European Journal of Ageing

The aims of this study were to investigate patterns of home and community care (HACC) use and to identify factors influencing first HACC use among older Australian women. Our analysis included 11,133 participants from the Australian Longitudinal Study of Women’s Health (1921–1926 birth cohort) linked with HACC use and mortality data from 2001 to 2011. Patterns of HACC use were analysed using a k-median cluster approach. A multivariable competing risk analysis was used to estimate the risk of first HACC use. Approximately 54% of clients used a minimum volume and number of HACC services; 25% belonged to three complex care use clusters (referring to higher volume and number of services), while the remainder were intermediate users. The initiation of HACC use was significantly associated with (1) living in remote/inner/regional areas, (2) being widowed or divorced, (3) having difficulty in managing income, (4) not receiving Veterans’ Affairs benefits, (5) having chronic conditions, (6) reporting lower scores on the SF-36 health-related quality of life, and (7) poor/fair self-rated health. Our findings highlight the importance of providing a range of services to meet the diverse care needs of older women, especially in the community setting.

This study examined social inequalities in health in the second half of life. Data for empirical analyses came from the second wave of the German Ageing Survey (DEAS), an ongoing population-based, representative study of community dwelling persons living in Germany, aged 40–85 years (N = 2,787). Three different indicators for socioeconomic status (SES; education, income, financial assets as an indicator for wealth) and health (physical, functional and subjective health) were employed. It could be shown that SES was related to health in the second half of life: Less advantaged persons between 40 and 85 years of age had worse health than more advantaged persons. Age gradients varied between status indicators and health dimensions, but in general social inequalities in health were rather stable or increasing over age. The latter was observed for wealth-related absolute inequalities in physical and functional health. Only income-related differences in subjective health decreased at higher ages. The amount of social inequality in health as well as its development over age did not vary by gender and place of residence (East or West Germany). These results suggest that, in Germany, the influence of SES on health remains important throughout the second half of life.

Stress can be a risk factor for mental and physical health. We investigated the role of social burden as a potential stressor in older age and its associations with cognitive aging (i.e., within the domains inhibition and cognitive flexibility of executive functioning). Eighty-three older adults (N = 38 male, mean age = 74.0 ± 5.7 years, body-mass index = 25.5 ± 4.1 kg/m2) aged 64 years or older participated. Cognitive flexibility and inhibition were assessed by means of a Trail-Making Test (TMT) and a Stroop task. Perceived levels of social burden and perceived stress in general were assessed via standardized questionnaires. Furthermore, diurnal cortisol profiles were assessed. Overall, older participants showed lower cognitive performance than the younger (both inhibition and cognitive flexibility; p < .044). However, this association did not remain significant when adjusting for multiple comparisons. Social burden was highly correlated with perceived stress, highlighting its importance as a stressor (p < .001). Furthermore, participants who reported higher levels of perceived stress showed lower performance in the TMT as a measure for cognitive flexibility (p < .001). Moreover, social burden was associated with cognitive flexibility, which was assessed by means of the TMT (p = .031). However, this association did not remain significant when using the adjusted α-level. Furthermore, we found that total diurnal cortisol output was a mediator for the relationship between age and inhibition, which was assessed by means of a Stroop task. At last, we found that the mediating role of cortisol interacts with social burden in the way that especially in younger age, high levels of social burden are associated with higher cortisol levels and, therefore, with lower cognitive performance. We conclude that it is important to consider social burden as an additional stressor in older age which is associated with cognitive aging.

Perceiving one’s own aging process as associated with many losses is linked to an increase in depressive symptoms over 2.5 years. We investigated whether this pattern of associations also applies for a 4.5-year interval. No study has yet investigated the pathways underlying the association between perceived age-related losses and depressive symptoms. We examined the mediating role of future time perspective (FTP) and general self-efficacy (GSE) in this association. Analyses were based on a sample of 40-to-98-year-old adults (Time 1: 2012, N = 423) that was assessed at two additional points covering 4.5 years (Time 2: 2015, N = 356; Time 3: 2017, N = 299). Perceived age-related losses were operationalized via the loss dimension of the Awareness of Age-Related Change instrument; FTP, GSE, and depressive symptoms were assessed via established questionnaires. Data were analyzed by means of a cross-lagged panel model and longitudinal mediation model realized as a structural equation model. In line with prior findings, perceived age-related losses were associated with an increase in depressive symptoms over 4.5 years. A higher amount of perceived age-related losses dampened FTP and GSE 2.5 years later, which in turn increased the level of depressive symptoms a further 2 years later, controlling for age, sex, education, physical health, and neuroticism, and taking into account the stabilities and time-synchronous correlations of the study variables. Effects were comparable across middle-aged and older individuals. FTP and GSE are important resources for understanding how perceived age-related losses translate into depressive symptoms.

If offline older citizens remain offline they will become increasingly disadvantaged from a socio-ecological point of view, as the Internet’s societal pervasiveness progresses. We study reasons for non-use and the frequency, intensity, and, the socio-demographic correlates of Internet use of older citizens in Europe. Theoretical relationships on the individual and societal level are ascertained. The Eurobarometer of 2003 offers a range of variables to explore the diffusion of Internet technology among 55+ year-old people in Europe. Descriptive statistics and population average models are used to identify the correlates of Internet access. Within the population segment of older citizens, age continues to have a differentiating effect, net of marital, occupational, and educational status for Internet access. Model replications show that only a few of the net coefficients differ in size. Decisions to remain offline are mainly based on private access possibilities, motivational indifference, and deficient knowledge. Existing socioeconomic inequalities regarding Internet access crystallise within the older population, particularly in the Southern regions of Europe. A claim is made for a necessity to maintain efforts to close the digital age gap.

To successfully address the challenges of age-related visual impairment in rehabilitation and health care settings, it is crucial to gain a better understanding of the psychological and behavioral adaptations that occur in these populations. The purpose of this study was to modify the optimization in primary secondary control (OPS) scale [Heckhausen et al., Optimization in primary and secondary control (OPS-Scales). Technical report, 1999] to assess the utilization of lifespan control strategies among older adults with visual impairment. The OPS scale [Heckhausen et al., Optimization in primary and secondary control (OPS-Scales). Technical report, 1999] was used to develop a vision-specific version of this measure (i.e., VIS-OPS). The VIS-OPS was administered to older adults with recent vision loss (N = 364; Mean age = 82.9 years). Theory-driven confirmatory factor analysis was used to help refine the instrument and confirm the scale’s four-factor structure. Items were removed from three of the four VIS-OPS subscales due to low squared multiple correlations and poor model fit. Inter-item reliabilities for the resultant subscales ranged from .61 to .72. The final four-factor model fit the data well (RMSEA = .06, 90 % CI .05–.06), with all items loading significantly on their associated factors (i.e., subscales). Correlational analyses provided criterion-related validity for the VIS-OPS with disability and psychosocial functioning measures in the expected directions. The VIS-OPS will allow researchers to more systematically and precisely measure control strategy use in reference to specific challenges associated with visual impairment, and may serve as a model for examining control strategy use in the context of other disabilities.

Various studies have pointed to the great importance of subjective health as an indicator for mortality in older age, while less is known about factors that contribute to changes of subjective (self-rated) health over time. Based on a nationwide longitudinal survey (German Ageing Survey, N = 1,286; initial age 40–85), two major findings emerged: first, the incidence of a serious health event caused greater changes in subjective health and life satisfaction in middle compared to older age. This was as expected because serious health events are less common in middle age and are correspondingly experienced more often as an “off-time event”. Secondly, the study extended previous findings on the impact of a positive view of ageing on health by showing that this optimistic view positively affects subjective health and life satisfaction even in the face of a serious health event. Overall, the study indicates that a positive view on ageing is an important psychological resource in the case of a serious health event, both when it occurs on-time or off-time from a developmental perspective.