The health and relationship dynamics of late-life couples: a systematic review of the literature

Late-life husband and wife relationships are increasingly recognised as an important factor in promoting wellbeing, particularly in terms of the health, social, emotional, financial and practical needs of older people. Knowledge of marital dynamics and how they affect both members of a couple remains scarce. This systematic review aimed to identify and appraise research that has focused explicitly on the dynamics of the relationship, as evinced by data from both spouses. Implementing rigorous identification strategies, 45 articles were identified and reviewed. These studies were grouped into three broad thematic areas: marital relations and satisfaction; concordance in emotional state or physical health; and the interplay between marital quality and wellbeing. The issues found to affect marital relations and satisfaction in late life included equality of roles, having adequate communication, and transitions to living apart. There is strong evidence for couple concordance in depression, that marital relationships affect ill-health, longevity and recovery from illness, and reciprocally that ill-health impacts on the marriage itself. The research also suggests important gender differences in the impact of marital dynamics on health. It has led to the conclusion that there is a need for more diverse studies of late-life marriages, particularly ones that examine the dynamics of non-traditional elderly couples and that extend beyond a predominant focus on the Caucasian population of the United States

Social resource correlates of levels and time-to-death-related changes in late-life affect

Little is known regarding how well psychosocial resources that promote well-being continue to correlate with affect into very late life. We examined social resource correlates of levels and time-to-death related changes in affect balance (an index of affective positivity) over 19 years among 1,297 by now deceased participants (aged 69 to 103 at first assessment, M = 80 years; 36% women) from the Australian Longitudinal Study of Aging. A steeper decline in affect balance was evident over a time-to-death metric compared with chronological age. Separating time-varying social resource predictors into between- and within-person components revealed several associations with level of affect balance, controlling for age at death, gender, functional disability, and global cognition. Between-person associations revealed that individuals who were more satisfied with family, and more socially active, expressed greater positivity compared with those who were less satisfied, and less socially active. Within-person associations indicated that participants reported higher positivity on occasions when they were more socially active. In addition, lower affect balance was associated with more frequent contact with children. Our results suggest that social engagement and satisfying relationships confer benefits for affective well-being that are retained into late life. However, our findings do not provide evidence to indicate that social resources protect against terminal decline in well-being.Australian Research Council (DP0879152 and DP130100428; LP 0669272; LP 100200413), and the National Health and Medical Research Council (Project Grant 229922)

The nature and correlates of self-esteem trajectories in late life

Is it possible to maintain a positive perspective on the self into very old age? Empirical research so far is rather inconclusive, with some studies reporting substantial declines in self-esteem late in life, whereas others report relative stability into old age. In this article, we examine long-term change trajectories in self-esteem in old age and very old age and link them to key correlates in the health, cognitive, self-regulatory, and social domains. To do so, we estimated growth curve models over chronological age and time-to-death using 18-year longitudinal data from the Australian Longitudinal Study of Ageing (N = 1,215; age 65–103 years at first occasion; M = 78.8 years, SD = 5.9; women: 45% of sample). Results revealed that self-esteem was, on average, fairly stable with minor declines only emerging in advanced ages and at the very end of life. Examination of the vast between-person differences revealed that lower cognitive abilities and lower perceived control independently related to lower self-esteem. Also, lower cognitive abilities were associated with steeper age-related and mortality-related self-esteem decrements. In our discussion, we consider a variety of challenges that potentially shape self-esteem late in life and highlight the need for more mechanism-oriented research to better understand the pathways underlying stability and change in self-esteem.Australian Research Council DP13010042

Longitudinal associations between activity and cognition vary by age, activity type, and cognitive domain

The demonstration of correlated change is critical to understanding the relationship between activity engagement and cognitive functioning in older adulthood. Changes in activity have been shown to be related to changes in cognition, but little attention has been devoted to how this relationship may vary between specific activity types, cognitive domains, and age groups. Participants initially aged 65−98 years (M = 77.46 years) from the Australian Longitudinal Study of Ageing (n = 1,321) completed measurements of activity (i.e., cognitive, group social, one-on-one social, and physical) and cognition (i.e., perceptual speed, and immediate and delayed episodic memory) at baseline, 2, 8, 11, and 15 years later. Bivariate latent growth curve models covarying for education, sex, and baseline age and medical conditions revealed multiple positive-level relations between activity and cognitive performance, but activity level was not related to later cognitive change. Change in perceptual speed over 15 years was positively associated with change in cognitive activity, and change in immediate episodic memory was positively associated with change in one-on-one social activity. Old-old adults showed a stronger change−change covariance for mentally stimulating activity in relation to perceptual speed than did young-old adults. The differentiation by activity type, cognitive domain, and age contributes to the growing evidence that there is variation in the way cognitive ability at different ages is related to activity.NHMRC Fellowship No. 1002560 and the ARC Centre of Excellence in Population Ageing Research (project # CE110001029)

Influence of health locus of control on recovery of function in recently hospitalized frail older adults

"This is the peer reviewed version of the following article: [Milte, C. M., Luszcz, M. A., Ratcliffe, J., Masters, S. and Crotty, M. (2015), Influence of health locus of control on recovery of function in recently hospitalized frail older adults. Geriatrics & Gerontology International, 15: 341–349.], which has been published in final form at [http://dx.doi.org/10.1111/ggi.12281]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms"AIM: To investigate the influence of health locus of control on physical function, quality of life, depression and satisfaction with care transition in a sample of older adults after a hospital admission. METHODS: A total of 230 older adults referred for transition care after a hospital admission (mean length of stay 25.7 days, SD 17.2) were recruited into a randomized controlled intervention trial investigating the effect of specialized coaching compared with usual care. Older adults completed the multidimensional health locus of control (MHLC) survey at baseline. Self-rated quality of life, depression and physical function were assessed at baseline and 12 months using the EuroQol five-dimension, Geriatric Depression Scale (GDS) and Modified Barthel Index (MBI), respectively. RESULTS: Results from hierarchical multiple regression analysis in 136 participants (70 usual care and 66 specialized care) with complete data showed that higher scores on the MHLC internal subscale were related to better quality of life, and better physical function in the usual care group at 12 months, but not depression or transition process satisfaction at 3 months. No relationships between MHLC subscales and outcome measures were observed in the specialized care group, where the coaching intervention might have precluded any relationship observed. CONCLUSIONS: A stronger sense of personal control over health was associated with better maintenance of quality of life and physical function at 12 months in older adults undergoing usual care transition after acute hospitalization. Modification of control beliefs has the potential to promote resilience and impact on health outcomes in older adults during care transitions

Cohort Profile: The Australian Longitudinal Study of Ageing (ALSA)

In response to the expressed need for more sophisticated and multidisciplinary data concerning ageing of the Australian population, the Australian Longitudinal Study of Ageing (ALSA) was established some two decades ago in Adelaide, South Australia. At Baseline in 1992, 2087 participants living in the community or in residential care (ranging in age from 65 to 103 years) were interviewed in their place of residence (1031 or 49% women), including 565 couples. By 2013, 12 Waves had been completed; both face-to-face and telephone personal interviews were conducted. Data collected included self-reports of demographic details, health, depression, morbid conditions, hospitalization, gross mobility, physical performance, activities of daily living, lifestyle activities, social resources, exercise, education and income. Objective performance data for physical and cognitive function were also collected. The ALSA data are held at the Flinders Centre for Ageing Studies, Flinders University. Procedures for data access, information on collaborations, publications and other details can be found at [http://flinders.edu.au/sabs/fcas/].Australian Research Council ARC (DP0879152 and 130100428; LP669272 and 100200413

Executive function in cognitive, neuropsychological, and clinical aging

California, US

Determinants of Self-Rated Health Items With Different Points of Reference Implications for Health Management of Older Adults

Objective: This study assessed whether three commonly used self-rated health (SRH) items (global, age-comparative, and self-comparative) are equivalent measures of health perception for older adults. Method: Regression analyses were used to simultaneously contrast the associations between physical, psychological, and social factors relating to health for three SRH items, in a large ( N = 2,034) population-based sample of older adults (65 years and older) from the Australian Longitudinal Study of Aging. Results: Health perceptions were more positive for the age-comparative SRH measure, compared to the pessimistic ratings of the self-comparative measure, particularly for the oldest-old adults. Different patterns of associations between the health factors and SRH measures were found. Discussion: These results show the three SRH items are not equivalent measures of health and cannot be used interchangeably. The reference point of the SRH item has a considerable influence on health perceptions of older adults as it encapsulates unique health information

A latent growth curve analysis of late-life sensory and cognitive function over 8 years: evidence for specific and common factors underlying change

Washington D