RESUMEN

Studies have shown how generativity, the concern for establishing and guiding the next generation and safeguarding its wellbeing, functions as an intergenerational conduit, bridging the developmental stages of older individuals with those younger. Yet, applications of generativity, as a means to bridge generational gaps within rapid social change, remain underexplored in the intergenerational field. Using Singapore as a case study, and through focus group discussions with 103 older persons, this paper examines how older Singaporeans express their generative concern and internalize their generative capacities across different social settings and rapid socioeconomic transformation. Mismatch between older Singaporeans' generative concern and capacity contributes to ambivalence - mixed feelings about guiding younger generations - which emerges out of older Singaporeans' struggles with cultural change prompted by economic progress, as well as concerns about their place and value in a technologically advanced global city-state. The concept of generative ambivalence can add value to policy perspectives on intergenerational cohesion, as it considers people's attempts to forge commonalities and mutual reciprocity despite differences (e.g. gender, age, race, skills), as well as highlights intergenerational complexities beyond superficial binaries. Policies aimed at bringing generations together must be intentional in creating opportunity structures that go beyond categorical differences, where multiple generations can thrive interdependently.

RESUMEN

Objectives: A short measure of quality of life in old age is essential. The present study examined the factor structure and validity of the 13-item WHOQOL-AGE among the oldest-old. Methods: Data came from 1,000 Chinese aged ≥85 years in Singapore. Exploratory and confirmatory factor analyzes were conducted on the WHOQOL-AGE. Regression examined the demographic, social and health correlates of the identified factors. Results: Factor analyzes suggested a bifactor model of the WHOQOL-AGE, which comprised three specific factors, namely "health," "environment" and "mastery," in addition to the general factor ("overall"). Partial scalar invariance (concerning only one item) and scalar invariance were established across gender and education level respectively, generally supporting the measurement invariance of this model. Regression results demonstrated known-groups validity. Health correlates were more predictive of "health" than "environment" and "mastery," with more basic and instrumental activities of daily living, lower depressive symptomatology and fewer falls positively relating to "health." Strength of social network and social engagement (social correlates) positively related to "environment" and "mastery" but not "health." Conclusion: The WHOQOL-AGE exhibits a bifactor structure and known-groups validity among the oldest-old Chinese in Singapore. It seems useful to capture different facets of quality of life in the concerned population.

Asunto(s)

RESUMEN

Background and Objectives: Studies on longitudinal trajectories of diet and the influence on aging in older adults are limited. We characterized diet quality trajectories over the past 2 decades among adults aged ≥85 years and examined their associations with cognitive and psychosocial outcomes. Research Design and Methods: We used data from 861 participants in the population-based Singapore Chinese Health Study. Dietary intakes were assessed at baseline (mean age [range]: 65 [60-74] years) and at follow-ups 3 (85 [81-95]) and 4 (88 [85-97]) years. Diet quality was measured by adherence to the Dietary Approaches to Stop Hypertension pattern, and group-based trajectory modeling was used to derive diet quality trajectories. At Follow-up 4, we assessed cognition using the Singapore-modified Mini-Mental State Examination, depressive symptoms using the 15-item Geriatric Depression Scale, social engagement, and self-rated health. Multivariable logistic regression models examined associations of diet quality trajectories with these outcomes. Results: About 49.7% had a trajectory with consistently low diet quality scores, whereas 50.3% had a trajectory with consistently high diet quality scores. Compared to the "consistently low" trajectory, the "consistently high" trajectory had 29% and 26% lower likelihoods of cognitive impairment and depressive symptoms, respectively (odds ratio, 95% confidence interval: 0.71 [0.51, 0.99] and 0.74 [0.55, 0.99], respectively); as well as 47% higher likelihood of social engagement (1.47 [1.09, 1.98]). No statistically significant association was observed between the trajectories and self-rated health. Discussion and Implications: Maintaining high diet quality throughout the older adult life course was associated with better cognitive and psychosocial well-being in adults aged ≥85 years.

RESUMEN

INTRODUCTION: Although successful aging (SA) studies have examined objective indicators such as disease and disability, physical and cognitive function, and social and productive engagement, as well as subjective indicators such as self-rated health, function, and well-being, the interplay among these indicators is rarely studied. We studied SA profiles that captured this interplay and evaluated the association of these profiles with mortality in the oldest-old. METHODS: Respondents were 1,000 Chinese Singaporeans aged ≥85 years during interview visits from 2017 to 2018. Latent class analysis examined 12 objective and subjective indicators to identify SA profiles. Multivariable Cox regression assessed the relationship between these profiles and all-cause mortality risk through 2020. RESULTS: Four distinct SA profiles were identified: "frail and dejected" (poor performance in nearly all objective and subjective indicators), "frail but resilient" (poor in objective but good in subjective indicators), "fairly fit and neutral" (good in about half of the indicators), and "fit and positive" (good in nearly all indicators). Compared with "frail and dejected," the adjusted hazard ratio (95% confidence interval) for mortality risk was 0.63 (0.40-0.97) in "frail but resilient," 0.56 (0.34-0.93) in "fairly fit and neutral," and 0.31 (0.19-0.49) in "fit and positive." DISCUSSION: SA in the oldest-old could take different profiles based on objective and subjective indicators, and these profiles have implications for mortality risk. Individuals with good subjective indicators have advantage in survival despite poor objective indicators.

Asunto(s)

RESUMEN

Mental ill-health prolongs and complicates other chronic illnesses, which is a major public health concern because of the potential stress it places on health systems. Prevention via active aging and place-based interventions thus became increasingly important with population aging, e.g., through health promotion and age-friendly neighborhoods. However, how the targeted outcomes of these efforts are related remains unclear. This paper examined whether the relationship between active living and mental health or health-related quality of life is mediated by neighborhood cohesion. Cross-sectional data were drawn from n = 270 community-dwelling adults aged 50 and above in the Gerontology Research Program-Center for Ageing Research in the Environment (GRP-CARE) Survey. Path analysis showed that one can live actively for better mental health (Btotal = 0.24), but it is largely mediated by neighborhood cohesion (37%). Further examination of the factors of neighborhood cohesion showed that this mediation is explained by communal affordance (Bindirect = 0.05) and neighborhood friendship (Bindirect = 0.05). Additional study of the association between these mediators and factors of mental health revealed two psychosocial processes: (1) better community spaces (e.g., greenery and third places) support communal living (B = 0.36) and help older adults obtain emotional support (B = 0.32) for greater autonomy (B = 0.25); (2) spending more time outdoors enhances neighborhood friendship (B = 0.33) and interpersonal skills (B = 0.37), which in turn improves coping (B = 0.39). In short, the effects of active living on health are limited by one's neighborhood environment. Neighborhood cohesion must be considered or it may stifle individual and policy efforts to age actively and healthily in urban environments. Context-sensitive implementations are required.

Asunto(s)

RESUMEN

Volunteering can be critical to late middle-aged adults' well-being. Hence, it is essential to understand the antecedents of volunteering in this age group. The present study of Singaporeans aged 50 to 59 (N = 1620) considered 18 volunteering acts and used latent class analysis (LCA) to identify volunteering profiles. The relationships between human, social, and cultural capital and the derived profiles were then examined with reference to resource theory. We observed three prevalent volunteering profiles: low (having a low tendency to engage in any volunteering acts), informal instrumental (primarily offering instrumental help in informal settings), and diverse (exhibiting instrumental and relational acts in formal and informal settings). Using low volunteering as the reference group, we found that informal instrumental volunteering was only predicted by the strength of social networks (social capital). In contrast, diverse volunteering was predicted by several factors including education level, work status, depressive symptoms (human capital), household size, the strength of social networks, attendance at community events (social capital), and religious affiliation (cultural capital). The LCA-derived volunteering profiles reveal population heterogeneity in terms of volunteering acts. The observed relationships between capital and volunteering profiles have implications for policies promoting volunteering in Singapore.

RESUMEN

The measures against the coronavirus disease (COVID-19) pandemic, such as lockdown, pose a major challenge to those who manage work and caregiving demands. Drawing on social cognitive theory, which emphasizes the critical role of self-referent thought and human agency in overcoming obstacles and striving toward goals, the present longitudinal study (prepandemic, during lockdown, and postlockdown) investigated work-family balance self-efficacy (WFBSE) and work-family balance (WFB) among working informal caregivers of older adults (i.e., those who manage paid work and informal eldercare) during the COVID-19 pandemic (N = 132). As hypothesized, prepandemic WFBSE was positively associated with the level of WFB during lockdown. Prepandemic WFBSE also mitigated the relationship between perceived work demands and WFB as well as the relationship between perceived difficulty to use technology for caregiving and WFB during lockdown. Prepandemic WFBSE, however, did not buffer the relationship between perceived caregiving demands and WFB and the relationship between perceived difficulty to use technology for work and WFB. We also observed that WFB during lockdown was associated with increased postlockdown WFBSE. Collectively, our research reiterates the relevance and utility of self-efficacy in the crisis context and provides empirical evidence for the proposition that positive changes may occur in the face of adversity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Asunto(s)

RESUMEN

OBJECTIVE: Network typology studies have identified heterogeneous types of older adults' social networks. However, little is known about stability and change in social network types over time. We investigate transitions in social network types among older adults, aged 60 years and older, and factors associated with such transitions. METHODS: We used data on 1,305 older adults, participating in 2 waves of a national, longitudinal survey, conducted in 2016-2017 and 2019, in Singapore. Latent transition analysis identified the distinct types of social networks and their transition patterns between the waves. Multinomial logistic regression examined the association of baseline and change in physical, functional, and mental health and baseline sociodemographic characteristics with network transitions into more diverse or less diverse types. RESULTS: We found 5 social network types at both waves, representing the most to the least diverse types - diverse, unmarried and diverse, extended family, immediate family, and restricted. Between waves, about 57% of respondents retained their social network type, whereas 24% transitioned into more diverse types and 19% into less diverse types. Those who were older and less educated and those with worsening functional and mental health were more likely to transition into less diverse types versus remaining in the same type. DISCUSSION: The findings capture the dynamics in social network composition among older adults in the contemporary aging society. We highlight sociodemographic and health disparities contributing to later life social network diversity.

Asunto(s)

RESUMEN

BACKGROUND: The importance of social network in mortality among older adults has been acknowledged. However, existing studies typically overlook the interplay among social network indicators, and seldom consider the change in social network over time. We take a person-centered approach to identify transitions between social network profiles, and examine the linkage of such transitions with subsequent mortality risk. METHODS: Data came from 2738 older Singaporeans enrolled in a longitudinal study. Latent transition analysis examined nine social network indicators assessed at two time points, two years apart to reveal the corresponding transitions between social network profiles. Adjusted Cox regression then associated the identified transitions with all-cause mortality risk in the subsequent four years. RESULTS: We observed three diverse social network profiles (that featured diversified social interaction and involved both household and non-household members) and three relatively restricted social network profiles (that focused on household or non-household members). Compared to sustained diverse profiles over time, sustained restricted profiles or a transition from diverse to restricted profiles entailed increased mortality risk. The mortality risk following a restricted-to-diverse profile transition could be as low as that associated with sustained diverse profiles. CONCLUSIONS: Dynamics of social network profiles have implications for mortality risk in later life. To promote longevity, initiatives are needed to help older people to maintain or shift to diverse social network profiles.

Asunto(s)

RESUMEN

BACKGROUND: Cerebrospinal fluid t-tau (CSF t-tau) is a measure of neurodegeneration in Alzheimer's disease (AD) and has been increasingly demonstrated to be a non-specific biomarker within the AD continuum. OBJECTIVE: We sought to test whether t-tau influences the longitudinal effects of amyloid-ß (Aß) and phospho-tau (p-tau) on memory and executive function (EF) in mild cognitive impairment (MCI). METHODS: 319 MCI individuals from the Alzheimer's Disease Neuroimaging Initiative (ADNI) with baseline and 2-year CSF Aß, p-tau, t-tau, and neuropsychological assessments were studied. Mediation and moderation analyses evaluated the role of t-tau in the effects of Aß and p-tau on memory and EF over 2 years. RESULTS: We found that high baseline p-tau but not Aß was associated with higher t-tau and lower memory scores at 2 years follow-up. The association between p-tau and memory impairment was partially mediated by t-tau, whereby higher p-tau was indirectly associated with lower memory via higher t-tau. t-tau also moderated the association between p-tau and memory. When t-tau level was relatively lower, higher p-tau was associated with lower memory scores at 2 years. When t-tau level was higher, the memory scores were low regardless of the p-tau level. CONCLUSION: Tau-induced neurodegeneration is one key pathway by which AD pathology (p-tau) affects memory impairment. Furthermore, in individuals with lower levels of tau-induced neurodegeneration, higher levels of p-tau were required for memory impairment. Our findings suggest that t-tau plays a significant role in how early AD pathology affects cognitive outcomes.

Asunto(s)

RESUMEN

BACKGROUND: The relation of changes in sleep duration with risk of cognitive impairment are inconclusive. This study evaluated the prospective relationships of changes in sleep duration with risk of cognitive impairment in Singapore Chinese. METHODS: We used data from 16,948 Chinese men and women who were aged 45-74 years at baseline (1993-1998) during recruitment into the Singapore Chinese Health Study cohort. Daily sleep duration was assessed at baseline, follow-up 2 (2006 to 2010) and follow-up 3 interviews (2014-2016). Cognitive function was evaluated with a Singapore-Modified Mini-Mental State Examination at follow-up 3 interviews when participants were 61-96 years old. Multivariable logistic regression models were used to calculate odd ratios (ORs) and 95% confidence intervals (95% CIs) for cognitive impairment. RESULTS: Of the 16,948 participants, 14.4% were defined to have cognitive impairment. Compared with 7 h/day sleep at both baseline and follow-up 2, the OR (95% CI) for cognitive impairment was 1.50 (1.04-2.16) for those who maintained long sleep duration (≥9 h/day), 2.18 (1.37-3.45) for those who prolonged sleep from short duration (≤5 h/day) to long duration (≥9 h/day), and 1.55 (1.20-2.02) for those who prolonged sleep from recommended duration (7 h/day) to long duration. The highest risk was observed in those who shortened sleep from long to short duration (2.93, 1.35-6.34). LIMITATIONS: Measures of sleep were self-reported. CONCLUSIONS: Substantial changes in sleep duration over time were associated with higher risks of cognitive impairment. The findings underscore the importance of maintaining optimal sleep duration for the prevention of cognitive impairment.

Asunto(s)

RESUMEN

OBJECTIVES: Little is known about composite patterns of productive engagement among older people. Related, the implication of these patterns for well-being remains unclear. The present study addresses these gaps. METHODS: The analytical sample comprised 2037 community-dwelling Singaporeans aged 60 years and above. We included nine productive activities and employed latent class analysis to identify prevalent patterns of productive engagement. Regression analysis was then conducted to investigate the association of these patterns with depressive symptomatology, loneliness, and cognitive function. RESULTS: Four productive engagement patterns (Low Activity, Family Support, Moderate Working-Volunteering, and Working-Family Support) were identified. Compared with Low Activity, Moderate Working-Volunteering, and Working-Family Support related to lower levels of depressive symptomatology and loneliness, respectively, and both patterns were associated with better cognitive function. CONCLUSION: Productive engagement patterns are differentially linked with depressive symptomatology, loneliness, and cognitive function. We interpret these findings with reference to the role perspective. We also discuss their policy implications.

Asunto(s)

RESUMEN

Objectives: The association between family support exchange and personal mastery among older adults remains unclear. The present study addresses this gap.Methods: We utilized two waves of data from the Panel on Health and Ageing of Singaporean Elderly (N = 1398). Latent class analysis was conducted to identify distinct patterns of family support exchange. Regression analysis was then used to assess whether the identified patterns predicted personal mastery four years later.Results: Four and three prevalent patterns of family support exchange emerged for males and females, respectively. Males who received monetary and material support from their kin developed lower personal mastery than those who only received monetary support. Females who provided and received monetary support developed higher personal mastery than those who lacked support exchange.Conclusion: Our latent class approach has captured the reality of family support exchange and thus provided a valid picture of the implication of such exchange for personal mastery. Our data suggest that support provision may elevate personal mastery. This observation is discussed with reference to the self-enhancement perspective and notion of valence of support provision.

Asunto(s)

RESUMEN

Prospective memory (PM) enables us to execute previously conceived intentions at a later time and is used when remembering to call a friend or submitting a proposal on time. Evidence that sleep benefits PM is presently mixed. Further, when a benefit is observed, it is unclear if this is achieved through improvements in strategic monitoring (maintaining an intention in mind and searching for cues) or spontaneous retrieval (an automatic process occurring without preparatory attention). We conducted a meta-analysis of 24 independent samples (N = 165,432) to quantify the effect of sleep on PM and gain clarity regarding the retrieval process benefitted by sleep. Cohen's d with 95% confidence intervals (CI95) were derived using random-effects models. The benefit of sleep on PM was statistically significant and in the small to medium range (d = 0.41, CI95 = 0.25-0.56). Moreover, sleep did not appear to influence monitoring (d = -0.11, CI95 = -0.40-0.17). In contrast, the benefits of sleep are significantly greater when the likelihood of spontaneous retrieval is high (d = 0.94, CI95 = 0.44-1.44) versus low (d = 0.45, CI95 = -0.02-0.93), suggesting that sleep may leverage on spontaneous retrieval processes to improve PM. These findings inform theoretical models of sleep and PM that could sharpen strategies to improve memory function in vulnerable populations.

Asunto(s)

RESUMEN

Wealth inequality is a prevalent social issue. The present study focuses on acceptance of wealth inequality, and considers personal income, perceived upward mobility, and future time perspective as its antecedents, and collective action intention as its outcome. With reference to the social identity literature and socioemotional selectivity theory, we posit a conditional indirect effect of income on collective action intention through acceptance of wealth inequality: only when mobility and future time perspective are relatively high, higher income is associated with higher acceptance of wealth inequality and in turn, lower collective action intention. Moderated mediation findings, based on territory-wide phone survey data from 866 Hong Kong adults, supported this prediction. This work indicates the relevance of an individual-level instrumental perspective to the understanding of acceptance of wealth inequality as well as collective action intention.

RESUMEN

Scholars are divided as to whether sexting-an unprecedented sexual activity using digital media-is objectifying or sexually liberating. One notion is that sexting involves the representation of an individual's sexuality in the presence of others and thus reinforces objectification. Another perspective contends that the self-portrayal of the body in sexting facilitates the exploration of sexual subjectivity and is, therefore, sexually liberating. By testing a model of sexting, objectified body consciousness (body surveillance, body shame, and body control beliefs), and comfort with nudity (indicator of sexual liberation) on 361 college students in Hong Kong, the current study revealed that, across genders, sexters demonstrated higher levels of body surveillance, body shame, and comfort with nudity than nonsexters. The results suggest that sexting is both sexually objectifying and liberating and that it has opened up a new sexual arena that combines sexual objectification and empowerment.

Asunto(s)

RESUMEN

PURPOSE: Sleep disturbance is common in late life. While social interaction is a basic human concern, few studies have explored the linkage between interpersonal relationships and sleep disturbance. The present study examines the reciprocal associations between weak social networks outside the household and sleep disturbance in elderly, as well as the underlying mechanisms. METHODS: We utilized data from a nationally representative longitudinal survey of community-dwelling elderly in Singapore (n = 1417; ≥ 60 years). Participants were assessed three times over 6 years (2009, 2011, 2015). Measures included strength of social networks outside the household, restless sleep (sleep disturbance), and the mediating variables of depressed mood, chronic diseases, and cognitive impairment. A cross-lagged mediation analysis was conducted. RESULTS: Bootstrapping results showed that weaker social networks were related to more restless sleep via more depressed mood. Also, restless sleep was negatively associated with social networks through depressed mood. The other mediators examined were not significant. CONCLUSIONS: Weak social networks and restless sleep reciprocally influence each other through depressed mood. Recognition of this interplay can inform efforts in improving elderly's sleep quality, social networks, and psychological well-being.

Asunto(s)

RESUMEN

Study Objectives: To determine the effects of changes in nocturnal sleep and daytime nap durations on all-cause mortality among older adults. Methods: Two-thousand four-hundred forty-eight community-dwelling older Singaporeans (≥60 years) reported their nocturnal sleep and daytime nap durations at baseline (2009) and the 2-year follow-up. At each phase, they were grouped into the recommended (7-8 hours), short (≤6 hours), and long (≥9 hours) sleep duration categories, and the none (0 hour), short (≤1 hour), and long (>1 hour) nap duration categories. Cox regression analysis was conducted to quantify the associations of changes in sleep and nap durations over 2 years with all-cause mortality risk in the subsequent 4 years (till end of 2015). Multivariable fractional polynomial regression, which treated sleep and nap durations as continuous variables was conducted as a supplementary analysis. Results: Relative to individuals who had the recommended sleep durations at both baseline and follow-up, the risks of all-cause mortality were higher among older adults who reported considerable changes in sleep duration (from short to long sleep and vice versa, hazard ratio [HR] = 2.14-2.56). Furthermore, compared to those who did not nap at both time points, significantly higher mortality risks were found in individuals who showed any increase in nap duration (HR = 1.86-2.16), or reduced their nap from long to short duration (HR = 1.86). Supplementary analysis revealed similar findings. Conclusions: In addition to the change in nocturnal sleep duration, change in daytime nap duration can also predict risks of all-cause mortality among older adults. It is crucial to track older adults' sleep and nap durations longitudinally.

Asunto(s)

RESUMEN

ABSTRACTBackground:Aging is accompanied by cognitive decline that is escalated in older adults reporting extreme sleep duration. Social relationships can influence health outcomes and thus may qualify the association between sleep duration and cognitive function. The present study examines the moderating effects of marital status, household size, and social network with friends and relatives on the sleep-cognition association among older adults. METHODS: Data (N = 4,169) came from the Social Isolation, Health, and Lifestyles Survey, a nationally representative survey of community-dwelling older Singaporeans (≥ 60 years). Sleep duration and social relationships were self-reported. Cognitive function was assessed with the Short Portable Mental Status Questionnaire. RESULTS: Regression analysis revealed that the inverted U-shaped association between sleep duration and cognitive function was less profound among older adults who were married (vs. unmarried) and those who had stronger (vs. weaker) social networks. In contrast, it was more prominent among individuals who had more (vs. fewer) household members. CONCLUSIONS: Being married and having stronger social networks may buffer against the negative cognitive impact of extreme sleep duration. But larger household size might imply more stress for older persons, and therefore strengthen the sleep duration-cognitive function association. We discuss the potential biological underpinnings and the policy implications of the findings. Although our findings are based on a large sample, replication studies using objective measures of sleep duration and other cognitive measures are needed.

Asunto(s)

RESUMEN

AIMS: We explored the direct and indirect impact of restrictions in daily living activities on the relationship between perceived visual symptoms associated with diabetic retinopathy (DR) and psychological functioning. METHODS: In this prospective, cross-sectional study, 514 tertiary patients with DR (mean age±SD, 60.4±12.6 years; 64% male) answered questions related to nine domains of DR-specific quality of life. These were classified into the following predictor, mediating and outcome variables: visual symptoms (predictor variable); activity limitation, driving, lighting, social restriction, inconvenience, mobility (mediating variables); and emotional distress and concerns (outcome variables). Direct and indirect relationships between study variables were assessed using path analysis, using interval-level person measures derived from Rasch analyses of the study questionnaires. RESULTS: We found no direct effect of DR-related visual symptoms on emotional distress or concerns. Rather, the association between visual symptoms and emotional distress was mediated (all p<0.05) by mobility (indirect effect=0.07), inconvenience (indirect effect=0.28), activity limitation (indirect effect=0.13) and social restriction (indirect effect=0.11). Similarly, the relationship between DR-related visual symptoms and concerns was mediated by inconvenience (indirect effect=0.36) and social restriction (indirect effect=0.11). Lighting and driving did not have a mediating role. CONCLUSIONS: The link between vision and psychological functioning outcomes such as emotional distress and concern is complex in patients with DR and mediated by limitations in daily living activities and social factors. Interventions to enhance daily functioning and social interaction may be effective in reducing emotional distress associated with DR-related vision impairment.

Asunto(s)