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Byline: Hui-Chuan Hsu (1) Keywords: Life satisfaction; Economic status; Hierarchical linear models; Trajectory; Successful aging Abstract: The aim of the study was to explore the relationship between subjective economic status and indicators of successful aging to life satisfaction trajectories among the elderly in Taiwan. Data were from the four waves of 'Survey of Health and Living Status of the Elderly in Taiwan'. Hierarchical linear modeling was conducted. Subjective economic status was measured by childhood economic status and time-varying economic satisfaction. Time-varying physical, mental, and social successful aging variables and demographics were also used to describe the trajectory of life satisfaction. Life satisfaction showed a slightly decreasing but generally stationary trend across time. The concurrent economic satisfaction was associated with life satisfaction trajectory, but childhood economic status was not significant. The time-varying depressive symptoms, cognitive function and social support were related to the life satisfaction trajectory. Policy on the elderly should take particular account of the economic security, mental health, and social support of the elderly. Author Affiliation: (1) Department of Health Care Administration, Asia University, Taichung, Taiwan, ROC Article History: Registration Date: 01/03/2010 Accepted Date: 01/03/2010 Online Date: 12/03/2010

This paper explores the embodied dimensions of computer and internet use in later life, and examines how technology use relates to constructions and experiences of the ageing body. It is argued that previous research on technology use and embodiment has neglected older bodies, in contrast to research on gender and disability. Furthermore, while earlier theorisations presented internet use as disembodied, it is argued that the experience of using such technologies is grounded in our embodiment. In the light of these limitations and arguments for more complete theories of the body, this paper explores how technology use relates to various aspects of embodiment. These issues are examined in the light of data from qualitative interviews and time-use diaries completed by retirees in 17 households in the United Kingdom. By examining the 'technobiographies' of these older computer users, it is shown that changes in body techniques are prompted and in some cases required by broader cultural and technological change. The findings evince the process of acquiring computing skills as an embodied competency, and as a form of 'practical knowledge' that can only be 'learned by doing'. These experiences of technology use were embedded within constructions and experiences of ageing bodies. Although the participants drew on discourses of ageing in complex ways, their coding of computer technologies in terms of the competences of youth often reproduced hierarchies between young and old bodies. KEY WORDS--embodiment, computers, internet, older adults, lifecourse, biographies. doi: 10.1017/S0144686X10000164

The portrayal of older characters in television commercials has over time become more varied and positive. This study examines how different portrayals of older characters relate to self-stereotyping, a process through which older individuals apply their beliefs about older people in general to themselves and behave accordingly. The study thereby seeks to connect, as few have previously done, cultural studies and critiques of media portrayals with psychological studies of the effects of self-stereotyping. Sixty participants aged 65-75 years were primed with television commercials that portrayed older characters in different ways: 'warm and incompetent', 'warm and competent', and 'cold and competent'. It was hypothesised that priming with warm/incompetent portrayals would have a negative effect on memory performance because such representations match the dominant stereotype, and that the effect would occur only among older people who identify with their own age group. It was found that the participants who identified with their own age group did indeed show impaired memory performance after priming with warm/incompetent portrayals, but also that the same effect was found after priming with warm/competent portrayals. The findings are discussed in terms of resistance against stereotyping by older individuals themselves as well as by media producers. KEY WORDS--television commercials, self-stereotyping, memory performance, age identity. doi: 10.1017/S0144686X10000152

This paper explores determinants of aging well in 1,502 randomly selected Chinese elders in China. In Chinese traditional culture, elders assume a socially integrated and productive social role within the family. This role parallels the active engagement domain of the Rowe and Kahn model of successful aging. However, in their model, health and physical functioning are prominent with less emphasis on psychosocial aspects such as culture. This study tests the strength of the relationship between two variables representative of Chinese aging traditions, productive activity and family relations, and the outcomes of self-rated health and depression. Two hierarchical regression models were tested. Step one entered age, gender, married, financial adequacy, live alone, and reading ability. Step two added the active engagement variables of productive activity and family relations. Each model was significant at both steps with an inverse association for depression ([R.sup.2] = 19.2%) and a positive association for self-rated health ([R.sup.2] = 9.9%). KEYWORDS Chinese, successful aging, active engagement, depression, health DOI: 10.1080/15313200903310742

Byline: Thomas Hansen (1), Britt Slagsvold (1), Torbjorn Moum (2) Keywords: Psychological well-being; Parental status; Childlessness; Norway; Cognitive; Affective; Moderating effects Abstract: The study explores and distinguishes links between parental status (childless persons, parents with residential children, and empty nest parents) and a range of psychological well-being outcomes in midlife and old age. Data are from the first wave of the Norwegian Life Course, Ageing and Generation (NorLAG) study (n = 5,189). We separate outcomes into cognitive (life satisfaction and self-esteem) and affective (positive and negative affect, depression, loneliness) components. Parental status has a net effect on cognitive well-being among women, as childless women report significantly lower life satisfaction and self-esteem than both mothers with residential children and empty nest mothers. However, motherhood is inconsequential for affective well-being. Among men, parental status is unrelated to any of the well-being aspects. Parental status effects are not modified by age, marital status, and education. The results demonstrate the importance of investigating the effect of parental status and other objective circumstances on a range of psychological well-being outcomes. Furthermore, the results reviewed and presented indicate somewhat more positive effects of parenthood in the Nordic countries than in the US, highlighting the role of social policies in shaping the impact of parental status on well-being. Author Affiliation: (1) Norwegian Social Research (NOVA), Pb. 3223 Elisenberg, 0208, Oslo, Norway (2) Department of Behavioral Sciences in Medicine, Medical Faculty, University of Oslo, P.O. Box 1111, Blindern, 0317, Oslo, Norway Article History: Registration Date: 22/12/2008 Received Date: 20/10/2008 Accepted Date: 22/12/2008 Online Date: 07/01/2009

This article examined the differences between rural/urban older adults in their trajectories of activities of daily living (ADL) over a 4-year period. The sample included 2,490 community dwelling older adults who completed three waves (1998, 2000, and 2002) of the Chinese Longitudinal Healthy Longevity Survey. Among them, 63.5% were from rural areas. Hierarchical linear modeling (HLM) was run for the whole sample and separately for rural and urban samples. For both rural and urban samples, older age and involvement in fewer activities predicted increases in ADL difficulties over time. In addition, being female and routinely smoking predicted increases in ADL difficulties for the rural sample. Implications for interventions to slow down ADL decline were discussed. doi: 10.2190/AG.69.3.b

This paper reviews the position of old age in the societies of post-Roman Europe, from the fifth to the 10th centuries. Drawing on both primary and secondary literary and material sources of the period, I suggest that living beyond the age of 60 years was an uncommon experience throughout the early Middle Ages. Not only was achieving old age a minority experience, it seems to have been particularly concentrated among the senior clergy. This, together with the growing importance of the Christian Church as the institution that stabilised post-Roman society, the decline of urban living and its attendant culture of leisure and literacy, and the transformation of kinship into a symbolic 'family under God' contributed to a more favourable status for old age, or at least one that was particularly favourable for older men. This was based not so much upon the accumulation with age of wealth and privilege, but upon the moral worth of old age as a stage of life. The early Middle Ages, the so-called 'Dark Ages', was in this respect a relatively distinctive period in the history of old age. With all around instability and the future uncertain and often threatening, survival into old age was a rare but frequently revered attainment. KEY WORDS- old age, early Middle Ages, Christian Church, life expectancy.

We explored the effect of age on executive functions by using script-sequencing and script-sorting tasks. Older participants (n = 39), relative to young subjects (n = 40), committed more errors in script sequencing. However, there was no difference in performance between elderly and young subjects in excluding irrelevant items. These results suggest that aging generates impairment in the ability to produce temporally coherent sequences without deficit in the ability to eliminate distractors in the action domain. We proposed that the sequencing difficulties in elderly participants could be due to working-memory and shifting deficits mediated by changes in the dorsolateral prefrontal cortex.

This paper assesses the impact of disturbing life events over five years on the wellbeing of 340 people aged 80-84 years at baseline, by analysing data from a longitudinal survey in Switzerland. The guiding proposition was that the negative effect of life events is moderated by the event domain, i.e. health, deaths and changes in family setting and relationships, and by cognitive adaptation to one's own health state (adopting a more or less optimistic view). Multi-level regression that controlled for the effect of socio-demographic and health factors was used. Corroborating the first hypothesis, a model that differentiated the event categories, instead of their additive inclusion, gave the best fit. In support of the second hypothesis, it was shown that the positive impact of self-rated health reduced the negative effect of life events on wellbeing for survivors, but not for those who died within five years. This suggests that the former made more optimistic appraisals of their mental and physical health, while the latter adjusted their subjective health rating to their functional abilities. Survivors had better psychological resources for coping with disturbing life events, while the deceased lacked these resources, which buffered the impact of negative events. The psychological meaning of stressful events at the end of life is discussed. By encouraging optimistic self-evaluations of health, and raising awareness of the range of normal functioning of older people, health- and social-care practitioners can promote the maintenance of meaningful lives in old age. KEY WORDS--life events, wellbeing, old age, mortality, multi-level analysis.

The present research examined self-reported rehearsal processes in naturalistic time-based prospective memory tasks (Study 1 and 2) and compared them with the processes in event-based tasks (Study 3). Participants had to remember to phone the experimenter either at a prearranged time (a time-based task) or after receiving a certain text message (an event-based task) and record the details of occasions when they thought about this intention during a 7-day delay interval. The rehearsal and retrieval of time-based tasks was mediated by more automatic than deliberate self-initiated processes. Moreover, the number of reported rehearsals without any apparent triggers was reliably higher in time- than in event-based tasks. Additional findings concern the effects of age, motivation, and ongoing activities on rehearsal and prospective memory performance. Keywords: time-based prospective memory, self-initiated vs. automatic retrieval, incidental cues, prospective memory and aging, time estimation

An understanding of patients' perspectives is crucial to improving engagement with health care services. For older people who may not wish to bother medical professionals with problems of living such as depression, such exploration becomes critical. General practitioners (GPs), nurses and counsellors working in 18 South London primary care teams were interviewed about their perceptions of depression in older people. All three professional groups shared a predominantly psychosocial model of the causes of depression. While presentation of somatic symptoms was seen as common in all age groups, identification of depression in older patients was complicated by co-existent physical illnesses. GPs reported that older patients rarely mentioned psychological difficulties, but practice nurses felt that older people were less inhibited in talking to them about 'non-medical' problems. Many older people were perceived to regard symptoms of depression as a normal consequence of ageing and not to think it appropriate to mention non-physical problems in a medical consultation. Men were thought to be particularly reluctant to disclose emotional distress and were more vulnerable to severe depression and suicide. Some GPs had mixed feelings about offering medication to address what they believed to be the consequences of loneliness and social isolation. Participants thought that many older people regard depression as a 'sign of weakness' and the perceived stigma of mental illness was widely recognised as a barrier to seeking help. Cultural variations in illness beliefs, especially the attribution of symptoms, were thought to profoundly influence the help-seeking behaviour of elders from minority ethnic groups. Families were identified as the main source of both support and distress; and as such their influence could be crucial to the identification and treatment of depression in older people. Keywords: Old age; Depression; Primary care; UK

This study examined the relationship between hope as disposition, adaptation to old age, and individual-demographic factors. One hundred and fifty older adults, aged 60-93 years old, completed the Adult Dispositional Hope Scale developed by Snyder et al. [1991, Journal of Personality and Social Psychology, 60, pp. 570-585], and the Adaptation to Old Age Questionnaire developed by Efklides et al. [2003, European Psychologist, 8, pp. 178-191]. Factor analyses revealed 2 factors for hope, 'Pathways Thought' and 'Agency Thinking', and 4 factors for adaptation to old age, 'Health Comparison', 'General Adaptation/Self-Efficacy', 'Self-Control', and 'Generativity'. Regression analyses showed that hope as pathways thought predicted all factors of adaptation, whereas hope as agency thinking predicted only 'General Adaptation/Self-Efficacy' and 'Self-Control'. There were also some effects of gender, education, marital status, place of residence, and health status on specific aspects of adaptation to old age. KEY WORDS: adaptation to old age, hope, individual differences

Background. Many studies that show improved health in older adults have relied on subjective measures of health. This article assesses changes in the physiological status of older Americans during the 1990s using biological measures of high-risk for morbidity and mortality. Methods. Changes in the prevalence of clinically-defined, high risk for 10 biological markers were assessed in respondents age 65 years and older from National Health and Nutrition Examination Surveys (NHANES) III (1988-1994) and IV (1999-2000). Results. Some changes in prevalence of high-risk values of biological markers indicate improved health among older adults in the 1990s: a 6% reduction in the prevalence of high-risk total cholesterol (p < .001) and a 7% reduction in the prevalence of high-risk homocysteine (p < .001). Other changes indicate worsening health: a 9% increase in the prevalence of high-risk systolic blood pressure (p < .01), a 10% increase in obesity (p < .001), and an 8 % increase in the prevalence of high-risk C-reactive protein (p < .001). These changes remained significant after adjusting for age, sex, and education. Results of logistic regressions indicate that changes in the frequency of medication usage, medication efficacy, prevalence of chronic disease, and diet explained some of these changes. Conclusions. Changes in the prevalence of high-risk values of biological markers in the 1990s are mixed. Greater use and effectiveness of lipid-lowering medication has contributed to the reduction in percentage of the population with high-risk lipid levels, and folate supplementation accounted for a decline in the percentage with high-risk homocysteine. However, increases in the percentage with high-risk systolic blood pressure occurred despite an increase in the use of antihypertensive medications, in part because of the limited ability of antihypertensive medications to bring blood pressure below high-risk levels.

This paper discusses some important dimensions of faith and of the social contexts surrounding faith that are illustrative of continuity and growth in spirituality in the lives of older adults. Examples of an evolving spirituality emerge in the analysis of a recent qualitative research study that probed the nature of religious experience among thirty-one community-dwelling elders and fifteen elders residing in long-term care facilities. Face-to-face interviews with these forty-six older adults and with seven people who directed or assisted with formal and informal programs of faith comprise the empirical base for this paper. The seven people, I refer to them mnemonically as faithreps, worked in various ways in the long-term care settings to provide programs involving faith to older adults. The faithreps came from a range of educational and religious backgrounds and are not accurately or handily categorized. An evolving spirituality is shaped by the older person's links to the structural and the socio-relational contexts that have been created through interaction in the past as well as through interaction in the present. Moreover, the interaction of older adults and faithreps encourages spiritual growth because as social actors engaged with one another over a sustained period of time ill an institutional setting, questions and dialogue about life and its meaning are regularly evoked. The social interactions that foster spiritual evolution may be all admixture of the secular and the sacred. Such socio-relational contexts were once part of the naturalistic settings of daily life among the old, but now must emerge through the efforts and planning of others. The salience of faith among present cohorts of older adults sensitizes us to the necessity of devoting more consideration to optimal ways of strengthening and building contexts that are conducive to the evolution of spirituality. KEYWORDS. Religion in late life, religion and spirituality in old age, identity in late life, religion and identity among older adults, the social value of faith, religion in everyday life of tile old

The results of studies conducted in the last 5 years in Poland formed the basis for the assumption that amongst many needs an individual or a Polish household seeks to satisfy, the need to provide for security in old age takes a prominent position. Determining the position of this need among other needs as defined in Schrab's classification (Schrab, 1943), was the objective of an empirical study conducted at the end of 2001. The results of the study indicate that within the Polish population, clusters of Poles with the highest frequency were those in which the need to provide for security in old age is ranked in first position in a declared hierarchy of needs. Those clusters pertaining to relatively worse economic situations are, however, positively motivated as it appears they are characterised by an apparent achievement drive. A lower ranking for the need to provide for security in old age correlates to a relatively better economic situation and an increasingly passive attitude reflected by the lack of an achievement drive, which can be a result of either mental inhibitions or of lifetime achievements so far, because the individuals in the cluster displaying a marginal position for the need to provide for security in old age were of a relatively older age compared to the remainder. KEY WORDS: positional concerns, preferences, relative standing, social comparison

This study examines the effect of characteristics of the caregiving network on the likelihood of using supportive services by dependent older persons. Logistic regression analysis was conducted with a probability sample of community-dwelling elders cared for by their wives or daughters (n = 209). Results indicate that the specific composition of the caregiving networks, including the identity of the primary caregiver (wives vs. daughters), the availability and identity (kin or friends) of secondary helpers determines the likelihood of service use. The findings suggest that elders cared for by their wives alone may be quite isolated and should be the priority for community outreach services. [Article copies available for a fee from The Haworth Document Deliver. Service: 1-800-HAWORTH. E-mail address: Website: [c]2004 by The Haworth Press, Inc. All rights reserved.] KEYWORDS. Service utilization, formal support, caregiving, caregiver relationships, wife caregivers, daughter caregivers, secondary helpers, informal support, informal networks, home and community-based services

The goal of this study was to reduce the inhibitory deficit on the elderly by creating 'optimizing conditions' in a categorization task. It was hypothesized that increasing the number of relevant pieces of information would reduce the difficulty associated with processing irrelevant information on a categorization task, since the number of relevant solutions to solve the problem would increase, while the total number of pieces of information to be processed would remain the same. This hypothesis was tested on 27 young adults and 30 elderly people using a task requiring the matching of a stimulus figure to one of the two response figures having one or more attributes in common with the stimulus. In line with previous findings, the results indicated an age-related inhibitory decline. However, consistent with the hypothesis, as the number of relevant attributes increased, the performance of elderly people improved and response times decreased, supporting the notion of latent cognitive resources.

Objectives. We evaluated self-perceived access to health care in a cohort of Medicare beneficiaries. Methods. We identified patterns of use and barriers to health care from self-administered questionnaires collected during the 1993-1994 annual examination of the Cardiovascular Health Study. Results. The questionnaires were completed by 4889 (91.1%) participants, with a mean age of 76.0 years. The most common barriers to seeing a physician were the doctor's lack of responsiveness to patient concerns, medical bills, transportation, and street safety. Low income, no supplemental insurance, older age, and female gender were independently related to perceptions of barriers. Race was not significant after adjustment for other factors. Conclusions. Psychological and physical barriers affect access to care among the elderly; these may be influenced by poverty more than by race.

Objectives. We sought to identify predictors of beginning and ending caregiving. Methods. At baseline and 3-year follow-up, we interviewed 4245 community residents (61.4% Black, 38.4% White, 0.20% other) aged 65 years or older. We used logistic regression to test predictors of beginning caregiving among baseline noncaregivers and of continuing caregiving among baseline caregivers. Results. After control for demographic variables, physically healthier individuals were significantly more likely to become caregivers and to continue caregiving. Mental health had little influence on beginning caregiving, but declining mental heath was associated with continuing caregiving. Conclusions. Maintenance of physical health and function is essential to the ability of older adults to begin and to continue caregiving. Studies that compare the health of current caregivers with that of noncaregivers may substantially underestimate the impact of caregiving on health.

Objectives. We sought to determine the association of depression and anxiety with 'area deprivation' (neighborhood socioeconomic deprivation) and population density among people older than 75 years in Britain. Methods. Postal codes were used to link census area information to individual data on depression and anxiety in 13349 people aged 75 years and older taking part in a trial of health screening. Results. Living in the most socioeconomically deprived areas was associated with depression (OR = 1.4), but this relation disappeared after adjusting for individual deprivation characteristics. There was no association with anxiety. Living in the highest density and intermediate low-density areas was associated with depression (OR = 1.6 and 1.5) and anxiety (OR = 1.5 and 1.3) compared with the lowest density areas. Conclusions. An association between area deprivation and depression in older people was explained by individual health, demographic, and socioeconomic factors. Higher population density was consistently associated with increased depression and anxiety.

Objectives. We used 1997 Medicare data to replicate an earlier study that used data from 1986 to examine racial differences in usage of specific medical procedures or tests among elderly persons. Methods. We used 1997 physician claims data to obtain a random sample of 5% of Medicare beneficiaries aged 65 years and older. We used this sample to study 30 procedures and tests that were analyzed in the 1986 study, as well as several new procedures that became more widely used in the early 1990s. Results. Racial differences remain in the rates of use of these procedures; in general, Blacks have lower rates of use than do Whites. Between 1986 and 1997, the ratio of White to Black use moved in favor of Blacks for all but 4 of the established procedures studied. Conclusions. The White-Black gap in health care use under Medicare is narrowing.

This study challenges the conventional wisdom that elderly, child, and overall poverty are divergent. Comparing the official U.S. measure with the Luxembourg Income Study's (LIS) measure, the author shows that the official measure underestimates elderly poverty by a significant amount and child poverty by a lesser amount. Both the elderly and children are much more likely to be poor than the overall population. Analyses of 18 rich Western democracies show that overall and child poverty are very strongly positively correlated, whereas elderly poverty is moderately correlated with those two. Multivariate analyses show some commonalities and some differences in the sources of these three. Two measures of the welfare state significantly reduce overall, elderly, and child poverty. Whereas female labor force participation reduces all three, manufacturing employment, economic performance, and demographic variables only influence one or two of the dependent variables. Keywords: poverty; elderly; children; welfare state

Four hundred young-, middle-, and old-old adults responded to a battery of quizzes dealing with life satisfaction and objective aging knowledge in the physical, psychological, and social domains. Analyses incorporated domains of aging knowledge, life satisfaction, age, gender, and demographic variables. Both means difference and regression analyses were computed. Significant age group, gender, and life satisfaction differences were found for the three aging knowledge domains. For successive age groups, knowledge of aging decreased, with females knowing less than males. The greater knowledge of aging, the higher the life satisfaction. The demographic variables education, financial status, health, living arrangement, and volunteerism were significant covariates for knowledge of aging. Results from this study indicate that knowledge of aging in specific domains varies among older adult age groups and is associated with life satisfaction.'

The purpose of this study was (a) to assess the intensity and energy cost of a single-set resistance training (RT) protocol as recommended by the recent American College of Sports Medicine (ACSM) guidelines for older adults and (b) to compare obtained values to those recently reported as eliciting health benefits via endurance-based physical activity (PA). Five males and 5 females (73.1 [+ or -] 5.5 years) performed 1 set of 15 repetitions of 8 RT exercises while connected to a portable metabolic unit (CosMed K4[b.sup.2]). The RT intensity (metabolic equivalents [METs]) was 3.3 [+ or -] 0.7 (males) and 3.0 [+ or -] 0.6 (females). Energy cost (kcal) was 84.2 [+ or -] 14.6 (males) and 69.7 [+ or -] 17.4 (females). We conclude that a single-set 8-exercise RT protocol may be a feasible alternative for achieving moderate intensity (3-6 METs) for older adults but that additional sets and/or repetitions appear to be necessary to accumulate moderate amounts (150-200 kcal) of PA. KEY WORDS. strength, aging, physical activity, energy expenditure

Background. Parkinsonian signs in patients without Parkinson's disease are often undetected but occur frequently in older people, and are often considered benign. We measured the association between parkinsonism and subsequent disability. Methods. We conducted a prospective, longitudinal, community-based population study in East Boston, Massachusetts, using a stratified random sample of 455 community residents, aged 65 years and older. Four categories of parkinsonian signs were measured at baseline: bradykinesia, gait disturbance, rigidity, and tremor. Parkinsonism was defined as the presence of two or more categories of parkinsonian signs, and cases of Parkinson's disease were excluded from analyses. Disability was assessed annually over a mean of 4.7 years using the Katz. Rosow-Breslau, and Nagi disability measures. Results. Parkinsonism at baseline strongly predicted subsequent disability as assessed with the three disability measures (on the Katz measure, [beta] = -1.30, p < .001). On average, a person with parkinsonism had a disability level at follow-up equal to that of a comparable person approximately 16.7 years for men and 8 years for women. The rate of developing disability for persons with parkinsonism increased each year; on the Katz measure, participants with parkinsonism declined on average 16.4% faster than those without. Gait impairment and bradykinesia strongly predicted subsequent disability; tremor and rigidity did not. The effect of parkinsonism was attenuated but still persistent in persons with coexistent moderate-to-severe cognitive impairment or stroke. Conclusions, Parkinsonism strongly predicts progressive disability in the older community population and has a marked aging effect on disability level.

Background. Disability in basic activities of daily living (ADLs) implies a loss of independence and increases the risk for hospitalization, nursing home admission, and death. Little is known about ways by which ADL disability can be prevented or reversed. The authors evaluated the efficacy of the Health Enhancement Program in preventing and reducing ADL disability in community-dwelling older adults. Methods. The authors analyzed data from a 12-month, randomized, single-blinded, controlled trial of a disability prevention, chronic disease self-management program involving 201 adults aged 70 years and older that was conducted from February 1995 to June 1996 at a senior center in western Washington state. Activities of daily living disability incidence, improvement, and worsening were assessed using intention-to-treat methods. Results. The cumulative incidence of ADL disability among those who were not ADL disabled at baseline (n = 56 in the intervention group, n = 57 in the control group) was modestly lower in the intervention group than in the control group at 12 months (14.3% vs 21.3 %, p = .466). Cumulative improvement in ADL function among those who reported any ADL disability at baseline (n = 41 in the intervention group, n = 43 in the control group) was greater in the intervention group at 12 months (80.5% vs 46.5%, p = .026). The likelihood for ADL improvement was greater in the intervention group compared with controls at 12 months (adjusted hazard ratio, 1.84; 95% confidence interval, 1.05 to 3.22; p = .020). Cumulative worsening of ADL function was slightly lower in the intervention group at 12 months (18.6% vs 26.5%, p = .237). Intervention participants tended to be at lower risk for ADL worsening (adjusted hazard ratio, 0.71; 95% confidence interval, 0.38 to 1.30; p = .266) compared with control participants. Conclusion. The Health Enhancement Program intervention led to improved ADL functioning in those who were disabled initially and thereby offers a promising strategy for limiting or reversing functional decline in disabled elderly persons.

Background. It remains unclear to what extent the associations between low serum beta-carotene concentration and increased risk for cardiovascular disease and cancers are attributable to inflammation. The objective of this study was to evaluate simultaneously the effects of serum beta-carotene concentration and inflammation on the subsequent all-cause mortality risk in high-functioning older persons. Methods. The authors conducted a prospective cohort study using information from 672 participants from the MacArthur Studies of Successful Aging. Baseline information was obtained for serum concentrations of beta-carotene, C-reactive protein, interleukin-6, cholesterols, and albumin; body mass index; waist:hip ratio; prevalent medical conditions; health behaviors; and medications. Sex-specific univariate and multivariate logistic regression analyses were used to study the effects of low beta-carotene, high inflammation burden or both on 7-year all-cause mortality rates while adjusting for other confounders. Results. The serum beta-carotene concentration was inversely associated with C reactive protein and interleukin-6 levels. After adjustment for inflammation markers and other covariates, the relative risks for low beta-carotene for the 7-year all-cause mortality risk were 2.30 (95% confidence interval [CI], 1.23 to 4.31) in men and 0.85 (95% CI, 0.42 to 1.75) in women. Compared with men with high beta-carotene levels and low inflammation, the multiply adjusted relative risk for low beta-carotene and high inflammation burden was 3.78 (95% CI, 1.69 to 8.47) in men. Conclusions. Low levels of serum beta-carotene are independently associated with an increased all-cause mortality risk in older men, even after adjustment for the effects of inflammation and other risk factors. In men, but not women, a synergistic effect occurs between low beta-carotene concentration and high inflammation burden in predicting higher mortality rates.

Cerebral white matter lesions (WMLs), also called 'leukoaraiosis,' are common neuroradiological findings in elderly people. WMLs are often located at periventricular and subcortical areas and manifest as hyperintensities in magnetic resonance imaging. Recent studies suggest that cardiovascular risk factors are associated with the development of WMLs. These lesions are associated with different geriatric syndromes such as falls, executive cognitive impairment, depressive symptoms, and urinary incontinence. Damage to associative pathways in frontal and subcortical regions due to hypoperfusion may disrupt frontal executive, motor control, and other systems, resulting in these manifestations. WMLs are associated with substantial disability and should not be considered a benign and silent condition as once believed. Interventions addressing cardiovascular risk factors should be undertaken in early or mid-life in order to prevent late-life functional impairment associated with WMLs. After these lesions develop and impair executive cognitive functions, the patient's ability to comply with a complex risk reduction program may be significantly compromised.

Lean soft tissue (LST) measured by dual-energy X-ray absorptiometry (DEXA) is used as a metabolic measure in aging research despite evidence of extracellular fluid expansion and a corresponding reduction in body cell mass (BCM) in older participants. We investigated the hypothesis that the fraction of LST as BCM is smaller with greater age. Men and women (n = 2043) had DEXA and [sup.40]K-counting for body potassium and BCM measured on the same day. Both BCM and LST were lower with greater age but the relative lowering was larger for BCM. A multiple linear regression model was fitted with BCM/LST as the dependent variable, and age, sex, and interaction terms as independent variables. Men had a mean BCM/LST greater (p < .001) than women; quadratic and cubic age terms were also significant or approached significance. Thus, the fraction of LST as BCM is smaller in older adults, a finding that has implications for the interpretation of DEXA results.

Critics have charged that American advertisers have often portrayed the elderly with negative stereotypes. These negative portrayals, they suggest, not only offend elderly consumers but also contribute to ageism. This study examined whether American advertisers have indeed used a great deal of negative stereotyping of the elderly, as the critics have suggested. Employing a concept of stereotypes found in cognitive psychology, the authors examined trends in the portrayal of the elderly in television commercials produced in the United States from the 1950s through the 1990s. Results of the study do not support the contentions of the critics. Very little negative stereotyping was discovered. Analysis indicated trends in the appearance of several positive stereotypes, and differences in the stereotyping of gender groups and age segments within the elderly group. Results are interpreted from both marketing and social science perspectives.

This article focuses on help received by a nationally-representative sample of 2,376 Mexican men age 60+ in 1994. In the month before the interview, about one-half of the men received in-kind or domestic assistance, two-fifths received financial assistance, and about one-fourth received physical assistance. This was so even as almost half the men still worked, and over half (57%) had no discernable functional limitation. Using logistic regression, the study found support for the common assumption that living arrangements are an important predictor of assistance. Other factors are important too however. In fact, many elders received help from non-coresiding relatives. Beside financial remittances, help from non-coresiding relatives included in-kind, domestic, and physical assistance. Research on Mexico suggests that we need to revisit notions of a modified extended family in which non-coresidential ties can be important. Surveys need questions about frequency of contact and geographic distance between elderly people and their kin.

Positive affect, an index of psychological well-being, is a known predictor of functionality and health in later life. Measures typically studied include joy, happiness, and subjective well-being, but less often interest--a positive emotion with functional properties that differ from joy or happiness. Following differential emotions theory, the present study measured trait joy and interest in a population-based sample of 1,118 adults aged 65-86 years. As predicted, trait joy was associated with greater religious participation, while trait interest was associated with greater education. Joy was associated with lower morbidity and stress while interest was not. Interest was, in fact, associated with greater stress. Both emotions were positively associated with social support. We use the pattern of predictors to develop a functionalist conceptualization of these two emotions in later life, concluding that it is worthwhile to treat interest and joy as partially-independent positive affects contributing differentially to human emotionality and later life adaptation.

This comparative study (i.e., three age groups, three measures) explores the distribution of retrospective and prospective autobiographical memory data across the lifespan, in particular the bump pattern of disproportionally higher recall of memories from the ages 10 to 30, as generally observed in older age groups, in conjunction with the well-known recency effect. The memory data patterns of the Life-line Interview Method (LIM, the measure of this study, were compared to the published data patterns of two other memory measures (i.e., the Time Line and Life event sorting task). The results of this comparative study confirm the universality of the bump for older adults, as well as the recency effect. From the LIM data patterns it is hypothesized that both bump and recency effects play a part not only in middle-aged and older adults but also in younger people. In search for an explanation of these patterns, a theoretical outline is presented for the study of autobiographical memory as a dynamic system of both retrospective and prospective memory, subject to continuous changes across the lifespan.

To assess Erikson's life cycle model, 86 men, initially selected for health, were prospectively studied at age 21, and reassessed 32 years later at age 53. Using the Vaillant and Milofsky (1980) modification of Erikson's model, 48 men (56%) achieved generativity, an advanced developmental stage, at follow-up. Results generally support Erikson's model and show that generativity was significantly associated with successful marriage, work achievements, close friendships, altruistic behaviors, and overall mental health. Successful young adult predictors of Erikson's model at midlife included a warm family environment, an absence of troubled parental discipline, a mentor relationship, and, most importantly, favorable peer group relationships. Significant predictors of Erikson's model were of moderate effect size and involve young adult social relationships rather than physical symptoms or parental social class standing.

The paper discusses, by making use of past experiences in the area, the main issues and the methodology of developing a health status instrument for a developing country from a well-established instrument. The use of Thurstone's model of paired comparisons in evaluating the relative importance of health symptoms has been reviewed and some alternative models, i.e., Linear, Exponential, and Information, are proposed. By applying the models to the health data of Chinese elderly persons, the three models have been demonstrated to be able to produce some valid and responsive health scores. KEY WORDS: health index, paired comparison, scaling method

This study examines the mediating role of psychological resources on life satisfaction, an indicator of subjective wellbeing. The evidence identifies several life events and changing circumstances that can be potentially detrimental to the wellbeing of older adults. Based on the literature, a theoretical model was developed with the hypothesis that adaptation to potentially adverse events draws on psychological resources central to the self. The study participants were a random sample of 423 community-dwelling people aged 70 years and over. All respondents were interviewed in their own homes using a structured schedule. Quantitative data were obtained on age, gender, social support, marital status, physical functioning, bodily pain, loneliness, isolation and housing difficulties. Subjective well-being was assessed by the life satisfaction index, and the psychological mediator was conceptualised as a measure of environmental mastery. The first round of analyses found that variations in well-being were associated with housing difficulties, isolation, loneliness, physical functioning, pain, support networks and marital status. The full model established perfect mediation by environmental mastery occurred for the variables housing problems and physical functioning, and partial mediation occurred for the variable loneliness--supporting the original hypothesis. The results add to the evidence from an increasing number of studies that demonstrates how psychological resources underlie the processes of adaptation to the changing situations that accompany increasing age and prevent negative outcomes. KEY WORDS--subjective wellbeing, older people, psychological resources, environmental mastery, mediation.

Gerontologists have recognised the important influence of leisure activity on the mental and physical health of older adults. To date, however, there have been few studies of the patterns of participation in leisure activity among older adults in Hong Kong. This study examines a large representative sample of Hong Kong older adults and the associations between their socio-economic and health characteristics and their leisure activities. The data are from a cross-sectional survey of 2,180 respondents aged 60 or more years, conducted in 2000 by the Hong Kong Census and Statistics Department. There were full records for 2,144 respondents. Among the participation rates in the seven categories of leisure activities, watching television of listening to radio was the highest, while the lowest was for playing mahjong or cards. The characteristics that significantly correlated with the level of participation differed by the activity. Although no consistent pattern emerged, gender, education, employment status, receiving welfare benefits, self-rated health and functional impairment were the strongest correlates for most types of leisure activity. The paper is concluded by comparing the results with previous findings, and by discussing the service implications of the findings, the limitations of the study, and directions for future research. KEY WORDS-leisure activity, Chinese older adults, participation pattern, Hong Kong.

This paper presents, analyses and interprets expressions of the experience of advanced old age based upon the concepts of the French phenomenologist, Maurice Merleau-Ponty, and the German philosopher, Martin Heidegger. During 1990, 262 older residents of the city of Jyvaskyla in central Finland were interviewed. They were born in 1910 and aged 80 years at the time. In addition to collecting epidemiological data, the narrative stories on the ageing experience of a sub-sample of 20 respondents (10 men and 10 women) were tape-recorded. A five-year follow-up was carried out with the same cohort in I995, when 17 of the original sub-sample of 20 were still alive. Unlike five years previously, most of the narrators said they had now crossed the line into old age. At the ten-year follow-up in 2000, six women and four men were still alive to describe their experience at 90 years of age. Collective history and objective structures had provided a common foundation for my narrators' notions of the world of right and wrong and of good and bad. Over their lifetime, this socio-cultural background had gradually changed, and they perceived the changes. Moreover, in the earlier stages of the study, they voiced criticisms of these changes. At age 90 years, however, they no longer criticised society or its people. By this time, it seems they felt they had completed the mission of living a life. KEY WORDS--narrative, ageing, bodiliness, temporality, follow-up.

Younger and older participants were trained in a triple conjunction visual search task to examine age differences in the development of proficient performance. For the first 8 days, participants searched for a target defined by its contrast polarity, shape, and orientation. On Days 9 through 16, the target identity was switched to one defined by opposing feature values. On Day 17, the target was returned to the original feature values. Results indicated that, after training, younger adults reduced their display size effects more than elderly adults. Disruption occurred after the first but not after the second transfer. However, each time the target was switched, there were no age differences in disruption. Eye movement data suggest that older adults use a similar feature selection strategy as younger adults but may be more susceptible to distraction. The results are discussed in terms of current models of attention and search.

Few studies have attempted to examine the meaning of health congruence, particularly in the oldest old. Participants were drawn from a longitudinal study of the oldest old (N = 151; M = 90 years). Dichotomized objective health was cross classified with dichotomized subjective health, producing four health congruence groups: good health realists, poor health realists, optimists, and pessimists. Both good health realists and pessimists had good objective health, yet pessimists had the highest depression, lowest functional status, and frequent reports of hospitalization. By contrast, the poor health realists and optimist groups had poor objective health, but the optimists had better outcomes on depression. This suggests that discrepancies between objective and subjective health may have significant implications for health outcomes.

The study is to determine whether state driver's license renewal policies are associated with the fatality rate among elderly drivers. A longitudinal study conducted using recent data of all fatal crashes in the contiguous United Sates to provide a comprehensive examination of the relationship between licensure laws and safety among elderly divers is described.

Purpose: We examined age-cohort differences in the interrelationships among marital processes and depressed affect. Design and Methods: We used data from individuals in first marriages that participated in the National Survey of Families and Households (NSFH). The NSFH interviewed one adult per household of a nationally representative sample. Participants were categorized into young (n = 2,289), middle-aged (n = 1,145), and older adult (n = 691) age cohorts. Results: The three age cohorts did not differ on negative marital processes (NMP), but older adults scored significantly higher on marital satisfaction than young and middle-aged adults. Marital satisfaction mediated the link between NMP and depressed affect for young adults and older adults. NMP were more strongly related to depressed affect for young adults than middle-aged adults, whereas marital satisfaction was more strongly related to depressed affect for older adults than young adults. Implications: Our findings on age-cohort differences in the salience of marital processes to depressed affect are discussed in light of socioemotional selectivity theory. Key Words: Marital processes, Marital quality, Age differences, Depressed affect

As the average human lifespan increases, so does the recognition that advancing age is associated with changes in nutrient intake and requirements as a consequence of biological, social, and pathological factors. Studies show that whereas protein requirements may not differ significantly between younger and older adults, the adaptive mechanisms and responses to nutritional or pathological stressors may differ and alter the balance between requirement and toxicity of specific amino acids (AAs). As an individual gets older, cardiovascular disease and cancer become the leading causes of morbidity and mortality. Advancing age is also associated with changes in appetite, food intake, and physical activity, all of which can influence protein and AA metabolism. The sulfur amino acids (SAAs) methionine and cysteine recently attracted attention because of their pivotal roles in methyl group metabolism and maintenance of the cellular redox state. Methionine, an indispensable AA, is important for methylation reactions and as a precursor for cysteine, which is the rate-limiting AA for glutathione (GSH) synthesis. On one hand, high intake levels or blood concentrations of methionine are associated with adverse consequences such as hyperhomocysteinemia and endothelial dysfunction, which are risk factors for cardiovascular disease. On the other hand, methionine deficiency is reported to lower the threshold of chemical-induced toxicity and play a role in carcinogenesis. Therefore, it is evident that understanding the biological significance of the interrelationship between SAAs, GSH, and methyl group metabolism is key to determining optimal dietary intakes of SAAs in older individuals. KEYWORDS: * aging * sulfur amino acids * glutathione * methyl groups * methionine * cysteine

The performance of older adults and depressed people on linear order reasoning is hypothesized to be best explained by different theoretical models. Whereas depressed younger adults are found to be impaired in generative inference making, older adults are well capable of making such inferences but exhibit problems with working memory (Experiments 1 and 2). Restriction of the available study time impairs reasoning by nondepressed control participants and, as such, proves to be a good model of older adults' but not depressed participants' limitations (Experiment 3). These results are replicated comparing depressed and older participants with a control group in the same study, providing increased power and linking the results to additional control measures of processing speed and working memory (Experiment 4).