Lynn M. Martire’s research while affiliated with Pennsylvania State University and other places

Objectives Despite extensive efforts to study individual differences in loneliness and neurocognitive health, little is known about how within-person changes in state loneliness relate to cognitive performance. This study addressed this gap by examining the association between within-person variation in state loneliness and cognitive performance assessed objectively in daily life. Method Participants were 313 community-dwelling older adults (70–90 years) who reported momentary feelings of loneliness and completed smartphone-based cognitive tests five times daily for 14 consecutive days. Mobile cognitive tests assessed visual associative memory, processing speed, and spatial memory. Results At the day level, average state loneliness levels were negatively related to cognitive performance on the same day and subsequent day. Consistent with the day-level analysis, momentary assessments of increased loneliness were consistently linked to worse cognitive performance on concurrent assessments. However, moments characterized by lower cognitive performance predicted higher levels of loneliness 3-4 hours later (next occasion), but not vice versa. Discussion Findings suggest a prospective association between loneliness and cognitive performance, with higher daily loneliness negatively associated with cognitive performance on the same day and predicting worse performance the following day. Notably, within a single day, lower cognitive performance at a given moment predicted elevated loneliness later in the day. This highlights a complex, reciprocal relationship – loneliness predicting and being predicted by cognitive performance depending on timescale.

Continuous-time modeling using differential equations is a promising technique to model change processes with longitudinal data. Among ways to fit this model, the Latent Differential Structural Equation Modeling (LDSEM) approach defines latent derivative variables within a structural equation modeling (SEM) framework, thereby allowing researchers to leverage advantages of the SEM framework for model building, estimation, inference, and comparison purposes. Still, a few issues remain unresolved, including performance of multilevel variations of the LDSEM under short time lengths (e.g., 14 time points), particularly when coupled multivariate processes and time-varying covariates are involved. Additionally, the possibility of using Bayesian estimation to facilitate the estimation of multilevel LDSEM (M-LDSEM) models with complex and higher-dimensional random effect structures has not been investigated. We present a series of Monte Carlo simulations to evaluate three possible approaches to fitting M-LDSEM, including: frequentist single-level and two-level robust estimators and Bayesian two-level estimator. Our findings suggested that the Bayesian approach outperformed other frequentist approaches. The effects of time-varying covariates are well recovered, and coupling parameters are the least biased especially using higher-order derivative information with the Bayesian estimator. Finally, an empirical example is provided to show the applicability of the approach.

Objectives We investigated whether receiving greater pain-related instrumental support is associated with poorer psychological well-being among chronic pain patients who report less positive (e.g., grateful) or more negative (e.g., angry) emotional responses to support. Methods We conducted regression analyses, utilizing data from two waves of interviews with 152 knee osteoarthritis patients. Three indicators of psychological well-being were examined: depressive symptoms, positive affect, and negative affect. Results Receiving greater support was associated with poorer psychological well-being at baseline, as well as higher depressive symptoms and negative affect at the 18-month follow-up, only among patients with low positive emotional responses to support. Furthermore, receiving greater support was related to poorer psychological well-being at baseline only among patients with high negative emotional responses to support. Discussion Care recipients’ less positive emotional responses to support may be a risk factor for poorer psychological well-being in both the short- and long-term, when receiving greater support.

As dyadic health science enters a golden age, important conceptual, theoretical, and technical challenges remain. Based on a forum review published in The Gerontologist by a group of dyadic scholars, this presentation will provide an overarching framework for understanding the essential components of robust dyadic health research, and the wide array of approaches used within the field. Each component of the framework will be discussed in relation to supporting empirical examples. The presentation will close by identifying crucial challenges and considerations that coincide with important future directions for the field.

Although it is well-established that negative affect is bi-directionally linked with pain, little research has examined their relationship in daily life among older adults. Even less is known about what social factors may help attenuate the affect-pain connection. We examined whether social interactions and reported enjoyment in daily life were associated with an attenuated link between negative affect and two important pain outcomes (pain intensity and perceived interference from pain). This was examined among a socioeconomically and racially diverse sample of 317 older adults aged 70+ (Mage = 77.45 ; 67% women; 40% Black; 13% Hispanic) who were recruited from the Bronx, NY as part of the Einstein Aging Study and who completed ecological momentary assessments five times daily for 14 days. Three-level multilevel models were estimated, controlling for mild cognitive impairment (MCI) status, gender, age, education, body mass index, and average level positive affect for models that did not include enjoyment. In given moments, higher negative affect and lower enjoyment were associated with higher pain intensity and pain interference (ps<.05). Moment-level negative affect and enjoyment significantly interacted to predict both higher pain intensity (p=.005) and pain interference (p<.0001), with patterns suggesting a buffering effect of enjoyment. In addition, a three-way interaction emerged such that during moments when no interactions occurred and negative affect was lower than a person’s average, there was a buffering effect of momentary enjoyment on pain intensity. Findings extend understanding of the affect-pain connection and the potential mitigating impact of social interactions and moments of enjoyment.

Poor physical function has been linked to greater depressive symptoms among older adults. On the other hand, older adults’ perceptions of positive and negative age-related changes provide personal strength and vulnerability to stressful events, respectively. We therefore expected that positive self-perceptions of aging (SPA) would be associated with fewer depressive symptoms, while negative SPA would be related to greater depressive symptoms, beyond the effect of physical function. We further tested the hypotheses that positive SPA would buffer the association between physical function and greater depressive symptoms, whereas negative SPA would exacerbate this association. This study used data from 108 older adults (mean age = 81.09) in independent-living or retirement communities. Results from a linear regression revealed that more positive SPA (B = -0.21, p = .02) and less negative SPA (B = 0.21, p = .06) were associated with fewer depressive symptoms, even after controlling for physical function, both types of SPA, and other covariates. In contrast, physical function was no longer significantly associated with depressive symptoms (B = -0.15, p = .19), after controlling for both types of SPA. There were no significant moderating effects of positive and negative SPA. Findings suggest that how positively and negatively older adults perceive their own aging may be important for their mental health while experiencing less physical function in late life.

The initial conditions of the COVID-19 pandemic made it such that individuals—especially older adults—experienced uncertainty about their own health/well-being, as well as that of their loved ones and communities. The current study examined how older adults’ social context shaped their well-being (i.e., anxiety, depressive symptoms, and sleep quality) early in the pandemic. Specifically, we tested whether there were differences in uncertainty, communal coping, and well-being among partnered individuals who indicated that their partner was their primary source of emotional support during the pandemic versus un-partnered individuals who indicated another social tie as their primary source of emotional support. Data were collected between May and August 2020 from 101 older adults (Mage = 80.63, SD = 8.96). Correlational analyses showed that uncertainty about one’s own health/well-being was positively associated with anxiety (p < .05) and communal coping (i.e., viewing the pandemic as a stressful period that will be worked through together) was negatively associated with depressive symptoms (p = .001) and anxiety (p < .01). Results from independent samples t-tests showed that, on average, partnered older adults reported fewer depressive symptoms (p < .05), less uncertainty about their own health/well-being (p < .05), and higher communal coping (p < .001) compared to un-partnered older adults. Unexpectedly, no group differences were found for anxiety or sleep quality. Results suggest the unique benefit of having a partner as an emotional support confidant in the context of the pandemic, perhaps because older adults were largely confined to their homes during lockdown.

As dyadic health science enters a golden age, important conceptual, theoretical, and technical challenges remain. This forum brings together perspectives on the burgeoning dyadic literature from several subdisciplines within aging research. We first define key concepts and terms so that interested researchers can navigate the complex and various ways in which dyadic health research is conducted. We discuss exciting scientific advances and close by identifying crucial challenges and considerations that coincide with important future directions for the field.

Pain catastrophizing is understood as a negative cognitive and emotional response to pain. Researchers, advocates and patients have reported stigmatizing effects of the term in clinical settings and the media. We conducted an international study to investigate patient perspectives on the term pain catastrophizing. Open-ended electronic patient and caregiver proxy surveys were promoted internationally by collaborator stakeholders and through social media. 3,521 surveys were received from 47 countries (77.3% from the U.S.). The sample was mainly female (82.1%), with a mean age of 41.62 (SD 12.03) years; 95% reported ongoing pain and pain duration > 10 years (68.4%). Forty-five percent (n = 1,295) had heard of the term pain catastrophizing; 12% (n= 349) reported being described as a ‘pain catastrophizer’ by a clinician with associated high levels of feeling blamed, judged, and dismissed. We present qualitative thematic data analytics for responses to open-ended questions, with 32% of responses highlighting the problematic nature of the term. We present the patients’ perspective on the term pain catastrophizing, its material effect on clinical experiences, and associations with negative gender stereotypes. Use of patient-centered terminology may be important for favorably shaping the social context of patients’ experience of pain and pain care. Perspective : Our large international patient survey results show that 45% of the sample had heard of the term pain catastrophizing, about one-third spontaneously rated the term as problematic, and 12% reported having the term applied to them with most reporting this to be a negative experience. Clinician education regarding the use of patient-centered terminology may help to improve patients’ experience of care and reduce stigma.

The current study included an examination of social factors that mitigate or exacerbate insomnia symptoms among older adults who are married or living with a partner. We first examined the unique effects of spousal support and strain on insomnia symptoms and then evaluated the degree to which extramarital social factors (e.g., friend support) moderated spousal influences. Data came from Waves 2 and 3 of the National Social Life, Health, and Aging Project. Our sample consisted of 495 participants who were either married or cohabitating with a partner ( M age in years = 69.84, SD = 8.08). Spousal strain—but not support—predicted higher insomnia symptoms 5 years later. Spousal influences on sleep, however, were moderated by extramarital factors in nuanced ways. Findings highlight the importance of taking into account older adults’ wider social context when examining the ways in which sleep is sensitive to positive and negative aspects of marital quality.