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Self-perception of aging and acute medical events in chronically institutionalized middle-aged and older persons with schizophrenia
- Authors:
- CHENG Sheung-Tak, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(9), September 2012, pp.907-913.
- Publisher:
- Wiley
Despite having a much shorter life expectancy, persons with schizophrenia are ageing along with the general population; those reaching 55 years or over is expected to double in the next 20 years in the USA. The aim of this study was to examine how self-perceptions of aging affect physical health status and service utilisation in people with a chronic history of schizophrenia. The study participants were 83 persons aged 40 years and over with schizophrenia residing in a long-stay care home. The participants received assessments in body mass index, functional health, and global mental status, and responded to measures of self-perception of aging. Acute events that required medical attention were recorded for the following 3 months. During this period, 7 participants (8.4%) had acute medical events. These acute medical events were predicted by physical conditions, cognitive impairment, and negative self-perception of ageing. Only mobility and negative self-perception of ageing had independent effects on the occurrence of acute medical events, with the effects of the latter being much stronger. Positive aging self-perception, body mass index, and smoking were unrelated to medical events. The article concludes that how older people with schizophrenia perceive their aging process, which is expected to regulate health behaviour and help-seeking, is an important factor in the development of acute medical events.
Attachment and physical health: introduction to the special issue
- Authors:
- EHRLICH Katherine B., CASSIDY Jude
- Journal article citation:
- Attachment and Human Development, 21(1), 2019, pp.1-4.
- Publisher:
- Taylor and Francis
Over the last 40 years, researchers have made considerable progress identifying the ways in which attachment security shapes individuals’ social and emotional functioning. In recent years, new investigations have shed light on connections between attachment and physiological systems in the body. The goal of this special issue is to focus attention on how attachment may be related to biological markers that relate to physical health, including inflammation, cortisol, and cardiometabolic risk. The papers in this special issue, highlighted in this introduction, demonstrate that these links may exist across the lifespan. The authors conclude with several examples of extensions of this work might emerge in the years to come. (Edited publisher abstract)
Persistence of depressive symptoms and gait speed recovery in older adults after hip fracture
- Authors:
- RATHBUN Alan M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(7), 2018, pp.875-882.
- Publisher:
- Wiley
Objective: Depression after hip fracture in older adults is associated with worse physical performance; however, depressive symptoms are dynamic, fluctuating during the recovery period. The study aim was to determine how the persistence of depressive symptoms over time cumulatively affects the recovery of physical performance. Methods: Marginal structural models estimated the cumulative effect of persistence of depressive symptoms on gait speed during hip fracture recovery among older adults (n = 284) enrolled in the Baltimore Hip Studies 7th cohort. Depressive symptoms at baseline and at 2‐month and 6‐month postadmission for hip fracture were evaluated by using the Center for Epidemiological Studies Depression Scale, and persistence of symptoms was assessed as a time‐averaged severity lagged to standardized 3 m gait speed at 2, 6, and 12 months. Results: A 1‐unit increase in time‐averaged Center for Epidemiological Studies Depression score was associated with a mean difference in gait speed of −0.0076 standard deviations (95% confidence interval [CI]: −0.0184, 0.0032; P = .166). The association was largest in magnitude from baseline to 6 months: −0.0144 standard deviations (95% CI: −0.0303, 0.0015; P = 0.076). Associations for the other time intervals were smaller: −0.0028 standard deviations (95% CI: −0.0138, 0.0083; P = .621) at 2 months and −0.0121 standard deviations (95% CI: −0.0324, 0.0082; P = .238) at 12 months. Conclusion: Although not statistically significant, the magnitude of the numerical estimates suggests that expressing more depressive symptoms during the first 6 months after hip fracture has a meaningful impact on functional recovery. (Edited publisher abstract)
Toward an understanding of late life suicidal behavior: the role of lifespan developmental theory
- Authors:
- FISKE Amy, O'RILEY Alisa
- Journal article citation:
- Aging and Mental Health, 20(2), 2016, pp.123-130.
- Publisher:
- Taylor and Francis
Objectives: Suicidal behaviour in late life differs in important ways from suicidal behaviour that occurs earlier in the lifespan, suggesting the possibility of developmental differences in the aetiology of suicidal behaviour. This paper presents a conceptual framework for using lifespan developmental theory to better understand late life suicidal behaviour. Results: The paper argues that the motivational theory of lifespan development, which focuses on control, is particularly relevant to late life suicide. This theory posits that opportunities to exert control over important aspects of one's life diminish in late life as a result of declines in physical functioning and other factors, and that successful ageing is associated with adaptive regulation of this developmental change. Although continued striving to meet goals is normative throughout the lifespan, most individuals also increase the use of compensatory strategies in old age or when faced with a decline in functioning. It is proposed that individuals who do not adapt to developmental changes by altering their strategies for exerting control will be at risk for suicidal behaviour in late life. This paper reviews evidence that supports the importance of control with respect to suicidal outcomes in older adults, as well as findings regarding specific types of control strategies that may be related to suicide risk in older adults with health-related limitations. Conclusion: Although suicidal behaviour is not a normal part of ageing, the application of lifespan developmental theory may be useful in understanding and potentially preventing suicide among older adults. (Edited publisher abstract)
The influence of prior rape on the psychological and physical health functioning of older adults
- Authors:
- SACHS-ERICSSON Natalie, et al
- Journal article citation:
- Aging and Mental Health, 18(6), 2014, pp.717-730.
- Publisher:
- Taylor and Francis
Objectives: Older adults who have experienced traumatic events earlier in life may be especially vulnerable to additional challenges associated with ageing. In a cross-sectional study of older females, the present study examines whether a history of rape is associated with current psychological and health problems. Method: This study used existing data from the female respondents (N = 1228) in the National Social Life, Health, and Aging Project (NSHAP), a national probability sample of adults between the ages of 57 and 85 interviewed in their homes. It was determined whether or not the participant experienced forced sexual contact since the age of 18. Measures of psychological health (e.g., scales of depression, anxiety, and loneliness), the presence or absence of a number of serious health problems, and a one-item measure of self-esteem were obtained. Results: Adult rape occurred in 7% of the sample. On average, 36 years had elapsed since the rape had occurred. Using structural equation modeling (SEM), rape was associated with lower self-esteem, psychological, and physical health functioning. Self-esteem partially mediated the association between rape and psychological functioning, but not health functioning. These associations were significant even after controlling for participant characteristics and risky health behaviours. Conclusions: Mechanisms linking prior rape to psychological and health problems in older age are discussed, as well as treatment recommendations for symptomatic older adults. (Edited publisher abstract)
Age and sex differences in prevalence and clinical correlates of depression: first results from the Irish Longitudinal Study on Ageing
- Authors:
- REGAN Claire O., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(12), 2013, pp.1280-1287.
- Publisher:
- Wiley
Using a population-representative sample of 8175 community-dwelling adults aged 50 years and over from the first wave of the Irish Longitudinal Study on Ageing (TILDA), this study aimed to determine the prevalence of depressive symptoms in a large population sample. The primary outcome measure was clinically significant depressive symptoms defined by a score of 16 or greater on the 20-item Centre for Epidemiologic Studies Depression scale. Overall, 10% of adults reported clinically significant depressive symptoms. Physical illness was associated with depressive symptoms only in adults 65 years and older; in adults aged 50–64 years, the association is mediated by medication use, and this age difference is statistically significant. Irrespective of age, chronic pain and incontinence were stronger predictors of depression in men. The findings identify age-specific and gender-specific clinical markers for depression risk among the older population, which may identify those more likely to present with depression in community settings. (Edited publisher abstract)
Chronic illness burden and quality of life in an aging HIV population
- Authors:
- BALDERSON Benjamin H., et al
- Journal article citation:
- AIDS Care, 25(4), 2013, pp.451-458.
- Publisher:
- Taylor and Francis
The population of persons living with HIV (PLWH) is growing older and more prone to developing other chronic health conditions. Disease progression has been shown to be related to quality of life (QoL). Approximately 452 PLWH aged 50 years or older were recruited from AIDS Service Organizations in nine US states. Participants completed a telephone survey that included measures of other chronic health conditions, perceived stress, depression, and health-related quality of life. As much as 94% of the sample reported a chronic health condition in addition to HIV. The highest reported conditions were hypertension, chronic pain, hepatitis, and arthritis. Despite relatively high rates of depression, overall QoL was moderately high for the sample. Physical functioning was most impacted by the addition of other chronic health problems. Social functioning, mental health functioning, stress, and depression were also strongly associated with chronic disease burden. Additional chronic health problems are the norm for PLWH aged 50 years and older. QoL is significantly related to the addition of chronic health problems. As increasing numbers of PLWH reach older age, this raises challenges for providing comprehensive healthcare to older PLWH with multiple chronic conditions. (Edited publisher abstract)
The Health of the Nation: a strategy for healthier longer lives
- Author:
- ALL-PARTY PARLIAMENTARY GROUP FOR LONGEVITY
- Publisher:
- All-Party Parliamentary Group for Longevity
- Publication year:
- 2020
- Pagination:
- 92
- Place of publication:
- London
This report by the APPG for Longevity explores what needs to be done to ensure that more of the population can live in good health for as long as possible. The report highlights the high levels of health inequalities that currently exist, with higher levels of preventable poor health amongst the poorest in society. As people live longer, premature poor health will also increase demand and cost for the NHS and social care. The report sets out what is need to improve the health of the nation and those in worse health in the following areas: making it easier to live well; national leadership; an NHS that is active in preventing ill health; good local leadership that understands local health needs and supports community asset-based approaches; enlisting business as a stakeholder in health; and maximising the contribution of science and technology. It concludes by making seven recommendations for achieve change over the next 15 years. (Edited publisher abstract)
A preliminary investigation of attachment style and inflammation in African-American young adults
- Authors:
- EHRLICH Katherine B., et al
- Journal article citation:
- Attachment and Human Development, 21(1), 2019, pp.57-69.
- Publisher:
- Taylor and Francis
Individuals’ social experiences are associated with their mental health, physical health, and even mortality. Over the last 30 years, researchers have examined the ways in which these social experiences might be associated with chronic inflammation – a component underlying many of the chronic diseases of ageing. Little research, however, has examined the role of adults’ attachment style as a specific social component that might be associated with inflammation. In the present study, the authors utilized data from a sample of 59 African-American adults from the Maryland Adolescent Development in Context Study (MADICS) to examine the links between attachment avoidance and attachment anxiety and C-reactive protein (CRP) and interleukin (IL)-6. After controlling for demographic characteristics, body mass index, and depressive symptoms, attachment avoidance and anxiety were associated with IL-6 but not CRP. This study adds to the growing body of research identifying the wide range of social experiences associated with inflammation and further suggests that attachment relationship experiences may have implications for biological processes relevant to many chronic diseases of ageing. (Edited publisher abstract)
Conceptualising person-centered advance care planning for people with intellectual disabilities: a multifaceted theoretical approach
- Authors:
- McGINLEY Jacqueline M., KNOKE Victoria
- Journal article citation:
- Ethics and Social Welfare, 12(3), 2018, pp.244-258.
- Publisher:
- Taylor and Francis
- Place of publication:
- Abingdon
Due to advances in care in recent decades, adults with intellectual disabilities (ID) are living longer than ever before. This requires increased attention to issues surrounding serious illness and end-of-life care. Person-centered advance care planning has been identified as an important aspect of respecting the wishes and values of individuals. Despite this, adults with ID are largely excluded from these discussions. This paper triangulates the Bioecological Theory of Human Development, Symbolic Interactionism, and the Human Rights Perspective to explore the complexity of person-centred care for older adults with ID. Specifically highlighted will be some of the ethical concerns and environmental barriers that limit the participation of adults with ID in person-centered care. The framework outlined in this paper seeks to facilitate a more comprehensive understanding among researchers, social workers, and care systems that there is nothing inherent in people with ID that precludes them from person-centered advance care planning and end-of-life care as they age and experience serious illness. Implications for social work practice will also be discussed. (Edited publisher abstract)