[Show abstract][Hide abstract] ABSTRACT: Reports an error in "Health is health is health? Age differences in intraindividual variability and in within-person versus between-person factor structures of self-reported health complaints" by Julia K. Wolff, Annette Brose, Martin Lövdén, Clemens Tesch-Römer, Ulman Lindenberger and Florian Schmiedek (Psychology and Aging, 2012[Dec], Vol 27, 881-891). There was an error in the Method section due to misinterpretation of the multilevel structure. Under the heading, Data Analysis, the authors wrote: "Muthén and Satorra (1995) proposed the calculation of a design effect (deff), where deff = 1 + (c - 1) × ICC, and c is the cluster size on the higher level (i.e., in this case, number of participants)." This sentence is incorrect. The corrected sentence is: "Muthén and Satorra (1995) proposed the calculation of a design effect (deff), where deff = 1 + (c - 1) × ICC, and c is average cluster size (i.e., in this case, average number of daily assessments per participant)." Due to this error in the interpretation of Muthén and Satorra (1995), the deff entries in Table 1 were calculated in the wrong manner. The corrected entries are shown in the erratum. (The following abstract of the original article appeared in record 2012-18117-001.) The variability of health complaints within individuals across time has rarely been studied, and the question whether between- and within-person factor structures of health-related variables are equivalent has not been tested so far. We examined self-reported health complaints in 101 younger (20-31 years) and 103 older adults (65-80 years) over a period of 100 daily assessments. Data were analyzed with confirmatory two-level factor analysis. One-factor structures of health complaints provided an acceptable fit at the between- and average within-person levels in both age groups, supporting the assumption of equivalent average within- and between-person factor structures for health complaints. Age differences in loading patterns indicated that subjective health may be experienced differently by younger and older adults. Small age differences in mean levels of health symptoms were observed. Intraindividual variability in health complaints was reliable. Older adults fluctuated less from day to day than younger adults, presumably reflecting less fluctuation in objective health, differences in response styles, situational influences, or habituation processes. We conclude that future research should consider intraindividual variability as being descriptive of a person's health status, and take possible differences between within- and between-person factor structures of subjective health into account. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
Psychology and Aging 09/2013; 28(3):886. · 2.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: With increasing age and multimorbidity, medication regimens become demanding, potentially resulting in suboptimal adherence. Social support has been discussed as a predictor of adherence, but previous findings are inconsistent. The study examines general social support, medication-specific social support, and social conflict as predictors of adherence at two points in time (6 months apart) to test the mobilization and social conflict hypotheses. A total of 309 community-dwelling multimorbid adults (65-85 years, mean age 73.27, 41.7% women; most frequent illnesses: hypertension, osteoarthritis and hyperlipidemia) were recruited from the population-representative German Ageing Survey. Only medication-specific support correlated with adherence. Controlling for baseline adherence, demographics, physical fitness, medication regimen, and attitude, Time 1 medication-specific support negatively predicted Time 2 adherence, and vice versa. The negative relation between earlier medication-specific support and later adherence was not due to mobilization (low adherence mobilizing support from others, which over time would support adherence). Social conflict moderated the medication-specific support to adherence relationship: the relationship became more negative, the more social conflict participants reported. Presence of social conflict should be considered when received social support is studied, because well-intended help might have the opposite effect, when it coincides with social conflict.
Social Science [?] Medicine 06/2013; 87:23-30. · 2.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The variability of health complaints within individuals across time has rarely been studied, and the question whether between- and within-person factor structures of health-related variables are equivalent has not been tested so far. We examined self-reported health complaints in 101 younger (20-31 years) and 103 older adults (65-80 years) over a period of 100 daily assessments. Data were analyzed with confirmatory two-level factor analysis. One-factor structures of health complaints provided an acceptable fit at the between- and average within-person levels in both age groups, supporting the assumption of equivalent average within- and between-person factor structures for health complaints. Age differences in loading patterns indicated that subjective health may be experienced differently by younger and older adults. Small age differences in mean levels of health symptoms were observed. Intraindividual variability in health complaints was reliable. Older adults fluctuated less from day to day than younger adults, presumably reflecting less fluctuation in objective health, differences in response styles, situational influences, or habituation processes. We conclude that future research should consider intraindividual variability as being descriptive of a person's health status, and take possible differences between within- and between-person factor structures of subjective health into account. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Psychology and Aging 07/2012; · 2.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND AND RESEARCH QUESTIONS: In the current paper, it is analyzed whether the extent of loneliness of adults in the second half of their lives has changed between 1996 and 2008 in Germany. Because patterns of objective social integration have evolved differently in different birth cohorts (familial integration in earlier birth cohorts more fragile, more solid in later birth cohorts), we expected different trends in the extent of loneliness in different birth cohorts. DESIGN AND METHODS: The three waves of the German Ageing Survey (DEAS) constitute the database for the analysis: 1996 (n = 3,979), 2002 (n = 2,766) and 2008 (n = 4,392). Loneliness was measured with the de Jong Gierveld Loneliness Scale. The German Ageing Survey (DEAS) is a nationwide representative survey of the German population aged 40-85 years. RESULTS: Only a minority of people report being very lonely in the second part of life. Between 1996 and 2008, there is a positive trend in the extent of loneliness in the second half of life, i.e., the prevalence of loneliness decreased during this period of time. From 1996 to 2008, the youngest respondents (40-54 years of age) and the middle aged respondents (55-69 years) demonstrated a decline from 1996 to 2002 followed by an increase in loneliness between 2002 and 2008. The oldest respondents (70-85 years of age) experienced a steady decline in loneliness. Gender differences (men are somewhat lonelier than women) remain stable between 1996 and 2008. DISCUSSION AND CONCLUSION: While people who are currently old are socially well integrated and, hence, experience loneliness only to a small degree, there is a higher risk for persons who are currently in middle adulthood because their social networks have become increasingly more fragile. Further changes have to be observed.
Zeitschrift für Gerontologie + Geriatrie 07/2012; · 0.74 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: Although health behavior theories assume a role of the context in health behavior self-regulation, this role is often weakly specified and rarely examined. The two studies in this article test whether properties of the environment (districts) affect if and how health-related cognitions are translated into physical activity. Methods: Multilevel modeling was used to examine the assumed cross-level interactions. Study 1 is a large-scale survey representative of the German adult population (N = 6,201). Gross domestic product (GDP) on the level of administrative districts was used to indicate environmental opportunities and barriers. Study 2 examined cross-level interactions of proximal predictors of physical activity (intentions, action planning, and coping planning) in older adults with multiple illnesses (N = 309), a high-risk group for health deteriorations. Results: Study 1 showed that on the individual level, health attitudes (B = .11) and education (B = .71) were significantly associated with physical activity. GDP moderated the attitudes-behavior relation (B = .01), with higher attitude-behavior relations in districts with higher GDP. Study 2 finds that intention (B = .16), action planning (B = .17), and coping planning (B = .13) significantly predict activity. In addition, district-level GDP significantly moderated the relations between action planning and coping planning, but not intention, on physical activity. Conclusions: Results suggest that the effects of health attitudes and planning on physical activity are moderated by environmental factors. Districts with higher GDP provide better contextual opportunities for the enactment of concrete if-then plans for physical activity. This has implications for both theory and health promotion. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
[Show abstract][Hide abstract] ABSTRACT: The year 2012 is the European Year of Active Aging and Intergenerational Solidarity. On this occasion, the journal GeroPsych presents an overview of the contributions of gerontopsychology to active aging across Europe. Active aging comprises both individual processes and societal opportunity structures for health, participation and integration. The goal of interventions for active aging is to enhance the quality of life as people age. In the following, we will sketch the situation of gerontopsychological research on active aging in Germany. We firstly describe some important milestones in the history of gerontopsychology in Germany, secondly point to some research institutions and their contributions to active aging in Germany, and thirdly give some examples of research on active aging we are involved in ourselves. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry. 01/2012; 25(3):167.
[Show abstract][Hide abstract] ABSTRACT: The proportion of the population with multiple illnesses increases with age and growing numbers of people are now living to a very old age. Despite medical progress and improved living conditions, many old people have to deal with physical, psychological, and social impairments. It is a crucial challenge for health and social policy to support the elderly with health-related impairments in their desire to lead as independent a life as possible. Against this background the research consortium Autonomy Despite Multimorbidity in Old Age (AMA I) examined the extent to which the self-determined life style of multimorbid old and very old persons can be supported and maintained. In order to reflect the diversity of life worlds of the elderly, the study sample included participants who were not notably impaired in their everyday functioning, participants in need of nursing care and participants with cognitive impairments. Moreover, the sample comprised both older persons who were still living in their own homes and nursing home residents. The studies conducted within the AMA framework focused on the resources available to old persons living in different situations and on how these resources can be strengthened. This article presents findings from the first phase of funding of the AMA research consortium. In a second phase of funding (2011-2013, AMA II), sustainable practice-based interventions are being developed to mobilize resources which can help multimorbid older persons to maintain their autonomy and the practical viability of these interventions will be tested.
[Show abstract][Hide abstract] ABSTRACT: Particularly in older adults, self-reports of physical health need not necessarily reflect their objective health status as they can be biased by optimism. In this study, we examine whether the effect of objective physical functioning on subjective physical functioning is modified by health-specific optimism and self-efficacy. A longitudinal study with three measurement points over 6 months and 309 older adults (aged 65-85) with multimorbidity was conducted. Subjective physical functioning was regressed on objective physical functioning, health-specific optimism and self-efficacy. Subjective physical functioning was predicted by both objective physical functioning and optimism as a mediator. Moreover, an interaction between optimism and self-efficacy was found: Optimism predicted subjective physical functioning only for individuals with low self-efficacy. Subjective physical functioning is as much based on objective physical functioning as it is on health-specific optimism. Older adults base their subjective physical functioning on objective indicators but also on optimism, when they are less self-efficacious.
Journal of Behavioral Medicine 07/2011; 35(4):400-6. · 3.10 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study examined whether socioeconomic status (SES) determines the degree to which psychological and social resources such as optimistic self-beliefs and social support affect health.
We used data from the representative German Ageing Survey (N = 2,454, aged 40-85 years). Structural equation modeling was employed to examine whether relationships between psychological (self-esteem, control beliefs, optimism) and social resources (perceived emotional and informational support, network size) and health differ between education and income groups. Main
Self-reported physical health, functional health, and subjective health.
Psychological resources positively affected health in all groups but were stronger predictors of functional and subjective health in low compared to higher educated participants. A higher level of social resources was associated with better functional and subjective health mainly in the low-income group. Social resources were particularly important for financially disadvantaged older people.
Our results provide evidence for differential effects of optimistic self-beliefs and social support on health depending on whether individuals are challenged by low incomes or low education. Future research, especially aimed at intervention, should consider that different aspects of SES have differential meanings and that the impact of health-protective factors may vary according to SES facet.
Health Psychology 05/2011; 30(3):326-35. · 3.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Self-rated health (SRH) is widely regarded a valid and reliable indicator of health status. The validity of self-rated health has been demonstrated in many studies, for example by predicting mortality over and above medical and epidemiological data. However, the meaning of SRH can differ between individuals, especially in elderly individuals with considerable individual differences in their physical health states. It is thus important to determine whether predictors of self-rated health vary according to physical health status in order to interpret self-rated health data.
In a representative survey study, 1174 individuals over 65 years of age rated their health and filled in questionnaires on subjective well-being, control beliefs, depressive symptoms, and functional health. Structural equation modeling with latent moderated structural equations was used to determine whether health status (number of illnesses) moderated the association of self-rated health with these predictors.
Self-rated health was predicted by positive affect, depressive symptoms, control beliefs, and physical functioning. Moderated effects were found for positive affect and physical functioning, suggesting that there are stronger associations with positive affect in healthier individuals and stronger associations with physical functioning in less healthy individuals.
This implies that SRH has differential associations depending on health status, which should be taken into account in interpreting any research with SRH as predictor or criterion.
Quality of Life Research 04/2011; 20(10):1573-80. · 2.86 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To examine factors preventing medication nonadherence in community-dwelling older adults with multiple illnesses (multimorbidity). Nonadherence threatens successful treatment of multimorbidity. Adherence problems can be intentional (e.g., deliberately choosing not to take medicines or to change medication dosage) or unintentional (e.g., forgetting to take medication) and might depend on a range of factors. This study focused in particular on the role of changes in beliefs about medication to explain changes in adherence.
Longitudinal study with N = 309 individuals aged 65-85 years with two or more diseases at three measurement points over six months. Medication adherence and beliefs about medicines were assessed by questionnaire. Hierarchical weighted least squares regression analyses were used to predict individual intentional and unintentional nonadherence.
Changes in intentional nonadherence were predicted by changes in specific necessity beliefs (B = -.19, P<.01), after controlling for sociodemographic factors, health status and number of prescribed medicines. Changes in unintentional nonadherence were predicted by changes in general overuse beliefs (B = .26, P<.01), controlling for the same covariates.
Beliefs about medication affect both intentional and unintentional adherence to medication in multimorbid older adults. This points to the importance of addressing medication beliefs in patient education to improve adherence.
Journal of psychosomatic research 02/2011; 70(2):179-87. · 2.91 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Medication adherence often lies below recommendations although it is crucial for effective therapies, particularly in older adults with multiple illnesses. Medication beliefs are important factors for individual adherence, but little is known about their origin. We examine whether changes in functional health predict changes in medication beliefs, and whether such changes in beliefs predict subsequent medication adherence.
At three points in time over a 6-month period, 309 older adults (65-85 years) with multiple illnesses were assessed. Latent true change modeling was used to explore changes in functional health and medication beliefs. Adherence was regressed on changes in beliefs.
Medication beliefs were measured by the Beliefs About Medicines Questionnaire; medication adherence by the Reported Adherence to Medication Scale.
Functional health and medication beliefs changed over time. Increasing physical limitations predicted increases in specific necessity and specific concern beliefs, but not in general beliefs. Changes in specific necessity beliefs predicted intentional adherence lapses, changes in general overuse beliefs predicted unintentional adherence lapses.
Medication beliefs partly depend on health-related changes, and changes in beliefs affect individual adherence, suggesting to target such beliefs in interventions and to support older adults in interpreting health changes.
Health Psychology 01/2011; 30(1):31-9. · 3.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Multimorbidity—the co-occurrence of multiple illnesses—is a frequent condition in older adults and poses serious threats to
autonomy. In order to identify resources for autonomy despite multimorbidity, our longitudinal study tested main and interaction
effects of personal and social resources (self-efficacy and social support) on maintaining autonomy. Three hundred and nine
individuals (aged 65–85years) with multiple illnesses completed measures of self-efficacy beliefs, received instrumental
social support and perceptions of autonomy. Data were analyzed using structural equation modeling. Cross-sectionally, individuals
with lower perceptions of autonomy received more support from their networks. Longitudinally, the relation of received support
with autonomy was moderated by self-efficacy: Simple slopes analyses showed that social support compensated for lower levels
of self-efficacy, whereas in individuals with higher self-efficacy the resources interfered. Receiving social support bolstered
autonomy in lower self-efficacious individuals, but in highly self-efficacious individuals support threatened autonomy. This
has implications for both theory and practice, as it suggests differential effects of social resources depending on personal
KeywordsAutonomy–Self-efficacy–Received instrumental social support–Multimorbidity–Old age
European Journal of Ageing 01/2011; 8(1):3-12. · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Multimorbidity challenges quality of life (QoL) in old age. Anticipating and providing social support have been shown to promote QoL whereas receiving support often had detrimental effects. Little is known about which psychological processes explain these effects. This study examines the effects of receiving, anticipating and providing emotional support on QoL, with control beliefs and self-esteem as simultaneous mediators in an elderly multimorbid sample (N = 1415). Anticipating and providing support positively predicted QoL, mediated through self-esteem and control beliefs. Received support negatively predicted QoL, without mediation. Self-esteem and control beliefs can help to explain the relation between QoL and support.
Journal of Health Psychology 07/2010; 15(5):660-70. · 1.88 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present paper starts by introducing different perspectives of the aging process and includes biological, psychological, and sociological theories in its scope. The article addresses the issue of when "old age" begins and why a distinction is made between the third and fourth age. With increasing age, it becomes more and more difficult to differentiate between health-related losses due to illnesses or to aging. However, this can be important with respect to health behavior and health care. Having the best possible health in old age is an important factor for a good life in old age. Over their whole lives, from childhood to old age, people can actively contribute to their health in old age. But health is not the sole criterion for a good life in old age. Having interests and aims are just as important as being integrated in a social network. In old age, people often differ greatly and this is why there is such variety in what people consider to constitute a good life for themselves in old age.
[Show abstract][Hide abstract] ABSTRACT: 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.
European Journal of Ageing 03/2010; 7(1):17-28. · 1.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Der vorliegende Beitrag stellt zunächst verschiedene Perspektiven auf den Alterungsprozess vor und berücksichtigt dabei biologische,
psychologische und soziologische Theorien. Er erläutert, wann der Lebensabschnitt „Alter“ beginnt und warum zwischen dem dritten
und vierten Lebensalter unterschieden wird. Mit steigendem Lebensalter wird es oftmals schwerer zu differenzieren, ob gesundheitliche
Einbußen krankheits- oder altersbedingt sind. Dies kann jedoch mit Blick auf das Gesundheitsverhalten und die Gesundheitsversorgung
wichtig sein. Eine (möglichst) gute Gesundheit ist für ein gutes Leben im Alter von großer Bedeutung. Während des gesamten
Lebens, also angefangen von der Kindheit bis hinein in das hohe Alter, kann aktiv etwas dafür getan werden. Allerdings ist
Gesundheit nicht das einzige Kriterium für gutes Leben im Alter. Interessen und Ziele sowie das Eingebundensein in soziale
Netzwerke haben ebenfalls einen hohen Stellenwert. Besonders im Alter unterscheiden sich Menschen oftmals stark voneinander,
sodass es eine große Vielfalt dessen gibt, was Menschen für sich selbst unter einem guten Leben im Alter verstehen.
The present paper starts by introducing different perspectives of the aging process and includes biological, psychological,
and sociological theories in its scope. The article addresses the issue of when “old age” begins and why a distinction is
made between the third and fourth age. With increasing age, it becomes more and more difficult to differentiate between health-related
losses due to illnesses or to aging. However, this can be important with respect to health behavior and health care. Having
the best possible health in old age is an important factor for a good life in old age. Over their whole lives, from childhood
to old age, people can actively contribute to their health in old age. But health is not the sole criterion for a good life
in old age. Having interests and aims are just as important as being integrated in a social network. In old age, people often
differ greatly and this is why there is such variety in what people consider to constitute a good life for themselves in old
SchlüsselwörterAltern-Drittes und viertes Lebensalter-Gesundheit-Krankheit-Lebenserwartung
KeywordsAging-Third and fourth age-Health-Illness-Life expectancy
[Show abstract][Hide abstract] ABSTRACT: Die Vielfalt der Lebensformen im mittleren Alter nimmt zu, doch die Dominanz der Ehe im höheren Alter besteht noch: Die Lebensformen der 40- bis 70-Jährigen sind etwas vielfältiger geworden, während diejenigen der über 70-Jährigen einheitlicher wurden. Von den 70- bis 85-Jährigen sind so viele verheiratet und haben Kinder wie noch nie. Im mittleren Erwachsenenalter steigt hingegen
der Anteil der Partner- und Kinderlosen und es fi nden sich mehr nichteheliche Partnerschaften und Folgeehen.
Der Wandel der Lebensformen ist sozial und räumlich differenziert: Vom Rückgang partnerschaft licher und familiärer Ressourcen im mittleren Alter sind gegenwärtig Männer stärker betroff en als Frauen, insbesondere in Ostdeutschland.
Die Zufriedenheit der in einer Paarbeziehung lebenden Menschen in der zweiten Lebenshälfte hängt nicht von der äußeren Form der Partnerschaft ab: Unverheiratete Paare sind ähnlich zufrieden mit der Paarbeziehung wie verheiratete Paare, obwohl sie häufi ger mit einer Trennung rechnen. Wiederverheiratete stufen ihre Partnerschaft als stabiler ein als Erstverheiratete und sind gleichermaßen zufrieden.
Die Lebensformen im Alter werden bunter, teilweise aber auch fragiler: Die im Alter vorherrschende Lebensform des langjährig verheirateten Ehepaars mit in der Nähe wohnenden gemeinsamen leiblichen Kindern hat ihren Zenit erreicht und wird quantitativ abnehmen. Der Wandel der Lebensformen führt dazu, dass die partnerschaft lichen und familialen Ressourcen im Alter zukünft ig etwas geringer und weniger erwartbar werden.