1. Age related diseases
a. Cardiovascular disease – most common cause of death in older adults
b. Cancer – 2nd most common cause of death in older adults
c. Hypertension – most common chronic disease in older adults
d. Osteoarthritis – 2nd most common chronic condition
e. Polypharmacy – 5 or more medications by a single patient
2. Cognitive functioning peak? (Hartshorne and Germine)
a. Fluid intelligence (short term memory) peaks early in adulthood
b. Crystalized intelligence (vocabulary) peaking in middle age
c. Vocab, information. Arithmetic peak mid life
d. Family pictures, word pairs, stories, letter-number sequencing peak earlier
i. Working memory and short-term memory
3. Sensory functioning and personality development
a. Poor vision and hearing at a baseline and decline over time were independently
related to steeper declines in extraversion, agreeableness, openness, and
conscientiousness and less of a decline in neuroticism
b. Sensory functioning was generally a stronger predictor of personality change than
disease burden or depressive symptoms
c. Poor or worse sensory functions compromise individual’s interactions with social
and physical environment and also associated with maladaptive personality
trajectories in older adults
4. Sex frequency and sexual satisfaction among partnered older adults (Gillespie)
a. Open sexual communication and setting the mood for sexual activity = more
active and satisfying sex lives
b. Synchronicity in sexual desire and activities is related to a high-frequency and
highly satisfying sex life in older adulthood
c. Expansive sexual repertoire (number of sexual activities used during last sexual
encounter and incorporation of sexual variety) is associated with greater sex
frequency and satisfaction also
5. Social relationships and physiological determinants of longevity across the human life
span
a. Higher degree of social integration was associated with lower risk of
physiological dysregulation
i. Both early and later life
b. Lack of social connections was associated with vastly elevated risk in specific life
stages
i. Social isolation increased the risk of inflammation by the same magnitude
as physical inactivity
c. Physiological vulnerabilities to social stress that may be specific to life course
stages and relationship stressors. Disrupting various social relation deficits and
physiological risk connections could directly arrest early progression toward
chronic diseases and delay disease onset or lessen the disease burden in late life
6. Associations among relational values, support, health, and well-being across the adult
lifespan (Chopik)
a. Study 1 - valuing friendships was related to better functioning, particularly among
older adults whereas valuing familial relationships exerted a static influence on
health and well-being across the lifespan
b. Study 2 – older adults only strain from friendships predicted more chronic
illnesses over a 6-year period; support from spouses, children, and friends
predicted high subjective well-being over an 8-year period
7. Successful aging: considering non-biomedical constructs (Carver and Buchanan)
a. Engagement, optimism and/or positive attitude, resilience, spirituality and/or
religiosity, self-efficacy and/or self-esteem, and gerotranscendence are nonbiomedical constructs associated with successful aging
8. Loneliness as a Public Health Issue
a. Sizable proportion of those ages 60+ in the U.S. reported loneliness
b. Chronic loneliness was significantly and positively associated with physician
visits
c. Loneliness was not significantly associated with hospitalizations
d. Loneliness is a significant public health concern among elders.
e. The identification and targeting of interventions for lonely elders may
significantly decrease physician visits and health care costs
9. Social support from church and family members and depressive symptoms among older
African Americans
a. Social support from church members was significantly and inversely associated
with depressive symptoms and psychological distress.
b. Frequency of negative interactions with church members was positively
associated with depressive symptoms and psychological distress
c. Social support from church members remained significant but negative interaction
from church members did not remain significant when controlling for indicators
of family social support
i. Emotional support from family was a protective factor and negative
interaction with family was a risk factor for depressive symptoms and
psychological distress
d. Social support from church networks was protective against depressive symptoms
and psychological distress
i. Remained significant when controlling for indicators of family social
support
e. If negative interactions with church members occurred – would find protective
factors within family members
10. Defining a good death (successful dying)
a. 11 core themes of good death
i. #1 most frequent theme - Preferences for a specific dying process (94%)
1. Death scene (how, who, where, and when
2. Dying during sleep
3. Preparation for death (advanced directives, funeral arrangements)
ii. #2 most frequent theme - Pain free (81%)
1. Not suffering
2. Pain and symptom management
iii. Religiosity/spiritualty
iv. #3 most frequent theme - Emotional well-being (64%)
1. Emotional support
2. Psychological comfort
3. Chance to discuss meaning of death
v. Life completion
vi. Treatment preferences
vii. Dignity
viii. Family
1. These 4 often common (more than 50% of groups)
ix. Quality of life
x. Relationship with health care provider (HCP)
11. Cultural patterns and death (couldn’t find book)
12. Support seeking among older adults with complicated grief (Ghesquiere)
a. Complicated grief (CG) themes
i. Observing that grief was causing a great deal of distress and impairment
ii. Grief not meeting expectations of what grief “should be”
iii. Important influence of social relationships on support seeking
iv. Lack of effectiveness of grief support groups and/or care from mental
health professionals prior to study enrollment
v. Strong reactions to the label of CG
13. Retirement, leisure activity engagement, and cognition among older adults in the U.S.
a. Older adults who remained retired showed significantly lower cognition than
those who remained working
i. Negative association between retirement and cognition was attenuated by
greater engagement mental activities
b. Interventions that encourage mental activities among retired individuals are
strongly suggested to help maintain cognitive function.
14. Working longer – Book Chapter 1
a. https://hrsonline.isr.umich.edu/sitedocs/databook/inc/pdf/HRS-Aging-in-the-21StCentury.pdf
b. Americans’ average age of retirement began increasing in early 1990s and
continues to increase
i. Baby boom generation is entering retirement
c. 50% of older adults work full time then go straight to full time retirement
d. 98% of workers say they enjoy going to work
e. Reasons for retiring – over 35% said wanted to spend more time with family
f. Despite having longer life expectancy, women have high frailty index scores than
men at all ages, regardless of race or ethnicity
g. Those with obesity are more likely to retire before age 64 because of it effects on
physical impairments and diseases that limit work
h. At age 61, 58% of men in good health work full time whereas only 30% of men in
poor health and 10% of men in terrible health work full time
i. Men are less likely to retire if that means they or their wives would lose their
health insurance
j. Most people seem to spend less money on eating out after retirement
k. Workers who retire from strenuous or physically demanding jobs seem to be at
higher risk of weigh gain following retirement
l. Some of the potentially negative effects of retirement on physical and mental
health seem to be related to lifestyle changes, such as declines in physical activity
and social interaction
m. Retirement leads to increased life satisfaction overall
15. Culture change and nursing home quality of care
a. Nursing homes that made culture changes included – resident direction, homelike
atmosphere, close relationships, staff empowerment, collaborative decision
making, and quality-improvement processes
b. Culture change in nursing homes key emphasis is to improve the quality of life for
residents
c. Culture change on quality of care of nursing home residents – adoption of culture
change (as defined by expert) was associated with fewer government-assigned
health-related deficiency citations.
16. The mental health of older LGBT adults
a. Approx. 1 million older lesbian, gay, bisexual, and transgender adults in the USA
b. Mental health issues result from interactions between genetic factors and stress
associated with membership in a sexual minority group
c. Sexual minority status remains associated with risks to physical and mental wellbeing
i. Older LGBT adults are more likely to have experiences mistreatment and
discrimination due to living a majority of their lives prior to recent
advancements in acceptance and equal treatment
d. All LGBT adults experience one common developmental challenge – deciding if,
when, and how to reveal to others their gender identity or sexual orientation
e. LGBT individuals have higher rates of anxiety, depression, and substance use
disorders and are at increased risk for certain medical conditions like obesity,
breast cancer, and HIV
i. Depression rates in the LGBT community may be as much as two to three
times higher, and a study of older trans-women identified the rate of
suicidal ideation to be over 50 %
ii. prevalence of SUD was approximately two times higher among lesbian,
gay, or bisexual persons than among heterosexuals
iii. The Alzheimer’s Association estimated there were 350,000 LGBT
individuals living with dementia in the USA as of 2012
17. Suicide: Why are older men so vulnerable?
a. Predominantly older men who die of suicide with variability by culture
b. European-descent older men are exposed to less severe aging adversities than
older women or ethnic-minority men – though they may be more impacted by
them
c. Rigidity in coping and in sense of self, consistent with hegemonic-masculinity
scripts, emerged as individual-level clues
18. Prevalence of depressive symptoms and predictors of treatment among U.S. adults 20052010
a. Prevalence of depressive symptoms increased from 20.92% to 25.66% over 6
years
i. Among patients with moderate to severe depression – 38.66% received
treatment
b. Being female, other Hispanic, younger age, having certain chronic comorbidities
or previous hospitalization, no health insurance and in poverty status were
associated with having depressive symptoms
c. Among patients with moderate to severe depression, being female, white, younger
age, having comorbidities (arthritis and hypertension) or previous hospitalization
were associated with receiving antidepressants or seeing a mental health
professional
d. Prevalence of depressive symptoms is high & only a small portion of patients
with moderate to severe depression received treatments