The Importance of Aging Studies: Understanding the Influence of Diversity and Culture

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Identifying factors of psychological distress on the experience of pain and symptom management among cancer patients

Background Epidemiological evidence suggests the impact psychological distress has on symptomatic outcomes (pain) among cancer patients. While studies have examined distress across various medical illnesses, few have examined the relationship of psychological distress and pain among patients diagnosed with cancer. This study aimed to examine the impact psychological distress-related symptoms has on pain frequency, presence of pain, and pain-related distress among oncology patients. Methods Data were collected from a sample of White and Black adults (N = 232) receiving outpatient services from a comprehensive cancer center. Participants were surveyed on questions assessing psychological distress (i.e., worry, feeling sad, difficulty sleeping), and health (pain presence, pain frequency, comorbidities, physical functioning), behavioral (pain-related distress), and demographic characteristics. Results Patients reporting functional limitations were more likely to report pain. Specifically, those reporting difficulty sleeping and feeling irritable were similarly likely to report pain. Data further showed age and feeling irritable as significant indicators of pain-related distress, with younger adults reporting more distress. Conclusions It must be recognized that psychological distress and experiences of pain frequency are contingent upon a myriad of factors that are not exclusive, but rather coexisting determinants of health. Further assessment of identified predictors such as age, race, socioeconomic status, and other physical and behavioral indicators are necessary, thus allowing for an expansive understanding of the daily challenges and concerns of individuals diagnosed with cancer, while providing the resources for clinicians, researchers, and policy makers to better meet the needs of this patient population

PSYCHOSOCIAL FACTORS INFLUENCING DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS FROM NORTHERN INDIA

This is a pre-copyedited, author-produced version of an article accepted for publication in Innovation in Aging following peer review. The version of record Banerjee, K., & Baker, T. A. (2019). PSYCHOSOCIAL FACTORS INFLUENCING DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS FROM NORTHERN INDIA. Innovation in Aging, 3(Suppl 1), S313. https://doi.org/10.1093/geroni/igz038.1146 is available online at: https://doi.org/10.1093/geroni/igz038.1146. This work is licensed under a Creative Commons Attribution 4.0 International License.Global data show a significant increase in the number of adults 65+ years of age in India. Despite this increase, there is a dearth of available resources to adequately service their mental health needs. Data indicate that residents in Northern India, in particular, report poorer mental health outcomes than those in the South. The prevalence and impact of neuropsychiatric disorders and depression remain particularly significant, but largely unexplored. The aim of this study was to examine possible psychosocial and health factors affecting depressive symptoms in North India. Data were taken from the Longitudinal Ageing Study in India (LASI). Participants included adults aged 45 years and above (n=792), from the states of Rajasthan and Punjab. A multiple linear regression model was calculated to determine the influence of identified demographic and psychosocial factors (e.g., financial and social support, life satisfaction) on depressive symptoms. Data show that low life satisfaction (β= -0.19,p<0.001), poorer self-reported health (β=0.15,p<0.01), and being a care provider (β= -0.12,p<0.01) were significant predictors of depressive symptoms. These results indicate an increased need for care-giver mental health support along with policy aimed at awareness about caregiver burnout, health care access, and economic instrumental support services. A magnified view of the impact of life satisfaction on depression will be of immense value for understanding the unique needs and challenges of working with this population

INTEREST GROUP SESSION—MENTAL HEALTH PRACTICE AND AGING: INTEGRATION OF SOCIAL DETERMINANTS OF HEALTH IN DEFINING HEALTH BEHAVIORS AND OUTCOMES AMONG DIVERSE OLDER ADULTS

This is a pre-copyedited, author-produced version of an article accepted for publication in Innovation in Aging following peer review. The version of record Minahan, J., & Baker, T. A. (2019). INTEREST GROUP SESSION—MENTAL HEALTH PRACTICE AND AGING: INTEGRATION OF SOCIAL DETERMINANTS OF HEALTH IN DEFINING HEALTH BEHAVIORS AND OUTCOMES AMONG DIVERSE OLDER ADULTS. Innovation in Aging, 3(Suppl 1), S393. https://doi.org/10.1093/geroni/igz038.1449 is available online at: https://doi.org/10.1093/geroni/igz038.1449. This work is licensed under a Creative Commons Attribution 4.0 International License.Social determinants of health (SDoH) are conditions in which individuals live, learn, work, and play. Specifically, they are influenced by the distribution of resources, money, and power, and have significant implications on health behaviors and outcomes across the life span. Existent data show the influence these indictors may have in the onset and progression of chronic illnesses. However, much of these data focus on the effect of race and health, as social determinants, but fail to adequately address the myriad other factors (e.g., health care, social and community context) that influence the social patterning across the life course. This symposium presents findings from several studies highlighting the nuanced role of SDoH across diverse populations of older adults. Scholars will present findings on the influence that identified determinants, such as social networks, lifestyle behaviors, and gender, have in defining health outcomes across the life course. Minahan presents the relationship between chronic illnesses and depression and compares depressive symptomatology according to disease cluster in a nationally-representative sample of older adults. Atakere discusses determinants of well-being among African American males with chronic illnesses and the challenges associated with this marginalized population. Booker examines spirituality as a mechanism for pain management among older African Americans and presents this as a crucial determinant of health. This symposium will expand on the existing body of literature by emphasizing social and cultural determinants, aside from race, that influence health behaviors and outcomes across the life span

THE INFLUENCE OF SOCIAL ISOLATION AND NEIGHBORHOOD DANGER ON OLDER ADULTS’ FUNCTIONAL STATUS

This is a pre-copyedited, author-produced version of an article accepted for publication in Innovation in Aging following peer review. The version of record Engel, I. J., & Baker, T. A. (2019). THE INFLUENCE OF SOCIAL ISOLATION AND NEIGHBORHOOD DANGER ON OLDER ADULTS’ FUNCTIONAL STATUS. Innovation in Aging, 3(Suppl 1), S529–S530. https://doi.org/10.1093/geroni/igz038.1947 is available online at: https://doi.org/10.1093/geroni/igz038.1947 This work is licensed under a Creative Commons Attribution 4.0 International License.Social isolation is often associated with smaller social networks, bereavement, and chronic health problems. In addition, underserved neighborhoods, without the resources and social support of other areas, may further promote social isolation among older adults. This study utilized data from the 2nd wave of the nationally representative National Social Life, Health, and Aging Project (NSHAP) to examine if perceived neighborhood danger mediates the relationship between social isolation and functional impairment. We hypothesized that those who are less socially connected and feel less safe in their communities may experience worse health outcomes. Data for the total sample (N=1,804; 62-91 years of age) showed that partial mediation was supported, (F 2, 1801 = 22.91, p<0.01). Similar statistics were found by gender (men, F 2, 985 = 8.20, p<0.01; women, F 2, 813 = 14.79, p<0.01). This relationship, however, showed a stronger association among women (β = -.39, p<.01) than men (β = -.26, p<.05). Findings indicate that the relationship between perceived social isolation and impaired functional status may be partially explained by perceived neighborhood danger. These findings suggest that older adults who perceive their neighborhoods as dangerous, may be more socially isolated, and at risk for functional decline. These results support the Reserve Capacity Model, which posits that social resources are of increased importance for socioeconomically disadvantaged individuals. Additional research is needed to examine how such factors as stress, environment, and access to care contribute to our understanding of health outcomes among this population of adults

Immuned by Race: Ethnic Identity, Masculinity, and Attachment as Predictors of Cancer Screening among Black Men

An individual’s motivation to screen for cancer is influenced by knowledge of cancer prevalence and perceived likelihood of being diagnosed. While the relationships between health and masculinity, identity, and attachment have been reported, much less is known as to how these factors influence the decision to screen for cancer. This study aimed to determine the influence identified health and social factors have on cancer screening among Black men. Participants (N = 369) were surveyed on questions assessing cancer knowledge, belief about cancer diagnoses, masculinity, self-esteem, attachment style, ethnic identity, and additional social and health characteristics. Results from the multivariate model showed that education, ethnic identity, masculinity, and attach- ment were significant indicators of cancer screening. Cancer screenings among Black men are contingent upon a myriad of psychological, social, and behavioral factors that are not exclusive, but rather coexisting determinants of health. Understanding the motivation for cancer screening among Black men may begin to diminish the prevalence of having an imminent and aggressive stage of diagnosis among this gendered population. Focusing exclusively on Black men enhances our understanding of this adult population by considering their identity as men of color, while recognizing unique factors that modify actions at the individual, institutional, and policy levels

Variability of Pain Outcomes and Physical Activity Among a Diverse Sample of Older Men: Is It More Than Just Race?

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.There is a compendium of data documenting the increasing number of older adults. This suggests the continued need to understand identified health outcomes across domains of pain and physical activity, particularly among older men. Therefore, the aim of this study was to evaluate race similarities and/or differences in pain and rates of physical activity among White, Black, and Hispanic men 60+ years of age. Data were taken from the Health and Retirement Study, a longitudinal panel study surveying a representative sample of people in the United States. Logistic regression analysis was used to examine associations between race and pain and the odds of regular physical activity. Results showed that Black men were less likely to participate in light or moderate/vigorous physical activity. Similarly, pain increased the odds of physical activity among Hispanics, but decreased the odds of physical activity among White men. Findings may reflect a number of factors that impact the well-being of what it means to experience pain and physical functioning, while also assuming a masculine identity. This perspective may allow for a better understanding of short- and long-term implications of the pain experience and the pain and physical functioning dyad among this group of men

The Importance of Aging Studies

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Disparities in Health Behavior Risks Among Employed and Unemployed Black and White Older Adults

Objective: Examine health behavior risk rates and disparities in health behavior risks related to race and employment among older adults. Methods: A cross-sectional analysis of a representative sample of noninstitutionalized adults aged 65 and older (150,669 in 2015 and 168,011 in 2016) from the Behavioral Risk Factor Surveillance System. Self-reported health behavior risks were measured as well as multiple logistic regression analyses assessing the independent effects of demographic variables on health behavior risks. Results: Employed older adults have greater health behavior risks than unemployed older adults. Black employed older adults have greater health behavior risks than Black unemployed older adults for all behaviors. Greater disparities in health behavior risks exist between Black and White employed older adults than between Black and White unemployed older adults (smoking, being overweight or obese, and physical activity). Discussion: Employers should design health insurance benefits and workplace health promotion programs to address the needs of all older persons

Influence of Social and Health Indicators on Pain Interference With Everyday Activities Among Older Black and White Cancer Patients

OBJECTIVE: This prospective study aimed to determine the influence social and health factors have on pain interference with everyday activities among older patients receiving outpatient treatment services from a comprehensive cancer center. METHOD: Participants were surveyed on questions assessing pain interference, and social (communication), health (pain severity, comorbidities), behavioral (self-efficacy, affect), and demographic characteristics. Multivariate analyses were specified to examine determinants of pain interference, with items loading on separate cluster composites: physical interference and psychosocial interference. RESULTS: Pain severity was a significant indicator for physical interference. Similarly, pain severity, education, self-efficacy, negative affect, and communication were predictors of psychosocial interference. DISCUSSION: Factors defining the daily lived experiences of older adults are important in providing baseline information on functional status. This emphasizes the need to rigorously examine the association between pain, and clinical and psychosocial indicators, but more importantly indicators that contribute to the patient’s ability to perform normal everyday activities