Kees C. P. M. Knipscheer

A Longitudinal Study of the Impact of Physical and Cognitive Decline on the Personal Network in Old Age

The effects of cognitive and physical decline on changes in the size and composition of four types of personal networks over a period of six years were investigated in a Dutch sample of 1552 older adults, aged 55–85 years. The effects of age and a decline in cognitive and physical functioning on the probability of changes in all possible network types were investigated. Transitions related to age and to cognitive and physical decline were observed for about one-third of the study sample. Greater age was associated with an increase in the number of family members in the network. Physical decline was associated with a replacement of friends and neighbors by family members only if the network was large. In small networks, no such association occurred. Cognitive decline was associated with a loss of relationships, most likely friends and neighbors, who were not found to be replaced by family members. Physical decline appears to be associated with an increase in the potential number of supporters in the network, whereas cognitive decline is associated with a decrease in the number of potential supporters.

Social Embeddedness and Late-Life Parenthood Community Activity, Close Ties, and Support Networks

This article focuses on the ways in which patterns of marriage and fertility shape older peoples involvement in community groups and their support networks. The data are from Australia, Finland, Germany, Israel, Japan, the Netherlands, Spain, the United Kingdom, and the United States. Findings show that childless older adults, regardless of marital status and gender, are equally as likely as parents to be active in the community and in voluntary organizations and to perform volunteer work. Never-married childless women are particularly active socially. Married, childless men are particularly dependent on their wives. In general, childless people are less likely than are parents to have robust network types capable of maintaining independent living without recourse to residential care during conditions of frailty. In some countries, it appears to be marriage rather than parenthood that makes the difference in support networks.

The Role of Coping Resources on Change in Well-Being During Persistent Health Decline:

Objectives: Research in older persons with deteriorative health shows a decrease in well-being. The aim of this study was to examine the role of psychological coping resources in the association between health decline and well-being, in a longitudinal design. Method: Data were used from the Longitudinal Aging Study Amsterdam (LASA). Health decline was defined as persistent deterioration of functioning (PDF), persistent decline in cognitive functioning and/or physical functioning, and/or increase of chronic diseases. Measurements of well-being included life satisfaction and positive affect. Measurements of coping resources included self-esteem, mastery, and self-efficacy. Results: Multivariate linear regression analyses showed that self-efficacy, mastery, and self-esteem mediated the association between PDF and change in well-being. Mastery also was a moderator of the association between PDF and life satisfaction. In older persons with a decreasing mastery, PDF was associated with a significant decrease on life satisfaction; this effect was not observed in older persons with stable or increasing mastery. Discussion: This study suggests that coping resources are of importance in explaining associations between persistent health decline and decreasing well-being. Stable or improving mastery even proves to protect older persons with PDF from decreasing well-being.Therefore, it may be of importance to develop interventions for older persons aimed at maintaining or improving psychological coping resources when health declines.

Do personal conditions and circumstances surrounding partner loss explain loneliness in newly bereaved older adults

This longitudinal study aims to explain loneliness in newly bereaved older adults, taking into account personal and circumstantial conditions surrounding the partner’s death. A distinction is made between emotional and social loneliness. Data were gathered both before and after partner loss. Results were interpreted within the framework of the Theory of Mental Incongruity. The findings reveal that being unable to anticipate the partner’s death is related to higher levels of emotional loneliness. Standards of instrumental support, measured indirectly by poor physical condition, lead to stronger emotional as well as social loneliness. Standards measured directly by importance attached to support or contacts result in higher emotional loneliness but, unexpectedly, in lower social loneliness. Furthermore, diculties with establishing personal contacts, caused, for instance, by social anxiety, add to loneliness. It is concluded that circumstances related to the partner’s illness may contribute to emotional loneliness after bereavement. Moreover, the results highlight the importance of taking coping attitudes into consideration for a better understanding of how newly bereaved older adults adapt to the loss of a partner.

Does widowhood affect memory performance of older persons

BACKGROUND The loss of a spouse has been found to have a negative effect on physical and mental health and leads to increased mortality. Whether conjugal bereavement also affects memory functioning has largely been unexamined. The present study investigates the effect of widowhood on memory functioning in older persons. METHOD The sample consisted of 474 married women and 690 married men aged 60-85 years in 1992, followed up in 1995 and 1998. During the study 135 (28%) of the women and 69 (10%) of the men lost their spouse. Linear regression analysis was used to examine whether widowed men and women differed from those who had not been widowed in rate of memory change over 6 years. Cross-domain latent-change models were subsequently used to evaluate the extent to which changes in memory are related to changes in other domains of functioning that may be affected by widowhood. RESULTS Older adults who lost a spouse during follow-up showed a greater decline in memory over 6 years than those who remained married. A higher level of depressive symptoms at baseline was related to lower levels of memory functioning and a greater decline. Memory decline was unrelated to changes in depressive symptoms and physical health. CONCLUSIONS Loss of the spouse is related to a greater decline in memory in older adults. The absence of an association with physical functioning and the weak association with mental functioning suggest that losing a spouse has an independent effect on memory functioning.

Patterns of Adjustment to Partner Loss in Old Age: The Widowhood Adaptation Longitudinal Study

The present longitudinal study aims to explain emotional and social loneliness experienced by older adults (N=99) during two-and-a-half years of widowhood. Utilization of multilevel analysis and a “visual” cluster analysis with prescribed classification criteria enabled us to search for average adaptational developments as well as individual variability in the adjustment process. Results were interpreted within the theory of mental incongruity. Adjustment to loneliness appears to develop along different individual-specific curves. About 30 percent of the bereaved had not adapted in two-and-a-half years to their loss in terms of emotional loneliness. Presence of favorable opportunities such as good health and high self-esteem as well as coping efforts like social behavior resulted in lower levels of emotional and social loneliness. It is concluded that the adjustment process among older bereaved does not exist. Moreover, including measures of cognitions and attitudes that are related to the relational needs and desires of widow(er)s may enlarge our knowledge of how older adults adapt to partner death.

Measuring older adults' filial responsibility expectations: exploring the application of a vignette technique and an item scale

This study focused on two conceptually distinct measures of the filial responsibility expectations of older adults: a vignette technique and an attitude item scale. Data were based on 1,553 respondents aged 61 to 92 years who participated in the Longitudinal Aging Study Amsterdam in 1998to 1999.The results showed that the item scale had multiple dimensions of filial expectations. Older adults distinguished between emotional-, instrumental-, contact-, and information-oriented expectations. The vignette technique resulted in a unidimensional measurement of expectations. The intercorrelation between the scores of the item scale and vignette technique was modest, indicating a certain amount of overlap. Child characteristics incorporated into the vignettes added to the specificity of measurements of the filial expectations. The authors observed that older adults were more likely to have expectations for care from an adult child who is not employed and does not have children. Minor differences between sons and daughters were observed.

Changes in contact and support within intergenerational relationships in the Netherlands: A cohort and time-sequential perspective

Abstract This study investigates whether the frequency of contact and support exchanged in relationships between parents and adult children declines over successive cohorts and over individual time in the Netherlands. Respondents included a birth cohort from 1928 to 1937 with data collected in 1992 (N=941) and in 2002 (N=574) and a birth cohort from 1938 to 1947 with data collected in 2002 (N=884). We assessed cohort and time-sequential changes. Parents of the later cohort had more contact and support exchanges with their children than the earlier cohort, revealing that families have not declined in importance. Furthermore, longitudinally, contact and supportive exchanges with adult children decreased, suggesting that parents and children devote less time to intergenerational relationships during this “empty nest” phase.

Persistent Deterioration of Functioning (PDF) and change in well-being in older persons

Background and aims: It is often assumed that aging is accompanied by diverse and constant functional and cognitive decline, and it is therefore surprising that the well-being of older persons does not appear to decline in the same way. This study investigates longitudinally whether well-being in older persons changes due to Persistent Deterioration of Functioning (PDF). Methods: Data were collected in the context of the Longitudinal Aging Study Amsterdam (LASA). Conditions of PDF are persistent decline in cognitive functioning, physical functioning and increase in chronic diseases. Measurements of well-being included life satisfaction, positive affect, and valuation of life. T-tests were used to analyse mean difference scores for well-being, and univariate and multivariate regression analyses were performed to examine changes in three well-being outcomes in relation to PDF. Results: Cross-sectional analyses showed significant differences and associations between the two PDF subgroups and non-PDF for well-being at T3. In longitudinal analyses, we found significant decreases in and associations with well-being over time in respondents fulfilling one PDF condition (mild PDF). For respondents fulfilling two or more PDF conditions (severe PDF), longitudinally no significant associations were found. Conclusions: Cognitive aspects of well-being (life satisfaction and valuation of life) and the affective element (positive affect) of well-being appear to be influenced negatively by mild PDF, whereas well-being does not seem to be diminished in persons with more severe PDF. This may be due to the ability to accept finally the inevitable situation of severe PDF.

Religious climate and geographical distribution of depressive symptoms in older Dutch citizens

This study examines whether the degree of conservatism of the religious climate affects the geographical distribution of late life depressive symptoms. A U-shaped relationship is hypothesized: high levels of depressive symptoms at the extremes (both a-religious and hyperconservative), and a low level in the middle (moderate-conservative). Subjects are 3051 older Dutch citizens (55-85 years), living in 11 municipalities. Depressive symptoms are assessed using the CES-D. Religious climate is estimated on the municipality level, using percentages votes on political parties with a Christian background (moderate-conservative versus hyperconservative). Using multi-level analysis, the results support the U-curve hypothesis.