Palmore, Nowlin, and Wang (1985) posit a theoretical framework in which to predict the health status of older adults over time as a function of social, economic, physical and mental health variables. The current study provides the first independent, empirical test of this model based upon longitudinal data derived from a representative sample of older British Columbians. The results of this study support the basic structure of the Palmore model; however, various revisions were required to improve the fit of data. Findings indicate that demographic and socio-economic variables have a direct effect upon functional status at baseline. Results further suggest significant consistency in the functional status of older adults over a two-year interval. Directions for future research as well as limitations of the current study are discussed.

Although previous research has examined the various correlates of self-rated health, little attention has been paid to how position in the social structure influences this important measure of health. Drawing upon the social structure and personality perspective, I examine whether the relationship between socio-economic status (income adequacy and education) and self-rated health is mediated by financial stress, self-esteem, mastery, social support, smoking, alcohol consumption and physical activity, using data from the 1994 National Population Health Survey. Results show that almost one-third of the relationship can be explained by the mediating effect of these variables. Income adequacy and education, however, remain significantly related to self-rated health net of these variables. Further research with a broader array of variables related to social position is required to specify the mechanisms connecting socio-economic status and perceived health.

This study investigates the effects of chronic use of benzodiazepines (BZ) as hypnotics on the neuropsychological performance of older adults with insomnia. Twenty-one older persons who had used BZ on a chronic basis (average duration = 21.7 years) for their sleep difficulties were enrolled in a medication withdrawal program. A neuropsychological evaluation was conducted before and after the taper program. A control group composed of older adults not using BZs and without sleep complaints were also evaluated for comparative purpose. The results showed that prolonged use of BZ produces mild and selective impairments of cognitive and psychomotor performance. However, BZ users subjectively evaluated their own performance much more negatively than good sleepers. The results are discussed in terms of a possible amplification of performance deficits among insomnia patients and also as a tolerance to adverse effects that develops with prolonged utilization of BZ.

Zarit Burden Interview (ZBI) is the most widely used instrument for assessing the burden experienced by the caregivers of persons with dementia. As part of the Canadian Study of Health and Aging, the 22-item ZBI was administered to a representative sample of 312 informal caregivers of community-dwelling subjects with dementia. The mean score was 22.4 out of 88 (sd: 16.2) and the median score was 18.5, which is far lower than those reported in previous studies using this instrument with convenience samples. There was no significant difference in the burden score according to the age, gender, living arrangement, marital status or employment status of the caregiver. The ZBI score was more strongly correlated to the depressive mood of the caregivers (r = 0.59) and the behaviour problems of the care recipients (r = 0.64) than their cognitive (r = 0.32) and functional (r = 0.31) status. Following a factor analysis, a 12-item short version of the instrument is proposed with two factors: personal strain (3 items) and role strain (9 items).

Drawing from life course theory, this article examines gender differences in formal assistance among functionally dependent Dutch older persons within five distinct marital history groups – first-married, never-married, divorced (not remarried), widowed (not remarried) and the remarried. Hierarchical logistic regression analyses are performed for each of the marital history groups to test hypotheses regarding the interrelationships among gender and three sets of variables: 1) measures of age and functional health; 2) measures of socio-economic status; and 3) measures of the social network. The results indicate gendered patterns of formal help use among the first-married, never-married and widowed. Consistent with other studies, older first-married women are approximately three times more likely to receive formal help than are men, a difference that remains robust after statistically controlling for other factors, including frailty of spouse. However, we also find that never-married women are about one-third as likely to use formal help than are never-married men, which may be reflective of different preferences regarding formal service use. Among the widowed, we find that men with poorer functional health are more likely to receive formal help than are their female counterparts, suggesting contrasting patterns of help-seeking behaviour and social vulnerability. Additional differences are observed among the marital history groups in terms of the other independent variables, which are also interpreted from a life course perspective.

Most care of older, ailing or disabled people within the home is carried out by a spouse. This paper examines late life marriage and the gendered consequences of caring for older married people in England. Qualitative interview data are analysed to contrast the sense of autonomy of older men and women while caring for a spouse and after widowhood. By encouraging older people to reflect retrospectively on the meaning of their caring roles, we illuminate the process of adjusting to transitions after long-term marriage. The research data indicate that gendered roles and expectations are crucial in understanding the mainly negative experience of older women as carers, in contrast to the more positive experience of older men.