Highlights
- •What is the primary question addressed by this study?This study examines risk and protective factors that are associated with cognitive, physical and mental health among a community-dwelling sample of older adults in the independent living sector of a continuing care senior housing community.
- •What is the main finding of this study?Physical health was correlated with both cognitive function and mental health, but there was no significant correlation between cognitive and mental health. Notably, global cognition, self-rated physical functioning, resilience, and social support were associated with physical health, while resilience, loneliness, and sleep disturbances were associated with mental health.
- •What is the meaning of the finding?Interventions to enhance protective factors and reduce risk factors should be considered among strategies to improve health in community-dwelling older adults. Continuing care senior housing communities are important sites for promoting healthy lifestyles.
Objective
To examine associations of sociodemographic and clinical factors with cognitive, physical,
and mental health among independent living older adults in a continuing care senior
housing community (CCSHC).
Methods
This was a cross-sectional study at the independent living sector of a CCSHC in San
Diego County, California. Participants included English-speaking adults aged 65–95
years, of which two-thirds were women. Of the 112 subjects recruited, 104 completed
basic study assessments. The authors computed composite measures of cognitive, physical,
and mental health. The authors also assessed relevant clinical correlates including
psychosocial factors such as resilience, loneliness, wisdom, and social support.
Results
The CCSHC residents were similar to a randomly selected community-based sample of
older adults on most standardized clinical measures. In the CCSHC, physical health
correlated with both cognitive function and mental health, but there was no significant
correlation between cognitive and mental health. Cognitive function was significantly
associated with physical mobility, satisfaction with life, and wisdom, whereas physical
health was associated with age, self-rated physical functioning, mental well-being,
and resilience. Mental health was significantly associated with income, optimism,
self-compassion, loneliness, and sleep disturbances.
Conclusion
Different psychosocial factors are significantly associated with cognitive, physical,
and mental health. Longitudinal studies of diverse samples of older adults are necessary
to determine risk factors and protective factors for specific domains of health. With
rapidly growing numbers of older adults who require healthcare as well as supportive
housing, CCSHCs will become increasingly important sites for studying and promoting
the health of older adults.
Key Words
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References
- An aging nation: the older population in the United States.United States Census Bureau, Economics and Statistics Administration, US Department of Commerce, 2014
- Projected future growth of the older population.A profile of older Americans, 2015
- The meaning of reporting forgetfulness: a cross-sectional study of adults in the English 2007 Adult Psychiatric Morbidity Survey.Age Ageing. 2011; 40: 711-717
- Strategic planning for transformative senior living: developing tomorrow's leadership and workforce.Seniors Hous Care J. 2017; 25: 113-126
- Today's Continuing Care Retirement Community (CCRC), CCRC Task Force.Am Seniors Hous Assoc. 2010;
- A revelation of numbers: will America's eldercare workforce be ready to care for an aging America?.Generations. 2011; 34: 11-20
- Health systems that meet the needs of older people.World Health Organization, Geneva2019
- Age-friendly communities initiative: public health approach to promoting successful aging.Am J Geriatr Psychiatry. 2016; 24: 1158-1170
- Residents of Independent Living: How Today's Residents Compare to Residents of 2001.American Seniors Housing Association, Washington, DC2013
- Association between older age and more successful aging: critical role of resilience and depression.Am J Psychiatry. 2013; 170: 188-196
- Paradoxical trend for improvement in mental health with aging: a community-based study of 1,546 adults aged 21-100 years.J Clin Psychiatry. 2016; 77: e1019-e1025
- The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.J Am Geriatr Soc. 2005; 53: 695-699
- Development of a brief scale of everyday functioning in persons with serious mental illness.Schizophr Bull. 2007; 33: 1364-1372
- The Montreal Cognitive Assessment (MoCA) in geriatric rehabilitation: psychometric properties and association with rehabilitation outcomes.Int Psychogeriatr. 2011; 23: 1582-1591
- Relationship of the Brief UCSD Performance-based Skills Assessment (UPSA-B) to multiple indicators of functioning in people with schizophrenia and bipolar disorder.Bipolar Disord. 2010; 12: 45-55
- Utility of TICS-m for the assessment of cognitive function in older adults.Int J Geriatr Psychiatry. 2003; 18: 318-324
- A Short Physical Performance Battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.J Gerontol. 1994; 49: M85-M94
- The Timed “Up & Go”: a test of basic functional mobility for frail elderly persons.J Am Geriatr Soc. 1991; 39: 142-148
- lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the Short Physical Performance Battery.J Gerontol A Biol Sci Med Sci. 2000; 55: M221-M231
- The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.Med Care. 1992; 30: 473-483
- Development of short forms from the PROMIS sleep disturbance and sleep-related impairment item banks.Behav Sleep Med. 2011; 10: 6-24
- Validation of the cumulative illness rating scale in a geriatric residential population.J Am Geriatr Soc. 1995; 43: 130-137
- The satisfaction with life scale.J Pers Assess. 1985; 49: 71-75
- Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study.BMJ. 2008; 337: a2338
- Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).Am J Prev Med. 1994; 10: 77-84
- Brief Symptom Inventory: BSI.Pearson, Upper Saddle River, NJ1993
- The PHQ-9: validity of a brief depression severity measure.J Gen Intern Med. 2001; 16: 606-613
- A global measure of perceived stress.J Health Soc Behav. 1983; 24: 385-396
- Psychometric analysis and refinement of the Connor-Davidson resilience scale (CD-RISC): validation of a 10-item measure of resilience.J Trauma Stress. 2007; 20: 1019-1028
- Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test.J Pers Soc Psychol. 1994; 67: 1063-1078
- The development and validation of a scale to measure self-compassion.Self Identity. 2003; 2: 223-250
- UCLA Loneliness Scale (version 3): reliability, validity, and factor structure.J Pers Assess. 1996; 66: 20-40
- (Edited by)Social Support Index (SSI), in Family Assessment Resiliency, Coping and Adaptation.in: McCubbin HI Thompson AI McCubbin MA Inventories for Research and Practice. University of Wisconsin, Madison, WI1996: 357-389 (Edited by)
- Multidimensional Measurement of Religiousness/Spirituality for use in Health Research.Fetzer Institute, Bethesda, MD1999
- Coefficients alpha, beta, omega, and the GLB: comments on Sijtsma.Psychometrika. 2009; 74: 145-154
- Variable selection for distribution-free models for longitudinal zero-inflated count responses.Stat Med. 2016; 35: 2770-2785
- Linear Regression Analysis.2nd. John Wiley & Sons, Hoboken, NJ2003
- Inconsistency between univariate and multiple logistic regressions.Shanghai Arch Psychiatry. 2017; 29: 124-128
- Anxiety symptoms and risk of cognitive decline in older community-dwelling men.Int Psychogeriatr. 2017; 29: 1137-1145
- High prevalence and adverse health effects of loneliness in community-dwelling adults across the lifespan: role of wisdom as a protective factor.Int Psychogeriatr. 2018; : 1-16
- Childhood adversity and schizophrenia: the protective role of resilience in mental and physical health and metabolic markers.J Clin Psychiatry. 2018; : 79
- Loneliness and health: potential mechanisms.Psychosom Med. 2002; 64: 407-417
- Anxiety, depression, loneliness and social network in the elderly: longitudinal associations from The Irish Longitudinal Study on Ageing (TILDA).J Affect Disord. 2019; 246: 82-88
- Neurobiology of wisdom: a literature overview.Arch Gen Psychiatry. 2009; 66: 355-365
- Emerging empirical science of wisdom: definition, measurement, neurobiology, longevity, and interventions.Harvard Review of Psychiatry. 2018; (in press)
- The getting of wisdom: theory of mind in old age.Dev Psychol. 1998; 34: 358-362
- Antecedents and effects of wisdom in old age.Res Aging. 2000; 22: 360-394
- A new scale for assessing wisdom based on common domains and a neurobiological model: the San Diego Wisdom Scale (SD-WISE).J Psychiatr Res. 2019; 108: 40-47
- Dispositional optimism and the risk of depressive symptoms during 15 years of follow-up: the Zutphen Elderly Study.J Affect Disord. 2006; 91: 45-52
- The impact of self-compassion on mental health, sleep, quality of life and life satisfaction among older adults.Geriatr Nurs. 2018; 39: 623-628
- Correlates of self-rated successful aging among community-dwelling older adults.Am J Geriatr Psychiatry. 2006; 14: 43-51
- The relation of low cognitive abilities to low well-being in old age is attenuated in individuals with greater cognitive reserve and greater social capital accumulated over the life course.Aging Ment Health. 2018; : 1-8
- The influence of cognitive decline on well-being in old age.Psychol Aging. 2013; 28: 304-313
- Quantitative gait dysfunction and risk of cognitive decline and dementia.J Neurol Neurosurg Psychiatry. 2007; 78: 929-935
- The effect of physical activity on cognitive function in patients with dementia: a meta-analysis of randomized control trials.Ageing Res Rev. 2016; 25: 13-23
- Psychiatric illness and sleep in older adults: comorbidity and opportunities for intervention.Sleep Med Clin. 2018; 13: 81-91
- DSM-5 sleep-wake disorders classification: overview for use in clinical practice.Am J Psychiatry. 2013; 170: 1099-1101
- Mind-body therapies for late-life mental and cognitive health.Curr Psychiatry Rep. 2018; 20: 2
- Exergames for subsyndromal depression in older adults: a pilot study of a novel intervention.Am J Geriatr Psychiatry. 2010; 18: 221-226
Article info
Publication history
Published online: April 10, 2019
Accepted:
April 4,
2019
Received in revised form:
April 2,
2019
Received:
January 31,
2019
Identification
Copyright
© 2019 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
