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In a youth-driven society such as Ireland, older adults may well find themselves marginalized by institutionalized ageism and figured as outsiders in the cultural imagination. Rather than static concepts of age, however, new patterns are emerging in post–Celtic Tiger Irish literature in its representations of aging. Read within the interdisciplinary framework of cultural gerontology, the narratives of aging explored in this chapter reveal recent changes among the middle-aged and older characters’ views on, as well as their place within, Irish society and culture. These works, spanning drama, poetry, and fiction, illuminate the complexities of later life, informed by declining health and experiences of loss, while at the same time highlighting generational interdependencies. Crucially, they avoid the nuclear family as a symbol on which to model the nation, urging readers to embrace new notions of the Irish family, ones that might adjust to accommodate and incorporate better the experiences of growing old.
Life experiences have been associated with significant changes in brain structure and functioning. This experience-dependent plasticity is thought to reflect the capacity of our nervous systems to adapt to environmental demands, and ultimately shape cognition. This chapter focuses on how such experiences and environment can specifically impact the hippocampus, a structure important for learning, memory, and healthy cognition. The hippocampal memory system maintains a competitive relationship with other memory systems, in particular the caudate nucleus of the striatum, part of the basal ganglia. Specific types of behavior, such as spatial-based vs. response-based navigational strategies, can influence these memory systems both positively and negatively and lead to long-term neuroplastic changes. Overreliance on non-hippocampus dependent navigational strategies is associated with a reduction in hippocampus volume and activity across the lifespan. Emerging research is now pointing to the wide use of electronic devices – GPS, smartphones, and video games – as a contributing factor to greater reliance on non-hippocampus dependent memory. Given the limited, but concerning, evidence that reliance on electronic devices can interact with already established factors related to underuse of the hippocampal memory system, further study is needed to better understand how these imbalances occur and how they can be mitigated.
Numerous investigations have documented that age-related changes in the integrity of the corpus callosum are associated with age-related decline in the interhemispheric transfer of information. Conversely, there is accumulating evidence for more efficient white matter organization of the corpus callosum in individuals with extensive musical training. However, the relationship between making music and accuracy in interhemispheric transfer remains poorly explored.
To test the hypothesis that musicians show enhanced functional connectivity between the two hemispheres, 65 professional musicians (aged 56–90 years) and 65 age- and sex-matched non-musicians performed the fingertip cross-localization test. In this task, subjects must respond to a tactile stimulus presented to one hand using the ipsilateral (intra-hemispheric test) or contralateral (inter-hemispheric test) hand. Because the transfer of information from one hemisphere to another may imply a loss of accuracy, the value of the difference between the intrahemispheric and interhemispheric tests can be utilized as a reliable measure of the effectiveness of hemispheric interactions.
Older professional musicians show significantly greater accuracy in tactile interhemispheric transfer than non-musicians who suffer from age-related decline.
Musicians have more efficient interhemispheric communication than age-matched non-musicians. This finding is in keeping with studies showing that individuals with extensive musical training have a larger corpus callosum. The results are discussed in relation to relevant data suggesting that music positively influences aging brain plasticity.
Following Canadian estimates of frailty, academic researchers and the Chiefs of Ontario came together to create the first Ontario-wide profile of aging in First Nations people in Ontario. Using self-reported data from First Nations adults who participated in the Ontario First Nations Regional Health Survey Phase 2, we found that First Nations people in Ontario experience higher rates of frailty than the general Canadian population and early onset frailty appears to affect First Nations communities. This is important to consider as communities plan for health care needs of an aging population and is particularly relevant in the face of Covid-19, as we know severity is exacerbated by underlying health conditions.
Rural Long-term Care (LTC) providers face unique challenges when planning, preparing for, and responding to disasters. We sought to better understand challenges and identify best practices for LTC in rural areas.
Case studies including key informant interviews and site visits were conducted with LTC staff and emergency planning, preparedness, and response partners in three rural communities. Themes were identified across sites using inductive coding.
Communication across disaster phases continues to be a challenge for LTC providers in rural communities for all disaster types. Communication challenges limit LTC providers’ ability to address patient needs during emergencies and limit the resilience of providers and patients to future disasters. Limited coordination among local leadership and LTC providers prevents dissemination of information, resources, and services, and slows response and recovery time. Including LTC providers as stakeholders in planning and exercises may improve communication and coordination.
More than two decades into efforts to increase preparedness of health care systems to all hazards, rural LTC facilities still face challenges related to communication and coordination. Agencies at the federal, state, and local level should include input from rural LTC stakeholders to address gaps in communication and coordination and increase their disaster resilience.
The Geriatric Anxiety Inventory (GAI) and its short form (GAI-SF) are self-reported scales used internationally to assess anxiety symptoms in older adults. In this study, we conducted the first critical comprehensive review of these scales’ psychometric properties. We rated the quality of 31 relevant studies with the COSMIN checklist. Both the GAI and GAI-SF showed adequate internal consistency and test-retest reliability. Convergent validity indices were highest with generalized anxiety measures; lowest with instruments relating to somatic symptoms. We detected substantial overlap with depression measures. While there was no consensus on the GAI’s factorial structure, we found the short version to be unidimensional. Although we found good sensitivity and specificity for detecting anxiety, cut-off scores varied. The GAI and GAI-SF are relevant instruments showing satisfactory psychometric properties; to broaden their use, however, some psychometric properties warrant closer examination. This review calls attention to weaknesses in the methodological quality of the studies.
Previous studies suggest that intergroup contact has a positive effect on older workers’ perception of ageism and satisfaction. This study aims at assessing such relationships amongst Canadian younger workers. Precisely, in light of the intergroup contact theory (ICT), it was first hypothesized that a positive perception of intergenerational workplace climate (IWC) and knowledge sharing practices (KSP) increase younger workers’ awareness of ageist behaviors targeting older peers. Second, it was hypothesized that such awareness has a positive effect on young workers’ level of satisfaction. Relying on a cross-sectional design composed of 612 participants, path analysis was conducted. Findings suggest that whereas KSP increases younger workers’ awareness of ageist behaviors towards older workers, this is not the case for IWC. On the other hand, both IWC and KSP have a direct and positive impact on younger workers’ level of satisfaction. Theoretical and practical implications of findings are discussed.
The main aim of this study was to examine the impact of age-related changes on mental health, metacognitive, and motor functioning in late adulthood, while controlling for the effect of gender. Additionally, this investigation intended to study the association between motor efficiency indexes and self-reported psychological well-being, depression and cognitive failures over a period of 24 months.
Prospective longitudinal study: post hoc analysis.
Ninety-one community-dwelling older participants (mean age = 78.7 years, SD = 5.6) were recruited in a rural village of the Sardinian Blue Zone – an area of exceptional longevity located in the central–eastern region of Sardinia, an Italian island in the Mediterranean Sea.
All respondents completed a battery of tests and questionnaires assessing motor and general cognitive efficiency, self-reported psychological well-being, negative affect, and cognitive failures.
The adoption of a multilevel modeling approach highlighted the significative impact of time on psychological well-being, as well as on mobility parameters like gait speed and cadence, while controlling for the gender effect. Overall, psychological well-being and motor swing significantly increase at follow-up, whereas the further above-mentioned measures decreased after 24 months. Moreover, compared to the national cut-off, at baseline and follow-up, participants reported higher perceived emotional well-being. Finally, significant relationships between motor scores and self-reported mental health and metacognitive measures were found both at baseline and follow-up.
The maintenance of motor efficiency and preserved mental health seems to contribute to the successful aging of older people living in the Sardinian Blue Zone.
Substantial research has examined cognition in aging bilinguals. However, less work has investigated the effects of aging on language itself in bilingualism. In this article I comprehensively review prior research on this topic, and interpret the evidence in light of current theories of aging and theories of bilingualism. First, aging indeed appears to affect bilinguals’ language performance, though there is considerable variability in the trajectory across adulthood (declines, age-invariance, and improvements) and in the extent to which these trajectories resemble those found in monolinguals. I argue that these age effects are likely explained by the key opposing forces of increasing experience and cognitive declines in aging. Second, consistent with some theoretical work on bilingual language processing, the grammatical processing mechanisms do not seem to change between younger and older bilingual adults, even after decades of immersion. I conclude by discussing how future research can further advance the field.
Previous cross-sectional studies have documented associations between positive psychosocial factors, such as self-efficacy and emotional support, and late-life cognition. Further, the magnitudes of concurrent associations may differ across racial and ethnic groups that differ in Alzheimer’s disease risk. The goals of this longitudinal study were to characterize prospective associations between positive psychosocial factors and cognitive decline and explicitly test for differential impact across race and ethnicity.
578 older adults (42% non-Hispanic Black, 31% non-Hispanic White, and 28% Hispanic) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures from the NIH Toolbox and standard neuropsychological tests over 2.4 years. Latent difference scores were used to model associations between positive psychosocial factors and cognitive decline controlling for baseline cognition, sociodemographics, depressive symptoms, physical health, and other positive psychosocial factors. Multiple-group modeling was used to test interactions between the positive psychosocial factors and race/ethnicity.
Higher NIH Toolbox Friendship scores predicted less episodic memory decline. One standard deviation increase in friendship corresponded to 6 fewer years of memory aging. This association did not significantly differ across racial/ethnic groups.
This longitudinal study provides support for the potential importance of friendships for subsequent episodic memory trajectories among older adults from three ethnic groups. Further study into culturally informed interventions is needed to investigate whether and how friend networks may be targeted to promote cognitive health in late life.
Executive deficits are a core characteristic of schizophrenia. Yet, the origin of these impairments remains unclear as they may be caused by processing slowing. This issue is of particular interest for aging insofar as cognitive aging is also associated with a decline in executive functioning and a slowing of processing speed. As schizophrenia patients’ life expectancy increases, a better understanding of the origin of older patients’ cognitive deficits becomes essential so that healthcare can be adapted to suit them. This study aims to determine whether processing speed mediates how schizophrenia affects executive functions and whether these relationships are moderated by age.
Sixty-two schizophrenia patients (27 women) and 62 healthy comparison subjects matched for age (range: 18–76 years), gender and education performed neurocognitive tests to evaluate their executive functions (shifting, updating, inhibition and access) and processing speed.
Processing speed mediated the effect of schizophrenia on the four specific executive functions, and age moderated this mediation for shifting, updating and access, but in different ways. Age moderated the effect of processing speed on shifting, the direct effect of schizophrenia on access, and both the effect of processing speed and the direct effect of schizophrenia on updating.
This research highlights the need to evaluate processing speed routinely during therapeutic follow-up, as it is easy and simple to assess and appears to be at the heart of the cognitive deficits in schizophrenia. Finally, processing speed abilities yield information about the evolution of cognition with aging in schizophrenia.
Supportive housing, including retirement homes and assisted living, is increasingly touted as a suitable living option for Canadian older adults. This scoping review describes the nature and content of studies that explore underlying factors that motivate older adults to relocate to supportive housing. We conducted a search of PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science, and PsycINFO, which identified 34 articles for review. Articles reviewed employed a variety of methods and guiding theoretical frameworks, of which the push and pull framework appeared to be most common. This review suggests that health and functional deficits are important reasons for relocation to supportive housing for older adults. Further longitudinal data are required to more comprehensively describe medical and social determinants for relocation and its consequences, in order to better describe this growing population and better align policies with the needs of older adults contemplating or undergoing relocation.
Positive psychiatry offers an unique approach to promote brain health and well-being in aging populations. Minimal interventions through behavioral activation to promote wellness are increasingly available using self-guided apps, yet little is known about the effectiveness of app technology or the difference between clinician-supported behavioral activation versus self-guided app methodologies.
Investigate the difference in users and outcomes between two methods of the Fountain of Health (FoH) positive psychiatry intervention for behavioral activation to promote brain health and well-being: (1) clinician-assisted and (2) independent app use for behavioral self-management.
Design and setting:
As part of a larger knowledge translation intervention in positive psychiatry, two specific methods of a behavioral activation intervention were retrospectively compared.
Two subsets of patients were compared; 254 clinician-assisted patients; 333 independent app users.
A minimal positive psychiatry intervention in frontline care using the FoH health and behavior change clinical tools
Main outcomes were changes in psychological (health and resilience, well-being scores) and behavioral indices (goal attainment, items of goal SMART-ness). User profiles (age, sex and completion rates) were also compared.
Clinician-assisted patients were more likely to be male, older, and have lower health and resilience scores at baseline. Clinician-assisted patients had notably higher completion rates (99.2% vs. 10.8%). Psychological outcomes (improved health and resilience, and well-being) were similar regardless of intervention method for those who completed the intervention. Behavioral outcomes revealed clinician-assisted patients set goals that better adhered to key goal-setting items.
Clinician–patient relationships appear to be an important factor for intervention completion and behavioral outcomes, while further exploration of best practices for intervention completion using health apps in clinical practice is needed. A preliminary goal-setting methodology for effective behavioral activation, to promote brain health and wellness, is given.
Rey’s Auditory Verbal Learning Test (AVLT) is a widely used word list memory test. We update normative data to include adjustment for verbal memory performance differences between men and women and illustrate the effect of this sex adjustment and the importance of excluding participants with mild cognitive impairment (MCI) from normative samples.
This study advances the Mayo’s Older Americans Normative Studies (MOANS) by using a new population-based sample through the Mayo Clinic Study of Aging, which randomly samples residents of Olmsted County, Minnesota, from age- and sex-stratified groups. Regression-based normative T-score formulas were derived from 4428 cognitively unimpaired adults aged 30–91 years. Fully adjusted T-scores correct for age, sex, and education. We also derived T-scores that correct for (1) age or (2) age and sex. Test-retest reliability data are provided.
From raw score analyses, sex explained a significant amount of variance in performance above and beyond age (8–10%). Applying original age-adjusted MOANS norms to the current sample resulted in significantly fewer-than-expected participants with low delayed recall performance, particularly in women. After application of new T-scores adjusted only for age, even in normative data derived from this sample, these age-adjusted T-scores showed scores <40 T occurred more frequently among men and less frequently among women relative to T-scores that also adjusted for sex.
Our findings highlight the importance of using normative data that adjust for sex with measures of verbal memory and provide new normative data that allow for this adjustment for the AVLT.
A cross-sectional analysis was conducted using data from a prospective cohort study to investigate whether frailty is associated with pain intensity, disability caused by low back pain (LBP), and quality of life in an older population with acute non-specific LBP. Six hundred and two individuals with a mean age of 67.6 (standard deviation [SD] 7.0) years were included in the analysis. In relation to frailty status, 21.3 per cent of the sample were classified as robust, 59.2 per cent were classified as pre-frail, and 19.5 per cent were classified as frail. In the unadjusted analysis, pre-frail and frail groups showed significantly higher pain and disability scores than the robust group. Moreover, the same two groups exhibited lower scores in both physical and mental domains of quality of life than the robust group. After adjusting for socio-demographic and clinical variables, disability scores and the physical component of quality of life were significantly associated with frailty. In older adults with acute LBP, frailty is associated with more disability and worse scores in the physical component of quality of life.
This study aims to generate country-specific norms for two episodic memory tasks and a verbal fluency test among middle-aged and older adults using nationally representative data from nine low-, middle-, and high-income countries.
Data from nine countries in Africa, Asia, Europe, and Latin America were analyzed (n = 42,116; aged 50 years or older). Episodic memory was assessed with the word list memory (three trials of immediate recall) and word list recall (delayed recall). Verbal fluency was measured through the animal naming task. Multiple linear regression models with country-specific adjustments for gender, age, education, and residential area were carried out.
Both age and education showed high influence on test performance (i.e. lower cognitive performance with increasing age and decreasing years of education, respectively), while the effect of sex and residential area on cognitive function was neither homogeneous across countries nor across cognitive tasks.
Our study provided sex-, age-, education-, and residential area-specific regression-based norms that were obtained from one of the largest normative study worldwide on verbal recall and fluency tests to date. Findings derived from this study will be especially useful for clinicians and researchers based at countries where cognitive norms are limited.
Self-reported health is a predictive measure of morbidity and mortality across populations. A comprehensive understanding of the factors that shape self-reported health among community-dwelling older adults, a growing population globally, is lacking. The aim of this review was to summarize the factors that are associated with self-reported health among this population and identify key areas for future research. Accordingly, we conducted a scoping review using the stage-wise framework developed by Arksey and O’Malley. We summarized 42 factors, as identified in 30 publications, and organized them into four categories. Key factors shaping self-reported health included the presence of chronic conditions and depressive symptoms. As the population of community-dwelling older adults continues to increase, there remains a need to understand how these identified factors shape self-reported health. To date, empirical research has been limited to observational and cross-sectional designs. There is a need to further explore these factors in longitudinal data.
In this paper, CuCr–Zr alloys prepared by vacuum melting with adding La and Ni elementswere heat-treated and aged, followed by plastic deformation using low-energy cyclic impact tests, to simultaneously improve their mechanical and electrical properties. Results showed that the grain size of the casted Cu–Cr–Zr alloys was significantly reduced after the solid-solution aging and plastic deformation process. There were a lot of dispersed Cr and Cu5Zr precipitates formed in the alloys, and the numbers of dislocations were significantly increased. Accordingly, the hardness was increased from 78 to 232 HV, and the tensile strength was increased from 225 to 691 MPa. Electrical conductivity has not been significantly affected after these processes. The enhancement of overall performance is mainly attributed to the combined effects of solid-solution hardening, fine grain hardening, and precipitation/dislocation strengthening.
The purpose of this study was to update our understandings of older adults’ experiences and perceptions of alcohol use. Taking a community-based research approach, three Knowledge Café workshops hosted 66 older adults and service providers in Vancouver, BC. Thematic analysis identified three overarching categories: (a) reasons older adults use alcohol, including out of habit, social expectations, or to self-medicate; (b) personal experiences of alcohol use, including reduced consumption over time as a result of the cost of alcohol, the physical effects, and increased knowledge about the effects of alcohol; and (c) older adults’ perceptions of alcohol use outcomes, including positive outcomes from drinking in moderation and negative outcomes that can worsen one’s health, lead to tolerance, and harm others. Developing and promoting healthy drinking behaviours in later life is needed as the general population continues to age.
Heavy alcohol consumption is associated with poorer cognitive function in older adults. Although understudied in middle-aged adults, the relationship between alcohol and cognition may also be influenced by genetics such as the apolipoprotein (ApoE) ε4 allele, a risk factor for Alzheimer’s disease. We examined the relationship between alcohol consumption, ApoE genotype, and cognition in middle-aged adults and hypothesized that light and/or moderate drinkers (≤2 drinks per day) would show better cognitive performance than heavy drinkers or non-drinkers. Additionally, we hypothesized that the association between alcohol use and cognitive function would differ by ApoE genotype (ε4+ vs. ε4−).
Participants were 1266 men from the Vietnam Era Twin Study of Aging (VETSA; M age = 56; range 51–60) who completed a neuropsychological battery assessing seven cognitive abilities: general cognitive ability (GCA), episodic memory, processing speed, executive function, abstract reasoning, verbal fluency, and visuospatial ability. Alcohol consumption was categorized into five groups: never, former, light, moderate, and heavy.
In fully adjusted models, there was no significant main effect of alcohol consumption on cognitive functions. However, there was a significant interaction between alcohol consumption and ApoE ε4 status for GCA and episodic memory, such that the relationship of alcohol consumption and cognition was stronger in ε4 carriers. The ε4+ heavy drinking subgroup had the poorest GCA and episodic memory.
Presence of the ε4 allele may increase vulnerability to the deleterious effects of heavy alcohol consumption. Beneficial effects of light or moderate alcohol consumption were not observed.