Search

Objective: The present study examined the cultural differences and similarities in the levels and predictors of subjective well-being in Japanese and American centenarians. Method: We analyzed data on cognitively intact Japanese (N = 59) and American (N = 125) participants from the Tokyo and Georgia Centenarian Studies, respectively. The Philadelphia Geriatric Center Morale Scale was used to measure subjective well-being, while sociodemographic, social, and health resources were assessed as potential predictors. Results: The American participants reported higher scores on well-being (satisfaction with social relations and psychological comfort). However, cultural differences in the levels of well-being disappeared after we controlled for its predictors. The regression models revealed that health resources (cognitive function, hearing problems, and activities of daily living) were strong predictors of well-being in both countries. Social resources (living with others) were strongly associated with one dimension of well-being (attitude toward one's aging) among the Japanese participants. Discussion: The findings support the existing lifespan and cross-cultural literature, indicating that declines in health impose certain limitations on adaptive capacity in oldest-old age irrespective of cultures, and that social embeddedness is valued in Eastern cultures. The authors speculate that cultural values, i.e. personal autonomy versus relational harmony, play an important role for well-being in oldest-old age. [ABSTRACT FROM AUTHOR]

Background Functional loss among older adults is known to follow a hierarchical sequence, but little is known about whether such sequences differ across socio-cultural contexts. The aim of this study is to construct activities of daily livings (ADL) scales for oldest-old adults in the United States and China so as to compare their functional loss sequences. Methods We use data from the Asset and Health Dynamics of the Oldest Old (n = 1607) and Chinese Longitudinal Healthy Longevity Survey (n = 5570) for years 1998–2008. ADL items are calibrated within a scale using the Rasch measurement model. Rasch scores are averaged across survey waves to identify the ADL loss sequence for each study population. We also assess scale stability over measurement periods. Results Factor analyses confirm that the ADL items in each study population can be combined meaningfully to form a hierarchical sequence. Internal consistency assessed by Cronbach’s alpha is high (0.81 to 0.95). We find that bathing is the first activity that both older Americans and Chinese have difficulty with, while eating is the last activity. There are, however, differences in the rank order for toileting (ranked more challenging in the Chinese sample) and dressing (ranked more challenging in the U.S. sample). Item orderings are stable over time. Conclusions The results highlight the relative importance of bathing in the functional loss sequence for older adults, regardless of socio-cultural context. Health interventions are needed to address deficits in the bathroom environment, especially in developing countries like China. [ABSTRACT FROM AUTHOR]

Objectives. This study explores how 2 measures of self-rated health (SRH) change are related to mortality among oldest-old adults. In doing so, it also considers how associations between SRH and mortality may depend on prior SRH. Method. Data come from the Asset and Health Dynamics survey—the oldest-old portion of the Health and Retirement Study—and follow 6,233 individuals across 13 years. I use parametric hazard models to examine relationships between death and 2 measures of short-term SRH change—a computed measure comparing SRH at time t–1 and t, and a respondent-provided retrospectively reported change. Results. Respondents who demonstrate or report any SRH change between survey waves died at a greater rate than those with consistent SRH. After controlling for morbidity, individual characteristics, and SRH, those who changed SRH categories between survey waves and those who retrospectively reported an improvement in health continue to have a greater risk of death, when compared with those with no change. Discussion. These findings suggest that the well-established associations between SRH status and mortality may understate the risk of death for oldest-old individuals with recent subjective health improvements. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Although the apolipoprotein E (APOE) ɛ4 allele is a major genetic risk factor for Alzheimer’s disease (AD), it is not clear whether this relationship persists among the oldest old. Several European studies suggest that the effect of the APOE ɛ4 allele on dementia and mortality disappears in very old age. We describe the APOE allele and genotype frequencies and examine whether the presence of the APOE ɛ4 or APOE ɛ2 alleles is related to prevalent dementia, incident dementia, and mortality in a population-based cohort of oldest-old participants in the United States. Methods: We studied 904 participants aged 90 years and older from The 90+ Study. Eight hundred two (89%) participants were genotyped and included in the prevalent dementia and mortality analyses. The 520 initially nondemented participants were included in the incident dementia analyses and were evaluated for dementia every 6 months. Results: The APOE ɛ4 allele was significantly associated with prevalent dementia (odds ratio = 2.06) and AD (odds ratio = 2.37) in women but not in men. The APOE ɛ2 allele was not related to prevalent dementia in either sex. After an average follow-up of 2.4 years, 188 incident dementia cases were identified. Neither the APOE ɛ4 nor the APOE ɛ2 allele was related to incident dementia or AD. Five hundred ten (64%) participants died after an average follow-up of 2.3 years, and their mortality was not related to the presence of either the APOE ɛ2 or APOE ɛ4 allele. Conclusions: Our findings suggest that the associations between APOE ɛ4, dementia, and mortality are age dependent, and that APOE ɛ4 no longer plays a role in dementia and mortality at very old ages. [Copyright &y& Elsevier]

We examined memory for pictures and words in middle-age (45-59 years), young-old (60-74 years), old-old (75-89 years), and the oldest-old adults (90-97 years) in the Louisiana Healthy Aging Study. Stimulus items were presented and retention was tested in a blocked order where half of the participants studied 16 simple line drawings and the other half studied matching words during acquisition. Free recall and recognition followed. In the next acquisition/test block a new set of items was used where the stimulus format was changed relative to the first block. Results yielded pictorial superiority effects in both retention measures for all age groups. Follow-up analyses of clustering in free recall revealed that a greater number of categories were accessed (which reflects participants' retrieval plan) and more items were recalled per category (which reflects participants' encoding strategy) when pictures served as stimuli compared to words. Cognitive status and working memory span were correlated with picture and word recall. Regression analyses confirmed that these individual difference variables accounted for significant age-related variance in recall. These data strongly suggest that the oldest-old can utilise nonverbal memory codes to support long-term retention as effectively as do younger adults. [ABSTRACT FROM AUTHOR]

The article presents a phenomenological study that describes the life experience of adults older than 85 years in the U.S. The study was conducted to identify how oldest-old adults perceived the experience of living alone in their homes and how they are accommodated. The analysis involves themes such as defining self through experience, being situated in time, knowing lifetime is limited, planning for the future and leaving a legacy.

Background/objectives: Exposure to air pollution may contribute to both increasing depressive symptoms and decreasing episodic memory in older adulthood, but few studies have examined this hypothesis in a longitudinal context. Accordingly, we examined the association between air pollution and changes in depressive symptoms (DS) and episodic memory (EM) and their interrelationship in oldest-old (aged 80 and older) women., Design: Prospective cohort data from the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes., Setting: Geographically diverse community-dwelling population., Participants: A total of 1,583 dementia-free women aged 80 and older., Measurements: Women completed up to six annual memory assessments (latent composite of East Boston Memory Test and Telephone Interview for Cognitive Status) and the 15-item Geriatric Depression Scale (GDS-15). We estimated 3-year average exposures to regional particulate matter with aerodynamic diameter below 2.5 μm (PM 2.5 ) (interquartile range [IQR] = 3.35 μg/m 3 ) and gaseous nitrogen dioxide (NO 2 ) (IQR = 9.55 ppb) at baseline and during a remote period 10 years earlier, using regionalized national universal kriging., Results: Latent change structural equation models examined whether residing in areas with higher pollutant levels was associated with annual changes in standardized EM and DS while adjusting for potential confounders. Remote NO 2 (β = .287 per IQR; P = .002) and PM 2.5 (β = .170 per IQR; P = .019) exposure was significantly associated with larger increases in standardized DS, although the magnitude of the difference, less than 1 point on the GDS-15, is of questionable clinical significance. Higher DS were associated with accelerated EM declines (β = -.372; P = .001), with a significant indirect effect of remote NO 2 and PM 2.5 exposure on EM declines mediated by DS. There were no other significant indirect exposure effects., Conclusion: These findings in oldest-old women point to potential adverse effects of late-life exposure to air pollution on subsequent interplay between DS and EM, highlighting air pollution as an environmental health risk factor for older women., (© 2020 The American Geriatrics Society.)

Objective: The aim of this study was to explore gender and race-specific mortality and comorbidities associated with dementia hospitalizations among the oldest-old., Method: Using the 1999-2008 Nationwide Inpatient Sample, we identified the association between dementia mortality and hospital characteristics in the oldest-old population., Results: The oldest-old population was mostly comprised of Whites (81.1%) and women (76.0%), had shorter length of hospital stay (6.12 days), and lower hospital charges (US$18,770.32) than the young-old, despite the higher in-hospital mortality. Crude in-hospital mortality was higher for White males in the young-old population, followed by Hispanics and African Americans. However, Hispanic males had the highest mortality, followed by Whites then African Americans in the oldest-old group. After adjusting for different variables, these relationships did not change., Discussion: There should be a greater focus on potential pre-existing biases regarding hospital care in the elderly, especially the oldest-old and elderly minority groups., (© The Author(s) 2015.)