intervention. Participants with a psychotic disorder also improved significantly in life satisfaction but at the same time their depressive symptoms increased significantly. Participants with a moderate to high level of depressive symptoms at baseline had relatively favorable outcomes. Their life satisfaction had improved significantly and they especially had a better attitude toward their aging.

Conclusion: The program is feasible and acceptable for adults with severe mental illness and it has potential benefits for them. More research is needed to find out what explains the increase of depressive symptoms for participants with psychotic disorders.     

Intergenerational support and life satisfaction of young-, old- and oldest-old adults in China

Objectives: This study investigated variation across different old-age groups in the association between intergenerational support and elderly life satisfaction in China, taking into account both exchange patterns and different types of support.

Method: Using the first two waves (2010 and 2012) of China Family Panel Studies, we applied the fixed-effect approach to examine the moderating effect of age separately for exchange patterns and different types of intergenerational support. The sample included 3989 elderly people.

Results: There were age differences in the association between intergenerational support and elderly life satisfaction, for both exchange patterns and different types of support. Particularly, there was significant difference between the young-old (61–70) and the oldest-old (85+) in terms of the association.

Conclusion: Theoretically, this study helps to elaborate on social exchange and equity theories by introducing explanations from socio-emotional selectivity theory. It further highlights how policies for elderly care should be developed considering the diverse needs, characteristics and goals of elderly people rather than treating them as a singular homogenous group, in particular in relation to different old-age groups.     

The predicament of time near the end of life: Time perspective trajectories of life satisfaction among the old-old

Objective: The present study investigated time perspective in old-old age as embodied in trajectories of life satisfaction ratings that individuals attribute to their past, present, and anticipated future. We hypothesized that these trajectories represent diverse strategies of coping with old age.

Method: The sample was composed of 164 participants (mean age 91.9, SD = 4.3) who survived the third wave of a national longitudinal study in Israel. The findings indicated four groups; three with distinctive trajectories of life satisfaction – equilibrated, descending, and no-future, along with an unreported trajectory group.

Results: The equilibrated trajectory group exhibited the highest functioning on central markers of adaptation (indicating depressive symptoms, self-rated health, and physical performance). The descending and the no-future trajectories were found to be moderately effective strategies. The unreported trajectory presented the lowest level of functioning.

Conclusions: The findings revealed the adaptive roles of time-related perspective on life in old-old people. This perspective reflects a variety of rudimentary trajectories that constitute a time-based module of well-being along the continuum of one's life story. The study suggests that the diverse trajectories relate to essential domains of functioning. Practitioners and therapists may profit from assessing the time perspective of the old-old and directing it into more adaptive trajectories.     

Possible error in the Danish version of the WHO Quality of Life (WHOQOL-BREF) Questionnaire

Background: The WHOQOL-BREF is widely used to measure quality of life.

Aims: The goal of the present study was to use the questionnaire in a doctoral study.

Methods: We studied all the instructions provided by the WHO.

Results: In the Danish version of the WHOQOL-BREF there is a discrepancy between the negatively phrased question 9 and both the syntax file and the verbal instructions for coding the data provided by the WHO.

Conclusions: This is a notification of possible error interpretations in projects that use the questionnaire. This could be corrected by manual correction in the coding process or by changing the negatively phrased question 9.     

Subjective forgetfulness is associated with lower quality of life in middle-aged and young-old individuals: A 9-year follow-up in older participants from the Maastricht Aging Study

Objectives: Many people regard themselves as being forgetful. They may be hindered by or worried about this subjective forgetfulness in daily life. The first aim of the present study was to determine whether perceived forgetfulness in healthy older adults is related to a lower quality of life. The second objective was to assess whether the association between perceived forgetfulness and quality of life changes over a 9-year follow-up period.

Method: A group of 412 participants in the longitudinal Maastricht Aging Study, aged 54 years or older, were interviewed and tested at baseline, 3, 6, and 9 years. Four proxy measures of quality of life were studied; satisfaction with life, mental well-being, and symptoms of anxiety and depression.

Results: Results showed that subjective forgetfulness was associated with a lower quality of life. In addition, in individuals considering themselves forgetful, a significant increase was found in symptoms of anxiety, compared to those who had no perceived forgetfulness. The relation between perceived forgetfulness and decreased satisfaction with life was stronger in younger (54–69 years) than in older participants (70–91 years).

Conclusion: The observation that perceived forgetfulness and reduced quality of life are related and that this relation persists over time demonstrates the relevance of subjective forgetfulness for daily life functioning, particularly in relatively young subjects.     

Association between cultural factors and the caregiving burden for Chinese spousal caregivers of frail elderly in Hong Kong

Objectives: The aim of this study was to explore the relationship between cultural factors and the caregiving burden of Chinese spousal caregivers who provided care to their frail partners.

Method: A sample consisting of 102 Chinese caregivers for frail elderly spouses was recruited from home care services across various districts in Hong Kong. Structured interviews were conducted with the participants in their homes, measuring demographics, the functional status of the spouse, the degree of assistance required in daily care, perceived health, the caregiver's orientation to traditional Chinese family values, social support, coping, and caregiver burden.

Results: Findings of regression analysis indicated that gender, activities of daily living (ADL) status, orientation to traditional Chinese family values, passive coping, and marital satisfaction associated with caregiver burden. Being female, having lower functioning in ADL or a strong orientation toward traditional Chinese family values, employing the strategies of passive coping more frequent, or experiencing a low degree of marital satisfaction were associated with high levels of caregiver burden.

Conclusion: These findings provided a basis for developing appropriate interventions to minimize the caregiver burden of spousal family caregivers.