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Adam Davey,
Ting Dai,
John L Woodard,
L Stephen Miller,
Yasuyuki Gondo,
Mary Ann Johnson,
Dorothy B Hausman, Peter Martin,
Robert C Green,
Robert H Allen,
Sally P Stabler,
Leonard W Poon
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ABSTRACT: Background/Study Context: The goal of the study was to identify and characterize latent profiles (clusters) of cognitive functioning in centenarians and the psychometric properties of cognitive measures within them. Methods: Data were collected from cross-sectional, population-based sample of 244 centenarians (aged 98 to 108, 15.8% men, 20.5% African American, 38.0% community-dwelling) from 44 counties in northern Georgia participating in the Georgia Centenarian Study (2001-2008). Measures included the Mini-Mental State Examination (MMSE), Severe Impairment Battery (SIB), Wechsler Adult Intelligence Scale-III Similarities subtest (WAIS), Hand Tapping, Behavioral Dyscontrol Scale (BDS), Controlled Oral Word Association Test (COWAT), and Fuld Object Memory Evaluation (FOME). The Global Deterioration Rating Scale (GDRS) was used to independently evaluate criterion-related validity for distinguishing cognitively normal and impaired groups. Relevant covariates included directly assessed functional status for basic and instrumental activities of daily living (DAFS), race, gender, educational attainment, Geriatric Depression Scale Short Form (GDS), and vision and hearing problems. Results: Results suggest two distinct classes of cognitive performance in this centenarian sample. Approximately one third of the centenarians show a pattern of markedly lower cognitive performance on most measures. Group membership is independently well predicted (area under the curve [AUC] = .83) by GDRS scores (sensitivity 67.7%, specificity 82.4%). Membership in the lower cognitive performance group was more likely for individuals who were older, African Americans, had more depressive symptoms, lower plasma folate, carriers of the apolipoprotein E (APOE) ε4 allele, facility residents, and individuals who died in the 2 years following interview. Conclusions: In a population expected to have high prevalence of dementia, latent subtypes can be distinguished via factor mixture analysis that provide normative values for cognitive functioning. The present study allows estimates for normative cognitive performance in this age group.
Experimental Aging Research 03/2013; 39(2):125-144. · 1.31 Impact Factor
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ABSTRACT: ABSTRACT We previously presented normative data from a relatively large, population-based sample (n = 244) of centenarians and a reference group of octogenarians (n = 80) for several brief, global neurocognitive tasks adapted for use for older adults with physical and sensory limitations ( Miller et al., 2010 , Neuropsychological, Development, and Cognition. Section B: Aging, Neuropsychology and Cognition, 17, 575). Here, we present additional normative data on several domain-specific tasks from these samples from Phase III of the Georgia Centenarian Study, including measures of verbal abstract reasoning, fluency, memory, and motor function. Expected age differences were demonstrated across all cognitive measures, and, consistent with our previous findings, centenarians showed a stronger association between age and performance. Normative tables are presented unweighted as well as population-weighted, and stratified by age and education level. These findings offer a unique contribution to the literature on cognitive aging, as normative performance in this age group is understudied and largely unavailable to clinicians and researchers.
Aging Neuropsychology and Cognition 02/2013; · 1.07 Impact Factor
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ABSTRACT: BACKGROUND: Marital status is associated with survival. PURPOSE: The aims of this study are to evaluate marital history and timing on mortality during midlife, test the role of pre-marital personality, and quantify the role of health risk behaviors. METHODS: Cox proportional hazard models were run with varying classifications of marital history and sets of covariates. RESULTS: In fully adjusted models compared to the currently married, lifetime marital history predicts premature mortality with never married at 2.33 times risk of death and ever married at 1.64 risk of death. Midlife marital history shows that not having a partner during midlife (hazard ratio (HR) = 3.10 formerly married; HR = 2.59 remaining single) has the highest risk of death. Controlling for personality and health risk behaviors reduces but does not eliminate the impact of marital status. CONCLUSION: Consistency of marital status during midlife suggests that lack of a partner is associated with midlife mortality.
Annals of Behavioral Medicine 01/2013; · 4.20 Impact Factor
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ABSTRACT: Changes and advancements in technology have the potential to benefit older adults by promoting independence and increasing the ability to age in place. However, older adults are less likely to adopt new technology unless they see benefits to themselves. This study assessed the perceptions of 30 older adults in the Midwest concerning technology via three separate focus groups (i.e., independent apartment complex, a rural community, exercise program participants), which addressed a need in the literature (i.e., inclusion of oldest-old and rural individuals). The focus group questions included items such as what technology older adults currently used, desired improvements in technology, and the greatest challenges participants were facing or would face in the future. Overall, older adults were enthusiastic about learning new forms of technology that could help them maintain their independence and quality of life. Five themes emerged from all three focus groups: (a) Frustrations, Limitations, and Usability Concerns; (b) Transportation; (c) Help and Assistance; (d) Self-Monitoring; and (e) Gaming. The themes have important implications for future technology developed for older adults; in particular, older adults were willing and eager to adopt new technology when usefulness and usability outweighed feelings of inadequacy.
Journal of Gerontological Nursing 12/2012; · 0.78 Impact Factor
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ABSTRACT: Mantle cell lymphoma (MCL) remains incurable using conventional chemotherapeutic approaches. New clinical data show that some patients have a chronic/indolent course and others have a more fulminant course and short survival, similar to that of patients with acute leukemias.
This review presents an overview of this aggressive disease, including the diagnosis, epidemiology, prognosis, and management of this protean and challenging condition.
Distinguishing indolent MCL from in situ MCL is important but can be challenging. Molecular exploration has identified SOX11 and HDAC11 as potential candidate genes for discrimination of indolent cases. Improvements in the prognosis in MCL are likely the result of earlier identification of more indolent cases and the application of modern modalities, including rituximab and autologous transplantation. Younger patients may be able to tolerate more intensive therapy, while treatment for elderly or frail patients may focus on maintenance to prolong remission. For patients with relapsed disease, some agents have shown promise, such as lenalidomide and bortezomib. Emerging drugs such as PCI37625 and CAL-101 are being explored in phase I and II studies.
Although patients with MCL continue to experience poor outcomes, new treatment approaches for various stages of disease are showing promise in improving survival.
Cancer control: journal of the Moffitt Cancer Center 07/2012; 19(3):227-35.
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Leonard W Poon,
John L Woodard,
L Stephen Miller,
Robert Green,
Marla Gearing,
Adam Davey,
Jonathan Arnold, Peter Martin,
Ilene C Siegler,
Lusine Nahapetyan,
Young Sek Kim,
William Markesbery
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ABSTRACT: The goals of this article are to (a) establish the concurrent and clinical validity of the Global Deterioration scale in assessing cognitive functions and stages of dementia among centenarians, (b) identify the prevalence of all-cause dementia in representative samples of centenarians, and (c) demonstrate how variations in sample demographic characteristics could significantly affect estimates of dementia prevalence. A quarter of the 244 centenarians in a population-based sample had no objective evidence of memory deficits. Another quarter showed signs of transient confusion, and about half showed classical behavioral signs of dementia with about 15% in each of Global Deterioration scale stages 4-6 and about 5% in the most severe stage 7. Variations in age, gender, race, residence status, and education of the study sample as well as criteria used for dementia rating were found to affect prevalence.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences 03/2012; 67(4):358-65. · 4.60 Impact Factor
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ABSTRACT: To examine age differences on specific items and subscales of the Geriatric Depression Scale (GDS).
Specific items, subscales, and total score on the GDS of three age groups were compared.
Community-dwelling older adults.
One hundred thirty-nine centenarians were compared with 93 octogenarians and 91 sexagenarians.
GDS scores.
Results indicated age group differences in overall depression score and in withdrawal-apathy-vigor (WAV), cognitive impairment, and hopelessness subscale scores. Significant age group differences were also obtained for 12 of the 30 items. Centenarians rated higher on all subscales, but there was no difference in dysphoric mood and worry.
It is important to distinguish different dimensions of depression when assessing very old populations because some of the questions on the GDS are associated with fatigue, mild cognitive decline, and decline in physical functioning, which increase with aging. Future research should revisit the concept of depression in very late life.
Journal of the American Geriatrics Society 02/2012; 60(2):238-42. · 3.74 Impact Factor
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ABSTRACT: This study examined whether oldest-old adults are successful agers. Three hundred and six octogenarians and centenarians of Phase III of the Georgia Centenarian Study participated in this study. A first model examined Rowe and Kahn's successful aging model (Rowe and Khan (1997 and 1998)) including the probability of disease, physical or cognitive capacity, and engagement with life. All three components were applied to assess how many oldest-old adults satisfied all three criteria. The result showed about 15% of octogenarians (15.1%), and none of centenarians satisfied all three components of successful aging. Consequently, a second alternative model focused on psychosocial aspects including three different components: subjective health, perceived economic status, and happiness. Different from Rowe and Kahn's successful aging model, a total of 62.3% of octogenarians and 47.5% of centenarians satisfied all three components of the alternative model of successful aging. The results suggest that additional criteria of successful aging should be considered thereby expanding the concepts and multidimensional aspects of successful aging among oldest-old adults.
Journal of aging research 01/2012; 2012:695854.
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ABSTRACT: Objectives. Using data from the first two phases of the Georgia Centenarian Study, we proposed a latent factor structure for the Duke OARS domains: Economic Resources, Mental Health, Activities of Daily Living, Physical Health, and Social Resources. Methods. Exploratory and confirmatory factor analyses were conducted on two waves of the Georgia Centenarian Study to test a latent variable measurement model of the five resources; nested model testing was employed to assess the final measurement model for equivalency of factor structure over time. Results. The specified measurement model fit the data well at Time 1. However, at Time 2, Social Resources only had one indicator load significantly and substantively. Supplemental analyses demonstrated that a model without Social Resources adequately fit the data. Factorial invariance over time was confirmed for the remaining four latent variables. Discussion. This study's findings allow researchers and clinicians to reduce the number of OARS questions asked of participants. This has practical implications because increased difficulties with hearing, vision, and fatigue in older adults may require extended time or multiple interviewer sessions to complete the battery of OARS questions.
Journal of aging research 01/2012; 2012:934649.
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ABSTRACT: This study examined the mediating and moderating role of social resources on the association between age and change in functional health for three age groups of older adults. Data were provided by those in their 60s, 80s, and 100s who participated in the first two phases of the Georgia Centenarian study. Analyses confirmed the study's hypothesis that social resources moderated the relationship between age group and change in functional health; in particular, centenarians who experienced the greatest decline in IADLs scored the highest on social resources at time 1. No evidence was found for mediation by social resources or a directional influence by either level of social resources or functional health on change in the other resource. Evidence from this study challenges researchers and service providers to consider the heterogeneity in resources among older adults.
The International Journal of Aging and Human Development 01/2012; 75(1):1-29. · 0.62 Impact Factor
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ABSTRACT: This study assessed the association between perceived health, fatigue, positive and negative affect, handgrip strength, objectively measured physical activity, body mass index, and self-reported functional limitations, assessed 6 months later, among 11 centenarians (age = 102 +/- 1). Activities of daily living, assessed 6 months prior to assessment of functional limitations, were also included in the model. Handgrip strength, positive affect, and self-rated current health were associated with higher functioning, expressed as either global, upper body, or lower body functioning (r > .60). Objectively measured physical activity was inversely related to the aforementioned measures of functioning. Thus, physical health as assessed by handgrip strength, but not by physical activity, is associated with better functioning in centenarians.
The International Journal of Aging and Human Development 01/2012; 75(4):351-63. · 0.62 Impact Factor
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ABSTRACT: The primary objective of the Iowa Centenarian Study is to further our understanding of determinants of exceptional longevity above and beyond health outcomes, particularly in rural environments. This introductory article provides a general overview of the study, its methodology and basic descriptive results. One hundred and fifty-two centenarians from a rural state participated in the study (average age was 101.6 years). Baseline data collection included questions on demographics, cognitive representation of being a centenarian, mental status, past family history, life events, activities of daily living, coping, physical health and health history, nutrition, exercise, personality, social support, mental health, economic status and perceptions, and fatigue. A subset of the baseline sample (n = 28) participated in a short-term longitudinal study that assessed stability and change in mental status, mental health, and activity. Four additional papers in this issue (Franke, Margrett, Heinz, & Martin, 2012; Garasky, Martin, Margrett, & Cho, 2012; Margrett, Hsieh, Heinz, & Martin, 2012; Martin, da Rosa, Margrett, Garasky, & Franke, 2012) will highlight substantive findings, including longitudinal analyses, in activities of daily living, economic status, mental status, and positive and negative affect.
The International Journal of Aging and Human Development 01/2012; 75(4):297-316. · 0.62 Impact Factor
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ABSTRACT: Centenarians are often concerned with outliving their accumulated resources. Yet, research consistently finds that older adults, despite low incomes, are more financially satisfied than younger adults. This "satisfaction paradox" has been attributed to psychological accommodation to poor financial circumstances and lower expectations. As a result, scholars differentiate between objective levels of need and subjective perceptions. Missing is an understanding of whether feeling economically secure is associated with physical, mental, and/or psychological well-being and whether it varies by institutionalization status. This study examined data from 152 centenarians who participated in the first wave of the Iowa Centenarian Study. Analyses examined six perceived economic status variables (sufficiency of financial resources, ability to meet expenses, finances compared to others, meeting needs, ability to purchase extras, and having enough money for the future) and measures derived from activities of daily living, the Short Portable Mental Status Questionnaire (Pfeiffer, 1975) and the Geriatric Depression Scale (Yesavage, Brink, Rose, Lum, Huang, Adey, et al., 1983). Findings indicated that most centenarians do not feel able to handle their finances, yet believe that they are doing relatively well financially. Perceived economic status was positively associated with ability to complete daily living activities, cognitive ability, and psychological well-being with results differing by institutional status. In the end, we agree with other scholars that these relationships are rarely simple and require future exploration.
The International Journal of Aging and Human Development 01/2012; 75(4):365-82. · 0.62 Impact Factor
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ABSTRACT: Equivocal evidence exists regarding the degree of cognitive stability and prevalence of cognitive impairment in very late life. The objective of the current study was to examine mental status performance and change over time within a sample of Iowa centenarians. The baseline sample consisted of 152 community-dwelling and institutionalized centenarians. Twenty eight of these centenarians participated in the next phase of the study which involved up to four subsequent assessments conducted over a 6-month period. Centenarians' Short Portable Mental Status Questionnaire (SPMSQ; Pfeiffer, 1975) performance indicated that 40% of the baseline sample performed within the normal range while an additional 40% of centenarians' performed within the moderately or severely impaired range. Examination of individual-level change indicated four patterns of short-term longitudinal performance which depicted stability, enhancement, decrement, and variability in scores across the 8-month testing period. The degree of reliable change as assessed by standard error of measurement largely mirrored change as classified by the traditional scoring categories, however, the former approach appeared more sensitive to meaningful intraindividual change in later assessments.
The International Journal of Aging and Human Development 01/2012; 75(4):317-35. · 0.62 Impact Factor
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ABSTRACT: Much information is available about physical and functional health among very old adults, but little knowledge exists about the mental health and mental health changes in very late life. This study reports findings concerning positive and negative affect changes among centenarians. Nineteen centenarians from a Midwestern state participated in four assessments over a 6-month period. Positive and negative affect, as well as physical activity, financial resources, mental status, and health were assessed at baseline and during four consecutive time points. Mean individual growth curves suggested mean decreases in positive affect, but no changes were observed in negative affect. Physical activity, financial resources, and self-rated health were associated with growth-curve changes in affect. Centenarians with fewer resources were more likely to show decreases in positive affect. Surprisingly, physical activity and health were associated with increases in negative affect over time. The results suggest that continued activity, high levels of financial resources, and self-rated health are important components in affective states among very old adults.
The International Journal of Aging and Human Development 01/2012; 75(4):337-49. · 0.62 Impact Factor
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Jinmyoung Cho, Peter Martin,
Jennifer Margrett,
Maurice MacDonald,
Mary Ann Johnson,
Leonard W Poon,
S M Jazwinski,
R C Green,
M Gearing,
J L Woodard,
J S Tenover,
I C Siegler,
C Rott,
W L Rodgers,
D Hausman,
J Arnold,
A Davey
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ABSTRACT: Fatigue is a common and frequently observed complaint among older adults. However, knowledge about the nature and correlates of fatigue in old age is very limited.
This study examined the relationship of functional indicators, psychological and situational factors and fatigue for 210 octogenarians and centenarians from the Georgia Centenarian Study.
Three indicators of functional capacity (self-rated health, instrumental activities of daily living, physical activities of daily living), two indicators of psychological well-being (positive and negative affect), two indicators of situational factors (social network and social support), and a multidimensional fatigue scale were used. Blocked multiple regression analyses were computed to examine significant factors related to fatigue. In addition, multi-group analysis in structural equation modeling was used to investigate residential differences (i.e., long-term care facilities vs. private homes) in the relationship between significant factors and fatigue.
Blocked multiple regression analyses indicated that two indicators of functional capacity, self-rated health and instrumental activities of daily living, both positive and negative affect, and social support were significant predictors of fatigue among oldest-old adults. The multiple group analysis in structural equation modeling revealed a significant difference among oldest-old adults based on residential status.
The results suggest that we should not consider fatigue as merely an unpleasant physical symptom, but rather adopt a perspective that different factors such as psychosocial aspects can influence fatigue in advanced later life.
Gerontology 11/2011; 58(3):249-57. · 2.78 Impact Factor
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ABSTRACT: Este trabajo estudia el efecto del apoyo comunitario y el bienestar psicológico en el envejecimiento en el hogar de las personas mayores de Iowa (EE. UU.). Se analizaron datos procedentes de 1134 participantes de 65 años o más para el estudio, y se llevaron a cabo análisis de varianza (ANOVA) y análisis multimuestra de Modelado de Ecuaciones Estructurales (Structural Equation Modeling, SEM), empleando Mplus 6.1, con el fin de evaluar en qué medida el apoyo comunitario predice el envejecimiento en el hogar a través del bienestar psicológico (soledad, depresión, autoevaluación del estado de salud) y para comparar el resultado de esta evaluación entre los residentes de zonas metropolitanas (metro) y a los residentes de zonas no metropolitanas (no-metro). Se observaron diferencias entre los residentes metro y no-metro en apoyo comunitario, depresión y autoevaluación del estado de salud. El análisis multimuestra apuntó a una diferencia entre las relaciones entre apoyo comunitario, bienestar psicológico y envejecimiento en el hogar. Concluimos que el ambiente (comunidad y grado de urbanización) es un factor clave en el mantenimiento de la salud física de las personas mayores, al igual que de su bienestar psicológico.This study examined the effect of community support and psychological well-being on aging on place in Iowa older people. The data of 1,134 older participants aged 65 years and over were analyzed in this study. Analysis of variance (ANOVA) and multiple sample analysis in Structural Equation Modeling (SEM) using Mplus 6.1 were performed to assess how community support predicted aging in place through psychological well-being (loneliness, depression, self-rated health) and to compare this assessment between metropolitan (metro) and non-metropolitan (non-metro) residents. Differences between metro and non-metro residents were obtained in community support, depression and self-rated health. Multiple sample analysis showed that there was a difference in the relationships among community support, psychological well-being, and aging in place. We concluded that the environment -community and degree of urbanization- is a key factor in maintaining physical health as well as psychological well-being among older adults.
Psyecology: Revista Bilingüe de Psicología Ambiental - Bilingual Journal of Environmental Psychology. 09/2011; 2(3):243-257.
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ABSTRACT: Affect and loneliness are important indicators of mental health and well-being in older adulthood and are linked to significant outcomes including physical health and mortality. Given a large focus on young-old adults within gerontological research, the primary aim of this study was to examine the ability of individual and social resources in predicting affect and loneliness within a sample of oldest-old individuals including centenarians, an understudied population.
Participants were assessed during the most recent cross-sectional data collection of the Georgia Centenarian Study. The eligible sample included 55 octogenarians (M = 83.70 years, SD = 2.68; range = 81-90) and 77 centenarians (M = 99.78 years, SD = 1.64; range = 98-109). Subjects scored 17 or greater on the Mini-Mental Status Exam and completed mental health assessments.
Hierarchical regression analyses were conducted to examine the relation of affect and loneliness with demographic characteristics, physical and social functioning, cognition, and personality. Within this sample of cognitively intact oldest old, measures of executive control and cognitive functioning demonstrated limited association with mental health. Personality, specifically neuroticism, was strongly related to mental health indicators for both age groups and social relations were particularly important associates of centenarians' mental health.
Findings indicate the distinctiveness of mental health indicators and the need to distinguish differential roles of individual and social resources in determining these outcomes among octogenarians and centenarians.
Aging and Mental Health 04/2011; 15(3):385-96. · 1.37 Impact Factor
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ABSTRACT: The aim of this investigation was to determine how cognitive performance was associated with positive and negative affect and life satisfaction over time. This study involved a secondary longitudinal analysis of cross-section data collected at Phase I (1988-1992) and during an 18-month longitudinal followup at Phase II (1992-1998) of the Georgia Centenarian Study. Participants included N = 137 centenarians at Time 1 and N = 68 survivors at Time 2. Significant stability in cognitive impairment existed at Time 1 and Time 2 for positive (β = .55, P < .01) and negative affect (β = .54, P < .01) models. Negative affect at Time 1 was associated with lower life satisfaction at Time 1 (β = -.42, P < .01 ). In addition, cognitive impairment at Time 2 was associated with decreased positive emotionality at Time 2 (β = -.39, P > .01). Furthermore, greater positive affect at Time 2 was associated with greater satisfaction with life at Time 2 (β = .35, P < .01). It appears that positive emotionality contemporaneously influences the association between cognitive impairment and life satisfaction among centenarians. Implications relative to improving life satisfaction among centenarians are discussed.
Journal of aging research 01/2011; 2011:953031.
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ABSTRACT: This study investigated how perceived stress, social support, and home-based physical activity affected older adults' fatigue, loneliness, and depression. We also explored whether social support and physical activity mediated the relationships between stress and mental health problems. The data of 163 older participants were analyzed in this study. Structural equation modeling using LISREL 8.71 was performed to assess the effects of stress, support, and physical activity on mental health. The findings indicate that perceived stress predicted higher levels of depression, social support predicted lower levels of loneliness and fatigue, and physical activity predicted lower levels of fatigue among older adults. Social support and physical activity mediated the relationships between stress and mental health, except depression. In conclusion, the relative impacts of perceived stress, social support, and physical activity on types of mental health (e.g., fatigue, loneliness, and depression) were different. Furthermore, stress had direct and indirect effects on each construct of mental health (e.g., fatigue, loneliness, and depression).
The International Journal of Aging and Human Development 01/2011; 72(2):137-54. · 0.62 Impact Factor
