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Background: In recent years, there has been a growing interest in the investigation of very old individuals. However, various challenges arise when collecting data from this age group. Given potential health and cognitive impairments and the difficulty of retrieving accurate self-reported data, involving individuals knowledgeable of the target person as proxy respondents are an invaluable solution. The primary goal of this study is to explore the association between proxy-centenarian relationship and item nonresponse, a pivotal data quality measure., Data and Methods: We used data from the phone study conducted within SWISS100, a study on centenarians in Switzerland, focusing on a subsample of 94 centenarians and 75 proxy respondents. We compared characteristics of centenarians who provided self-reports with those interviewed through proxy respondents using descriptive analyses, and Firth's regression models to investigate the association of different types of proxies (children, other relatives, and non-relatives) with item nonresponse., Results: We noted differences between centenarians participating themselves in interviews and those represented by proxies, observing higher proportions of men and private home residents in the self-report group. There was a low prevalence of item nonresponse among proxy respondents. Proxy type significantly impacted item nonresponse, particularly with non-relatives showing notably higher unanswered question rates. A robust association between non-relatives as proxies and increased item nonresponse persisted even when controlling for potential confounding factors., Discussion and Conclusions: This study enhances the understanding of data quality, particularly item nonresponse, and highlights the impact of the proxy-centenarian relationship when studying the oldest-old. The findings stress the importance of carefully choosing proxy respondents, preferably children, to improve data quality and inclusivity for those individuals hard to reach or to interview. Future research should investigate various data quality indicators and rely on larger samples to enhance the representation and methodological rigour in the study of the oldest-old., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Zaccaria et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Internet use has dramatically increased worldwide, with over two-thirds of the world's population using it, including the older adult population. Technical resources such as internet use have been shown to influence psychological processes such as stress positively. Following the Conservation of Resources theory by Hobfoll, stress experience largely depends on individuals' personal resources and the changes in these resources. While personal resource loss has been shown to lead to stress, we know little regarding the role that technical resources may play on the relationship between personal resources and stress., Objective: This study aims to investigate the moderating effect of technical resources (internet use) on the relationship between personal resources and stress in younger and older adults., Methods: A total of 275 younger adults (aged 18 to 30 years) and 224 older adults (aged ≥65 years) indicated their levels of stress; change in personal resources (ie, cognitive, social, and self-efficacy resource loss and gain); and internet use. Variance analyses, multiple regression, and moderation analyses were performed to investigate the correlates of stress., Results: Results showed that older adults, despite experiencing higher levels of resource loss (questionnaire scores: 1.82 vs 1.54; P<.001) and less resource gain (questionnaire scores: 1.82 vs 2.31; P<.001), were less stressed than younger adults (questionnaire scores: 1.99 vs 2.47; P<.001). We observed that the relationship among resource loss, resource gain, and stress in older adults was moderated by their level of internet use (β=.09; P=.05). Specifically, older adults who used the internet more frequently were less stressed when they experienced high levels of both loss and gain compared to their counterparts who used internet the less in the same conditions. Furthermore, older adults with low resource gain and high resource loss expressed less stress when they used the internet more often compared to those with low internet use., Conclusions: These findings highlight the importance of internet use in mitigating stress among older adults experiencing resource loss and gain, emphasizing the potential of digital interventions to promote mental health in this population., (©Angélique Roquet, Paolo Martinelli, Charikleia Lampraki, Daniela S Jopp. Originally published in JMIR Aging (https://aging.jmir.org), 19.07.2024.)

Background: Given the increasing number of people achieving exceptionally long lifespans, there is an urgent need for a better understanding of mental health in centenarians. This study aimed to understand the prevalence of mental health conditions-depressive symptoms, anxiety, sleep disturbances, disinhibition, and aberrant motor behaviour-among centenarians in Switzerland., Methods: Data were collected from N = 169 participants via telephone interviews or paper questionnaires, either directly from centenarians or through proxy informants. Half the data were collected during a period when protective measures were imposed due to the COVID-19 pandemic, and half were collected after the measures were lifted., Results: Mental health conditions were prevalent in our sample, particularly depressive symptoms (44.51%) and anxiety (42.17%). Significant positive associations were found between depressive symptoms and anxiety, and between disinhibition and aberrant motor behaviour. Furthermore, we identified statistical predictors for the occurrence of mental health conditions. Notably, institutionalised living increased the odds of depressive symptomatology, while those with higher education levels or an absence of cognitive impairment experienced more sleep disturbances. Finally, cognitive impairment was linked to increased disinhibition and aberrant motor behaviour., Conclusions: The high prevalence of mental health conditions underscores the need for proactive mental health care strategies in advanced old age. Moreover, it is vital to consider the interconnected nature of mental health conditions and to prioritise vulnerable groups, such as centenarians in institutional settings., (© 2024 The Author(s). Psychogeriatrics published by John Wiley & Sons Australia, Ltd on behalf of Japanese Psychogeriatric Society.)

The current study explored Asian Americans' lay perceptions of successful aging and examined the differences and similarities between Asian Americans and White/Caucasian Americans. One hundred forty-five Asian American adults and 86 White/Caucasian adults were asked how they view successful aging. Open-ended responses were coded for recurring themes. The theme most often mentioned by Asian Americans was health, followed by quality of life, activities/interests, and social resources. Compared to White/Caucasian participants, Asian Americans' meaning of successful aging in the current study did not differ greatly in terms of major themes mentioned, but Asian Americans were more likely to mention certain themes, such as physical appearance and youthful look. In sum, the findings suggest that Asian Americans have a multifaceted understanding of successful aging, and reinforce the importance of cultural variations of the perceptions of successful aging., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Despite most centenarians facing age-related declines in functional and cognitive capacities, the severity of these declines varies among individuals, as does the maintenance of good mental health (e.g., depressive symptoms) despite these declines. This study aims to examine this heterogeneity in centenarians from the Second Heidelberg Centenarian Study, which collected data from 112 centenarians living in Germany. In our study, we focus on a subsample of 73 centenarians who provided self-reports for our measures of interest (M age = 100.4, SD age = 0.55)., Methods: We examined correlations between functional capacity (i.e., PADL, IADL), cognitive capacity (i.e., MMSE), and depressive symptoms (i.e., GDS), and the existence of different profiles using hierarchical clustering., Results: Higher functional capacity was related to higher cognitive capacity and to fewer depressive symptoms. Yet, higher cognitive capacity was associated with more depressive symptoms. Hierarchical clustering analysis elucidated this contradiction by identifying three profiles: low-capacity individuals (i.e., 24 individuals had low functional and cognitive capacities, with low depressive symptoms), high-capacity individuals (i.e., 33 individuals with high functional and cognitive capacities, with low depressive symptoms), and low-functional-high-cognitive-capacity individuals (i.e., 16 individuals showed low functional but high cognitive capacity, with high depressive symptoms). Our post-hoc analyses highlighted arthritis and pain as risk factors for functional dependence and depression., Conclusions: Our findings emphasize the importance of identifying centenarian subgroups with specific resource- and risk profiles to better address their needs, and of treating pain to improve functional capacity and mental health in centenarians., (© 2024. The Author(s).)

As people age, they tend to spend more time indoors, and the colours in their surroundings may significantly impact their mood and overall well-being. However, there is a lack of empirical evidence to provide informed guidance on colour choices, irrespective of age group. To work towards informed choices, we investigated whether the associations between colours and emotions observed in younger individuals also apply to older adults. We recruited 7393 participants, aged between 16 and 88 years and coming from 31 countries. Each participant associated 12 colour terms with 20 emotion concepts and rated the intensity of each associated emotion. Different age groups exhibited highly similar patterns of colour-emotion associations (average similarity coefficient of .97), with subtle yet meaningful age-related differences. Adolescents associated the greatest number but the least positively biased emotions with colours. Older participants associated a smaller number but more intense and more positive emotions with all colour terms, displaying a positivity effect. Age also predicted arousal and power biases, varying by colour. Findings suggest parallels in colour-emotion associations between younger and older adults, with subtle but significant age-related variations. Future studies should next assess whether colour-emotion associations reflect what people actually feel when exposed to colour., (© 2023 The British Psychological Society.)

This study aims to investigate changes in the income-health gradient over the later life course. We test the age-as-leveler, the cumulative advantage/disadvantage, and the persistent inequality pattern for physical and cognitive health domains, and analyze whether these patterns are gendered. We used HRS data (1992-2016) and Poisson growth curve models to predict multimorbidity (33,860 participants) as an indicator of physical health and memory (25,291 participants) as an indicator of cognitive health. We disentangled the within-participant from the between-participant effects. For multimorbidity, the income-health gradient weakened as individuals aged; whereas for memory, the income-health gradient strengthened as individuals aged. The cumulative advantage/disadvantage of higher/lower income on memory may be more pronounced among women than men. Findings were confirmed by sensitivity analyses. Findings suggest that the support for the age-as-leveler or cumulative advantage/disadvantage pattern may depend on health domains and the effect strength may depend on gender., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Child undernutrition and later-life non-communicable diseases (NCDs) are major global health issues. Literature suggests that undernutrition/famine exposure in childhood has immediate and long-term adverse health consequences. However, many studies have theoretical and methodological limitations. To add to the literature and overcome some of these limitations, we adopted a life course perspective and used more robust methods. We investigated the association between exposure to the 1959-1961 Chinese famine and later-life NCDs and if this association depends on: life stage at exposure, famine severity, and sex. We conducted a secondary data analysis of a large-scale, nationally representative, longitudinal study-the China Health and Retirement Longitudinal Study (2011-2018, 11,094 participants). We measured famine exposure/severity using self-reported experience, life stage using age at exposure, and health using the number of NCDs. We performed Poisson growth curve models. We obtained three findings. First, compared with unexposed participants, those exposed before age 18 had a higher risk of later-life NCDs, particularly if exposed in-utero (IRR = 1.90, 95% CI [1.70, 2.12], p < .001) and in the "first 1,000 days" of life (IRR = 1.86, 95% CI [1.73, 2.00], p < .001; for 0-6 months group, IRR = 1.95, 95% CI [1.67, 2.29], p < .001). Second, the famine effects among participants moderately and severely exposed were similar (IRR = 1.18, 95% CI [1.09, 1.28], p < .001 and IRR = 1.24, 95% CI [1.17, 1.32], p < .001). Third, the famine effects did not differ between females and males (IRR = 0.98, 95% CI [0.90, 1.07], p = .703). In an individual's life course, in-utero and the "first 1,000 days" are a particularly sensitive time period with marked long-term implications for NCDs if undernutrition/famine is experienced in this period. However, this window remains open until young adulthood. This highlights the need to invest more in preventing and treating child/adolescent undernutrition to tackle later-life NCDs., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Cheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Some studies show that the protective effect of higher income on health weakens with old age (age-as-leveller pattern), whereas others show that it strengthens with old age (cumulative advantage/disadvantage pattern). Many existing studies are limited in that they use single-country and/or single-timepoint designs. To overcome these limitations and better understand how the income-health gradient evolves in older age, we used cross-national and longitudinal data of the Survey of Health, Ageing and Retirement in Europe (2004-2019, N = 73,407) and the China Health and Retirement Longitudinal Study (2011-2018, N = 10,067). We operationalised health using multimorbidity and three alternative indicators (functional disability, mobility disability, and memory). We performed Poisson growth curve modelling to capture the between-participant effects of age and the within-participant effects of aging. We obtained three consistent and robust findings for Europe (patterns were observed in most countries) and China. First, the protective effect of higher income on multimorbidity, functional disability, and mobility disability was weaker for older than for younger adults (between-participant age-as-leveller pattern). Second, only the protective effect of higher income on mobility disability weakened over the later life course (within-participant age-as-leveller pattern). Third, the protective effect of higher income on memory was stronger for older than for younger adults and strengthened over the later life course (between-participant and within-participant cumulative advantage/disadvantage pattern). Longitudinal data, growth curve modelling distinguishing the between-participant from within-participant effect, and adjustments for potential confounders based on the hypothesised causal structure enabled us to better navigate the landscape of causal inference. Findings suggest that the income-related gap in physical health but not in cognitive health narrows in old age for both Europe and China., (© 2023. Springer Nature B.V.)

Background and Objectives: The ubiquity of multimorbidity makes it crucial to examine the intermediary factors linking it with quality of life (QoL). The objective was to examine to what extent the association between multimorbidity and QoL was mediated by functional and emotional/mental health and how these mediation pathways differed by sociodemographic factors (age, gender, education, and financial strain)., Research Design and Methods: Data from Waves 4 to 8 of 36,908 individuals from the Survey of Health, Aging, and Retirement in Europe (SHARE) were included. Multimorbidity (exposure) was defined as having 2 or more chronic conditions. Mediators included limitations with (instrumental) activities of daily living (ADL and IADL), loneliness, and depressive symptoms. QoL (outcome) was assessed with the CASP-12 scale. Longitudinal model-based causal mediation analyses were performed to decompose the total association between multimorbidity and QoL into direct and indirect effects. Moderated mediation analyses tested for differences in mediation pathways by sociodemographic factors., Results: Multimorbidity was significantly associated with lower QoL (direct effect: b = -0.66). This association was mediated by ADL limitations (percentage mediated 0.97%), IADL limitations (3.24%), and depressive symptoms (16.70%), but not by loneliness. The mediation pathways were moderated by age, education, financial strain, and gender., Discussion and Implications: ADL, IADL, and depressive symptoms are crucial intermediary factors between multimorbidity and QoL in older European adults, with changing importance according to age, education, financial strain, and gender. The findings may help to increase the QoL of individuals with multimorbidity and redirect care efforts to these factors., Competing Interests: None., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Introduction: There are limited data on prevalence of dementia in centenarians and near-centenarians (C/NC), its determinants, and whether the risk of dementia continues to rise beyond 100., Methods: Participant-level data were obtained from 18 community-based studies (N = 4427) in 11 countries that included individuals ≥95 years. A harmonization protocol was applied to cognitive and functional impairments, and a meta-analysis was performed., Results: The mean age was 98.3 years (SD = 2.67); 79% were women. After adjusting for age, sex, and education, dementia prevalence was 53.2% in women and 45.5% in men, with risk continuing to increase with age. Education (OR 0.95;0.92-0.98) was protective, as was hypertension (odds ratio [OR] 0.51;0.35-0.74) in five studies. Dementia was not associated with diabetes, vision and hearing impairments, smoking, and body mass index (BMI)., Discussion: Among the exceptional old, dementia prevalence remains higher in the older participants. Education was protective against dementia, but other factors for dementia-free survival in C/NC remain to be understood., (© 2022 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Introduction: Research on coping in advanced old age is scarce. In the present study, we explored coping patterns in near-centenarians and centenarians, and characteristics associated to using a specific coping pattern., Methods: We analyzed the frequency with which participants (N = 87, MAge = 99.05; SDage = 2.6; age range 95-107) reported using specific coping strategies (i.e., coping strategy use) and the relative preference for specific strategies (i.e., relative coping preferences) in data from the Fordham Centenarian Study. Moreover, we applied cluster analysis to detect coping patterns, and we compared cluster characteristics., Results: Very old individuals reported using emotion control and acceptance the most. Cluster analysis further revealed two distinct groups: The high coping group reported significantly higher coping strategy use than the low coping group (p &lt; 0.001). The two groups also favored different strategies (p &lt; 0.001), with the high coping group showing significantly higher relative preferences than the low coping group for active problem-solving, proactive prevention, and strategic planning (all ps &lt; 0.05). The groups furthermore differed significantly in psychological strengths (i.e., personality, self-efficacy, ps &lt; 0.001) and well-being outcomes (i.e., life satisfaction, p = 0.05)., Discussion: This study provides evidence for a general preference for acceptance and emotion control in very old individuals, supporting theories of a developmental coping shift in old age, yet our findings also document the existence of groups with different coping patterns. More frequent coping use, and particularly continued use of active problem-solving and proactive prevention, may enable well-being in very old age., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Many factors may influence adaptation to critical life events such as divorce and bereavement in the second half of life, including having faced childhood adversity. However, pathways to reduced adaptation success are poorly understood. Self-continuity, an identity mechanism that incorporates life changes into a coherent life story, may contribute to better adaptation to adult critical life events, such as feeling less socially and emotionally lonely. We investigated the mediating role of self-continuity channeling the effects of childhood adversity on later life adaptation outcomes among individuals who had experienced divorce or bereavement. Data were derived from the longitudinal LIVES Intimate Partner Loss Study conducted in Switzerland from 2012 to 2016. The sample consisted of individuals who had experienced divorce ( n  = 416, M age  = 57.35) or bereavement ( n  = 339, M age  = 71.36) in later life, and a continuously married control group ( n  = 925, M age  = 67.04). Multilevel moderated mediations were used. Self-continuity mediated the effect of childhood adversity on emotional loneliness for all marital groups, but to a greater extent among divorcees. Self-continuity also mediated the effect of childhood adversity on social loneliness; however, this effect did not differ by marital group. In conclusion, childhood adversity was associated to greater loneliness in later life through self-continuity. Divorcees were the most impacted group regarding emotional loneliness, as they experienced lower levels of self-continuity. Interventions that aim to reinforce self-continuity may help overcome social and emotional loneliness, especially for individuals who have experienced the loss of their partner through divorce., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lampraki, Jopp and Spini.)

Social isolation and loneliness have been recognized as problems older people face due to their adverse effects on health and mortality, but very few researchers have analyzed their co-occurrence, which might be particularly prevalent and critical among the very old. In this study, we investigated the prevalence of combinations of social isolation and loneliness among near-centenarians and centenarians. We used data collected from 94 individuals aged 95-107 from the Fordham Centenarian Study. We built a four-group typology and explored associations with individual characteristics in various domains (demographic, socioeconomics, social, health, care, and psychological) with multinomial logistic regression models. Considering their combinations, the most prevalent groups were "isolated and lonely" and "neither isolated nor lonely" (29.8% and 28.7%, respectively). The "lonely but not isolated" (20.2%) and "isolated but not lonely" (21.3%) groups were also notably large. The likelihood of belonging to each group varied according to various individual characteristics, such as education, health, and personality. Social isolation and loneliness are distinct phenomena among centenarians. The consideration of their varied combination can help better assess life conditions at very old ages. Taking into account the differences between groups can facilitate the design of tailored interventions to improve the lives of near-centenarians and centenarians.

In early pandemic waves, when vaccination against COVID-19 was not yet an option, distancing and reduced social contact were the most effective measures to slow down the pandemic. Changes in frequency and forms of social contact have reduced the spread of the COVID-19 virus and thus saved lives, yet there is increasing evidence for negative side effects such as mental health issues. In the present study, we investigate the development of loneliness and its predictors to examine the role of changes in social networks due to social distancing and other COVID-19-related life changes. A total of 737 participants (age range = 18-81 years) completed an online survey in three waves during the last quarter of 2020 at one-month intervals. Latent growth and multilevel modeling revealed that emotional loneliness increased over time, while social loneliness remained stable. Moreover, socially lonely individuals were likely to also develop emotional loneliness over time. Increased social distancing and sanitary measures were accompanied by decreased social interactions and loss of individuals considered SOS contacts and confidants. Changes in specific social network indicators were differentially associated with changes in emotional vs social loneliness: Loss of friends considered confidants was associated with increasing emotional loneliness, whereas loss of friends considered SOS contacts and reduced overall social interactions were related to increasing social loneliness. Lastly, individuals with more family-and-friend SOS contacts, more friends as confidants and an overall higher number of social interactions were more protected from feeling socially or emotionally lonely. Study findings enhance the understanding of underlying mechanisms differentially contributing to social and emotional loneliness and offer practical suggestions to reduce mental-health side effects of social distancing., Competing Interests: The authors have declared that no competing interests exist.

Background and Objectives: Very old parents and their "old" children are a growing group in industrialized countries worldwide. Care needs of very old parents can be substantial, while children may also face their own age-related issues. Continued mutual support represents an important pathway to addressing emerging care needs. This study aimed to identify patterns of support exchanges occurring in very old parent-child dyads and to ascertain associated individual and relationship factors., Research Design and Methods: Participants were 114 very old parents (aged ≥90) and their children (aged ≥65) from the Boston Aging Together Study. Data were collected using comprehensive, semistructured in-person interviews with both dyad members, including standardized assessments of support exchanges, relationship quality, health, and perceptions of family norms. Actor-Partner Interdependence Models were used to predict upward and downward support reported by children and parents., Results: Both dyad members not only reported substantial upward support (child to parent) in all domains but also notable amounts of downward (parent to child) in the domains of emotional support, listening, and socializing. Findings showed significant associations of parent functional impairment, parent and child relationship quality, and child perceptions of family obligation with upward support and of relationship quality with downward support., Discussion and Implications: Continued support exchanges among very old parents and their children indicated that intergenerational theories still hold up in very late-life relationships. Health care professionals should be aware that attention to relationship quality and family norms might be vital to ensure that support needs are met., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Very old parents and their "old" children are a growing group in industrialized countries worldwide. However, virtually nothing is known about the nature and implications of this relationship constellation. To fill this gap, this study explored the challenges and rewards of the very old parent-child relationship. In-depth interviews were conducted with 114 parent-child dyads (parent age ≥90; child age ≥65). While both challenges and rewards were present, the balance of challenges and rewards was notably less favorable for children with more challenges experienced overall. Challenges reported by children were often characterized by references to children's own advanced age and health problems, and the prolonged caregiving involvement due to their parents' longevity. Health care professionals, policymakers, and families should be made aware of this increasingly common phenomenon, and specific services and policies will be needed to adequately support very old adults and their families.

Paranormal beliefs (PBs) are common in adults. There are numerous psychological correlates of PBs and associated theories, yet, we do not know whether such correlates reinforce or result from PBs. To understand causality, we developed an experimental design in which participants experience supposedly paranormal events. Thus, we can test an event's impact on PBs and PB-associated correlates. Here, 419 naïve students saw a performer making contact with a confederate's deceased kin. We tested participants' opinions and feelings about this performance, and whether these predicted how participants explain the performance. We assessed participants' PBs and repetition avoidance (PB related cognitive correlate) before and after the performance. Afterwards, participants rated explanations of the event and described their opinions and feelings (open-ended question). Overall, 65% of participants reported having witnessed a genuine paranormal event. The open-ended question revealed distinct opinion and affect groups, with reactions commonly characterized by doubt and mixed feelings. Importantly, paranormal explanations were more likely when participants reported their feelings than when not reported. Beyond these results, we replicated that 1) higher pre-existing PBs were associated with more psychic explanations (confirmation bias), and 2) PBs and repetition avoidance did not change from before to after the performance. Yet, PBs reminiscent of the actual performance (spiritualism) increased. Results showed that young adults easily endorse PBs and paranormal explanations for events, and that their affective reactions matter. Future studies should use participants' subjective experiences to target PBs in causal designs (e.g., adding control conditions).

Intimate partner loss in later life can be one of the most stressful events in adulthood. Individuals who struggle to adapt to the new life conditions may need support from a mental health professional. However, less is known about the likelihood to seek professional help after separation, divorce, or bereavement in later life and associated factors. This study investigated professional help-seeking (PHS) for partner loss after a long-term marriage in separated, divorced, and bereaved individuals and examined the extent to which specific person and event-related variables, as well as depressive symptoms, increase its likelihood. The data were derived from the LIVES "Intimate Partner Loss Study." The self-administered questionnaires were completed by 388 adults. PHS was higher after separation (57%) and divorce (49%), compared to widowhood (18%). Higher likelihood of PHS was associated with separation and divorce, female gender, having someone to count on, loss unexpectedness, needing more time to overcome the loss, and more depressive symptoms. Informing individuals unlikely to seek help (e.g., males, bereaved, and individuals with no confidant) about PHS benefits may facilitate adaptation to partner loss., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Jopp, Lampraki, Meystre, Znoj and Brodbeck.)

Objectives: This study examined the measurement invariance and longitudinal trajectories of multidimensional self-perceptions of aging (SPA) and factors that predict between-person variability in the level and change of SPA in middle-aged and older adults., Method: Data were drawn from the German Ageing Survey spanning four waves, covering a 15-year period. Multidimensional SPA was assessed with the Personal Experience of Aging Scale, consisting of three dimensions, physical decline, social loss, and continuous growth., Results: The measurement invariance models across age groups (middle-aged versus older adults) and across time showed a good fit after allowing one item to vary at metric and/or scalar levels. Growth curve models showed only minor declining trajectories in two of the three dimensions of SPA, social loss and continuous growth dimensions, toward more negative views. Participants with poor resources in general were more likely to have negative SPA across all three dimensions. The protective effect of having a spouse was observed on only the social dimension of SPA, supporting a domain-specific effect of having a spouse., Discussion: The study demonstrates the usefulness of a multidimensional understanding of SPA and recognizes the need for identifying different factors that may promote positive perceptions on aging in different dimensions of life., (© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

In this paper, we highlighted links between personality traits and successful ageing through a systematic review of recent empirical studies. Particularly, we addressed the question of whether personality traits are related to successful ageing and, if so, why and how? Answers to this question provided, for example, arguments that supported personality's role in planning an individual's future based on self-knowledge, thereby contributing to a sense of identity throughout their life. Then, considering longitudinal studies, we examined whether personality is stable over one's life course, or does it change and, if so, why and under what conditions? Answers to this question gave substance to the idea that a stable personality allows for continuous and consistent development. In addition, certain personality changes are likely to allow an individual to develop the resilience to better adapt to life's challenges. Therefore, the arguments brought by these two questions can help clarify the modulating role of personality for successful ageing via health and well-being outcomes. These insights may contribute to the development of new prevention approaches, more focused on inter- and intraindividual differences, to promote successful ageing., (© Springer Nature B.V. 2020.)

Engagement in leisure activities has been claimed to be highly beneficial in the elderly. Practicing such activities is supposed to help older adults to preserve cognitive function, physical function, and mental health, and thus to contribute to successful aging. We used structural equation modeling (SEM) to analyze the impact of leisure activities on these constructs in a large sample of Japanese older adults (N = 809; age range 72-74). The model exhibited an excellent fit (CFI = 1); engaging in leisure activities was positively associated with all the three successful aging indicators. These findings corroborate previous research carried out in Western countries and extend its validity to the population of Eastern older adults. Albeit correlational in nature, these results suggest that active engagement in leisure activities can help older adults to maintain cognitive, physical, and mental health. Future research will clarify whether there is a causal relationship between engagement in leisure activities and successful aging., Competing Interests: The authors have declared that no competing interests exist.

This study examined how common thinking of and planning for the end of life (EOL) is among German and Portuguese centenarians, and whether patterns of EOL views are shaped by cultural and individual characteristics. A significant portion of centenarians in both countries reported not thinking about the EOL, not believing in the afterlife, and not having made EOL arrangements. Latent class analysis identified three EOL patterns: Class 1 ( EOL thoughts with EOL arrangements and afterlife beliefs ), Class 2 ( EOL arrangements and afterlife beliefs without EOL thoughts ), and Class 3 ( Overall low endorsement of EOL items ). The proportion of Portuguese centenarians was higher in Class 1 and of German centenarians higher in Classes 2 and 3. Centenarians' demographic, social, and health characteristics were significantly different across EOL patterns. As lack of EOL planning can result in poor EOL quality, enhancing communication among centenarians, family, and health-care professionals seems imperative.

Background: Critical events in the second half of life, such as divorce, pose a significant threat to well-being. Individuals undergoing divorce often experience feelings of social loneliness and may benefit differently from available resources depending on how much time has passed since the event. Personality traits have been found to be related to adaptation, with particularly strong effects immediately after the critical event. Other resources, such as identity-stabilizing mechanisms (i.e., valued social groups and self-continuity), may play a role only later in adaptation. However, little is known about the benefits of these resources and their potentially time-dependent effects on social loneliness when one is overcoming later-life divorce., Objectives: This study investigates the role of psychological (e.g., personality, self-continuity, multiple important group memberships) and social resources (e.g., new partner, having someone to help deal with divorce) for social loneliness in two post-divorce phases, using a married group as the reference, controlling for sociodemographic aspects and health., Methods: A representative sample of 850 divorced (aged 40-79 years) and 869 married individuals (aged 40-78 years) living in Switzerland were compared, using multiple regression analyses., Results: Differential predictive patterns for social loneliness between the two divorced groups and the married group were observed. For the short-term divorced (up to 2 years after divorce), higher extroversion and agreeableness and lower neuroticism were associated with lower levels of loneliness. For the long-term divorced (2-5 years after divorce) and for those who remained married, extroversion was similarly important for loneliness. Additionally, higher levels of self-continuity and multiple group memberships predicted lower loneliness, but the short-term divorced did not benefit from them. Having someone to help overcome the divorce benefited members of both divorced groups. A new partner was related to less loneliness, but only in the long-term divorced group., Conclusions: Our findings demonstrate that the effects of psychological and social resources on social loneliness vary by adaptation phase. Although extroversion is beneficial for all divorced and married individuals, other personality traits play a more decisive role in the initial adaptation phase. Identity-promoting resources (i.e., multiple group memberships, perceived self-continuity) are beneficial only later in the adaptation process. To be successful, professional interventions must be tailored as needed., (© 2019 S. Karger AG, Basel.)

Background: Self-perceived uselessness is associated with poorer health in older adults. However, it is unclear whether there is a difference in self-perceived uselessness between centenarians and non-centenarians, and if so, which factors contributed to the difference., Methods: We used four waves of a nationwide longitudinal dataset from 2005 to 2014 in China to investigate these research goals. We first performed multinomial logit regression models to examine the risk of the high or moderate frequency of self-perceived uselessness relative to the low frequency among centenarians (5778 persons) in comparison with non-centenarians aged 65-99 (20,846 persons). We then conducted a cohort analysis for those born in 1906-1913, examining differences in self-perceived uselessness between those centenarians and those died between ages 91 and 99 during 2005-2014., Results: Compared to persons aged 65-79, centenarians had 84% (relative risk ratio (RRR) = 1.84, 95% CI:1.69-2.01) and 35% (RRR = 1.35, 95% CI: 1.25-1.46) higher risk to have the high frequency and the moderate frequency of feeling useless versus low frequency, respectively, when only demographic factors were controlled for. However, centenarians had 31% (RRR = 0.69, 95% CI: 0.54-0.88), 43% (RRR = 0.57, 95% CI: 0.49-0.68), and 25% (RRR = 0.75, 95% CI: 0.67-0.83) lower risk, respectively, to have the high frequency of self-perceived uselessness relative to the low frequency when a wide set of study covariates were controlled for. In the case of the moderate versus the low frequency of self-perceived uselessness, the corresponding figures were 18% (RRR = 0.82, 95% CI: 0.66-1.02), 22% (RRR = 0.78, 95%CI: 0.67-0.90), and 13% (RRR = 0.87, 95% CI: 0.79-0.96), respectively. The cohort analysis further indicates that those who became centenarians were 36-39% less likely than those died at ages 91-94 to report the high and the moderate frequencies of self-perceived uselessness versus the low frequency; no difference was found between centenarians and those died at ages 95-99. In both period and cohort analyses, behavioral and health-related factors affected the perception substantially., Conclusions: Overall, centenarians were less likely to perceive themselves as useless compared to non-centenarians of younger birth cohorts when a wide set of covariates were considered and non-centenarians of the same birth cohort. How centenarians manage to do so remains an open question. Our findings may help improve our understanding about the longevity secrets of centenarians.

Background: While a fair amount of research has investigated the impact of sensory impairments on the mental health of young older adults (65-79 years of age), only a few studies have focused on the associations of sensory impairments with mental health outcomes in the oldest-old (80 years and older). To close this gap, this study examined the separate and combined effects of self-reported vision and hearing impairment for depressive symptoms in a sample of oldest-old individuals, controlling for other mental health risks (e.g., functional disability, health interference, and loneliness)., Methods: Centenarians and near-centenarians (N = 119; average age = 99) were recruited from the community and geriatric healthcare organizations. In-person interviews were conducted at participants' place of residence., Results: Vision impairment and its interaction with hearing impairment as well as functional disability, health interference with desired activities, and loneliness were significant predictors of depressive symptoms in hierarchical regression analyses. Hearing impairment alone was not associated with depressive symptoms, but follow-up analyses clarifying the interaction effect showed that individuals with poor vision had the highest levels of depressive symptoms, if they had a concurrent hearing impairment. Thus, a concurrent presence of poor vision and poor hearing resulted in an increased vulnerability for depressive symptoms., Conclusions: Given that a majority of oldest-old has sensory impairments which can result in mental health issues, it is important to facilitate this population's access to vision and audiological treatment and rehabilitation., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background and Objectives: Valuation of life (VOL) represents a construct capturing individuals' active attachment to their life. The majority of studies on VOL were conducted in North America and Europe where personal autonomy and independence are highly valued, leaving open the question about the relevance of this construct in interdependence-oriented cultures. Using a framework of cross-cultural and life-span theories, the present study compared levels and predictors of VOL between the young-old and old-old individuals from Germany and Japan., Research Design and Methods: Two hundred fifty-seven Germans and 248 Japanese, matched by age, gender, education, and IADL, answered a 5-item VOL scale and shared information on sociodemographic, social, and health resources., Results: Germans' VOL levels were higher than in Japanese participants. Both culture- and age-moderated predictions of VOL: education was significant only in the young-old Japanese, and close social partners mattered in the old-old, not in the young-old. Health determined VOL irrespective of culture and age., Discussion and Implications: The findings suggest that cultural values and aging processes should be considered to better understand how individuals value their life and to help older adults to feel that his/her life is meaningful and worth living.

Objectives: To explore how centenarians think about and plan for the end of life (EOL) and to what extent their primary contacts (proxy informants) are aware of these thoughts., Design: Population-based study with semistructured in-person interviews., Setting: Defined geographical region approximately 60 km around Heidelberg, Germany., Participants: Subsample drawn from the larger study of centenarians (N = 78) with data on centenarians' EOL thoughts from the centenarian and the proxy informant., Measurements: Centenarians reported on their thoughts about the EOL, perception of the EOL as threatening, longing for death, engagement in any EOL planning, and type of EOL plan (will, living will, healthcare surrogate) in place. Proxy respondents answered the same set of questions based on what they thought the centenarians' perspective was., Results: In nearly half of cases, proxies misjudged whether the centenarian thought about EOL. Although only few centenarians perceived the EOL as threatening, and approximately one-quarter reported longing for death, proxies overestimated centenarians' reports on the former and underestimated the latter. Proxies reported more centenarian EOL planning than centenarians themselves., Conclusion: Even though enrolled proxies were mostly persons very close to the centenarian, many of them did not seem to be well informed about the centenarians' thoughts and plans regarding the EOL, suggesting a lack of communication between centenarians and social network members in this respect. Healthcare professionals should be aware that, even for very old adults approaching the end of their lives, discussions about EOL and EOL planning may need to be actively encouraged and supported., (© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.)

Objectives: The group of individuals aged 80 and over is growing faster than other segments of the population, and within this group the number of centenarians has risen exponentially worldwide. This paper reports the numbers of centenarians (total, and ratio relative to total population) in 32 European countries and their key characteristics: gender distribution, level of education, and type of residence., Study Design: Population based study., Measures: We used national census data collected in 2011 for individuals aged 100 and over living in Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland and the UK. Data on gender, residence and education were used., Results: The total number of centenarians was 89156, corresponding to 17.3 centenarians per 100000 inhabitants of the total population and 98.0 centenarians per 100000 individuals aged 65 and older. Centenarian ratios were highest in France, Italy and Greece, and lowest in Bulgaria, Romania, and Croatia. The percentage of men was 16.5% on average, and ranged from around 13% (Germany, Latvia, Belgium) to 37% (Hungary). Across Europe, 62.7% of the centenarians lived in private households, with a range from 10.9% (Iceland) to 90.0% (Romania). Education levels varied across countries, with an average of 13.6% having no formal education, ranging from 0.0% (the UK, Finland, Iceland) to 61.6% (Portugal)., Conclusions: Centenarian numbers have increased substantially since last available data. The findings will inform specific health promotion policies, the strengthening of current services and the development of innovative care systems., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Context: Direct care workers in long-term care can develop close relationships with their patients and subsequently experience significant grief after patient death. Consequences of this experience for employment outcomes have received little attention., Objectives: To investigate staff, institutional, patient, and grief factors as predictors of burnout dimensions among direct care workers who had experienced recent patient death; determine which specific aspects of these factors are of particular importance; and establish grief as an independent predictor of burnout dimensions., Methods: Participants were 140 certified nursing assistants and 80 homecare workers who recently experienced patient death. Data collection involved comprehensive semistructured in-person interviews. Standardized assessments and structured questions addressed staff, patient, and institutional characteristics, grief symptoms and grief avoidance, as well as burnout dimensions (depersonalization, emotional exhaustion, and personal accomplishment)., Results: Hierarchical regressions revealed that grief factors accounted for unique variance in depersonalization, over and above staff, patient, and institutional factors. Supervisor support and caregiving benefits were consistently associated with higher levels on burnout dimensions. In contrast, coworker support was associated with a higher likelihood of depersonalization and emotional exhaustion., Conclusion: Findings suggest that grief over patient death plays an overlooked role in direct care worker burnout. High supervisor support and caregiving benefits may have protective effects with respect to burnout, whereas high coworker support may constitute a reflection of burnout., (Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Chronic fatigue syndrome (CFS) represents a unique clinical challenge for patients and health care providers due to unclear etiology and lack of specific treatment. Characteristic patterns of behavior and cognitions might be related to how CFS patients respond to management strategies., Methods: This study investigates control beliefs in a population-based sample of 113 CFS patients, 264 individuals with insufficient symptoms or fatigue for CFS diagnosis (ISF), and 124 well individuals., Results: Controlling for personality and coping, individuals with low confidence in their problem-solving capacity were almost 8 times more likely to be classified as ISF and 5 times more likely to be classified as CFS compared to being classified as well. However there was a wide distribution within groups and individuals with "low confidence" scores were found in 31.7% of Well individuals. Individuals with low levels of anxiety and who were more outgoing were less likely to be classified as ISF or CFS., Conclusions: These findings suggest that fostering control beliefs could be an important focus for developing behavioral management strategies in CFS and other chronic conditions.

Objectives: Having a role model of successful aging may contribute to views on aging. This article investigated the nature and correlates of young, middle-aged, and older adults' successful aging role models., Method: One hundred and fifty-one individuals aged 18-99 were asked whether they had a role model of successful aging and if so, the reasons for their choice. Open-ended answers were coded for recurring themes. Views on aging and attitudes toward own aging were assessed with questionnaires., Results: Eighty-five percent of participants indicated at least one role model. Most mentioned role models from their family, including parents and grandparents. Role models were gender matched. Most frequent reasons for model choices were health, activities, and social resources. Participants with family role models had less negative views on aging. Mediation analyses confirmed that family role models were associated with more reasons for role model choice, which in turn was associated with less negative views on aging. Furthermore, the effect of reasons on attitudes toward own aging was mediated by negative views on aging., Discussion: Young, middle-aged, and older adults have role models for successful aging. Links between role model features and views on aging suggest that role models may be useful in promoting successful aging., (© The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Health research suggests that findings on young-old adults cannot be generalized to old-old adults and thus that old-old age seems not a simple continuation of young-old age due to qualitative changes that result in a discontinuity in old age. Specifically, it would be of conceptual and methodological importance to inform research regarding estimates around which chronological age the beginning of old-old age could be placed at a population level, and whether this is universal or domain-specific. To derive such criteria, we investigated potential discontinuity of age relations between young-old and old-old age in a large population-based sample considering measures in different domains (processing speed, verbal abilities, general health status, activity participation, and life satisfaction). For processing speed, verbal abilities, general health status, and life satisfaction we observed some very small indication that there might be a discontinuity of age relations at the end of individuals' eighties, and for activity participation already at the beginning of individuals' eighties. In conclusion, models conceptualizing aging as a gradual development might not suffice to adequately represent the differences between the stages of young-old and old-old age due to some very small indication that there might be discontinuity in late adulthood., Competing Interests: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; and in the decision to publish the results.

This qualitative study describes the lived experience of maladaptive daydreaming (MD), an excessive form of unwanted daydreaming that produces a rewarding experience based on a created fantasy of a parallel reality associated with a profound sense of presence. A total of 21 in-depth interviews with persons who self-identified as struggling with MD were analyzed utilizing a phenomenological approach. Interviewees described how their natural capacity for vivid daydreaming had developed into a time-consuming habit that resulted in serious dysfunction. The phenomenology of MD was typified by complex fantasized mental scenarios that were often laced with emotionally compensatory themes involving competency, social recognition, and support. MD could be activated if several requirements were met. Because social interaction seems to be incompatible with this absorbing mental activity, solitude was necessary. In addition, kinesthetic activity and/or exposure to evocative music also appeared to be essential features. Besides delivering a firsthand description of key characteristics of MD, the study also indicates that MD is associated with dysfunctionality for which participants expressed a substantial need for help.

Living a long life is desired by many individuals, and this dream is likely to become reality in more and more industrialized societies. During the past 3 decades, the number of very old individuals has increased significantly, creating a global demographic challenge with consequences at the individual, family, and societal levels. Yet, life in very old age is still poorly understood in terms of its unique characteristics and challenges. Besides specific content areas, very old age represents an understudied field of research. This lack of knowledge may be one reason that the very old also are an underserved population. This special issue introduces an international network of three centenarian studies that describe and compare the life circumstances and characteristics of centenarians across Germany, Portugal, and the United States. Our parallel studies comprehensively assess centenarians' physical, cognitive, social, and psychological functioning to create a knowledge base regarding their capacities and needs. A specific focus lies in the investigation of psychological aspects, social resources, and societal/cultural contexts, factors that may contribute to longevity and successful aging. Determining key characteristics of this very old population and investigating similarities and differences across countries is timely and urgent, both from an applied and a policy standpoint.

This paper provides a detailed picture of the sources and types of informal support available to centenarians, depending on their housing and care arrangements. Participants were 112 centenarians and 96 primary contacts of centenarians enrolled in the population-based Second Heidelberg Centenarian Study. Findings indicate that children of centenarians were their primary source of support in daily life. Those without living children had overall less help. Most frequently reported was help with administrative tasks, regardless of centenarians' residence or living arrangement. All other types of help (e.g., with activities of daily living and housework) were reported by about one-third and were mostly provided by children; centenarians without children were more likely to have friends/neighbors involved in some of these tasks. The one category reported by a third of the centenarians regardless of residence, living arrangements, or presence of a child was help with socializing/companionship. Findings constitute an important step toward identifying and meeting the support needs of centenarians and their families. Policy implications are discussed.

This article examines the challenges experienced by very old individuals and their consequences for well-being and mental health. In order to capture unique issues experienced in very old age, 75 participants of the population-based Fordham Centenarian Study answered open-ended questions on everyday challenges. Theme-based coding was then used to categorize and quantify responses. The challenges mentioned most often were challenges faced in the functional (e.g., physical health/activities of daily living restrictions, mobility, sensory impairment), psychological (e.g., loss of well-liked activity, dependency, negative emotions, death), and social (e.g., family loss) life domains. Functional challenges were negatively associated with aging satisfaction and positively associated with loneliness. Psychological challenges were positively linked to aging satisfaction. Social challenges were marginally related to loneliness. Notably, challenges were not related to depression. In conclusion, the challenges experienced in very old age are multidimensional and multifaceted, unique in nature, and have differential relations to mental health. Functional, psychological, and social challenges affect very old individuals' lives and therefore need to be better understood and addressed. Given their consequences, it is imperative for policy makers to develop an awareness for the different types of challenges faced by centenarians, as there may be unique policy implications related to each.

This study explored the fantasy activity of 16 individuals who were seeking online peer-support and advice for maladaptive daydreaming (MD). MD is an under-researched mental activity described as persistent vivid fantasy activity that replaces human interaction and/or interferes with important areas of functioning. We employed a grounded theory methodology that yielded seven common themes presented as a sequential descriptive narrative about the nature, precursors, and consequences of MD. The presented "storyline" included the following themes: (1) daydreaming as an innate talent for vivid fantasy; (2) daydreaming and social isolation-a two-way street; (3) the role of trauma in the development of MD; (4) the rewards of daydreaming; (5) the insatiable yearning for daydreaming; (6) shame and concealment; (7) unsuccessful treatment attempts. A main conclusion of our study is that there is an urgent need for early identification of MD and its correct diagnoses in adulthood.

This study explores the recently described phenomenon of Maladaptive Daydreaming (MD) and attempts to enhance the understanding of its features. It documents the experiences of 340 self-identified maladaptive daydreamers who spend excessive amounts of time engaged in mental fantasy worlds, in comparison to 107 controls. Our sample included a total of 447 individuals, aged 13-78, from 45 countries who responded to online announcements. Participants answered quantitative and qualitative questions about their daydreaming habits and completed seven questionnaires assessing mental health symptoms. Findings demonstrated that MD differs significantly from normative daydreaming in terms of quantity, content, experience, controllability, distress, and interference with life functioning. Results also demonstrated that Maladaptive Daydreamers endorsed significantly higher rates of attention deficit, obsessive compulsive and dissociation symptoms than controls. In sum, findings suggested that MD represents an under-acknowledged clinical phenomenon that causes distress, hinders life functioning and requires more scientific and clinical attention., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Centenarian studies from around the world have shown that reaching age 100 typically involves substantial health issues. The present study adds to the existing knowledge from other countries by describing health conditions in German centenarians., Methods: A total of 112 centenarians or their primary contacts provided information on acute and chronic health conditions and pain in the context of the Second Heidelberg Centenarian Study (mean age = 100.45 years, standard deviation [SD] = 0.47, 89% females)., Results: Participants showed high comorbidity, with an average of five illnesses (mean = 5.3; SD = 2.20). Health conditions with highest prevalence were sensory (vision, hearing; 94%), mobility (72%) and musculoskeletal conditions (60%). Cardiovascular conditions (57%) and urinary system ailments (55%) were also common. Pain was experienced often by 30% of the participants. Of those reporting any pain, 36% indicated pain exceeding bearable levels., Conclusion: German centenarians experienced a substantial number of ill nesses, dominated by sensory and mobility conditions. Cardiovascular diseases were the only potentially lethal illnesses with high prevalence. Evidence of unaddressed pain seems alarming, requiring future research. Emerging health profiles indicate that even in very advanced age, quality of life may be improved by enhanced diagnostics and optimal disease management. Mobility limitations may be addressed with preventive efforts.

Background: Despite their strong increase, the population of the very old, including near-centenarians and centenarians, represent an unstudied and underserved population. Available studies mostly concentrate on predictors of exceptional longevity, but rarely extend their focus to other areas of functioning. Also, little is known about what contributes to experiencing a quality life in very old age. The present population-based study aims at providing a comprehensive picture of key domain of functioning, including physical, cognitive, social and mental function in very old individuals and to determine predictors of mental health indicators., Methods: A total of 119 individuals aged 95 to 107 living in private dwellings and residential care facilities were recruited based on the New York City Voters Registry. Participants answered questions regarding their health and activities of daily living. Their cognitive functioning was determined using the Mini-Mental State Examination and the Global Deterioration Scale. Social resources were measured with number of children and the Lubben Scale. Mental health was assessed with the Geriatric Depression Scale and the Satisfaction with Life Scale., Results: An unexpectedly large proportion of the sample lived in the community. On average, cognitive functioning was high. Although five diseases were reported on average, participants reported good health. Functional status was reduced. Most participants had at least one person for communication/social support. On average, depression was below cut-off, and most participants reported high life satisfaction. Regression analyses indicated that individual differences in depression were associated with subjective health, IADL and relatives support. For life satisfaction, subjective health, ADL and number of children were most important. Demographic characteristics, number of illnesses or cognitive status were not significant., Conclusions: Despite reduced levels of physical functioning and social resources, very old participants were in good mental health suggesting high resilience and ability to adapt to age-associated challenges. That a large proportion of them lived in the community further highlights their desire for leading an autonomous life, which may have been facilitated by New York service culture. More research is necessary to provide guidance for the development of well-suited services for this very old population.

Background: Previous studies have examined the relationships between physical health and leisure activities and between leisure activities and well-being, but, to our knowledge, none has examined these relationships simultaneously., Objective: This study investigated the relationships between leisure activities, health and well-being considering the role of age, and whether leisure activities mediate the relationship between physical health and well-being., Methods: Utilizing a cross-sectional database of 259 adults (ages 18-81 years) who completed several questionnaires, linear regression models and mediation models were tested., Results: Regression analyses indicated that physical health was related to leisure activities and leisure activities were related to well-being. When physical health was measured by subjective ratings, age had a stronger relationship with leisure activities. However, when physical health was indicated by health restrictions, physical health had a stronger relationship with leisure activities than did age. Leisure activities were a partial mediator of the relationship between physical health and well-being., Conclusion: The results demonstrated that the reduction in leisure activities with age has more to do with physical health limitations than with older age itself. In addition, regardless of age, the benefits of physical health for well-being are due in part to the level of leisure activity participation. These results highlight the importance of leisure activities for successful aging throughout the adult life span. Interventions designed to improve well-being through increasing leisure activity participation should take physical health into consideration, particularly for older adults., (© 2016 S. Karger AG, Basel.)

This study describes the development of the Maladaptive Daydreaming Scale (MDS), a 14-item self-report instrument designed to gauge abnormal fantasizing. Our sample consisted of 447 English-speaking individuals from 45 different countries. A 3-correlated-factors model best presented the underlying dimensions Yearning, Kinesthesia and Impairment, capturing related rewarding experiences as well as psychological impairment of maladaptive daydreaming. MDS scores were associated with obsessive-compulsive behavior and thoughts, dissociative absorption, attention deficit, and high sense of presence during daydreaming, but less with psychotic symptoms. The MDS and its subscale demonstrated good validity, sound internal consistency and temporal stability and discriminated well between self-identified individuals with and without maladaptive daydreaming. Considering the instrument's high sensitivity and specificity levels, it seems an excellent measure for future investigation of MD that will, hopefully, shed light on the etiology and psycho-biological mechanisms involved in this mental condition, as well as on the development of effective MD treatment methods., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: This study aims to present the psychometric properties of the Portuguese version of the Positive Valuation of Life Scale (Lawton et al. in J Aging Ment Healt 13:3-31, 2001)., Method: Sample included 207 community-dwelling elders (129 women; M Age = 77.2 years, SD = 7.5). The data collection included the translated and adapted Portuguese version of Positive Valuation of Life Scale, Life Satisfaction Index Z, Meaning in Life Questionnaire and Geriatric Depression Scale., Results: From exploratory factor analysis, two factors emerged, existential beliefs and perceived control, explaining 49 % of the total variance. Both factors were positively related with meaning in life and life satisfaction and negatively related with depression (p < 0.05). The values obtained for internal consistency for the total scale and for each subscale were good (α > 0.75)., Conclusion: The Portuguese version of Positive VOL Scale represents a reliable and valid measure to capture the subjective experience of attachment to one's life. The two-factor structure is an update to Lawton's previous work and in line with findings obtained in the USA (Dennis et al. in What is valuation of life for frail community-dwelling older adults: factor structure and criterion validity of the VOL, Thomas Jefferson University, Center for Applied Research on Aging and Health Research, 2005) and Japan (Nakagawa et al. in Shinrigaku Kenkyu 84:37-46, 2013). Future research is required to investigate VOL predictors and the potential changes toward the end of the life span.

Because of the increasing number of older workers, it is important to develop models of work-related constructs for this population. The present article developed a model surrounding occupational self-efficacy, testing its relation to other factors (e.g., intrinsic job motivation), predictors (e.g., self-perceptions of aging), and outcomes (e.g., job satisfaction). Employed adults of ages 50 and older (n = 313) were recruited via organizations and social media sites. Study participants (M = 59.7, SD = 6.1, range = 50-78) volunteered to fill out an Internet survey. Occupational self-efficacy predicted job satisfaction, and intrinsic job motivation fully mediated this relationship. More negative self-perceptions of aging predicted poorer occupational self-efficacy. Occupational self-efficacy also predicted life satisfaction. Expected retirement age and job performance were unrelated to occupational self-efficacy. These findings may inform workplace interventions that seek to maintain or increase older worker job and life satisfaction., (© The Author(s) 2015.)

Context: Patient death is common in long-term care (LTC). Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily LTC, experience patient death and to what extent they are prepared for this experience., Objectives: To 1) determine how grief symptoms typically reported by bereaved family caregivers are experienced among direct care staff, 2) explore how prepared the staff members were for the death of their patients, and 3) identify characteristics associated with their grief., Methods: This was a cross-sectional study of direct care staff experiencing recent patient death. Participants were 140 certified nursing assistants and 80 homecare workers. Standardized assessments and structured questions addressed staff (e.g., preparedness for death), institutional (e.g., support availability), and patient/relational factors (e.g., relationship quality). Data analyses included bivariate group comparisons and hierarchical regression., Results: Grief reactions of staff reflected many of the core grief symptoms reported by bereaved family caregivers in a large-scale caregiving study. Feelings of being "not at all prepared" for the death and struggling with "acceptance of death" were prevalent among the staff. Grief was more intense when staff-patient relationships were closer, care was provided for longer, and staff felt emotionally unprepared for the death., Conclusion: Grief symptoms like those experienced by family caregivers are common among direct care workers after patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers and ultimately allow them to provide better palliative care in nursing homes and homecare., (Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose of the Study: This article investigates lay perspectives of the concept of successful aging in young, middle-aged, and older adults from 2 cultures, the United States and Germany, to potentially guide the development of scientific theories of successful aging. The empirical findings are embedded in a comprehensive overview of theories of successful aging and life-span development and offer implications for theory development., Design and Methods: Two samples of young, middle-aged, and older adults from the United States (N = 151) and Germany (N = 155) were asked about definitions and determinants of successful aging. Codes were developed to capture common themes among the answers, resulting in 16 categories., Results: Themes mentioned included resources (health, social), behaviors (activities), and psychological factors (strategies, attitudes/beliefs, well-being, meaning). There were striking similarities across countries, age, and gender. Health and Social Resources were mentioned most frequently, followed by Activities/Interests, Virtues/Attitudes/Beliefs, Well-being, and Life management/Coping. Age differences were limited to Growth/Maturation and Respect/Success, and gender differences were limited to Social Resources and Well-being. Educational and cultural effects were limited to psychological factors and Education/Knowledge, which were more often mentioned by U.S. participants and individuals with more education., Implications: Young, middle-aged, and older lay persons from the United States and Germany have quite similar concepts of successful aging, which they view in far more multidimensional terms than do established scientific theories (Rowe & Kahn, 1998). Given evidence that factors mentioned by laypeople do promote successful aging, considering them in more comprehensive theoretical models may enhance our understanding., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: Research focusing on the consequences of sensory impairments for the everyday competence of the oldest-old is emerging. The two main goals of this study were to document the prevalence of self-reported vision, hearing, and dual sensory impairment and to explore associations of these impairments with functional disability in near-centenarians and centenarians., Methods: Centenarians and near-centenarians (N = 119; average age = 99) were recruited, with about 80% living in the community. In-person interviews included self-ratings of vision and hearing impairment and functional disability conceptualized as having difficulties performing personal and instrumental activities of daily livings (PADLs and IADLs)., Results: Based on self-report ratings, 17% of participants were classified as having a visual impairment only, 18% as having a hearing impairment only, and 38% with both a visual and hearing impairment (dual sensory impairment). Regression analyses demonstrated that having a vision impairment only and being dual sensory impaired were the strongest predictors of functional disability. They were associated with higher levels of functional disability over and above higher levels of depressive symptomatology, interference of health with desired activities, and living in a nursing home., Conclusions: Sensory impairments-especially dual sensory impairment-are prevalent in the oldest-old. Having dual sensory impairment or a single visual impairment among other factors are strongly associated with less-optimal everyday functioning in the oldest-old.