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How does social support affect functional impairment in late life? Findings of a multicenter prospective cohort study in Germany
- Authors:
- HAJEK Andre, et al
- Journal article citation:
- Age and Ageing, 46(5), 2017, pp.813-820.
- Publisher:
- Oxford University Press
Objective: To investigate how social support affects functional impairment (FI) in late life in a longitudinal approach. Methods: in a multicenter prospective cohort study, subjects in old age (≥75 years at baseline) were interviewed every 1.5 years. Social support was quantified in the follow-up (FU) Waves 2 and 4 (FU Wave 2: n = 2,349; FU Wave 4: n = 1,484). FI was assessed by using the Lawton and Brody Instrumental Activities of Daily Living scale. Results: Fixed effects regressions showed that a decrease in social support is associated with FI in the total sample and in both sexes. The effect on FI was most pronounced with the dimension social integration, whereas changes in practical support only affected FI in the total sample and changes in emotional support only affected FI in men. Conclusions: The findings emphasise the importance of social support for functional status in late life. Thus, strengthening social support in old age might be effective in maintaining functional abilities. (Edited publisher abstract)
Impairment of activities of daily living requiring memory or complex reasoning as part of the MCI syndrome
- Authors:
- PERNECZKY Robert, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(2), February 2006, pp.158-162.
- Publisher:
- Wiley
Mild Cognitive Impairment (MCI) is a borderline state between age-associated cognitive decline and mild dementia. MCI is separated from mild dementia by an absence of global intellectual deterioration and the preservation of activities of daily living (ADL). However, even mild degrees of cognitive deterioration are known to have negative effects on complex ADL. The aim was to examine whether patients with MCI have impaired ADL as compared to healthy controls, which areas of ADL are particularly involved, and whether limitations on ADL are associated with demographical or clinical data. Forty-eight patients with MCI diagnosed according to research criteria and 42 cognitively unimpaired controls were enrolled. Cognitive function was inter alia assessed by the MMSE, complex ADL by the ADCS-MCI-ADL scale. Frequency distributions were compared between patients and controls using chi-square tests. Mean values were examined for statistically significant differences using Kruskal-Wallis tests. A Bonferroni correction for multiple comparisons was applied to the comparison of the 18 areas of the ADCS-MCI-ADL scale. Associations between ADL and biographical or clinical data were analysed using non-parametric correlations. The overall score on the ADCS-MCI-ADL scale was significantly lower in the MCI group. Patients performed significantly worse on 14 out of 18 activities. Activities involving memory or complex reasoning were particularly impaired, whereas more basic activities were unimpaired. There were no statistically significant associations of the ADCS-MCI-ADL overall score with age, years of formal education, gender, or number of cognitive domains affected in the group of MCI patients. However, there was a statistically significant association between the ADCS-MCI-ADL and the MMSE score. MCI patients may be impaired in complex ADL.
Potential technological solutions to promote mental well-being in older age
- Authors:
- COOK Glenda, et al
- Journal article citation:
- Generations Review, 20(3), July 2010, Online only
- Publisher:
- British Society of Gerontology
Using a multi-national Appreciative Inquiry (AI) design, the strategies that older people adopt to maintain their well-being were examined. Fifty-nine people participated in the study, from the countries of Australia, Germany, South Africa and United Kingdom. Participants described their experiences of mental well-being in relation to: social isolation and loneliness; social worth; self-determination; and security. The authors the reflected on the participants experiences, literature and research to identify potential technologies that may have assisted participants to enhance their self-reported strategies to promote their mental well-being.
Subjective health in old age from a salutogenic perspective
- Authors:
- WIESMANN Ulrich, NIEHORSTER Gabriele, HANNICH Hans-Joachim
- Journal article citation:
- British Journal of Health Psychology, 14(4), November 2009, pp.767-787.
- Publisher:
- Wiley
Healthy aging was studied in a in community sample of elderly people using a salutogenic framework (Antonovsky's model). Salutogenic theory states that generalised resistance resources build-up a sense of coherence which in turn determines an individual's health level. The relationship between 19 bio-psychosocial resources (such as social support, emotional and motivational resources, activities of daily living, and sociodemographic resources), the sense of coherence (comprehensibility, manageability and meaningfulness), and three subjective health measures (psychological health, symptom reporting, and physical health) were examined in a cross-sectional questionnaire study with volunteering elders in Germany (n=387, mean age 74 years, 73.4% women and 22.2% nursing home residents). The method controlled for dependent living to account for the inclusion of nursing home residents. Resources, sense of coherence, and subjective health were inter-related. Optimism, self-esteem, low depressive mood, self-efficacy, and social support predicted the sense of coherence. When predicting psychological health and symptom reporting, the sense of coherence remained significant when resources were added in the final step of the regression; this did not hold true for physical health. Mediator analyses showed that every eligible resource influenced both psychological health and symptom reporting, but not physical health, indirectly via the sense of coherence. The sense of coherence was largely shaped by individual difference variables. As a mediator it strongly accounted for the relation between resources and psychogenic aspects of health but not physical health. The authors emphasise the importance of resource-oriented health care for elders.